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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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Study: Osteoarthritis Patients Report Sustained Benefits From Cannabis

London, United Kingdom: Patients diagnosed with osteoarthritis report pain-specific 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 a cohort of osteoarthritis 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 measures over a one-year period.

Patients reported symptom improvements at one-month, three-months, six-months, and at one-year.

“Commencement of CBMP treatment was associated with reductions in pain-specific PROMs [patient-reported outcome measures] at all time points in patients with osteoarthritis,” researchers reported. Patients also reported improved sleep. Contrary to the results of several other studies, patients prescribed opioids did not decrease their opioid intake following their initiation of medical cannabis.

Investigators documented few serious side-effects associated with cannabis. “AEs [adverse events] were mainly mild or moderate in severity,” they wrote. “Fatigue was the most common AE in this study.”

The study’s authors concluded: “These results suggest an improvement in pain-related outcomes for patients with osteoarthritis following the initiation of CBMP treatment. Furthermore, there was an improvement in general HRQoL [health-related quality of life] metrics across the follow-up period. CBMPs also appeared to be well-tolerated at 12-month follow-up. … Hence, this study supports the development of RCTs [randomized clinical trials] for CBMP use in osteoarthritis.”

Other 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, inflammatory bowel disease, and other afflictions.

Full text of the study, “Assessment of clinical outcomes in patients with osteoarthritis: Analysis from the UK Medical Cannabis Registry,” appears in theJournal of Pain & Palliative Care Pharmacotherapy.

Randomized Clinical Trial: CBD Effectively Treats Acute Dental Pain

Kilmarnock, Scotland: The administration of a purified formulation of plant-derived CBD (aka Epidiolex) provides significant short-term relief to patients suffering from acute toothaches, according to placebo-controlled clinical trial data published in the journal Evidence-Based Dentistry.

A pair of Scottish scientists assessed the use of Epidiolex versus placebo in 61 patients with moderate-to-severe dental pain. Forty patients received CBD in doses of either 10 or 20 mgs. Twenty-one subjects received a placebo. Patients’ pain was monitored for three hours following dosing.

Patients who consumed CBD, on average, experienced a greater than 50 percent reduction in their pain, investigators reported. By contrast, those receiving placebo experienced a 37.5 percent decrease in pain.

“Based on this randomized clinical trial, pure CBD drug Epidiolex demonstrates effective analgesia against acute toothache,” the study’s authors concluded.

The US Food & Drug Administration approved the prescription use of Epidiolex as an anti-epileptic drug in 2018. The DEA removed Epidiolex from the Controlled Substances Act in 2020.

Full text of the study, “Cannabidiol – an effective analgesic for toothache,” appears in Evidence-Based Dentistry.

Analysis: Fewer Young Adults Driving Impaired Following Marijuana Legalization

Seattle, WA: The legalization of marijuana in Washington state is not associated with any uptick in the percentage of young people driving under the influence of either cannabis or alcohol, according to data published in the journal Prevention Science.

A team of researchers with the University of Washington assessed DUI trends among young adults immediately prior to the adoption of adult-use sales and for the next five years.

Following legalization, fewer young people engaged in DUI alcohol. Among young people who used cannabis, fewer acknowledged driving under its influence.

“[These] trends may reflect some success in reducing DUI, but additional detection and prevention efforts are needed,” the study’s authors concluded.

The findings are similar to those of a 2022 study concluding, “The risk of self-reported DUIC [driving under the influence of cannabis] is lower in recreational and medical cannabis states compared to states without legal cannabis.”

Full text of the study, “Young adult alcohol and cannabis impaired driving after the opening of cannabis retail stores in Washington state,” appears in Prevention Medicine.

Review: Use Of Nicotine Products Typically Precedes Teens’ Use Of Cannabis

Phoenix, AZ: Teens’ use of cigarettes and other nicotine products is predictive of later cannabis use, according to data published in Substance Use & Misuse.

A team of investigators affiliated with the University of Arizona assessed data from 21 studies involving nearly 2.8 million adolescents.

They determined, “Nicotine-product use emerged as a significant factor associated with future cannabis use among adolescents.”

