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Clinical Trial: Cannabis Oil Effective at Improving Sleep in Adults with Insomnia
Melbourne, Australia: The short-term use of plant-derived cannabis extracts is well-tolerated and effective in patients diagnosed with insomnia, according to placebo-controlled trial data published in the Journal of Sleep Research.
Australian researchers assessed the use of a proprietary cannabis oil product (Entoura-10:15) versus placebo in 29 subjects with chronic insomnia. Extracts contained 10mg of THC and 15mg of CBD. Participants consumed either extracts or placebo for a period of two weeks.
Investigators reported that those receiving cannabis extracts experienced improved sleep quality by up to 80 percent, and that "60 percent of participants no longer classified as clinical insomniacs at the end of the two-week intervention period."
They concluded: "Our short-term trial suggests Entoura 10:15 medicinal cannabis oil, containing THC:CBD 10:15 and lesser amounts of other CBs and naturally occurring terpenes, to be well tolerated and effective in significantly improving sleep quality and duration, midnight melatonin levels, quality of life, and mood within 2-weeks in adults with insomnia. … Long-term studies are needed to assess whether chronic medicinal cannabis intake can restore natural circadian rhythm without the need for ongoing cannabis intake."
The results are similar to those of a prior placebo-controlled clinical trial, published in 2021, that also reported that plant-derived cannabis extracts are "well tolerated and improve insomnia symptoms and sleep quality in individuals with chronic insomnia symptoms." Observational trials similarly report benefits in patients' sleep quality following the inhalation of cannabis flowers prior to bedtime.
Full text of the study, "Medicinal cannabis improves sleep in adults with insomnia: A randomized double-blind placebo-controlled crossover trial," appears in the Journal of Sleep Research.
Review: Cannabis Safe and Effective in Migraine Treatment
Fairfield, CA: The inhalation of cannabis flowers is effective and well-tolerated among patents with migraine, according to a systematic review of the literature published in the journal Cureus.
A team of researchers affiliated with the California Institute of Behavioral Neurosciences and Psychology reviewed nine recent studies involving over 5,600 subjects.
They reported: "All the studies showed encouraging findings on the therapeutic effects of medicinal marijuana in migraine treatment. Additionally, medical marijuana is well-tolerated with fewer side effects and is safe to use in migraine patients."
Authors concluded: "The studies demonstrated that medical marijuana has a significant clinical response by reducing the length and frequency of migraines. No severe adverse effects were noted. Due to its effectiveness and convenience, medical marijuana therapy may be helpful for patients suffering from migraines."
Survey data published earlier this year reported that an estimated one-third of patients suffering from headache disorders acknowledge using cannabis products for symptom management.
Full text of the study, "Efficacy and safety of medical marijuana in migraine headache: A systematic review," appears in Cureus.
Study: Oral Cannabis Products Show Long-Term Safety and Efficacy in Patients
Western Australia, Australia: Patients authorized to consume plant-derived oral cannabis products show sustained improvements in their symptoms, according to longitudinal data published in the journal PLOS One.
Researchers assessed the long-terms safety and efficacy of oral cannabis products in a cohort of nearly 4,000 Australian patients authorized to use them. Study participants were naïve to cannabis prior to their enrollment in the trial. The majority of the study's subjects (64 percent) suffered from chronic pain conditions. All of the study's participants consumed oral cannabis products for a period of two years.
Investigators reported: "This is the largest and longest real-world analysis of the efficacy and safety of GMP [good manufacturing practices]-like oral medicinal cannabis (MC) in a continuous enrolment cohort registry. 3,961 heterogenous, cannabis naïve patients with a wide range of ages, clinical and complex conditions, and concomitant medications, prescribed oral MC, demonstrated a rapid and significant improvement across all measured patient and clinical reported validated outcomes. … Oral MC was well tolerated. … This safety is particularly salient in contrast to the safety and tolerability of prescribed long-term opioids."
They concluded, "This large Australian longitudinal cohort registry of cannabis naïve, complex chronic disease patients treated with oral MC for over 24 consecutive months, demonstrates safety of oral generic medicinal cannabis, and demonstrated oral MC improves patient and clinician reported impact of pain, sleep and well-being."
An estimated 100,000 Australians have been prescribed cannabis products following the enactment of legal changes in 2016 providing patients with regulatory access to medical marijuana products.
