Tag: Media

Federal: Language Facilitating Medical Cannabis Access for Veterans Included in Senate, House Versions of Military Spending Bill

Washington, DC: Members of the US Senate and the House of Representatives have approved amendments allowing physicians affiliated with the Department of Veterans Affairs to recommend medical cannabis to qualified patients in jurisdictions that regulate its use.

Federal regulations currently preclude physicians associated with the Veterans Affairs Department from filling out the paperwork necessary to issue a state-authorized medical marijuana recommendation. The pending language amends these rules so that no federal funds may be used to prohibit physicians from engaging in the medical marijuana authorization process.

The new provisions are included in the House and Senate versions of a much broader legislative package, the Military Construction, Veterans Affairs, and Related Agencies Appropriations Act. However, because the two chambers have approved differing versions of the Act, members must still reconcile the language of the two bills. That process typically takes place in a conference committee.

In prior years, lawmakers have removed similar cannabis reform language from the Military Construction bill during the conference committee process.

Lawmakers are anticipated to take further action on the Act shortly after reconvening from their August recess.

Study: Medical Cannabis Associated With Health-Related Quality of Life Improvements, Reduced Opioid Use Among Patients With Substance Use Disorders

London, United Kingdom: Patients diagnosed with substance use disorders (SUD) report improved sleep quality, reduced anxiety, and decreased opioid use following the sustained use of medical cannabis products, according to observational data published in the journal European Addiction Research.

British investigators assessed the use of cannabis-based medicinal products (CBMPs) in SUD patients enrolled in the UK Medical Cannabis Registry. (British health care providers may prescribe cannabis-based medicinal products to patients unresponsive to conventional medications.) More than half (53 percent) of the participants suffered from an opioid use disorder. Patients’ outcomes were assessed at one, three, and six months.

“[T]herapy with CBMPs in patients with SUDs was associated with improvements in [patients’] anxiety, sleep quality and HRQoL [health-related quality of life] at 1, 3 and 6 months,” investigators reported. “Additionally, treatment with CBMPs was associated with a reduction in the median daily OME [oral morphine equivalent] from baseline to 6 months with no severe or life-threatening adverse events reported. These findings are in line with similar studies and broader data from the UK Medical Cannabis Registry for other conditions.”

The study’s authors concluded: “In the context of SUD, CBMPs may … play a role in the maintenance therapy of opiate-dependent individuals with co-morbid anxiety and sleep disorders or symptoms. … CBMPs may also play a role during tapering of opioid doses during maintenance therapy due to the prevalence of anxiety and sleep disruption in individuals experiencing withdrawal from medications. … Although capturing a 6-month follow-up is valuable, longitudinal data to see if PROMs [patient-reported outcome measures] would stay the same, improve further or instead decline would also prove useful in strengthening the evidence base for CBMPs in the treatment of substance use disorders.”

Survey data have previously reported that a significant percentage of patients undergoing opioid maintenance therapy acknowledge consuming cannabis to ease withdrawal symptoms and drug cravings.

Other observational studies assessing the use of cannabis products among those enrolled in the UK Medical Cannabis Registry have reported them to be effective for patients diagnosed with treatment-resistant epilepsy, cancer-related pain, anxiety, fibromyalgia, inflammatory bowel disease, hypermobility disorders, depression, migraine, multiple sclerosis, osteoarthritis, and inflammatory arthritis, among other conditions.

Full text of the study, “UK Medical Cannabis Registry: A clinical analysis of patients with substance use disorder,” appears in the European Addiction Research.

Study: Patients Engage in Compensatory Driving Behaviors Following Ingestion of THC Extracts

Queensland, Australia: Patients who consume oral doses of THC drive at slower speeds and engage in other compensatory behaviors, according to driving simulator data published in the journal Psychopharmacology.

Australian researchers assessed subjects’ simulated driving performance prior to and 90 minutes after their ad libitum consumption of prescribed THC oil extracts. (Australian physicians may prescribe cannabis products to patients unresponsive to conventional prescription treatments.) On average, study subjects consumed 11 mg of THC prior to driving.

Similar to the results of prior studies, subjects engaged in compensatory driving behaviors – such as driving at slower speeds and increasing the distance between their vehicle and the vehicles in front of them – following THC dosing. Few other changes in participants’ baseline performance were identified, leading investigators to presume that patients likely become tolerant to THC’s potential effects on cognitive and psychomotor performance.

“Our results align with a growing body of evidence demonstrating that chronic THC use can mitigate the acute effects of the substance on driving performance and driving-related cognitive functions,” researchers reported.

