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Analysis: Cannabis Use Not Associated With Elevated Risk of Carotid Artery Calcification

La Jolla, CA: People with a history of cannabis use do not possess higher rates of carotid artery calcification (CAC) in either middle age or older adulthood, according to data published in the journal Vascular Medicine. Carotid artery calcification is an established marker of atherosclerosis (hardening of the arteries), which is linked to an elevated risk of heart attack and stroke.

Researchers at the University of California, San Diego, assessed the relationship between cannabis smoking and CAC in a representative cohort of 2,152 subjects between 45 and 84 years old.

Consistent with other studies, investigators determined, “In [this] racially and ethnically diverse cohort of older adults with a moderately high prevalence of carotid artery calcification, there were no statistically significant associations between a history of regular cannabis smoking, duration, or recency of cannabis smoking, and the prevalence of carotid calcified plaque.”

The study’s authors concluded: “The null findings reported herein are consistent with our previous research. … If smoking cannabis increases the risk of atherosclerotic disease, one would anticipate finding consistent evidence of adverse cardiac outcomes in human research. This is not the case.”

According to data published earlier this year in the Journal of the American Heart Association, the use of either alcohol or opioids is implicated in nearly 80 percent of all cardiovascular deaths related to substance use. By comparison, a history of cannabis use is associated with fewer than one percent of all substance use-related cardiovascular deaths.

Full text of the study, “Regular cannabis smoking and carotid artery calcification in the Multi-Ethnic Study of Atherosclerosis (MESA),” appears in Vascular Medicine.

Study: Patients Report Reduced Pain, Improved Mental Health Following Medical Cannabis Treatment

Melbourne, Australia: Chronic pain patients report physical and mental health improvements following their use of medical cannabis preparations, according to observational data published in the Journal of Pain & Palliative Care Pharmacotherapy.

Australian researchers assessed the use of medical cannabis preparations in 96 chronic pain patients. (Under Australian law, physicians may only authorize cannabis products to patients unresponsive to conventional prescription treatments.) Study participants consumed cannabis formulations either high in CBD, high in THC, or containing equal ratios of both cannabinoids. Patients’ symptoms were assessed at three, six, and 12 months.

Investigators reported: “We identified clear associations between patient commencement of a prescribed medicinal cannabis product and improvements in pain, mental health and sleep difficulties, with the most pronounced therapeutic effects visible within the first six months of treatment. Furthermore, significant improvements were noted across diverse domains of symptom interference on daily functions, suggesting an improved quality of life for patients. In relation to pain management, the majority of patients exhibited a notable decline in their use of both prescription and over-the-counter pain medications. This reduction in the use of other medications is consistent with the substantial improvements in pain severity reported by most patients.”

The most frequently reported adverse events were dry mouth and sleepiness.

The study’s authors concluded: “Overall, we found that the use of medicinal cannabis was associated with reduced pain during the first six months and improved mental well-being over 12 months. … Further longitudinal and controlled studies are necessary to better understand the sustained effects of cannabis-based medications on pain and mental health.”

Similarly designed studies of patients enrolled in the United Kingdom’s medical cannabis access program have reported that medical cannabis treatment is safe and effective for those suffering from chronic pain, anxiety, post-traumatic stress, fibromyalgia, depression, migraine, multiple sclerosis, osteoarthritis, inflammatory arthritis, inflammatory bowel disease, and other afflictions.

Full text of the study, “Changes in mental health symptoms associated with prescribed medicinal cannabis use: A one-year longitudinal study,” appears in the Journal of Pain & Palliative Care Pharmacotherapy.

Study: Those With a History of Cannabis Use Are Less Likely To Use Opioids Following Lower Back Surgery

Chicago, IL: Patients with a history of cannabis use consume fewer opioids following lower back surgery as compared to matched controls, according to data published in the Asian Spine Journal.

Investigators affiliated with the Chicago Medical School and Yale University assessed opioid utilization trends in a cohort of 1,216 patients who had undergone lumbar fusion surgery. Half of the cohort had a history of cannabis consumption and half did not. Participants were tracked for six months.

“Cannabis users had lower rates of opioid utilization compared to non-cannabis users as early as two months after fusion [surgery],” researchers determined. “[This] relationship … persisted at six months.”

The study’s authors concluded: “We found that cannabis users tended to wean off opioid analgesics earlier than non-cannabis users postoperatively, offering support for the opioid-sparing effect of cannabis theory. … Knowledge of cannabis use patterns may potentially allow physicians to cater to individual needs and provide appropriate dose titration over time. This may help reduce opioid dependence and improve patient outcomes.”

