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Analysis: Jurisdictions Permitting Adult-Use Retail Facilities Experience Employment Growth

Albuquerque, NM: Local jurisdictions that permit licensed marijuana operations experience job growth at higher rates than do localities that prohibit them, according to data published in the IZA Journal of Labor Economics.

A team of economists affiliated with the University of New Mexico and with California Polytech State University compared county-level economic data in Colorado between the years 2011 and 2018. They reported that unemployment fell in counties where dispensaries opened relative to counties in which they did not.

Authors reported, "[W]e find consistent evidence of a decrease in unemployment and increases in the number of employees in manufacturing."

They concluded: "Overall, the findings in this paper provide evidence that recreational cannabis dispensaries improved county-level labor market conditions in Colorado. ... Our results suggest that policymakers considering recreational access to cannabis should consider employment effects as a potential outcome from recreational cannabis legalization."

Separate studies have previously reported that marijuana retailers are positively associated with rising property values and reductions in certain types of localized criminal activities, such as larceny.

NORML's Deputy Director Paul Armentano said that the data should guide local city councilmembers when deciding whether to regulate marijuana-related retail activities in their jurisdictions. "Locally-elected officials must choose which sort of cannabis marketplace they want operating in their neighborhoods - an above ground, transparent, legally regulated marketplace or an underground illicit market. These data should reassure local politicians that licensing the marijuana marketplace provides economic benefits without compromising public health or safety."

Full text of the study, "The effects of recreational cannabis access on labor markets: Evidence from Colorado," appears in the IZA Journal of Labor Economics.

Study: Chronic Pain Patients Significantly Decrease Opioid Use Following Initiation of Medical Cannabis

Washington, DC: Chronic pain patients dramatically reduce their use of prescription opioids following their enrollment into a statewide medical cannabis access program, according to data published in the journal Cureus.

A team of investigators assessed opioid use trends in a cohort of 63 pain patients following their registration into Delaware's medical cannabis program. All 63 patients were using prescription opioids at the time of their enrollment.

Consistent with dozens of other studies, subjects significantly decreased their overall use of opioids over time.

Authors reported: "For non-outlier individuals with positive baseline opioid use before receiving medical marijuana certification (n=63), the average percent change in opioid use was found to be -31.3 percent. Examining subgroups based upon pain location, individuals with low back pain (n=58) displayed a 29.4 percent decrease in MME [morphine milligram equivalent] units, while individuals with neck pain (n=27) were observed to have a 41.5 percent decrease in opioid use. Similarly, individuals with knee pain (n=14) reduced their opioid use by 32.6 percent. ... Since the underlying pathology and their source of pain in the individuals was unlikely to significantly change during the period examined, medical marijuana use could have played a large role in allowing the individuals to decrease their opioid use."

They concluded: "The results of this study indicate that medical marijuana certification is associated with a decrease in prescription opiate use for chronic pain treatment and supports greater use of this adjunct treatment modality. Given the significance of opioid addiction in American society, any treatment or additional resource to reduce opioid overuse can aid in the multifactorial management of chronic pain. Although marijuana use causes a variety of side effects, the findings here suggest that the use of medical cannabis as an adjunct treatment for chronic pain may be beneficial to public health."

Full text of the study, "Medical cannabis certification is associated with decreases opiate use in patients with chronic pain: A retrospective cohort study in Delaware," appears in Cureus.

Analysis: Unregulated Delta-8 Vape Products Frequently Mislabeled, May Contain Heavy Metals

Rochester, NY: Delta-8 vapor products frequently contain heavy metals and are typically far less potent than advertised on the products' labeling, according to data published in the journal Chemical Research in Toxicology.

A pair of researchers affiliated with the University of Rochester, Department of Environmental Medicine assessed the purity of 27 e-cigarette products containing synthetically derived delta-8 THC.

Researchers determined that none of the products provided accurate labeling regarding delta-8 THC content - a finding that is consistent with prior research. They wrote, "Delta-8 THC levels can vary as much as 40 percent from the label value, suggestive of poor testing capabilities and falsified results."

