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Clinical Trial: Transdermal Application of Plant-Derived Cannabinoids Significantly Mitigates Diabetic Neuropathy

Khon Kaen, Thailand: The transdermal application of oil extracts containing plant-derived cannabinoids significantly reduces diabetic neuropathy, according to clinical data published in the journal Medical Cannabis and Cannabinoids.

A team of Thai investigators conducted a Phase III, randomized, double-blind, placebo-controlled clinical trial involving 100 patients diagnosed with diabetic neuropathy of the lower extremities. Participants received either transdermal formulations containing THC (3.20 mg/drop), CBD (0.32 mg/drop), and CBN (0.65 mg/drop) or a placebo (coconut oil) for 12 weeks. Subjects’ pain levels were assessed at baseline and at four, eight, and 12 weeks.

“Mean total NPSI-T (Neuropathic Pain Symptom Inventory) scores decreased markedly from 25.60 to 5.57 in the treatment cohort, contrasting with minimal reduction from 25.24 to 22.85 in the placebo group,” researchers reported. “GEE (Generalized Estimating Equation) analysis revealed significant pain amelioration at weeks 4, 8, and 12. The cannabis formulation exhibited an excellent safety profile, with only 10 percent of participants reporting mild adverse events, comparable to placebo group outcomes.”

The study’s authors concluded: “This novel transdermal medical cannabis formulation (consisting of THC, CBD, and CBN) demonstrated significant therapeutic efficacy in ameliorating painful DPN [diabetic peripheral neuropathy] symptoms while maintaining a favorable safety profile. These findings provide robust clinical evidence supporting its potential as an innovative therapeutic option for managing painful diabetic peripheral neuropathy.”

Prior studies have similarly shown that a wide range of cannabis formulations, including vaporized cannabis flower, oral CBD extracts, and aerosolized THC can mitigate neuropathic pain.

Full text of the study, “Efficacy and safety of transdermal medical cannabis (THC: CBD: CBN formula) to treat painful diabetic peripheral neuropathy of the lower extremities,” appears in Medical Cannabis and Cannabinoids.

Study: Arthritis Patients Report “Substantial” Improvements Following Cannabis Use

Orlando, FL: Arthritis patients report “substantial reductions” in pain and other symptomatic improvements following their use of medical cannabis products, according to data published in the journal Cureus.

Investigators affiliated with the University of Central Florida, College of Medicine assessed the perceived efficacy of cannabis in a cohort of 290 patients diagnosed with either rheumatoid arthritis (RA) or psoriatic arthritis (PsA). Patients reported their pain levels prior to cannabis treatment and following the sustained use of the substance. Patients with RA typically inhaled cannabis flower, while participants with PSA typically administered topical formulations of cannabis.

Patients reported “a substantial reduction in pain severity post-taking cannabis products compared to baseline levels.” Specifically, patients’ mean pain levels fell from 6.16 prior to cannabis treatment to 3.89 following treatment. Many patients also reported improvements in stiffness, fatigue, and joint swelling.

“Our study also found that inhaled cannabinoids were the most common form used by RA patients, likely due to their rapid systemic absorption and quicker pain relief. In contrast, PsA patients predominantly used topical formulations, which may provide localized effects beneficial for cutaneous symptoms,” the study’s authors concluded. “Our data indicate that the reduction in pain was statistically significant, suggesting cannabinoids may help alleviate the pain associated with these conditions…. Overall, our findings contribute to the growing literature on cannabinoid therapy for arthritis symptoms, emphasizing the need for continued research to optimize treatment strategies for affected individuals.”

Survey data reports that an estimated one in five arthritis patients use cannabis to mitigate their symptoms and that many reduce their use of prescription opioids following their initiation of medical marijuana.

Full text of the study, “Patient-reported outcomes of pain, stiffness, and fatigue reduction in rheumatoid arthritis and psoriatic arthritis with cannabis use,” appears in Cureus.

Survey: Older Adults Are Frequently Consuming CBD Products

Austin, TX: Nearly one in five adults between the ages of 50 and 64 acknowledge having consumed a CBD product within the past year and one in seven adults over the age of 65 have done so, according to survey data published in the journal Clinical Gerontologist.

Researchers at the University of Texas assessed CBD use in a nationally representative cohort of older adults.