Separate studies have reported that postoperative patients who self-report consuming cannabis are less likely than non-users to engage in the long-term use of prescription opioids.

Full text of the study, “Effects of cannabis use surgery on post-operative opioid utilization in lumbar fusion patients: An American retrospective study,” appears in the Asian Spine Journal.

Survey: Six Years After Legalization, Nearly Two-Thirds of Canadians Approve of the Policy Change

Ottawa, Canada: Sixty-two percent of Canadians approve of Parliament’s 2018 decision to legalize cannabis use and retail sales nationwide, according to nationally representative polling data.

The percentage of Canadians expressing support for legalization has held steady for the past four years. Fewer than 20 percent of Canadians favor legalizing and regulating the use of other controlled substances.

Pollsters also reported that the majority of Canadians purchase “all” of their cannabis products from legal retailers. Separate polling data has previously reported that the percentage of Canadian consumers transitioning to the legal cannabis market has grown year over year.

Additional polling information is available from Research Co.

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Study: Cannabis Provides Sustained Benefits for Fibromyalgia Patients

London, United Kingdom: Patients with fibromyalgia (FM) report symptom improvements following their use of medical cannabis preparations, according to observational data published in the Journal of Pain & Palliative Care Pharmacotherapy.

British researchers assessed the use of cannabis-based medicinal products (CBMPs) consisting of either flower or oil extracts in 148 patients enrolled in the UK Medical Cannabis Registry. (Since 2018, British specialists have been permitted to prescribe cannabis-based medicinal products to patients unresponsive to conventional medications.) Researchers assessed changes in patient-reported outcomes at one, three, six, and twelve months.

“Improvements in the generalized anxiety disorder-7 questionnaire, single-item sleep quality scale, fibromyalgia symptom severity score and EQ-5D-5L Index values [a descriptive scale assessing mobility, self-care, usual activities, pain/discomfort and anxiety/depression] were observed at each follow up period compared to baseline,” investigators reported.

Study participants also significantly reduced their use of prescription opioids during the trial. The most frequently reported adverse events were fatigue, headache, and dry mouth.

The study’s authors concluded: “Positive associations between initiation of CBMP therapy and decreased fibromyalgia severity were observed at all time points. … These findings are complemented by the wider literature.”

Other observational studies assessing the use of cannabis products in patients enrolled in the UK Cannabis Registry have reported them to be effective for those suffering from chronic pain, anxiety, post-traumatic stress, depression, migraine, multiple sclerosis, osteoarthritis, inflammatory arthritis, and inflammatory bowel disease.

Full text of the study, “Comparison of cannabis-based medicinal product formulations for fibromyalgia: A cohort study,” appears in the Journal of Pain & Palliative Care Pharmacotherapy.

Study: Prenatal Cannabis Exposure Not Associated With Elevated Rates of ADHD, Behavior Disorders in Early Adolescence

San Francisco, CA: Infants who test positive for prenatal cannabis exposure are not at higher risk of being diagnosed with ADHD (Attention Deficit Hyperactivity Disorder) or DBD (Disruptive Behavior Disorder) in early adolescence, according to data published in the Journal of Developmental and Behavioral Pediatrics.

Investigators affiliated with the University of California at San Francisco and Kaiser Permanente assessed the relationship between in-utero cannabis exposure and behavioral outcomes in a cohort of over 141,000 children born between 2011 and 2018. Children were followed up to a maximum age of 11.

“Maternal prenatal cannabis use was not associated with ADHD, and there was an inverse association with DBD,” researchers determined.

They added: “The data reflect offspring population-level outcomes and do not predict the outcome for any individual. Additional research is needed to tease apart the mechanisms underlying the inverse association between prenatal cannabis use and the risk of ADHD and DBD.”

The lack of association between prenatal cannabis exposure and ADHD is consistent with previous findings.

Several members of the same research team published separate studies in the Journal of the American Medical Association, finding that prenatal cannabis exposure is not positively associated with elevated rates of either childhood autism or an increased risk of early childhood developmental delays.

Studies assessing the relationship between in-utero cannabis exposure and various neonatal outcomes, such as birth weight, have historically yielded inconsistent results. However, longitudinal data suggests that cannabis exposure is not typically associated with adverse neurodevelopmental consequences in late adolescence, finding, “Although there is a theoretical potential for cannabis to interfere with neurodevelopment, human data drawn from four prospective cohorts have not identified any long-term or long-lasting meaningful differences between children exposed in utero to cannabis and those not.”