Additionally, 11 of the products contained high levels of "unlabeled cutting agents," and all of the products tested positive for the presence of heavy metals - including magnesium, chromium, nickel, and mercury. Investigators suggested, "These metals are likely leachates from vaporizer components or production materials, and their inhalation could cause deleterious effects on the respiratory tract that stem from the generation of reactive oxygen species." Prior analyses of commercially available vapor cartridges have similarly identified the presence of metal contaminants following the use of the cartridges' heating mechanisms.

"Further chemical, pharmacological, and toxicological testing of these and similar products is necessary," authors concluded.

Although delta-8 THC appears organically in cannabis, it is only produced in minute amounts. By contrast, the elevated quantities of delta-8 THC in grey market products is the result of a chemical synthesis during which manufacturers convert CBD to delta-8 THC. Manufacturers engaged in synthetizing delta-8 THC are not regulated and often use potentially dangerous household products to facilitate this process.

In October, 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.

Full text of the study, "Novel delta-8 tetrahydrocannabinol vaporizers contain unlabeled adulterants, unintended byproducts of chemical synthesis, and heavy metals," appears in Chemical Research in Toxicology.

Oral THC Treatment Associated with Prolonged Survival Times in Palliative Outpatient Care Patients

Kleinmachnow, Germany: The administration of oral THC (e.g., dronabinol) is associated with prolonged survival times in patients with advanced illnesses who are at the end-stages of their lives, according to preliminary data posted online by a team of German researchers.

Investigators assessed the use of cannabis-based medicines in relation to survival times in a cohort of patients in Specialized Palliative Outpatient Care (SAPV). SAPV offers team-based home care for patients with advanced and progressive diseases whose life expectancies are limited to days, weeks or months.

Researchers reported, "The therapy with CBM [cannabis-based medicines] was associated with prolonged median survival ... from 44 to 65 days." Prolonged survival was most pronounced among female patients and those over 75 years of age.

Authors concluded, "From the available data, we can conclude that ... CBM therapy should be included as first line therapy for the patient groups considered due to the significant prolongation of survival time."

They added: "Due to the pressing relevance of our observations for palliative care patients, we are making the preliminary data from our ongoing retrospective study available in this pre-publication. Based on the current trend in the evaluation, we consider that patients could promptly benefit from a low and slowly increasing dose."

A summary of the data, "Cannabis-based medicines prolong survival time in patients under Specialized Palliative Outpatient Care," is available online.

European Island Nation of Malta Moves to Depenalize Marijuana Possession

Valletta, Malta: Lawmakers in the island nation of Malta (population 525,000) have approved legislation permitting the personal possession of marijuana by adults without penalty.

Members of Parliament voted in favor of the legislation Tuesday and it is expected to be signed into law imminently. Under the measure, those ages 18 and older may legally possess up to seven grams of cannabis and/or home-cultivate up to four plants for personal use. (Up to 50 grams of homegrown flower may be legally stored at home.) Possessing higher amounts will trigger civil fines.

The measure does not formally regulate the commercial cannabis marketplace, but it does permit not-for-profit cooperatives to provide personal use quantities of cannabis flowers and seeds to their members.

The nation's President is anticipated to sign the legislation into law as soon as this weekend.

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Congress: Bipartisan Legislation Introduced to Facilitate Expungements for Those with State-Level Cannabis Convictions

Washington, DC: Representatives Dave Joyce (R-OH) and Alexandria Ocasio-Cortez (D-NY) have introduced legislation to incentivize state and local governments to expunge the criminal records of those who have previously been convicted of marijuana offenses.

Their bill, entitled The Harnessing Opportunities by Pursuing Expungement (HOPE) Act, seeks to appropriate $20 million to the US Attorney General for the purposes of financially assisting states and local governments with the process of reviewing and expunging cannabis convictions.