Full text of the study, "A large Australian longitudinal cohort registry demonstrates sustained safety and efficacy of oral medicinal cannabis for at least two years," appears in PLOS One.
Study: No Adverse Events in Stroke Survivors Taking Cannabis Spray
Genova, Italy: The daily consumption of a proprietary oromucosal spray containing equal ratios of plant-derived THC and CBD (nabiximols aka Sativex) is not associated with cardiovascular complications in stroke survivors, according to clinical data published in the journal Frontiers in Cardiovascular Medicine.
A team of Italian researchers assessed the safety of nabiximols in a cohort of 34 spasticity patients that had previously suffered from strokes.
Investigators reported: "No cardiovascular treatment-emergent adverse drug effects emerged during nabiximols treatment, namely no significant fluctuation of blood pressure and heart rate, nor ischemic or hemorrhagic events occurred. During nabiximols treatment, self-assessed blood pressure and heart rate did not change compared to the baseline condition. No patients showed significant acceleration or decrease in heart rate or change in rhythm and none required an additional ECG or cardiological evaluation during the study."
They concluded, "These data support the cardiovascular safety of nabiximols."
Analyses of nationally representative samples of recreational marijuana consumers have reported inconsistent results regarding the relationship between cannabis and adverse cardiovascular events. A 2021 study of 57,000 US adults concluded, "After controlling for several confounding variables, we found that there was a decrease in the prevalence of cardiovascular events with marijuana use (Odds Ratio: 0.74)." By contrast, a 2020 review of nearly 134,000 US adults reported, "Frequent marijuana smoking is associated with significantly higher odds of stroke and myocardial infarction or coronary artery disease, with a possible role in premature cardiovascular disease."
More recently, the results of a literature review of 67 studies published in The American Journal of Medicine concluded, "[M]arijuana itself does not appear to be independently associated with excessive cardiovascular risk factors." Authors did caution, however, that "it can be associated with other unhealthy behaviors such as alcohol use and tobacco smoking that can be detrimental" to cardiovascular health.
Similarly, a separate review published last year of 46 randomized clinical trials involving 2,800 patients concluded that consumption of either purified or synthetic cannabinoids, including THC, is not associated with any increased risk of serious cardiovascular events.
Full text of the study, "Nabiximols effect on blood pressure and heart rate in post-stroke patients of a randomized controlled study," appears in the journal Frontiers in Cardiovascular Medicine.
New Mexico: Regulators Approve Changes Expanding Medical Cannabis Access
Santa Fe, NM: State regulators have expended the pool of patients eligible to access medical cannabis products to include those with anxiety disorders. Members of the New Mexico Medical Cannabis Advisory Board approved the policy expansion, which takes effect on January 1, 2023.
A pair of physicians petitioned regulators to expand the scope of the program, opining that alternatives to conventional medications are needed to address the needs of those with treatment-resistant anxiety disorders.
Survey data indicates that those who consume cannabis for purposes of self-medication are most likely to do so to mitigate symptoms of pain, anxiety, and to improve sleep.
According to data compiled by the state's Department of Health, over 130,000 New Mexicans are registered to access medical cannabis products.
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Study: Cannabis Products Associated with Quality of Life Improvements in Patients with Post-Traumatic Stress
London, United Kingdom: Patients with post-traumatic stress experience symptom improvements following the use of cannabis products, according to data published in the journal Expert Review of Neurotherapeutics.
British investigators assessed the safety and efficacy of cannabis products in 162 PTSD patients with a physician's authorization. Study subjects were participants in the UK Medical Cannabis Registry. Study participants consumed either cannabis extracts or THC-dominant flowers for a period of six-months.
Authors reported that patients showed "statistically significant improvements" in a variety of domains, including sleep, anxiety, and stress. Self-reported adverse events were typically mild in severity.
"This observational study suggests an association between CBMP [cannabis-based medicinal products] treatment and improvement in PTSD-specific, HRQoL [health-related quality of life], sleep, and anxiety outcomes at up to 6-month follow-up," they concluded. "CBMPs were well-tolerated and adverse events manageable. … [T]his study can serve to inform future randomized placebo-controlled trials with the aim of confirming these promising effects, whilst informing current clinical practice."
Observational studies assessing the role of cannabinoids in mitigating symptoms of PTSD have generally yielded mixed results. A 2021 clinical trial reported that the inhalation of marijuana flowers provided limited benefits compared to placebo in treating symptoms of PTSD.