Full text of the study, “Prenatal cannabis use and offspring Attention Hyperactivity Disorder and Disruptive Behavior Disorders: A retrospective cohort study,” appears in the Journal of Developmental and Behavioral Pediatrics.

Survey: Cannabis as Effective as Prescription Medicines for Treatment of Hand Pain

Chicago, IL: Patients with hand pain-related pathologies frequently turn to cannabis for pain relief, according to data published in the journal Hand.

Researchers affiliated with the University of Chicago surveyed 122 patients suffering from hand-related pain. Fifteen percent of respondents acknowledged using cannabis to manage their symptoms.

Investigators reported: “Compared with pre-usage pain scores, both cannabinoids and Rx/OTC medications induced significant reductions in pain associated with patients’ hand pathologies. … Subjectively, … cannabinoids were preferred over Rx/OTC medications by 64 percent of the cannabinoid cohort, and no respondents preferred traditional medications over cannabinoids.”

The study’s authors concluded: “Although this is a small-scale study, these findings support the idea that cannabinoids are used regularly and are effective for pain control in orthopedic hand patients. Given the variety of cannabinoids among patients surveyed, future directions include examining the formulations, ingestion methods, and potencies that most improve pain from hand pathologies. Orthopedic surgeons should continue working with their patients to find successful, safe, and personalized ways to achieve adequate pain control.”

Full text of the study, “Prevalence and effect of cannabinoids in pain management and hand pathologies,” appears in Hand. Additional information on cannabis and chronic pain is available from NORML’s publication, Clinical Applications for Cannabis & Cannabinoids.

Delaware: Governor Signs Legislation Providing State-Level Protections for Businesses Providing Financial Services To Licensed Cannabis Retailers

Dover, DE: Democrat Gov. John Carney has signed legislation (HB 355) into law providing state-level legal protections for financial institutions and other entities that provide financial or accounting services to licensed cannabis-related businesses.

The law stipulates that “banks, credit unions, armored car services, and providers of accounting services are not subject to prosecution under Delaware law merely by providing lawful services to licensed businesses engaged in the production, distribution and sale of cannabis.”

Lawmakers passed legislation in 2023 regulating adult-use cannabis sales. However, regulators have yet to award licenses to cannabis business applicants.

The new law does not protect banks and other institutions from potential federal litigation. Federal law currently discourages financial institutions from partnering with state-licensed cannabis businesses because of their involvement with a Schedule I controlled substance.

Federal legislation seeking to amend the law currently has 36 co-sponsors in the US Senate and 130 co-sponsors in the House, but has yet to receive a floor vote in either chamber during the current session.

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Study: Cannabis Edibles Reduce Chronic Lower Back Pain

Boulder, CO: The consumption of cannabis-infused edible products, particularly those that are higher in THC content, provides acute relief for patients with chronic lower back pain, according to data published in the journal Frontiers in Pharmacology.

Researchers with the University of Colorado at Boulder assessed the ad libitum use of three distinct edible products (THC-dominant products, CBD-dominant products, or products containing similar amounts of THC and CBD) in 249 subjects with low back pain. Participants consumed the products for two weeks. Researchers evaluated changes in patients’ pain intensity and subjective mood, which were assessed at the conclusion of the study.

“Pain intensity following edible cannabis use decreased over time across all three broadly defined product groups,” investigators reported. Decreases in pain intensity were most pronounced in patients who consumed THC-dominant edibles. CBD-dominant products were “primarily associated with short-term tension relief” rather than significant reductions in acute pain.

:
The study’s authors concluded: “These findings support the short-term analgesic effects of THC and anxiolytic effects of CBD … [and] indicate that edible cannabis may be a safe and suitable alternative pain therapy for those looking to substitute more traditional pain medications.”

Longitudinal data published in 2022 determined that patients suffering from chronic back pain reduce their use of prescription opioids and report improvements in their condition following medical cannabis treatment.

Full text of the study, “Edible cannabis for chronic low back pain: Associations with pain, mood, and intoxication,” appears in the journal Frontiers in Pharmacology.

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Harris Campaign Pledges To Work With Congress To Legalize Marijuana at the Federal Level

Washington, DC: The Kamala Harris campaign released a policy agenda this week that includes a pledge to “legalize marijuana at the federal level.”

