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Analysis: Medical Cannabis Legalization Associated With Lower Healthcare Premiums



Miami, FL: Medical cannabis access is associated with significant decreases in employees’ healthcare premiums, according to data published in the journal Applied Health Economics and Health Policy.

Researchers affiliated with the medical cannabis technology company Leafwell assessed the relationship between medical cannabis legalization laws and employer-sponsored healthcare premiums over ten years (2003-2022).

They determined, “For states that adopted a medical cannabis law, there was a significant decrease in the … average total premium per employee for single and employee-plus-one coverage plans per year … compared with states without such laws. … Our results are significant as healthcare costs, primarily driven by the cost of premiums, have grown in the past decade or more and account for an increasing proportion of an employer and employees’ budget.”

The authors’ findings are consistent with a 2023 study, which reported that medical cannabis access is associated with “a sizeable and statistically significant reduction in annual per-enrollee premiums of about $1600.”

Authors of the latest study also acknowledged, “Had all 50 states implemented medical cannabis at the same time, employers may have experienced a total savings of $14.9 billion for single coverage plans and $8 billion for employee-plus-one coverage plans in a given year; employees may have seen a total savings of $4.2 billion for single plans and $2.3 billion for employee-plus-one plans in a given year. Under this assumption, medical cannabis laws could have reduced healthcare expenditure GDP by 0.65 percent in 2022 had all states adopted this policy change at the same time.”

They concluded, “Medical cannabis laws ... likely decrease the cost of private, employer- sponsored health insurance for both single and employee-plus-one coverage plans. … States should consider these positive externalities associated with medical cannabis legalization when considering whether or not to adopt a medical cannabis law.”

Full text of the study, “Measuring the impact of medical cannabis law adoption on employer-sponsored health insurance costs: A difference-in-difference analysis, 2003-2022,” appears in Applied Health Economics and Health Policy.


Study: Medical Cannabis Associated With Clinically Meaningful Quality of Life Improvements



Philadelphia, PA: Newly authorized patients who begin using medical cannabis products experience rapid and clinically meaningful improvements in their health-related quality of life, according to data published in the Journal of Cannabis Research.

Investigators affiliated with Philadelphia’s College of Osteopathic Medicine assessed changes in patients’ general health prior to their use of medical cannabis and then three months later. Researchers described their study as “one of the largest longitudinal studies of quality of life in individuals using medical marijuana in the US.”

They reported, “New medical marijuana users experienced improvements across all domains of HRQoL [health-related quality of life] over the first three months of medical marijuana use. ... We believe that these HRQoL gains represent clinically meaningful change in our participants.”

Specifically, respondents reported greater than 20 percent improvements in their physical health, social functioning, and emotional well-being.

“In conclusion, the use of medical marijuana for three months was associated with improvements in physical, social, emotional and pain-related HRQoL,” the study’s authors determined. “Results from this study can help patients, their caregivers, and their providers to make more informed and evidence-based decisions on whether to incorporate medical marijuana into their treatment regimens.”

Their conclusions are consistent with those of several other studies, finding that medical cannabis use is associated with sustained quality of life improvements in a broad range of patient populations.

Full text of the study, “Changes in health-related quality of life over the first three months of medical marijuana use,” appears in the Journal of Cannabis Research.


Clinical Trial: Topical Application of Hemp Seed Oil Reduces Osteoarthritic Knee Pain



Rafsanjan, Iran: The daily topical application of hemp seed oil improves osteoarthritic knee pain, according to placebo-controlled clinical trial data published in the journal Pain Management Nursing.

Iranian investigators assessed the efficacy of cold-pressed hemp seed oil versus either placebo or the NSAID diclofenac (aka Voltaren) in 90 patients with osteoarthritic knee pain and stiffness. Patients enrolled in the trial were between the ages of 45 and 70 years old. Study participants were assessed at baseline and again at four weeks and at eight weeks.

Researchers reported that the topical application of hemp seed oil provided therapeutic effects similar to those of diclofenac and superior to those of the placebo. Investigators reported that the oil was “safe and well tolerated.”

