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Congress: House Appropriations Committee Approves Amendment to Protect Legal State Marijuana Programs

Washington DC: The House Committee on Appropriations voted this week to approve an amendment that would prevent the Department of Justice from interfering with legal adult-use marijuana programs as part of the Commerce, Justice, Science, and Related Agencies appropriations legislation for Fiscal Year 2023.

The bipartisan amendment, introduced by Reps. Barbara Lee (D-CA) and David Joyce (R-OH), with the non-committee support of past champions Reps. Earl Blumenauer (D-OR), Tom McClintock (R-CA), and Eleanor Holmes Norton (D-DC), would bar the DOJ from using resources to interfere with the ability of states, territories, tribal governments, or the District of Columbia to implement laws and regulations governing the legal and regulated production, sale, and use of cannabis by adults or to target people acting in compliance with those laws.

This amendment was approved by the full House of Representatives as part of the annual spending omnibus for the last two years but has yet to be included in the final legislation. Since 2014, members of Congress have passed annual spending bills that have included a provision protecting those who are in compliance with state medical cannabis programs from undue prosecution by the Department of Justice. That provision has been included in the base appropriations legislation since 2018.

"As federal lawmakers steadily work to determine the best way to finally end marijuana prohibition and undo the damage it has caused, the people involved in regulated cannabis programs in the growing number of states that are leading the way on this issue deserve to know whether the federal government will actively get in the way of their continued successes," said NORML Political Director Morgan Fox. "Including these protections in the federal budget will go a long way toward giving individuals, businesses, and state governments some peace of mind while signaling to the vast majority of Americans who support legalizing and regulating cannabis that their elected representatives are actually listening to them."

"Congress must honor the will of the voters and prevent wasteful Department of Justice prosecution of those complying with their respective state's or tribe's cannabis regulations," said Congressman Blumenauer. "I have spearheaded the work to develop this language, which protects the state and tribal-legal programs that have been enacted laws to end prohibitionary policies and allow the development of both adult-use and medical marijuana programs. I appreciate the partnership and leadership of my colleagues, Representatives McClintock, Lee, Joyce, and Norton to move this important language forward today."

Official DOJ internal guidance to de-prioritize prosecutions of people acting in compliance with state cannabis laws was in place from 2013 until 2018 when former Attorney General Jeff Sessions rescinded the Cole Memo. As recently as April, Attorney General Merrick Garland has reiterated his position that it is a waste of DOJ resources to interfere with state cannabis programs. Unfortunately, such guidance has not been officially renewed under the current Administration and does not carry the force of law, and federal prosecutors have a great deal of discretion in terms of the cases they pursue.

There are currently 19 states as well as the District of Columbia and several territories where cannabis is legal for adults, and 37 states have effective medical cannabis laws. National and state polling shows significant majority support for making cannabis legal.

Survey: Consumers Most Likely to Self-Medicate with Cannabis to Alleviate Anxiety, Pain, and Depression

Quebec City, Canada: Canadians who consume cannabis for purposes of self-medication most frequently report doing so to address pain, anxiety, sleep disturbances, and depression, according to data published in the Journal of Cannabis Research.

Canadian researchers surveyed 489 subjects who purchased cannabis products at adult-use retailers, but who acknowledged doing so to self-medicate. Consistent with prior data, respondents were most likely to report consuming cannabis products to mitigate anxiety (70 percent), improve sleep (56 percent), alleviate pain (53 percent), and address feelings of depression (37 percent). Subjects were also likely to acknowledge using cannabis to alleviate muscle spasticity, migraine, nausea, and symptoms of post-traumatic stress.

Survey respondents typically reported using cannabis flower and selecting products dominant in THC. However, those respondents that exclusively defined their cannabis use as medical-only expressed a preference for CBD-dominant products.

In contrast with other surveys, most respondents acknowledged reporting their cannabis use to their health care professionals.

The results of another recent survey, published in the journal Complimentary Therapies in Clinical Practice, similarly determined that patients certified to use medical cannabis in the US most commonly do so to treat symptoms of pain, anxiety, post-traumatic stress, and depression. The results of yet another recent survey, conducted by Harris Polling, also found that consumers most often report consuming cannabis to reduce stress, improve sleep, and mitigate anxiety.

