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Analysis: Patients in Medical Cannabis States Report Improved Mental Health

Cambridge, United Kingdom: Patients suffering from chronic health conditions, particularly chronic pain, report improvements in their mental health following the adoption of medical marijuana access laws, according to data published in the journal Health Economics, Policy, and Law.

Researchers from Switzerland and the United Kingdom assessed the relationship between state-level medical marijuana laws and patients’ self-reported mental health over a 26-year period (1993-2018).

Investigators reported, “Eased access to marijuana through medical marijuana laws reduce the reported number of days with poor mental health for individuals [who] consume marijuana for medical purposes and for those individuals who likely suffer from frequent pain.”

State laws permitting patients to home-cultivate medical cannabis and allowing its use for a wide range of pain conditions were associated with the most significant improvements.

The study’s authors concluded: “Overall, our results are in line with the hypothesis that MMLs [medical marijuana laws] benefit those individuals for whom they are nominally designed without systematically harming other groups.”

Full text of the study, “Marijuana laws and mental health in the United States,” appears in Health Economics, Policy, and Law.

Marijuana Test Failures Continue To Drive Exodus From Commercial Trucking Industry

Washington, DC: Over 38,000 commercially licensed truck drivers failed federally mandated drug screens for marijuana in 2023 and many are not reapplying for work within the industry, according to data provided by the US Department of Transportation.

Additionally, nearly 13,000 drivers in 2023 failed to show up for their required drug tests – the highest number of refusals ever reported by the agency.

Federal law mandates commercially licensed drivers to undergo random marijuana urinalysis testing, which detects the presence of the inert carboxy-THC metabolite. This non-psychoactive metabolite is detectable in subjects’ urine for weeks or even months following past exposure. According to a report from the US Department of Justice, the detection of this metabolite “only indicates that a particular substance is present in the test subject’s body tissue. It does not indicate abuse or addiction; recency, frequency, or amount of use; or impairment.”

Since 2020, more than 139,000 commercially licensed drivers have failed mandatory drug tests for cannabis – far more than the total number of test failures for all other substances combined. Approximately 70 percent of drivers with drug test failures have not reapplied for work.

In a syndicated op-ed, NORML’s Deputy Director Paul Armentano called the federal drug testing mandates “antiquated” and argued that their enforcement is “exacerbating supply chain issues” in the trucking industry.

In 2023, the US Department of Transportation proposed changes to existing federal drug testing guidelines to allow oral fluid testing as an alternative to urinalysis for those working in the transportation industry. However, those changes have not yet been implemented.

Lawmakers in several states – including California and New York – have amended their laws so that most employers may not terminate workers solely based on a positive drug test for the presence of THC metabolites. However, those statewide protections do not apply to federally licensed workers.

Poll: Most Americans Say That Adults Should Be Able to Legally Grow Marijuana at Home

New York, NY: An estimated six in ten US adults believe that the home cultivation of cannabis for one’s personal use should be legally permissible, according to nationwide survey data compiled by Harris Polling on behalf of European cannabis company Royal Queen Seeds.

Among those respondents who consume cannabis, 81 percent support home cultivation rights. Sixty-two percent say that they would prefer to grow their own marijuana rather than buy it from retailers.

Of the 24 states that have legalized the adult-use marijuana market, only three states maintain criminal prohibitions on home cultivation.

NORML has long supported the rights of patients and others to grow personal use quantities of cannabis at home, arguing that the practice provides consumers with an affordable alternative to the retail marketplace.

Oregon: Governor Signs Legislation Halting Issuance of New Cannabis Licenses

Salem, OR: Democratic Gov. Tina Kotek has signed legislation (HB 4121) into law placing an indefinite hold on licenses for those seeking to enter the state’s commercial marijuana marketplace.

The law prohibits the state’s Liquor and Cannabis Commission from accepting any new cannabis production or retail license applications until there are significant increases in population growth.

Representatives from the state’s cannabis industry lobbied for the change, arguing that Oregon’s marijuana market is already oversaturated with nearly 3,000 licensed cannabis businesses.

Oregon voters approved a citizens’ initiated ballot measure in 2014 legalizing the adult-use marijuana market. Retail cannabis sales began the following year.