The study’s authors concluded: “This randomized controlled trial found that the daily application of topical hemp seed oil improved knee pain, physical function, and perceived knee stiffness. ... Topical herbal compounds may have a role in the treatment of painful chronic conditions, such as knee OA [osteoarthritis], to reduce the systemic adverse effects of oral drugs.”

Full text of the study, “Effect of topical hemp (cannabis sativa) seed oil on knee osteoarthritis: A randomized double-blind controlled trial,” appears in Pain Management Nursing.


Swing State Voters Overwhelmingly Favor Marijuana Legalization, Banking Reforms



Alexandria, VA: Likely voters in Arizona and Nevada strongly support allowing adults to use marijuana and other related reforms, according to polling data compiled by the market research firm The Tarrance Group.

Specifically, supermajorities of voters in both states favored legalizing cannabis, removing it from its Schedule I classification under federal law, and permitting banks and other financial institutions to explicitly partner with state-licensed cannabis businesses.

Polling previously compiled by the firm reported similar results in the battleground states of Michigan, Pennsylvania, and Wisconsin.

“Legalizing and regulating adult-use cannabis access is not only good policy, but it’s also good politics,” NORML’s Deputy Director Paul Armentano said. “State and federal politicians who continue to ignore their constituents’ sentiments on these issues do so at their own political peril.”

In recent weeks, both Presidential candidates have called for ending marijuana-related possession arrests. Donald Trump also recently tweeted his intention to vote for Florida’s Amendment 3 initiative, which permits existing medical cannabis facilities to engage in adult-use marijuana sales.

On election day, voters in four states – Florida, Nebraska, North Dakota, and South Dakota – will decide on cannabis-specific ballot measures.


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Fourth Circuit Ruling Contradicts DEA’s Opinion on the Legality of Certain Hemp-Derived Products

Richmond, VA: Judges with the Fourth Circuit Court of Appeals have ruled that all hemp-derived products, including those that undergo a chemical synthesis during manufacturing, are legal under federal law.

The decision is consistent with a 2022 Ninth Circuit ruling, but contradicts guidance provided more recently by the Drug Enforcement Administration. In a February 13, 2023 letter, the DEA argued that the 2018 Farm Bill never intended to legalize products “that do not occur in the cannabis plant and can only be obtained synthetically,” such as THC-O, regardless of their THC content.

In its ruling, judges acknowledged that the DEA and the Ninth Circuit disagreed on the matter. “The Ninth Circuit held that it didn’t need to consider the DEA’s position on synthetically derived substances because the definition of ‘hemp’ under the 2018 Farm Act was unambiguous in its application to all products derived from the cannabis plant, ‘so long as they do not cross the 0.3 percent delta-9 THC threshold,'” the Court determined. “Between the DEA’s February 2023 letter and [the Ninth Circuit decision], we think the Ninth Circuit’s interpretation of the 2018 Farm Act is the better of the two. And we’re free to make that determination ourselves, despite a contrary interpretation from the DEA, because we agree with the Ninth Circuit that § 1639o is unambiguous.”

The case before the Court centered on whether an employer could fire a worker for using hemp products. Ultimately, judges upheld the defendant’s termination because they failed to provide sufficient evidence that the products consumed possessed THC at limits below the threshold (0.3 percent) established by the Agriculture Improvement Act of 2018.

NORML and other groups have urged the FDA to establish regulatory guidelines governing the production, testing, labeling, and marketing of certain intoxicating hemp-derived products. In 2021, NORML issued a report on delta-8 THC and other novel, synthetically derived cannabinoids that cautioned consumers to avoid these unregulated products because they are untested and may contain impurities.

Survey: Patients With Rheumatic Conditions Frequently Substitute Cannabis for Prescription Medications

Montreal, Canada: Patients with neuropathy, fibromyalgia, osteoarthritis, and other rheumatic conditions frequently substitute cannabis in place of prescription medications, according to survey data published in the journal Open Neurology.

Researchers affiliated with McGill University in Montreal and the University of Michigan surveyed 763 US and Canadian patients with rheumatic conditions.