They found that just over 18 percent of those between the ages of 50 and 64 reported past-year CBD consumption. Among those ages 65 and older, slightly more than 14 percent reported consuming CBD products.

“CBD use is common ... in the 65+ age group and positively correlated with both medical and nonmedical cannabis use,” investigators concluded.

Separate survey data finds that a growing percentage of older adults similarly report using cannabis, primarily to assist with anxiety, to improve sleep, or to relieve pain.

Commercially available CBD products lack federal regulatory oversight, are often mislabeled, and may contain impurities. Consumers of CBD products typically report using them for symptom management in place of prescription medications. Survey data compiled by the National Consumers League reports that more than eight in ten voters desire greater oversight over the production and marketing of commercially available CBD products.

Full text of the study, “Cannabidiol use among older adults: Associations with cannabis use, psychical and mental health, and other substance use,” appears in Clinical Gerontologist.

Texas: Attorney General Sues to Halt Implementation of Citywide Marijuana Depenalization Ordinance

Dallas, TX: Republican state Attorney General Ken Paxton has filed litigation that seeks to halt the city of Dallas from adopting a voter-approved measure prohibiting police from making low-level marijuana possession arrests.

On election day, voters in Dallas (population 1.3 million) and two other cities (Bastrop and Lockhart) decided in favor of municipal ballot initiatives limiting the ability of local law enforcement to make misdemeanor marijuana possession arrests. Those cities join Austin, Killeen, and several other Texas municipalities that have previously passed similar measures. The Attorney General has also filed suit against several of those cities, but his office has thus far been unsuccessful in halting their implementation.

“Cities cannot pick and choose which State laws they follow,” AG Paxton said. “The City of Dallas has no authority to override Texas drug laws or prohibit the police from enforcing them. This is a backdoor attempt to violate the Texas Constitution, and any city that tries to constrain police in this fashion will be met swiftly with a lawsuit by my office.”

State law defines marijuana possession of 2 ounces or less as a criminal misdemeanor, punishable by up to 180 days in jail, a $2,000 fine, and a criminal record. According to data compiled by Texas NORML, police made an estimated 219,000 marijuana-related arrests between 2017 and 2021. Ninety-seven percent of those arrested were charged with possession only. Fifty-six percent of those arrested were under 25 years of age.

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Study: Cannabis Extracts Reduce Disease Burden In Chronic Pain Patients

Haifa, Israel: Patients’ use of cannabis oil extracts is associated with long-term improvements in their pain intensity and related symptoms, according to data published in the journal Pain Reports.

Israeli researchers assessed the safety and efficacy of cannabis extracts in a cohort of 218 middle-aged chronic pain patients (mean age: 54) over six months. Patients consumed sublingual extracts containing standardized THC and CBD concentrations.

Cannabis treatment was associated with sustained reductions in pain intensity, opioid use, anxiety, depression, and sleep deprivation. Though some subjects did report “mild to moderate” side effects from cannabis, these events did not interrupt their “continuous use” of marijuana extracts throughout the study period.

“Cannabis seems to have an impact on the ‘disease burden’ of chronic pain,” the study’s authors concluded. “It also has a positive effect on functioning and health-related quality of life.”

The researchers’ findings are consistent with those of other larger observational studies involving thousands of pain patients enrolled in medical cannabis access programs.

Full text of the study, “Cannabis oil extracts for chronic pain: What else can be learned from another structured prospective cohort,” appears in Pain Reports.

Senate Leadership Reintroduces Legislation Repealing Federal Cannabis Prohibition

Washington, DC: Senators Cory Booker (D-NJ), Senate Majority Leader Chuck Schumer (D-NY), Finance Committee Chair Ron Wyden (D-OR), and 15 other Democrats have reintroduced legislation, S. 4226: The Cannabis Administration and Opportunity Act (aka CAOA), to remove cannabis from the Controlled Substances Act – thereby empowering states to regulate marijuana primarily as they see fit.

NORML’s Political Director Morgan Fox said: “NORML is pleased to once again support this comprehensive bill that deschedules cannabis federally and emphasizes repairing the harm and injustices caused by decades of prohibitionist policies. We strongly encourage senators on both sides of the aisle to support and cosponsor this legislation so that Congress can finally bring about an end to the conflict between state and federal marijuana laws and to the ongoing damage being done to communities across the nation because of cannabis criminalization.”