"This bipartisan effort represents the growing consensus to reform marijuana policies in a manner that addresses the harms inflicted by prohibition," said NORML Political Director Justin Strekal. "It provides cash assistance for states and localities that are wisely choosing to remove these stigmatizing records. There is no justification for continuing to prevent tens of millions of Americans from fully participating in their community and workforce simply because they bear the burden of a past marijuana conviction."

Legislatures in over a dozen states have enacted laws explicitly facilitating the expungement of low-level cannabis convictions. State officials have vacated an estimated 2.2 million marijuana-related convictions under these laws over the past two years.

"Having been both a public defender and a prosecutor, I have seen first-hand how cannabis law violations can foreclose a lifetime of opportunities ranging from employment to education to housing," said Rep. Dave Joyce. "By helping states establish and improve expungement programs for minor cannabis offenses, the HOPE Act will pave the way for expanded economic opportunities to thrive alongside effective investments to redress the consequences of the War on Drugs."

Representative Alexandria Ocasio-Cortez added, "As we continue to advocate for the decriminalization and legalization of marijuana, this bipartisan bill will provide localities the resources they need to expunge drug charges that continue to hold back Americans, disproportionately people of color, from employment, housing and other opportunities."

To contact your lawmakers in support of The HOPE Act, please visit NORML"s Take Action Center.

Analysis: Cannabis Use Not Associated with Increased Risk of Adverse Perioperative Outcomes

Ottawa, Canada: Surgery patients with a history of moderate cannabis use are no more likely to experience adverse perioperative outcomes than are those with no history of use, according to data presented at the 2021 Meeting of the American Society of Regional Anesthesia and Pain Medicine.

Canadian researchers assessed surgical outcomes among a cohort of cannabis users and non-users at a single institution over a 14-month period. After controlling for potential confounders – such as age, sex, and surgery type – investigators identified no statistically significant differences among the two patient groups.

"Our results do not demonstrate a convincing association between self-reported cannabis use and either major surgical outcomes or [post-operative] pain management," one of the study's researchers told Anesthesiology News.

In some US jurisdictions, patients with a history of medical cannabis use have been denied access by hospitals to certain surgical procedures, like organ transplants, despite any evidence indicating that they are at higher risk for experiencing adverse outcomes.

Separate analyses have previously identified a correlation between patients with a history of cannabis use and lower in-hospital mortality among those with COPD, congestive heart failure, cancer, pancreatitis, HIV, burn-related injuries, traumatic brain injuries, and other types of severe trauma.

A poster of the study, "Effect of preoperative cannabis use on perioperative outcomes: A retrospective cohort study," is available online.

National Poll: Marijuana Legalization Supported by Majorities of All Age Groups

Washington, DC: Majorities of those ages 18 and older say that "the recreational use of marijuana should be made legal in the United States," according to nationwide polling data compiled by YouGov America.

Overall, 57 percent of respondents backed legalization, while 27 percent opposed it. Support was strongest among Democrats (70 percent), those respondents between the ages of 25 and 44 years old (62 percent), and Independents (61 percent).

Only 40 percent of Republican respondents who participated in the survey endorsed legalization. Forty-four percent opposed it.

The polling data is consistent with prior surveys showing majority support for legalizing cannabis among US adults, though recent polls by Gallup and others have identified greater levels of public support.

Study: Inhalation of CBD-Dominant Cannabis Does Not Negatively Influence Fitness to Drive

Bern, Switzerland: The inhalation of CBD-dominant cannabis flowers does not influence subjects' reaction time, concentration, balance, time perception, or other skills associated with driving ability, according to data published in the journal Forensic Sciences Research.

A team of Swiss researchers assessed the influence of either CBD-dominant cannabis (16.6 percent CBD and 0.9 percent THC) or placebo on a variety of neurocognitive and psychomotor skills. Researchers observed "no symptoms of impairment" and "no significant impact on driving ability" in study subjects who inhaled CBD-dominant cigarettes.

Despite showing no impairment of performance, several subjects did nonetheless test positive for trace levels of THC in their blood 45 minutes after smoking. Authors cautioned that subjects' elevated THC levels would place them in violation of certain traffic safety per se laws that criminalize the operation of a motor vehicle with detectable quantities of THC or THC metabolites in the driver's bloodstream.