Compared to other states, Oregon imposes comparatively few regulatory barriers for establishing state-licensed marijuana businesses.

In 2022, Oklahoma lawmakers enacted legislation barring the establishment of any new medical cannabis-related businesses. That moratorium was extended in 2023. Oklahoma has more registered medical marijuana patients per capita than any other state.

Hawaii: Governor Offers Support for Greatly Expanding Medical Cannabis Access

Honolulu, HI: Democratic Gov. Josh Green wants to have regulators amend the state’s medical cannabis program so that far more Hawaiians can obtain access to marijuana products.

Governor Green supports permitting physicians to issue medical cannabis recommendations to any patient who may benefit from it, regardless of whether they suffer from a state-specific qualifying condition. He hopes regulators can expand the program without requiring legislative action.

State lawmakers legalized medical cannabis access for qualified patients in 2000. Approximately 31,000 residents are registered with the state to access cannabis products.

In recent years, lawmakers in several states—including Maine and Virginia—have enacted legislation providing doctors with greater flexibility to issue medical cannabis authorizations. Last week, Delaware lawmakers advanced a similar bill to the Governor’s desk. If enacted, that legislation will also permit those 65 or older to self-certify for a registration card absent a doctor’s recommendation.

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Study: Occasional Cannabis Use During Adolescence Not Associated With Cognitive Decline

Porto, Portugal: Subjects who engage in the occasional use of cannabis during their teens exhibit no significant changes in cognitive functioning in young adulthood, according to longitudinal data published in the journal Psychopharmacology.

Portuguese researchers assessed reward-related brain activity, psychopathology, and cognitive functioning in a cohort of cannabis consumers and controls. Subjects in the study were all cannabis naïve at age 14. Investigators then conducted follow-up investigations when subjects were 19 and 22 years of age.

Researchers did not identify any significant cognitive differences at age 22 between occasional cannabis consumers and abstainers.

“After cannabis use initiation, light CAN [cannabis users] and CON [controls] did not differ in internalizing psychopathology, cognitive functioning, or brain activity,” the study’s authors concluded. “Overall, future longitudinal studies should oversample participants with higher frequency of cannabis use and follow them through midlife to re-evaluate this pattern of findings.”

Other studies have similarly failed to identify significant changes in either brain morphology or IQ specifically attributable to adolescents’ cannabis use.

Full text of the study, “Light cannabis use and the adolescent brain: An 8-years longitudinal assessment of mental health, cognition, and reward processing,” appears in Psychopharmacology.

Review: Detection Of THC In Bodily Fluids Not Correlated With Impairment

Davis, CA: Neither the detection of THC nor its metabolites in blood, breath, urine, or saliva is predictive of behavioral impairment, according to a literature review published in the Journal of AOAC (the Association of Official Analytical Chemists) International.

Researchers affiliated with the University of California at Davis affirmed that there is “no direct relationship between impairment and THC concentrations” in subjects’ bodily fluids – a finding that is consistent with the opinions of numerous traffic safety groups, including the National Highway Traffic Safety Administration and the American Automobile Association.

The investigators further acknowledged, “Current methods that focus on THC and/or metabolite concentrations in blood, saliva, urine, or exhaled breath can lead to false-positive results for recent use due to the persistence of THC well outside of the typical 3-4-hour window of potential impairment following cannabis inhalation.”

Consequently, the study’s authors determined that per se traffic safety laws adopted in several states that criminalize drivers who test positive for trace levels of THC in their blood are “not supported by science,” and that they risk “wrongly accusing” motorists who are neither impaired nor have recently consumed cannabis.

Five states – Illinois, Montana, Ohio, Pennsylvania, and Washington – impose various per se limits for the detection of trace amounts of THC in blood while ten states (Arizona, Delaware, Georgia, Indiana, Iowa, Michigan, Oklahoma, Rhode Island, Utah, and Wisconsin) impose zero tolerant per se standards. In these states, it is a traffic safety violation to operate a vehicle with detectable levels of THC in blood – even absent any demonstrable evidence of psychomotor impairment.