Said Leader Schumer in a prepared statement: “It’s past time for the federal government to catch up to the attitudes of the American people when it comes to cannabis. That’s why we’re reintroducing the Cannabis Administration and Opportunity Act, legislation that would finally end the federal prohibition on cannabis while prioritizing safety, research, workers’ rights and restorative justice.”

Added Sen. Wyden: “Our comprehensive Cannabis Administration and Opportunity Act doesn’t tell states what to do – but it provides them with the tools to effectively implement the laws their voters and legislators choose. Public health, public safety, opportunity, and social justice must be at the core of any cannabis reform proposal, and it is crucial stakeholders continue to have a seat at the table. I look forward to working with my colleagues and advocates across the country to make these priorities a reality.”

A previous version of CAOA was introduced in the 117th Congress. That version of the bill only gained four co-sponsors and it failed to receive a hearing.

Additional information on The Cannabis Administration and Opportunity Act is available from Senator Booker.

Analysis: THC Dosing Associated With Increased Survival Time In Palliative Cancer Patients

Berlin, Germany: The daily use of 5mg of oral THC is associated with increased survival times in palliative cancer patients, according to data published in the journal Medical Cannabis and Cannabinoids.

German researchers evaluated the impact of THC dosing in a cohort of 9,419 advanced cancer patients enrolled in Specialized Palliative Outpatient Care (SAPC). SAPC offers team-based home care for patients with advanced and progressive diseases whose life expectancies are limited to days, weeks, or months.

Researchers reported that patients’ daily use of 4.7mg of THC was associated with significantly increased survival time, whereas lower doses were not.

The study’s authors concluded: “The data … show a significant impact of THC on survival in ambulatory palliative care patients [who] … use more than 4.7 mg/day. Median survival time was prolonged by 15 days – from survival time of 25 days without THC therapy to 40 days with a daily THC dose higher than 4.7 mg per day. This prolongation by more than two weeks can be considered substantial. In addition to mere survival, patients [treated] with THC become more mentally and physically active. … The increased activity and improved quality of life might enable the patients to renew social contact with relatives and friends and to settle essential affairs before dying.”

The study’s findings are consistent with data published in 2021 that similarly reported that THC was associated with increased survival times in German hospice patients, particularly among women ages 75 and older.

Full text of the study, “The use of tetrahydrocannabinol is associated with an increase in survival time in palliative cancer patients: A retrospective multicenter cohort study,” appears in Medical Cannabis and Cannabinoids.

Florida: Republican Party To Formally Oppose Marijuana Legalization Initiative

Orlando, FL: The Republican Party of Florida is calling upon voters to reject Amendment 3, a proposed constitutional initiative legalizing adult-use marijuana sales. Voters will decide on the amendment this November.

Members of the Party’s Executive Board voted to formally oppose the amendment at its quarterly meeting, resolving that it “[puts] children at risk and endanger[s] Florida’s family-friendly business and tourism climates.”

Republican Gov. Ron DeSantis has also committed to raising money to assist ‘counter-messaging’ efforts to defeat the amendment.

Speaking at a recent press conference, the Governor claimed that passing Amendment 3 would “reduce [Floridians’] quality of life.”

Amendment 3 amends the state Constitution to allow existing medical cannabis facilities to engage in adult-use marijuana sales. Under the proposal, those 21 and older may legally possess up to three ounces of cannabis, of which not more than five grams may be in the form of concentrate. Home cultivation of marijuana for one’s own personal use is not permitted. The majority of funding for the measure was provided by the multi-state cannabis company Trulieve.

Because the ballot proposal is in the form of a constitutional amendment, it requires approval from a supermajority of voters (60 percent) to become law.

Florida law defines the possession of more than 20 grams of marijuana as a felony offense, punishable by up to five years in prison. Those who possess lesser amounts are guilty of a criminal misdemeanor, punishable by a year in jail.

For the past several years, state agencies have failed to provide comprehensive marijuana-related arrest data to the FBI. Historically, Florida was among the leading states in the nation in marijuana-related arrests. Additional information on Amendment 3 is available from Smart & Safe Florida.

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