Numerous studies have confirmed that the presence of THC in blood is not predictive of psychomotor impairment. As a result, NORML opposes the imposition of THC per se thresholds for cannabinoids in traffic safety legislation, opining: "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, "Impact of smoking cannabidiol (CBD)-rich marijuana on driving ability," appears in Forensic Sciences Research.

Survey: IBD Patients Frequently Report Using Medical Cannabis

San Juan, Puerto Rico: More than a quarter of patients diagnosed with Inflammatory Bowel Disease report having used cannabis therapeutically, according to survey data published in the Puerto Rico Health Sciences Journal.

A team of investigators affiliated with the University of Puerto Rico School of Medicine surveyed IBD patients about their use of medical marijuana. Medical cannabis products are legal in Puerto Rico for patients with certain inflammatory bowel diseases, such as Crohn's.

Twenty-seven percent of survey respondents affirmed having consumed cannabis for medical purposes. The majority of those who did so (68 percent) said that cannabis improved their symptoms. Most (78 percent) did not discuss their cannabis use with their primary care physician.

The findings are consistent with those of other surveys showing that a significant percentage of IBD patients acknowledged using cannabis and gaining relief from it.

Full text of the study, "Knowledge, perception, and use of cannabis therapy in patients with Inflammatory Bowel Disease," appears in the Puerto Rico Health Sciences Journal.

Analysis: Plant-Derived Cannabinoids Provide Relief from Neuropathic Pain

Los Angeles, CA: The use of either herbal cannabis or medicines containing plant-derived cannabinoids is associated with significant reductions in patients' neuropathic pain, according to a review of placebo-controlled clinical trial data published in the Journal of Dental Anesthesia and Pain Medicine.

Researchers with the University of Southern California reviewed data from 17 placebo-controlled clinical trials involving 861 neuropathic pain patients. Patients in the trials consumed a variety of cannabis-related products, including whole-plant cannabis, plant-derived cannabis medicines (e.g., Sativex), oral CBD, and/or synthetic cannabinoids (e.g., dronabinol).

Authors reported that patients receiving either whole-plant cannabis containing THC or plant-derived medicines containing both THC and CBD received significant improvements in pain intensity, while subjects administered other cannabinoids (e.g., CBD and CBDV) and/or synthetic cannabinoids (e.g., dronabinol and CT-3) did not. Most commonly reported side-effects among patients in the trials were anxiety, sedation, and dizziness.

Investigators concluded, "THC/CBD and THC interventions provide statistically significant improvements in pain intensity in NP patients and [are] more likely to provide a 30 percent reduction of NP [neuropathic pain] when smoked or vaped at different concentrations (3.56 percent to 9.4 percent THC) or using a spray (THC 2.5-2.7 mg and CBD 2.5 mg per 100mL) compared to placebo. … Additional long-term studies with more uniform study parameters are needed to achieve more clinically relevant recommendations."

Full text of the study, "Efficacy of cannabis-based medications compared to placebo for the treatment of chronic neuropathic pain: A systematic review with meta-analysis," appears in the Journal of Dental Anesthesia and Pain Medicine.

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Analysis: Marijuana Legalization Associated with Improved Clearance Rates for Violent Crimes

Salt Lake City, UT: The legalization of marijuana is associated with improvements in police clearance rates for multiple types of violent crimes, according to data published online ahead of print in The International Journal of Drug Policy.

A pair of researchers affiliated with the University of Utah and the University of China assessed trends in crime clearance rates in Oregon versus control states in the years prior to and immediately following the enactment of adult-use legalization.

Investigators identified "significant increases in the clearance rate for overall violent crimes and for aggravated assault in Oregon counties relative to those in non-legalized states following legalization." They concluded, "The finding largely aligns with the argument made by the proponents of marijuana legalization that legalization would improve police effectiveness in addressing serious crimes, and as a result would increase clearance rates and generate a crime deterrence effect."

