Analysis: Cannabis Consumers Possess Reduced Risk of Type 2 Diabetes
Tabriz, Iran: Adults with a history of cannabis use are less likely than non-consumers to develop type 2 diabetes, according to data published in the journal Phytotherapy Research. A team of Iranian investigators performed a meta-analysis of the relevant literature, including 11 surveys and four cohorts consisting of more than 478,000 subjects. They reported, “[T]he odds of developing T2DM [type 2 diabetes] in individuals exposed to cannabis was 0.48 times lower than in those without cannabis exposure.”
Authors speculated that cannabis may possess “protective effects” against the development of diabetes, but they cautioned against drawing any definitive conclusions absent additional studies.
“To our knowledge, our meta-analysis presents the … most up-to-date evidence on the association between cannabis consumption and T2DM,” they concluded. “Given the rising trend of cannabis consumption, and legalization of cannabis consumption there is an increasing need to design prospective longitudinal randomized studies investigating the honest effects of cannabis consumption and providing practical guidelines to manage cannabis usage.”
Several prior observational studies have identified a correlation between cannabis use and lower odds of obesity and adult-onset diabetes, while clinical trial data has shown that the administration of THCV is associated with improved glycemic control in type 2 diabetics. Placebo-controlled trial data published earlier this year reported that the use of plant-derived cannabinoid extracts significantly improves blood sugar and cholesterol levels in diabetic subjects.
Full text of the study, “Association between cannabis use and risk of diabetes mellitus type 2: A systematic review and meta-analysis,” appears in Phytotherapy Research. Additional information on cannabinoids and diabetes is available from NORML’s publication, Clinical Applications for Cannabis and Cannabinoids.
Study: Users of Non-Prescription Opioids Frequently Turn to Cannabis to Reduce Drug Cravings
Vancouver, Canada: Those who consume unregulated opioids frequently report using cannabis to mitigate their drug cravings, according to data published in the International Journal of Drug Policy.
Canadian investigators assessed cannabis use trends among a cohort of 205 consumers of non-prescription opioids. Many of the cohort were IV drug users and at-risk youth.
Nearly half of the study’s participants (45 percent) acknowledged using cannabis to manage opioid cravings. Of those, 62 percent “reported self-assessed decreases in opioid use during periods of cannabis use.” Subjects suffering from chronic pain were most likely to engage in opioid substitution.
Authors concluded: “In the present study, we observed that cannabis use to manage opioid cravings was significantly associated with self-assessed decreases in opioid use during periods of cannabis use among a structurally marginalized population of PWUD [people who use unregulated opioids]. The sub-analysis indicated that this association was mainly driven by those living with moderate to severe pain. … This suggests that future studies of cannabis substitution for opioid use should measure and analyze the impact of pain, as not doing so may lead to equivocal findings when the effects of cannabis substitution may vary based on the prevalence of chronic pain.”
Although numerous studies indicate that patients typically decrease their use of prescription opioids after initiating cannabis therapy, data regarding the relationship between cannabis use and non-prescription opioids is less consistent. According to a 2020 review paper: “Growing pre-clinical and clinical evidence appears to support the use of cannabis … to combat OUD [opioid use disorder]. The evidence summarized in this article demonstrates the potential cannabis has to ease opioid withdrawal symptoms, reduce opioid consumption, ameliorate opioid cravings, prevent opioid relapse, improve OUD treatment retention, and reduce overdose deaths. … The compelling nature of these data and the relative safety profile of cannabis warrant further exploration of cannabis as an adjunct or alternative treatment for OUD.”
Full text of the study, “Cannabis use to manage opioid cravings among people who use unregulated opioids during a drug toxicity crisis,” appears in the International Journal of Drug Policy. Additional information is available from the NORML Fact Sheet, ‘Relationship Between Marijuana and Opioids.’
Analysis: Cannabis Use Doesn’t Negatively Impact Survival Outcomes in Liver Transplant Patients
Ottawa, Canada: A history of cannabis use is not negatively associated with survival rates among patients receiving liver transplants, according to data published in the Canadian Liver Journal.