Separate survey data compiled in April reported that 21 percent of US Medicare recipients acknowledge consuming cannabis for therapeutic purposes, typically to address symptoms associated with chronic pain, anxiety, and depression.

Full text of the study, "A description of self-medication with cannabis among adults with legal access to cannabis in Quebec, Canada," appears in the Journal of Cannabis Research.

Analysis: Flower Continues to Dominate US, Canadian Marijuana Markets

Santa Monica, CA: Cannabis consumers in the United States and Canada predominantly consume marijuana flower instead other product formulations, according to data published in the International Journal of Drug Policy.

Investigators affiliated with the RAND Drug Policy Research Center in California and the University of Waterloo in Ontario, Canada assessed cannabis consumption patterns in the US and in Canada in a cohort of more than 40,000 subjects.

Consistent with prior surveys, they reported, "Dried flower was the most commonly used product" among consumers – regardless of whether those consumers patronized either the licit or illicit marketplace. However, investigators acknowledged that the popularity of other formulations of cannabis, particularly vape oils and edibles, had increased in recent years – especially in markets where cannabis products are legally available from licensed retailers.

Authors concluded: "The current study provides one of the most comprehensive assessments of cannabis consumption at the population level in Canada and the US to date. The findings highlight the rapidly evolving nature of the cannabis product market, including notable shifts in the types of cannabis products used by consumers. ... Although dried flower continues to dominate the market, it has begun declining with a notable shift towards increasing popularity of processed cannabis products."

Full text of the study, "Trends in the use of cannabis products in Canada and the USA, 2018 – 2020: Findings from the International Cannabis Policy Study," appears in the International Journal of Drug Policy.

Study: Cannabis Use by College Students Seldom Tied to Negative Consequences Absent Concurrent Use of Other Substances

Gainesville, FL: College students who consume cannabis, but not other controlled substances, do not appear to be at significant risk of suffering from either substance use disorder or low academic achievement, according to data published in the Journal of American College Health.

A team of investigators affiliated with the University of Florida at Gainesville assessed the relationship between college students' self-reported use of marijuana and other substances and academic outcomes.

They reported that those students who consumed cannabis – but who did not also consume either alcohol, cigarettes, or other substances – were less likely to report problems associated with substance abuse, skipping class, or poor grades than were those who were polysubstance users.

Authors determined: "The cannabis-only users reported experiencing the least amount of cannabis-related consequences and CUD [cannabis use disorder] symptoms but used cannabis on more days in the past month than any other group except the all-substance user group (CACS-cannabis, alcohol, cigarettes and other substance users). ... These findings may indicate that although cannabis-only users use more frequently than other groups, this group may be at lower risk for negative consequences associated with use compared to all-substance users. This is in line with previous findings showing that polysubstance use is related to more negative consequences compared to single use."

They concluded: "Overall, the current findings suggest that (1) alcohol use is prevalent among cannabis-using college students and (2) concurrent polysubstance use of four or more substances is associated with increased risk of cannabis-and academic-related problems including CUD symptom severity, skipping classes, and lower GPA. When addressing cannabis use among college students, clinicians should assess and target multiple substances in addition to cannabis. Risks associated with sole cannabis use were low compared to concurrent substance use. Hence, efforts aimed at preventing the initiation of additional substance use may be warranted."

Full text of the study, "Independent and concurrent cannabis use with alcohol, cigarettes, and other substances among college students: Rates and consequences," appears in the Journal of American College Health.

Analysis: Labels of Hemp-Derived CBD Products Often Provide Inaccurate Information

Lexington, KY: Commercially available CBD products are often labeled in ways that misrepresent the true percentage of cannabinoids available in them, according to data published in the Journal of Cannabis Research.

Researchers affiliated with the University of Kentucky College of Medicine lab-tested 80 commercially available hemp-derived CBD products. Products were acquired either online on at brick and mortar retail stores.

Consistent with dozens of other analyses, authors reported that a significant percentage of the products tested (46 percent) contained CBD concentrations that were significantly different than the concentration listed on the label.

Authors reported: "These data suggest that additional regulation is required to ensure label accuracy as nearly half of the products in this study were not properly labelled (i.e., not within a +/- 10 percent margin of error). Consumers and practitioners should remain cautious of unregulated and often-mislabeled CBD products due to the risks of taking too much CBD (e.g., drug-drug interactions, liver enzyme elevations, increased side effects) and the consequences of taking too little (e.g., no clinical benefits due to underdosing)."