Their findings are consistent with those of a prior study documenting improved crime clearance rates in Colorado and Washington following legalization, particularly for violent crimes and property crimes.

Commenting on the study's findings, NORML's Deputy Director Paul Armentano said: "These conclusions reaffirm the notion that states can sensibly regulate the adult use and sale of cannabis in a manner that doesn't adversely impact public safety. Moreover, in some cases, legalization may contribute to an environment that positively affects police officers' performance in solving serious crimes."

Full text of the study, "Effect of recreational marijuana legalization on clearance rates for violent crimes: Evidence from Oregon," appears in The International Journal of Drug Policy.

Clinical Trial: CBD Cigarettes Associated with Reductions in Antipsychotic Medications in Patients with Schizophrenia

Basel, Switzerland: The adjunctive use of CBD is associated with a reduction in patients' use of antipsychotic medicines, according to placebo-controlled trial data published in the journal Frontiers in Psychiatry.

An international team of researchers from Canada, Switzerland, and Germany assessed the use of CBD cigarettes versus placebo in a cohort of acutely psychotic patients with schizophrenia or other psychotic disorders. Patients received either CBD or a placebo daily for 28 days in addition to their standard treatments.

Investigators reported that both CBD and placebo were associated with similar reductions in psychotic symptoms and depression, but that those participants who consumed CBD cigarettes used fewer antipsychotic medication during treatment. Conversely, those in the placebo group increased their use of prescription medications.

They concluded: "The main group effects in the discontinuous multilevel model were higher subjective well-being and less overall antipsychotic medication use throughout the acute therapy for the CBD-group. These results may suggest an antipsychotic medication sparing effect of CBD-cigarettes as adjunctive therapy in acutely psychotic patients. ... However, future studies with more rigorous study designs and larger samples are needed."

CBD administration is established to have anxiolytic and antipsychotic effects in human subjects, and its use is associated with changes in brain activity that may lower some people's risk of a psychotic episode. Previously published clinical trial data indicates that the daily administration of high doses of CBD (1,000mg) reduces psychotic symptoms in patients with schizophrenia in a manner that is superior to the prescription antipsychotic agent amisulpride.

Full text of the study, "Cannabidiol cigarettes as adjunctive treatment for psychotic disorders – A randomized, open-label pilot study," appears in Frontiers in Psychiatry.

South Dakota: State's Supreme Court Strikes Down Adult-Use Marijuana Vote

Pierre, SD: Justices on the South Dakota Supreme Court ruled 4 to 1 last week to strike down a voter-approved initiative (Constitutional Amendment A) legalizing the adult-use possession and sale of cannabis.

"Legalization opponents cannot succeed in the court of public opinion or at the ballot box," NORML's Deputy Director Paul Armentano said. "Thus, they are now petitioning the courts to overturn the will of the people. Whether or not one supports marijuana legalization, Americans should be deeply concerned by this trend and by the outcome of this case."

Fifty-four percent of South Dakota voters decided on Election Day in favor of the ballot measure. However, shortly following the vote, Republican Gov. Kristi Noem facilitated litigation seeking to strike down the law as unconstitutional. In February, Judge Christina Klinger of the state's Sixth Judicial Circuit Court ruled in favor of the challenge - opining that the amendment violated state requirements that ballot measures not encompass more than one topic. Last week, the majority of the Supreme Court affirmed her ruling, opining that the amendment "violated the single subject requirement in the South Dakota Constitution."

The decision marks the second time this year that a state Supreme Court has nullified the result of a statewide vote legalizing the use of cannabis. In May, justices of the Mississippi Supreme Court ruled 6 to 3 to nullify Initiative 65, which sought to regulate medical cannabis access in the state. Seventy-three percent of Mississippi voters had approved the measure on Election Day.

Over the past year, political opponents of marijuana law reform have been more frequently turning to the courts in efforts to either repeal cannabis-related votes or to stop them from taking place. In Nebraska, members of the state Supreme Court struck down a 2020 ballot initiative months after it had been approved by the Secretary of State's office. Polling in the state showed that 77 percent of Nebraskans backed the proposal. More recently, Florida's Republican attorney general successfully brought suit to preemptively deny a proposed 2022 legalization initiative from appearing on the ballot.