Full text of the study, "Assessment of clinical outcomes in patients with post-traumatic stress disorder: Analysis from the UK Medical Cannabis Registry," appears in the journal Expert Review of Neurotherapeutics.
Analysis: Medical Cannabis Access Associated with Reduced Alcohol Sales
Ontario, Canada: The adoption of medical cannabis access in Canada was associated with reductions in alcohol sales, according to data published in the journal Health Policy.
A Canadian researcher evaluated the relationship between medical cannabis legalization and retail sales of alcohol in various regions of the country over an eight-year period.
The author determined: "This study found a significant negative association between legal medical cannabis sales and liquor store alcohol sales: each cannabis sales dollar was associated with an average alcohol sales reduction of between $0.74 and $0.84. The negative association was robust with respect to several alternative modeling choices."
He concluded, "From a public health perspective, the results likewise imply that reductions in alcohol-related health impacts might partly offset the increased cannabis-related health impacts that legalization might bring."
A 2017 analysis of US beverage sales identified a similar decline in alcohol sales following the adoption of statewide medical cannabis legalization laws, as did a 2021 assessment of Youth Risk Behavioral Survey data. By contrast, a more recent study evaluating the impact of adult-use legalization laws in the United States reported an association with increased alcohol use those age 21 and older.
Full text of the study, "Relationship between sales of legal cannabis and alcohol in Canada," appears in Health Policy.
Study: Consumption of Commercially Available CBD Products Associated with Perceived Improvements in Pain, Anxiety, Sleep, and Well-Being
Los Angeles, CA: Subjects who consume commercially available CBD products report improvements in their overall well-being as compared to those taking a placebo, according to data published in the journal Integrative Medicine Reports.
A team of investigators affiliated with the University of California, Los Angeles and with the Scripps Institute assessed the health and safety of 13 commercially available CBD products in a cohort of over 2,800 participants. Subjects were randomly assigned to consume either CBD or a placebo for a period of 4 weeks.
Researchers reported: "Well-being, anxiety, sleep disturbance, and pain significantly improved among those assigned to take a CBD product relative to waitlist controls. Among those assigned to a CBD product, the percentage of individuals with a given condition who experienced an improvement which could be considered clinically meaningful or important was 46.6 percent for anxiety; 47.9 percent for sleep disturbance, and 35.2 percent for pain. … [A]ll products in the study exhibited a favorable safety profile; no severe side effects were reported."
They concluded: "Our results suggest that the commercially available CBD products included in this study are safe and may serve as potentially effective complementary therapies for management of anxiety, sleep disturbance, and pain. These effects appear independent of the prior CBD use and product spectrum."
Prior analyses of commercially available CBD products have raised concerns about their purity and potency. Survey data compiled by the National Consumers League in 2020 determined that more than eight in ten US voters desire greater federal regulatory oversight over the labeling and marketing of commercially available CBD products.
Full text of the study, "The safety and effectiveness of commercially available cannabidiol products for health and well-being: A randomized, multi-arm, open-label waitlist-controlled trial," appears in Integrative Medicine Reports.
Review: Evidence Lacking for Supposed Cannabis 'Hangover' Effect
New South Wales, Australia: The majority of available data fails to support claims that cannabis may potentially impact either cognitive function or subjects' performance of safety sensitive tasks 24 hours after consumption, according to a review of the scientific literature published in the journal Cannabis and Cannabinoid Research.
A team of Australian researchers reviewed data from 20 studies involving 458 subjects. Selected studies assessed subjects' performance 12 to 24 hours following THC dosing.
Investigators failed to identify any evidence of so-called THC-specific "next-day effects" in 16 of the 20 studies reviewed.
They concluded: "A small number of lower-quality studies have observed negative (i.e., impairing) 'next day' effects of THC on cognitive function and safety-sensitive tasks. However, higher-quality studies, and a large majority of performance tests, have not. Overall, it appears that there is limited scientific evidence to support the assertion that cannabis use impairs 'next day' performance."
Authors further opined that the imposition of workplace drug testing policies that detect the long-term presence of cannabis metabolites and impose sanctions upon those who test positive for them are arguably not justified by the available data.
Full text of the study, "The 'next day' effects of cannabis use: A systematic review," appears in Cannabis and Cannabinoid Research.
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