They concluded: "The findings reported here emphasize the continued need for clear and consistent regulation from federal and state agencies to ensure label accuracy of CBD products and subsequent enforcement. These results also indicate the need for continued development of good manufacturing practices and testing standards. As consumers are taking CBD products for an ever-increasing range of conditions, independent of medical guidance, the accuracy of content labeling is important for the safety of the consumer."

More than three years following the passage of federal legislation legalizing hemp production, the US Food and Drug Administration (FDA) has yet to promulgate rules regulating the marketing and sale of commercial products containing hemp-derived CBD or other cannabinoids. Survey data compiled by the National Consumers League previously determined that more than eight in ten US voters desire greater federal regulatory oversight over the labeling and marketing of commercially available CBD products.

Full text of the study, "Label accuracy of unregulated cannabidiol (CBD) products: Measured concentration vs. label claim," appears in the Journal of Cannabis Research.

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Analysis: Cannabis Consumers Less Likely to Be Diagnosed with Liver Cancer

Cleveland, OH: Adults with a recent history of cannabis use are twice less likely to be diagnosed with hepatocellular carcinoma (the most common type of liver cancer) than are those with no history of use, according to data published in the scientific journal Cureus.

A team of researchers affiliated with the Cleveland Clinic and with Georgetown University Hospital in Washington, DC assessed the relationship between cannabis consumption and HCC in a cohort of over one million subjects.

Investigators reported that those who reported current cannabis use were "55 percent less likely to have HCC compared to non-cannabis users."

Authors concluded: "To the best of our knowledge, this is the first and largest population-based cross-sectional study of hospitalized patients to explore the association between cannabis use and HCC. ... Due to the cross-sectional structure of our study, we are unable to draw direct causation effects. Hence, we suggest prospective clinical studies to further understand the mechanism by which various active ingredients, particularly CBD in cannabis, may possibly regulate hepatocellular carcinoma development."

Cannabinoids possess anti-cancer activity in cellular models and a limited number of case reports have documented antineoplastic activity in patients. Observational data has also shown an association between cannabis use and a reduced risk of head and neck cancers.

Numerous human studies have also shown an inverse relationship between cannabis consumption and various types of liver diseases.

Full text of the study, "Lower rates of hepatocellular carcinoma observed among cannabis users: A population-based study," appears in Cureus.

SCOTUS: Justices Decline to Weigh in on Whether Medical Cannabis Costs Can Be Reimbursed by Employers

Washington, DC: Justices on the US Supreme Court have declined to weigh in on the issue of whether employees can be reimbursed for their medical marijuana-related costs through their workers' compensation insurance plans.

Litigants sought the Court's intervention following divergent opinions from several state supreme courts. Empire State NORML and two other groups – the New York City Cannabis Industry Association and the Hudson Valley Cannabis Industry – had filed a friend-of-the-court (amicus) brief urging justices to take the case and to use it as an opportunity to settle broader conflicts between state and federal marijuana laws.

The denial of certiorari indicates that most justices did not believe that the lower court decisions merited review by the high court.

David C. Holland, Esq, the Executive and Legal Director of Empire State NORML and the author of the brief said: "By failing to take up the case, SCOTUS only further exacerbated the split between the highest state courts as it continues to evade the fundamental question with regard to cannabis' medical validity, a key factor in the Schedule I designation. Empire State NORML and the New York and Hudson Valley Cannabis Industry Associations will continue to advocate for those cases that will eventually bring resolution to the issue once and for all."

In 2021, courts in three separate states upheld employees' ability to be financially reimbursed for their use of medical cannabis, while the court in another state ruled against the issue.

Currently, five states - Connecticut, New Hampshire, New Jersey, New Mexico, and New York – explicitly allow for employees to have their medical cannabis expenses reimbursed. By contrast, seven states expressly prohibit workers' compensation insurance from reimbursing medical marijuana-related costs: Maine, Massachusetts, Minnesota, Florida, North Dakota, Ohio, and Washington.

In all other jurisdictions, the law is either silent on the issue or states that insurers are "not required" to reimburse employees who are injured on the job for the costs related to their use of medical cannabis.