Consistent with other studies, 63 percent of respondents reported substituting cannabis products for other medications, including nonsteroidal anti-inflammatory drugs (55 percent), opioids (49 percent), sleep aids (30 percent), and muscle relaxants (25 percent). Following substitution, most participants reported decreases or cessation in their medication use. Respondents typically reported turning to cannabis because it offered “better symptom management” and was associated with “fewer adverse effects.”

Those who substituted medical cannabis in place of other medications reported greater improvements in pain, sleep, joint stiffness, muscle spasm, inflammation, and global health.

“The acceptance of MC [medical cannabis] as a treatment strategy for rheumatic conditions is evolving,” the study’s authors concluded. “These encouraging results of medication reduction and favorable effect of MC require confirmation with more rigorous methods. ... Comparative effective clinical trials of MC versus other pain treatments are needed, as are more prospective studies investigating the effects of MC on the use of medications and other substances in rheumatic populations.”

Full text of the study, “Substituting medical cannabis for medications among patients with rheumatic conditions in the United States and Canada,” appears in Open Neurology.

North Carolina: Cherokee Tribe Expands Retail Marijuana Sales to Those Ages 21 and Older

Qualla, NC: Members of the North Carolina Eastern Band of Cherokee Indians have begun selling cannabis products to patrons ages 21 and older, regardless of whether they are members of federal recognized Indian tribes.

Tribal members initially began selling marijuana products to authorized patients in April. In July, they began engaging in adult-use sales exclusively to other tribal members. On Saturday, they expanded sales to anyone over 21 years of age. That day, an estimated 4,000 customers were on hand to purchase cannabis products.

According to data published in May in the trade journal Marijuana Business Daily, federally recognized tribes are currently operating cannabis businesses in nine states: California, Michigan, Minnesota, Nevada, New Mexico, New York, North Carolina, South Dakota, and Washington.

Neither the recreational use nor the medical use of cannabis is permitted in North Carolina. Senate lawmakers earlier this year advanced legislation to regulate medical cannabis access, but House leaders failed to take up the measure. Statewide polling shows that 78 percent of North Carolina voters support legalizing cannabis for eligible patients.

In response to the Cherokee tribe’s actions, Congressman Chuck Edwards (R-NC) introduced federal legislation (HR 5323) seeking to withhold federal funding from jurisdictions that permit marijuana sales. The bill is not anticipated to receive a hearing.

Tennessee: Supreme Court Rules Drug-Sniffing Dog Alerts Still Constitute Probable Cause for Certain Marijuana-Related Searches

Nashville, TN: Judges on the Tennessee Supreme Court have determined that an alert from a drug-sniffing dog justifies a broader search of a defendant’s automobile, despite acknowledging that dogs cannot distinguish between legal hemp products and marijuana.

In its ruling, the Court affirmed that an alert from a drug dog -- absent other evidence of suspicious activity -- is not probable cause for a search. Rather, judges determined that probable cause is “based on a totality of the circumstances, and a positive indication from a drug-sniffing dog is part of the total circumstances.”

A summary of the case posted on the Tennessee Courts website stated, “Even though Tennessee’s decision to legalize hemp made the dog alert less certain, probable cause does not demand absolute certainty and an alert from a drug-sniffing dog still shows a likelihood that illegal drugs are present.”

Tennessee legalized the possession and use of hemp products in 2019. Marijuana remains illegal in the state.

Judges in the case concluded: “We hold that a positive indication from a drug-sniffing canine may continue to contribute to a finding of probable cause when examining the totality of the circumstances, notwithstanding the legalization of hemp. … Sufficient facts existed for [law enforcement] to conclude that contraband or evidence of a crime was present inside the vehicle. … Accordingly, we affirm the judgment of the Court of Criminal Appeals reinstating the indictments against the defendant and remanding for further proceedings.”

A trial court had previously granted the defendant’s motion to suppress evidence obtained in the search. The Court of Criminal Appeals reversed that decision.

The case is Tennessee v. Green.

Courts in several other states where cannabis is legal for either medical or adult-use purposes – including Delaware, Maryland, Minnesota, Pennsylvania, and Vermont – have previously determined that the odor of marijuana emanating from a motor vehicle is not by itself sufficient grounds to justify a warrantless search.

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