The study’s authors concluded, “Current evidence suggests an association between nicotine-product use and subsequent recreational cannabis use among adolescents.”

Longitudinal data published last year in the journal Drug and Alcohol Dependence similarly reported that young people typically try either alcohol or tobacco before ever experimenting with cannabis.

Full text of the study, “Nicotine and alcohol use as predictors of recreational cannabis use in adolescence: A systematic review and narrative synthesis,” appears in Substance Use & Misuse.

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Analysis: Elevated Levels Of Heavy Metals Identified In Some Commercially Available Rolling Papers

Marie, MI: Consumers’ use of certain brands of commercially available rolling papers may result in heavy metal exposure, according to data published in the journal of the American Chemical Society (ACS Omega).

Researchers affiliated with Lake Superior State University’s School of Chemistry analyzed metal concentrations in 53 brands of rolling papers and paper cones. Products were purchased from four Michigan retail outlets. They included brands that are available nationally and internationally.

Investigators identified elevated levels of certain metals – including copper, chromium, and vanadium – in about one-quarter of the products tested. Metals were most frequently identified in colored rolling paper products.

The study’s authors concluded: “Under the current regulatory scheme, rolling papers are virtually unregulated, except in a limited number of jurisdictions. … This general lack of regulation is of concern in light of their potential to substantially increase exposure to several potentially toxic elements, particularly copper. … Additional efforts by state regulatory agencies to reach a consensus on limits to toxic elements in cannabis and smoking papers are warranted based on our findings, as is additional research to determine exposures based on realistic use patterns.”

A 2020 analysis of 101 rolling paper products purchased in California similarly reported that some papers used by the manufacturers of pre-rolled cannabis cigarettes contain metal contaminants and pesticides.

Full text of the study, “Elemental composition of commercially available rolling papers,” appears in ACS Omega.

Study: Cannabis Use Seldom Associated With Cognitive Impairments In People With HIV

San Diego, CA: Neither the use of whole-plant cannabis or cannabis-based medicines (e.g., dronabinol) are associated with significant cognitive changes in people with HIV, according to the results of a meta-analysis published in the journal Current HIV/AIDS Reports.

Researchers affiliated with the University of California at San Diego reviewed data from 34 clinical studies. They reported, “Overall, the number of reported adverse effects were largely outnumbered by beneficial or null findings, providing insufficient support for the detrimental impact of CU [cannabis use] on cognition in PWH [people with HIV].”

They concluded, “[These results] suggest [that] cannabis and [cannabis-based] medications can be prescribed to PWH while posing little threat to cognitive function.”

Survey data shows that people with HIV frequently use cannabis for symptom relief. Studies have reported that cannabis use is associated with increased appetite, reduced inflammation, and greater levels of physical activity in patients with HIV.

In 1985, the US Food and Drug Administration approved synthetic oral THC capsules (dronabinol) for the treatment of HIV-induced cachexia.

Full text of the study, “The impact of cannabis use on cognition in people with HIV: Evidence of function-dependent effects and mechanisms from clinical and preclinical studies,” appears in Current HIV/AIDS Reports.

Survey: Patients Report Improvements, Few Serious Side-effects Following Use Of High-THC Flower

Hannover, Germany: Patients prescribed high-THC prescription-grade cannabis chemovars report them to be safe and effective, according to data published in the journal Pharmacopsychiatry.

An international team of investigators surveyed more than 1,000 German patients authorized to use medical cannabis. (Plant cannabis and cannabinoid treatments, such as dronabinol, were legalized by prescription use in Germany in 2017.) Survey respondents obtained lab-tested cannabis flower from regional pharmacies. Potency of the most frequently used chemovar was 22 percent.

The overwhelming majority of patients surveyed reported medical cannabis to be effective at treating their symptoms. Patients reported no significant differences between chemovars, most of which were dominant in THC and low in CBD content. The most commonly reported side effects were dry mouth, increased appetite, and somnolence.

“Patients self-reported very good efficacy and tolerability [to] medical cannabis,” the study’s authors concluded.

Pharmaceutical-grade cannabis flower in Europe, Israel, and elsewhere typically contain THC levels of 20 percent or greater.