NORML has long opposed the imposition of per se THC limits for motorists and has alternatively called for the expanded use of mobile performance technology like DRUID. In a peer-review paper published by the Humboldt Journal of Social Relations, NORML’s Deputy Director Paul Armentano wrote: “The sole presence of THC and/or its metabolites in blood, particularly at low levels, is an inconsistent and largely inappropriate indicator of psychomotor impairment in cannabis consuming subjects. … Lawmakers would be advised to consider alternative legislative approaches to address concerns over DUI cannabis behavior that do not rely solely on the presence of THC or its metabolites in blood or urine as determinants of guilt in a court of law. Otherwise, the imposition of traffic safety laws may inadvertently become a criminal mechanism for law enforcement and prosecutors to punish those who have engaged in legally protected behavior and who have not posed any actionable traffic safety threat.”

Full text of the study, “Complexity of translating analytics to recent cannabis use and impairment,” appears in the Journal of AOAC International.

Poll: Voters Strongly Support Letting States Make Their Own Marijuana Laws

Washington, DC: Voters favor permitting state governments to establish their own marijuana policies free from federal interference, according to polling data compiled by FTP Insights on behalf of the Coalition for Cannabis Policy, Education, and Regulation (CPEAR).

Pollsters surveyed likely voters’ attitudes in three states: Missouri, Ohio, and Wyoming.

Respondents in all three states – including majorities of Democrats and Republicans – strongly supported allowing states to set their own policies.

“The polling is straightforward – midwestern voters want autonomy to develop policies that work best for them,” said CPEAR’s Executive Director Andrew Freedman in a press release. “Voters understand the importance of having the right to choose what cannabis policies work best for them without interference from the federal government.”

He said the polling results show strong support among voters for proposed federal legislation, HR 6673, which exempts legal cannabis states from the federal Controlled Substances Act. The bill, sponsored by Ohio Republican David Joyce, currently has nine co-sponsors.

The poll’s results are consistent with those of prior surveys, which found that supermajorities of Americans believe that states should “be able to enact their own marijuana laws without interference from the federal government.”

Analysis: Labels of Hemp-derived Products Often Provide Misleading Information

Chicago, IL: The contents of hemp-derived cannabinoid products seldom match the information advertised on the products’ labels, according to a laboratory analysis conducted by the University of Chicago.

Of the 17 different hemp-derived flower products analyzed, fifteen contained lesser quantities of advertised cannabinoids (e.g., delta-8 THC, delta-10 THC, CBD). One sample contained no detectable level of cannabinoids.

Of the eight edible products analyzed, three contained no detectable levels of advertised cannabinoids. One product contained lower levels of advertised cannabinoids, while three contained higher quantities.

The findings are consistent with those of other studies reporting discrepancies in the contents of unregulated hemp-derived products.

“Most of the edible and plant cannabinoid products do not match their packaging and labeling,” the study’s author concluded. “This, in conjunction with the absence of regulations and safety testing, is a cause for concern for public safety as people (and minors) consume these products.”

Delta-8 THC and other cannabinoids present in commercially available hemp-derived products are typically produced following a chemical synthesis. Those engaged in manufacturing these products are not regulated and may use potentially dangerous household products to facilitate this process. Lab analyses of these unregulated products have repeatedly found that they contain lower levels of cannabinoids than what is advertised on the products’ labels. Some products have also been found to possess heavy metal contaminants and unlabeled cutting agents.

In 2022, 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.

The full text of the study, “The public safety risk of hemp products sold at unlicensed retailers,” appears in the Journal of Toxicology Current Research.

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Oklahoma: Lab Report Finds Medical Cannabis Less Potent Than Advertised

Oklahoma City, OK: Cannabis sold in medical dispensaries in Oklahoma frequently contains lower quantities of THC than are advertised on the products’ labels, according to reporting from NPR.

An independent laboratory analysis of 15 varieties of cannabis flower obtained at three dispensaries identified discrepancies between the products’ labels and their THC content. In each instance, the products’ advertised THC potency was inflated.

“The average reported THC level of the strains tested is about 24 percent, but the average measured THC number was just over 14 percent,” NPR reported.

Results from the lab analysis were provided to the Oklahoma Medical Marijuana Authority. The agency indicates that it is in the process of improving lab testing regulations and standards.