Canadian researchers reviewed the relevant literature on cannabis use and transplantation survival rates. Eight studies involving over 5,500 subjects were included in the review.
Authors determined, “[C]annabis use has not been associated with poor patient outcomes in terms of 1-, 3-, and 5-year patient survivals. Therefore, liver transplant candidates who use cannabis should not be denied access to transplantation.”
Their findings are consistent with those of several other studies concluding that marijuana use is not contraindicated in patients receiving organ transplants. Nonetheless, in several states – including some states that permit medical cannabis access – those with a history of marijuana use are ineligible to receive organ transplants.
Full text of the study, “Review of liver transplantation candidacy and outcomes among patients who use cannabis,” appears in the Canadian Liver Journal.
Missouri: County Officials Expunge Over 70,000 Marijuana Convictions
Columbia, MO: County officials have expunged over 70,000 marijuana-related convictions, including more than 10,000 felonies, since December, according to an update provided by NORML Board of Directors Member Dan Viets.
Viets is a co-author of Missouri’s citizens-initiated adult-use marijuana law and he served as Advisory Board Chair to the successful Legal Missouri 2022 campaign.
Provisions in the law, which took effect on December 8, 2022, required officials to expunge all eligible marijuana-related misdemeanor convictions by June 8, 2023.
Viets said that some counties had failed to make a “good faith effort” to meet the June deadline. He indicated that advocates may seek an order from the Missouri Supreme Court to compel certain counties to comply with the mandate.
Twenty-four states and the District of Columbia have enacted laws providing explicit pathways to either expunge (or otherwise set aside) the records of those with low-level marijuana convictions. This month, officials in Minnesota are beginning the process of reviewing and expunging an estimated 66,000 low-level cannabis convictions. According to publicly available data compiled by NORML, state and local officials have issued over 100,000 pardons and more than 1.7 million marijuana-related expungements since 2018.
The full text of NORML’s report, Marijuana Pardons and Expungements: By the Numbers, is available online. Additional information is available from Missouri NORML. Dan Viets may be contacted directly at danviets@gmail.com or by phone at (573) 819-2669.
Clinical Trial: Plant-Derived CBD Effective in Patients with Gastroparesis
Rochester, MN: Patients with gastroparesis (partial stomach paralysis) respond favorably to a proprietary spray (Epidiolex) containing plant-derived CBD, according to placebo-controlled data published in the journal Clinical Gastroenterology and Hepatology.
Investigators affiliated with the Mayo Clinic in Minnesota compared Epidiolex versus a placebo in 44 patients with gastroparesis. Subjects consumed either CBD or a placebo for a period of four weeks.
Researchers reported, “Our study shows that pharmaceutical grade CBD provides symptom relief in patients with idiopathic or diabetic gastroparesis with reduced total GCSI-DD [Gastroparesis Cardinal Symptom Index Daily Diary] scores and severity of symptoms, including reduced inability to finish a normal meal, number of vomiting episodes, in addition to greater tolerance of food intake at comfortable fullness.”
Authors concluded: “In summary, in patients with well documented idiopathic or diabetic gastroparesis, pharmaceutical-grade CBD can be administered safely for a period of four weeks and results in significant improvements in symptoms of gastroparesis. … These encouraging results suggest that further multicenter, larger, randomized, controlled trials of longer term in both idiopathic and diabetic gastroparesis are warranted.”
Studies have previously reported that cannabis can reduce gastroparesis-related abdominal pain, and that gastroparesis patients with a history of marijuana use possess “better hospitalization outcomes, including decreased length of stay and improved in-hospital mortality” as compared to those with no history of recent use.
Epidiolex has been FDA-approved since 2018 for the treatment of two rare forms of severe epilepsy: Lennox-Gastaut syndrome and Dravet syndrome.
Full text of the study, “A randomized, controlled trial of efficacy and safety of cannabidiol in idiopathic and diabetic gastroparesis,” appears in Clinical Gastroenterology and Hepatology. Additional information on cannabis and gastrointestinal disorders is available from NORML’s publication, Clinical Applications for Cannabis & Cannabinoids.