The study’s findings push back against claims that cannabis strains higher in THC pose unique risks to health or that there is an absence of research supporting the efficacy of medical cannabis chemovars above 10 percent THC.

Full text of the study, “Medical use of different cannabis strains: results from a large prospective study in Germany,” appears in Pharmacopsychiatry.

Colorado: Most Voters Strongly Support State’s Decision To Legalize Marijuana

Denver, CO: Most Colorado voters are supportive of the state’s decision to legalize the adult-use cannabis market.

In 2010, Colorado and Washington became the first two states to legalize marijuana possession. Colorado was the first state to initiate state-licensed retail sales of cannabis products.

According to statewide polling data compiled by the Colorado Polling Institute, 67 percent of voters say that “allowing the regulation of marijuana” is a “good thing.” Separate survey data compiled by Public Policy Polling similarly finds that most voters believe, “Colorado’s regulated marijuana industry has had a positive impact on the state economy.”

Responding to the polling data, NORML’s Deputy Director Paul Armentano said: “There’s no ‘buyer’s remorse’ among the public when it comes to legalizing cannabis. That’s because these policies are largely working as intended and because voters prefer legalization and regulation over the failed policy of cannabis prohibition.”

Armentano emphasized this point in a new syndicated op-ed, highlighting that public support for legalization has grown in parallel with more states legalizing it.

“After a century of failed policies and ‘canna-bigotry,’ the verdict is in,” he wrote. “Legalization is a success, and the end of cannabis prohibition can’t come soon enough.”

Hawaii: Senators Abruptly Reject Marijuana Decriminalization Legislation

Honolulu, HI: Senate members voted 15 to 9 to defeat legislation, SB 2487, which sought to reduce marijuana possession penalties.

The defeat marked a sudden about-face for Senate lawmakers. In April, Senators voted 24 to 1 in favor of the bill. Last week, they once again expressed support for the measure, agreeing to House-backed changes to the legislation.

State law defines the possession of more than three grams of cannabis as a criminal misdemeanor, punishable by up to 30 days in jail and a $1,000 fine. Those penalties would have been reduced to a $25 civil fine under the proposal.

In April, Senators voted 19 to 6 in favor of separate legislation, SB 3335, which sought to legalize and regulate the adult-use cannabis market. That legislation was ultimately tabled by the House.

Opponents of both measures alleged that liberalizing Hawaii’s cannabis laws would undermine tourism and send the wrong message to young people.

Nikos Leverenz, board president for the Drug Policy Forum of Hawaii, told Marijuana Moment: “Too many legislators this cycle have ceded to the histrionic arguments by many in the criminal legal lobby and others who want to ensure broad prohibition. Hopefully next year’s legislature will produce a bona fide recalibration of cannabis policy in Hawaii.”

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Report: Cannabis Industry Employs Over 440,000 Full-time Workers

Denver, CO: The state-licensed cannabis industry added over 23,000 new jobs in 2023 and now employs over 440,000 full-time workers, according to data compiled by Vangst and Whitney Economics.

Job growth increased more than five percent between 2022 and 2023, while retail cannabis sales grew over ten percent to $28.8 billion, authors reported. Year-over-year growth was especially strong in Michigan and more nascent adult-use markets such as Missouri, New Jersey, Connecticut, and Rhode Island.

By contrast, ten states experienced negative growth during the past year. The report’s authors suggested that market saturation and waning demands for cannabis tourism likely played a role in those markets’ contraction.

“Now more than ever, America’s cannabis industry is a state-by-state, region-by-region job market,” the study’s authors concluded. “Young markets in recently legalized states continue to expand and create employment opportunities, while labor demand in mature markets contracts along with revenue and profit margins.”

Between 2017 and 2022, the state-legal cannabis industry experienced year-over-year double-digit growth. Since then, industry growth has plateaued.

Survey: Fibromyalgia Patients Report Improved Symptoms Following Cannabis Use

Rochester, MN: Fibromyalgia (FM) patients frequently use cannabis therapeutically and most say that it improves their disease symptoms, according to survey data published in the journal Mayo Clinic Proceedings.

Researchers affiliated with the Mayo Clinic in Minnesota surveyed 1,336 patients with fibromyalgia. Half (49.5 percent) acknowledged using cannabis following their FM diagnosis.