Oklahoma voters in 2018 approved a statewide ballot initiative permitting the licensed production and retail sale of cannabis for those with a physician’s authorization. The state currently has more licensed cannabis businesses per capita than any other medical-only jurisdiction.

Lab analyses of certain cannabis products sold in other states – including California, Colorado, and Washington – have identified similar incidences of THC inflation.

A recent analysis in the Journal of Cannabis Research of 107 flower samples obtained in California, Colorado, and Oregon reported that nearly 70 percent of the products over-labelled the THC content. However, the authors did not specify whether the samples came from state-licensed or unlicensed retailers.

Full text of the study, “Evaluation of dispensaries’ cannabis flowers for accuracy of labeling cannabinoids content,” appears in the Journal of Cannabis Research.

Analysis: Heavy Metals Present In Some Cannabis Vape Cartridges

Ontario, Canada: The use of certain cannabis vape cartridges may result in heavy metal exposure, according to an analysis of products available in the Canadian marketplace. The findings were presented at the spring meeting of the American Chemical Society.

Canadian scientists analyzed 41 products for heavy metals, including lead, cadmium, arsenic, and mercury. Several of the liquids in vape cartridges tested positive for metal contamination. In some instances, nano-sized particles were present prior to the products’ heating mechanism being turned on – suggesting that metal contaminants may be produced during the production process rather than during the products’ use.

Products obtained from unregulated producers were more likely than legally regulated products to contain elevated levels of heavy metals.

The findings are consistent with US data reporting that the use of some commercially available cannabis e-liquid devices may result in exposure to unwanted metals, including copper, nickel, and lead.

Third-party testing of unregulated delta-8 products and CBD vape cartridges has also identified the presence of heavy metals, including arsenic, chromium, and mercury.

Study: Opioid Maintenance Patients Frequently Report Using Cannabis In Place Of Other Drugs

Mannheim, Germany: Nearly sixty percent of people undergoing opioid maintenance treatment (OMT) use cannabis to reduce their cravings for other drugs, including heroin, according to survey data published in the journal European Archives of Psychiatry and Clinical Neuroscience.

German investigators assessed cannabis use trends in 118 subjects enrolled in OMT. Fifty-seven percent of respondents acknowledged consuming herbal cannabis, despite its use being a violation of the program’s rules.

Nearly half (45 percent) of cannabis consumers said that they used it “to reduce cravings for heroin,” and 24 percent acknowledged doing so to reduce cravings for cocaine. Respondents also reported using cannabis as a substitute for alcohol, benzodiazepines, and other controlled substances.

The study’s authors concluded: “A substantial proportion of patients using cannabis in our sample reported beneficial effects of cannabis use on craving for and use of other drugs, in many cases arguably more harmful substances. … [These results question whether] restricting cannabis use in general really promotes health in OMT patients. … Overall, our results suggest that cannabis should be considered as a strategy for harm reduction in OMT with the goal to reduce use of more dangerous drugs.”

The results of a 2021 study concluded that those in treatment for opioid use disorder who used cannabis were less likely to suffer from a non-fatal opioid overdose than were non-cannabis consumers. Other studies have reported that cannabis use is associated with greater opioid treatment retention rates and that it may mitigate opioid-related cravings among dependent subjects.

Full text of the study, “Does cannabis use substitute for opioids? A preliminary exploratory survey in opioid maintenance patients,” appears in the European Archives of Psychiatry and Clinical Neuroscience.

Washington: New Law Exempts Patients From Taxes When Purchasing Eligible Cannabis Products

Olympia, WA: Legislation (HB 1453) signed into law by Democrat Gov. Jay Inslee provides a tax break for patients who purchase certain cannabis products.

Under the new law, patients registered in the state’s voluntary medical cannabis access program are exempt from the state’s 37 percent excise tax when they purchase designated products. The exemption only applies to products designated ‘DOH (Department of Health) compliant.’ DOH-compliant products have undergone more rigorous safety testing than is typically required under state law.

The new law sunsets on June 30, 2029.

Most states minimize patients’ tax burdens when purchasing medical cannabis products.

Washington legalized medical marijuana access in 1998. State voters approved an initiative legalizing the adult-use marijuana market in 2012.

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