Survey: Over 80 Percent of Americans Support Uniform Quality Controls for Cannabis Products

Washington, DC: More than eight in ten Americans believe that there should be uniform standards in place regulating the manufacturing of commercially available cannabis products, according to national polling data commissioned on behalf of the regulatory compliance group SIPCA and the Foundation of Cannabis Unified Standards (FOCUS).

Most respondents (72 percent) said that cannabis products should be grown and produced using "consistent product safety standards (regardless of which state they are legally purchased in)," and 84 percent support the notion of the "federal government setting standards for product safety and quality that must be met for any cannabis products produced or sold in the United States."

Because cannabis remains classified as a Schedule I illicit substance under federal law, regulations governing the manufacturing and testing of marijuana products vary from state to state.

Separate polling has similarly shown that a majority of Americans desire greater regulatory authority over the safety and quality of hemp-derived CBD products, most of which are currently subject to little or no federal or state regulatory oversight.

"The U.S. has a plethora of consumer protection laws and organizations, at both the federal and state level, that regulate consumer affairs. So, it is understandable that Americans expect these same consumer protections in cannabis, like they do for everything they purchase," said Lezli Engelking, President & Founder of FOCUS. "The lack of protections for cannabis consumers is simply one more example of the extreme risks to public health and safety Americans are exposed to [because of] the lack of action around cannabis at the federal level."

Consistent with other national polls, a super-majority of respondents (78 percent) to the SIPCA/FOCUS poll agreed that marijuana should be legalized under federal law.

More information on the SIPCA/FOCUS polling data is available online.

Review: Cannabis Provides Benefits for Migraine Sufferers

Tucson, AZ: Cannabis preparations likely provide for the prophylactic and abortive treatment of migraines, according to a review of the relevant literature published in the journal Frontiers in Neurology.

A team of investigators with the University of Arizona reviewed the findings of 12 previously published studies involving 1,980 participants.

Authors reported evidence of plant cannabinoids' ability to reduce migraine frequency and to abort the onset of migraine headaches. The use of various preparations of cannabis was also associated with significant reductions in migraine-induced vomiting, pain, and nausea.

They concluded: "[T]here is some evidence for MC's [medical cannabis'] beneficial effect on treating migraine in adults. However, further research is needed to assess effective dosing and safety critically. Mindful of the upsurge of interest in MC use to treat migraines, there is an urgent need to implement well-designed studies to evaluate the effectiveness and safety of medical marijuana for treating adults with migraines."

The results of a prior literature review, which assessed 34 scientific papers on cannabis and migraine, similarly identified "encouraging data on medicinal cannabis' therapeutic effects on alleviating migraines in all of the studies reviewed."

Numerous surveys of patients report that those suffering from migraines often turn to cannabis for symptomatic relief, and many patients say that it is more effective than prescription medications.

Full text of the study, "Cannabis for the treatment of migraine in adults: A Review of the evidence," appears in Frontiers in Neurology.

Colorado: Youth Marijuana Use Declines Sharply Among Teens

Denver, CO: The percentage of young people who acknowledge consuming cannabis and having ready access to it declined sharply between 2020 and 2021, according to statewide data provided by the Colorado Department of Public Health and Environment (CDHPE).

Researchers reported a 35 percent year-over-year decline in the percentage of teens who admitted having consumed cannabis products within the past 30 days. They also reported a 22 percent drop in the percentage of teens who said that they could easily access cannabis. There was a 50 percent drop in the percentage of teens who admitted having driven after using cannabis.

"These data are consistent with other surveys showing that marijuana regulation policies can be implemented in a manner that provides access for adults while simultaneously limiting youth access and misuse," NORML's Deputy Director Paul Armentano said. "These findings ought to reassure lawmakers and others that cannabis access for adults can be regulated in ways that do not inadvertently impact young people's habits."

Nationwide, there was a 38 percent year-over-year reduction in self-reported marijuana use among eighth graders, a 38 percent decline among 10th graders, and a 13 percent decrease among 12th graders, according to data provided by the University of Michigan's annual Monitoring the Future survey.

Since Coloradoans legalized adult-use marijuana sales, lifetime cannabis use has fallen an estimated 30 percent among high-schoolers and an estimated 40 percent among middle-schoolers. Adult-use legalization in other states has also failed to overlap with any significant uptick in either young people's use of cannabis or access to marijuana products.

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