South Dakota voters last November also decided in favor of a separate ballot measure (Measure 26) regulating medical marijuana access by qualified patients. State lawmakers have not challenged that law from taking effect.

Proponents behind Amendment A have already taken steps to place a new legalization measure before voters in 2022. Some state lawmakers are also recommending that the legislature implement legalization legislation next year.

A summary of the decision is available online from the Supreme Court of South Dakota.

Study: Cannabis Use History Inversely Associated with Common Stomach Infection

Pittsburgh, PA: The use of cannabis is associated with a decreased risk of Helicobacter Pylori infection (HPI) – a bacterial stomach infection that can be associated with abdominal pain, weight loss, and ulcers. HPI is relatively common in adults worldwide, though many people with it do not experience severe symptoms.

A team of investigators from the United States and Canada assessed the relationship between cannabis use and an HPI diagnosis in a nationally representative cohort of 4,556 subjects.

They reported that subjects with no prior use of cannabis were nearly twice as likely to have HPI as compared to subjects with a history of marijuana use, even after authors adjusted for demographic confounders and comorbidities.

They concluded: "Recreational cannabis use is associated with diminished risk of HPI. These observations suggest the need for additional research assessing the effects of medical cannabis formulations on HPI."

Separate studies have shown that cannabis can provide relief to patients with a variety of gastrointestinal disorders, including IBS, Crohn's disease, while preclinical data indicates that cannabinoids can inhibit the development of gastric ulcers.

Full text of the study, "Relationship between recreational cannabis use and Helicobacter pylori infection," appears in Cannabis and Cannabinoid Research.

Study: Maternal Cannabis Use Not Linked to Higher Risk of Autism in Children

Aurora, CO: Mothers with a history of consuming cannabis in the months prior to or during pregnancy do not possess a greater likelihood of having children with autism spectrum disorder (ASD), according to data published in the Journal of Autism and Developmental Disorders.

A team of researchers with the University of Colorado, School of Public Health assessed whether mothers with a self-reported history of maternal cannabis use are more likely to give birth to children with either ASD or development disorders. They reported that mothers with a history of marijuana use were no more likely than non-users to have children with either autism or developmental delays by age five.

Other studies have shown inconsistent results with respect to in utero cannabis exposure and certain neonatal outcomes, including birth weight and certain behavioral outcomes.

Full text of the study, "Per-pregnancy cannabis use and autism spectrum disorder in the offspring: Findings from the study to explore early development," appears in the Journal of Autism and Developmental Disorders.

FDA: No Regulations on OTC CBD Products Forthcoming

Washington, DC: Nearly three years following the passage of federal legislation legalizing hemp production, the US Food and Drug Administration (FDA) has yet to promulgate rules regulating the marketing and sale of commercial products containing hemp-derived CBD.

Speaking last month at the National Industrial Hemp Business Summit in Washington, DC, FDA representative Gail Sipes said that the agency cannot move forward with regulations without more data on the safety of CBD products. She reiterated the agency's position that companies which market CBD-infused products as either food products or as dietary supplements are violating the Food, Drugs, and Cosmetics Act.

NORML and other groups have urged the FDA to provide regulatory guidelines overseeing the production, testing, labeling, and marketing of hemp-derived CBD products. Analyses conducted by the FDA and others have consistently reported that many over-the-counter (OTC) CBD products are of variable quality and potency, and that they may contain contaminants or elevated levels of heavy metals.

Survey data compiled last year by the National Consumers League reported that more than eight in ten US voters desire greater federal regulatory oversight over the labeling and marketing of commercially available CBD products.

In a report provided by the FDA to Congress in 2020, the agency said that regulating OTC CBD products presents unique challenges because the substance is already available as a FDA-approved medicine (Epidiolex).

Additional information is available from the NORML fact sheet, "FAQs About Cannabidiol (CBD)."

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