Study: THC/CBD Spray Effective for Patients with Refractory Back and Neck Pain
Sydney, Australia: The oral administration of a cannabinoid spray containing standardized ratios of THC and CBD produces clinically significant reductions in pain among patients with chronic back and neck pain, according to open-label trial data published in the journal Medical Cannabis and Cannabinoids.
Australian researchers assessed the safety and efficacy of an oromucosal spray containing 10 mg of THC and 25 mg of CBD in a cohort of 28 patients with moderate to severe back or neck pain. Participants in the study were unresponsive to over-the-counter non-opioid analgesics. Patients administered escalating doses of the spray daily for four weeks.
Investigators documented decreases in patients’ pain at even the lowest doses. Patients experienced further reductions in pain and improvements in mood in a dose-dependent manner over the course of the trial. Overall, side-effects from the spray were mild and well-tolerated.
“There were significant reductions in pain [at] all doses,” authors concluded. “There was also a reduction in pain interference in all domains including general activity, mood, walking ability, normal work, relationships, sleep, and enjoyment of life by dose.”
Australian law permits physicians to authorize cannabis products to patients unresponsive to conventional prescription treatments.
Full text of the study, “Tolerability and efficacy of a 10:25 preparation of delta-9-tetrahydrocannabinol and cannabidiol for treatment of chronic back or neck pain: A multiple-dose escalation study,” appears in Medical Cannabis and Cannabinoids. Additional information on cannabis and chronic pain is available from NORML’s publication, Clinical Applications for Cannabis & Cannabinoids.
Luxembourg: Law Permitting Adult-Use Cannabis Cultivation, Possession Takes Effect
Luxembourg City, Luxembourg: Legislation permitting the limited possession and cultivation of cannabis in private took effect late last week in the European nation of Luxembourg.
Under the new law, those 18 or older may legally cultivate up to four cannabis plants in a private household. Home grows may not be visible to the public.
By contrast, consuming cannabis in public remains criminalized, as does the public possession of more than three grams of marijuana. Home grows of more than four plants are also subject to criminal penalties.
Officials say that the new policy is the first step in what they anticipate will be additional future reforms loosening the nation’s marijuana laws.
In 2021, the European nation of Malta similarly approved legislation permitting the possession and home cultivation of personal use quantities of cannabis.
Analysis: Cannabis Use Not Associated with Increased Risk of Either High Blood Pressure or Hypertension
San Diego, CA: A history of marijuana use is not associated with an increased risk of either high blood pressure or hypertension, according to data published in the American Journal of Hypertension.
Researchers affiliated with the University of California at San Diego assessed the relationship between cannabis consumption and blood pressure/hypertension in a nationally representative sample of nearly 10,000 middle-aged adults.
They determined that those with a history of using cannabis for the past year had no higher risk of either high blood pressure or hypertension as compared to non-users.
The study’s authors concluded: “A history of monthly cannabis use for more than one year was not independently associated with either increased blood pressure or prevalent hypertension in a study using a nationally representative sample of middle-aged US adults. Moreover, no significant associations were observed for duration of monthly use, recency, or frequency of recent use. The lack of association found in the present study contributes to the observational evidence suggesting frequent cannabis use over decades may not be associated with increased blood pressure or hypertension in middle aged US adults.”
A prior analysis of over 91,000 French subjects, published in February in the journal Nature: Scientific Reports, reported that both current and lifetime cannabis use is associated with lower blood pressure. Israeli data, published in the European Journal of Internal Medicine, reported that the use of medical cannabis products was associated with decreases in hypertension among elderly subjects.
Full text of the study, “Trends in cannabis use, blood pressure and hypertension in middle-aged adults: Findings from NHANES: 2009-2018,” appears in the American Journal of Hypertension. Additional information on cannabis and hypertension is available from NORML’s publication, Clinical Applications for Cannabis & Cannabinoids.