Ninety-nine percent of consumers reported using cannabis for pain, and 94 percent reported using it to mitigate stress, anxiety, depression, and insomnia.

Eighty-two percent said that marijuana reduced their FM-related pain, and most respondents also rated cannabis as effective in mitigating other disease symptoms.

In an accompanying editorial, authors acknowledged that cannabis use among FM patients is “widespread” and that most patients perceive it to have a “favorable impact on pain, stress, and sleep disturbances.” The editorial’s authors described cannabis as a “promising” option for FM patients, but cautioned, “More research is needed to determine the best doses and composition for each symptom, long-term safety, and whether people might become dependent on MC [medical cannabis] when using it to manage FM.”

Recent observational trial data from Germany and the United Kingdom reports that FM patients typically reduce their use of other prescription medications following their use of cannabis products.

Full text of the study, “A cross-sectional survey study of cannabis use for fibromyalgia symptom management,” appears in Mayo Clinic Proceedings.

Kentucky: Lawmakers Advance Legislation Imposing New Restrictions Upon State’s Nascent Medical Cannabis Access Program

Frankfort, KY: Lawmakers in the House and Senate have approved legislation, Senate Bill 829, imposing new restrictions on patients’ ability to access medical cannabis products. The bill awaits action from Democratic Gov. Andy Beshear.

The legislation makes several amendments to the state’s nascent medical cannabis program, which lawmakers approved last year. Among the legislation’s more restrictive provisions, it subjects patients to criminal background checks prior to entering the state’s cannabis registry. Those patients with certain criminal records are disqualified from participating in the program. No other state imposes such patient restrictions.

Other provisions in the bill provide school administrators the discretion to prohibit students registered in the program from accessing medical cannabis products while on school grounds and mandate physicians to perform a complete intake of a patient’s prescription drug history prior to issuing a medical cannabis recommendation. Efforts to expand the pool of qualifying conditions for which doctors may recommend medical cannabis products were unsuccessful.

While separate provisions in the legislation seek to expedite the timeline for which state-licensed growers and others can begin their operations, representatives of Kentucky NORML remain opposed to the bill.

“House Bill 829 introduces burdensome provisions that will likely hinder patients’ ability to access medical cannabis,” Lauren Bratcher, Deputy Director of Kentucky NORML said. “These include background checks for patients, redundant regulations, and other requirements that will limit patients’ participation in the program. While expediting timelines may seem advantageous, the potential negatives embedded within the bill outweigh any perceived benefits. Patient access and rights must take precedence over expediency.”

She added: “As advocates for patient-centric cannabis reform, Kentucky NORML urges Gov. Beshear to veto HB 829 and protect patient access to medical cannabis in Kentucky. We stand ready to work collaboratively with lawmakers to develop legislation that prioritizes patient well-being and aligns with the principles of compassion and justice.”

Kentucky NORML representatives worked closely with lawmakers and the Governor to pass the 2023 medical law, which is set to take effect on January 1, 2025.

Hawaii: Despite Law, Few People Are Having Their Cannabis Convictions Expunged

Honolulu, HI: Few Hawaiians have had their marijuana-related convictions expunged, despite the intentions of a 2020 law.

Under the law, those with low-level (possession of less than three grams of cannabis) convictions can petition the courts to have their records expunged. Criminal justice experts have estimated that 12,000 Hawaiians are eligible for relief under the law. However, fewer than 60 people have had their convictions expunged, according to reporting by Hawaii Public Radio.

In March, House lawmakers approved legislation, HB 1595, facilitating state-initiated expungements for anyone with a marijuana misdemeanor conviction on their record. However, members of the Senate Judiciary Committee significantly amended the bill. As amended, the legislation calls upon the state Attorney General’s office to initiate a marijuana expungement pilot program in a single county (Hawaii County). The Senate approved the amended bill earlier this month.

Since 2018, 24 states have enacted laws explicitly providing pathways for expunging eligible marijuana convictions. As a result, state courts have either expunged or sealed the records of more than two million marijuana-related cases, according to publicly available data compiled by NORML.

The full text of the report, Marijuana Pardons and Expungements: By the Numbers, is available from NORML.

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