If elected, Harris promises to “work with Congress to ensure that the safe cultivation, distribution, and possession of recreational marijuana is the law of the land.”

The pledge comes nearly two weeks after Harris said in an interview, “I just think we have come to a point where we have to understand that we need to legalize [marijuana] and stop criminalizing this behavior.”

Republican Presidential contender Donald Trump had previously declared that he intends to vote ‘yes’ on a Florida ballot initiative legalizing adult-use marijuana sales, and if elected, he would work with Congress to enact reforms at the federal level, including SAFER Banking.

As a US Senator, Kamala Harris sponsored legislation to end the federal prohibition of cannabis. In 2022, the Biden administration provided pardons to low-level offenders convicted of federal marijuana offenses and initiated an administrative petition to reclassify cannabis under federal law. In March, Harris led a round-table discussion with marijuana pardon recipients.

Pennsylvania: Pittsburgh Enacts Ordinance Protecting Medical Cannabis Patients From Employment Discrimination

Pittsburgh, PA: Pittsburgh lawmakers have enacted municipal legislation protecting state-registered medical cannabis patients from employment discrimination due to their off-the-job marijuana use.

The law defines patients as a “protected class” under local law, thereby making it unlawful for most employers to require them to participate in pre-employment drug testing for marijuana. It also limits most employers’ ability to require qualified patients to undergo marijuana testing while they are on the job, absent suspicion that they are impaired.

Certain employers, such as construction companies and companies subject to federal drug testing regulations, are exempt from the ordinance.

“Gainful employment should be accessible to everyone regardless of the type of medical treatment they receive,” said Rachel Shepherd, The Executive Director of the Pittsburgh Commission on Human Relations.

Theresa Nightingale, Executive Director of Pittsburgh NORML – which lobbied on behalf of the bill – added: “Many of these patients are seniors, low-income and middle-class Pennsylvanians. Being able to provide for their families is integral to their survival. [It’s] discriminatory to deny them employment based on their medical conditions.”

In recent years, lawmakers in three states – Michigan, Nevada, and Washington – and in numerous other municipalities and counties nationwide – including Atlanta, Cleveland, the District of Columbia, Philadelphia, and St. Louis – have similarly ended pre-employment marijuana screening for most public employees. Several other states — including California, Connecticut, Minnesota, Montana, New Jersey, New York, and Rhode Island — have enacted broader workplace protections limiting employers’ ability to either test or sanction workers for their use of cannabis use while off the job.

Nebraska: Judge Sets Trial Date in Medical Cannabis Ballot Fight

Lincoln, NE: A judge has set a trial date to hear arguments brought by litigants who oppose the certification of a pair of medical cannabis access ballot initiatives.

State regulators affirmed on August 30th that advocates Nebraskans for Medical Marijuana had gathered the requisite number of signatures to place the measures before voters. Opponents filed litigation shortly thereafter, alleging several thousand signatures should have been determined invalid because of clerical errors or malfeasance.

The judge has requested to hear evidence substantiating litigants’ allegations on October 29th. If substantiated, the trial will continue, and representatives of the campaign will have the opportunity to respond on October 31st. If the case extends beyond that date, it is unlikely that the issue will be resolved prior to Election Day.

Early voting has already begun in Nebraska and paper ballots have already been printed containing both ballot questions.

In a prepared statement responding to the allegations, the Nebraskans for Medical Marijuana campaign said: “It is appalling that the State of Nebraska is working to silence and disenfranchise the voices of tens of thousands of Nebraskans based on primarily unsubstantiated technical issues. These issues have absolutely nothing to do with the more than 115,000 voters who signed each of these petitions, or the dedicated patients and Nebraska citizens who worked hard to get the issue on the ballot.”

The two proposed ballot measures (Initiated Measures 437 and 438) are complementary. The first permits qualified patients to possess and use cannabis. The second measure regulates the production and distribution of cannabis to authorized patients. Advocates had to frame the issue as two separate ballot questions so as not to run afoul of the state’s ‘single subject’ rule. In 2020, the state Supreme Court invalidated a similar stand-alone measure for addressing issues that it deemed were “not naturally and necessarily connected to the [initiative’s] primary purpose.” A 2022 effort failed to obtain sufficient signatures to qualify for the ballot.

Voters in Florida, North Dakota, and South Dakota will be deciding on adult-use legalization measures this fall.

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