The study’s authors concluded: “Taken together, our findings suggest that … medicinal cannabis users may … be more inclined to compensate for cannabis impairment through alterations in speed and following distance. … Future research is needed to further investigate the effects of THC on these driving-related skills and behaviors using a wider range of doses and administration methods, with populations of varying tolerance levels.”

The study’s findings are consistent with those of several others, determining that daily cannabis consumers, and patients especially, exhibit tolerance to many of cannabis’ psychomotor-influencing effects. According to the findings of a literature review published in the Journal of the German Medical Association, “Patients who take cannabinoids at a constant dosage over an extensive period of time often develop tolerance to the impairment of psychomotor performance, so that they can drive vehicles safely.”

Full text of the study, “The effects of orally ingested delta-9-tetrahydrocannabinol on drivers’ hazard perception and risk-taking behaviors: A within-subjects study of medicinal cannabis users,” appears in Psychopharmacology.

Analysis: Cannabis Use Not Associated with Elevated Risk of Kidney Disease

Baltimore, MD: Adults with a history of cannabis use do not possess an elevated risk of kidney disease at midlife, according to longitudinal data published in the journal Cannabis and Cannabinoid Research.

A team of investigators affiliated with Johns Hopkins University School of Medicine in Baltimore and Tulane University in New Orleans assessed the relationship between cannabis use and kidney function. Study participants included current cannabis consumers and non-users. Participants were assessed at baseline and again nearly a decade later.

“Compared with those with no history of cannabis use, participants with current regular cannabis use were not at higher risk of incident CKD [chronic kidney disease] (OR: 0.79), rapid kidney function decline (OR: 0.80) or incident albuminuria [the presence of albumin in urine, a symptom of kidney disease (OR: 0.84) after adjustment for [confounders],” researcher reported.

The study’s authors concluded, “[T]here was no independent association between cannabis use and adverse kidney outcomes over time.”

Full text of the study, “Evaluating the association of cannabis use and longitudinal kidney outcome,” appears in Cannabis and Cannabinoid Research.

Analysis: Marijuana Legalization in California Associated With Lower Alcohol Consumption

San Francisco, CA: The passage of adult-use marijuana legalization in California is associated with sustained decreases in alcohol consumption, according to data published in the journal Addiction.

Researchers affiliated with the University of California, San Francisco and the healthcare provider Kaiser Permanente assessed trends in self-reported alcohol consumption among northern Californians prior to and following voters’ decision to legalize marijuana. (California legalized marijuana in 2016.) Study participants were Kaiser Permanente patients who underwent annual screenings for alcohol use during visits with their primary care doctors. Investigators reviewed data from over 3.5 million adults over four years.

Researchers identified sustained declines in participants’ weekly drinking patterns, as well as in how often they engaged in heavy episodic drinking, following legalization. Declines were most pronounced among those ages 35 to 49.

“Specifically, this group showed a significant immediate reduction in frequent HED [heavy episodic drinking], along with gradual declines over time in HED and rates of exceeding both daily and weekly limits,” investigators determined. “This may suggest that cannabis policy changes contributed to a meaningful shift away from higher risk drinking behaviors, potentially reflecting greater substitution effects as compared to younger groups.”

Declines were less pronounced among those ages 21 to 34 and among those 65+.

The study’s authors concluded, “Cannabis policy changes in California, USA, appear to be linked to age-specific changes in alcohol use, with moderate reductions, particularly among middle-aged adults.”

The findings are consistent with those from Canada determining that alcohol sales declined in that country following the adoption of adult-use marijuana legalization.

Survey data published last year in The Harm Reduction Journal found that 60 percent of cannabis consumers acknowledge using it to reduce their alcohol intake.

Full text of the study, “Are cannabis policy changes associated with alcohol use patterns? Evidence from age-group differences based on primary care screening data,” appears in Addiction.

Survey: IBD Patients Report Symptomatic Benefits, Decreased Reliance on Opioids Following Cannabis Use

Cleveland, OH: Patients with inflammatory bowel disease (IBD), including Crohn’s disease and ulcerative colitis, frequently report using cannabis products to manage their symptoms, according to survey data published in the journal Academia Medicine.

Investigators affiliated with the Case Western Reserve School of Medicine surveyed 93 IBD patients regarding their use of either cannabis or CBD products.

Among those participants who acknowledged consuming cannabis, most said that it mitigated their IBD-related pain, stress, and anxiety. Many patients also reported using CBD oil products; however, they did not perceive them to be as effective as cannabis.

Thirty-four percent of patients reported decreasing their opioid consumption when using either cannabis or CBD products – a finding that is consistent with prior data. Fifteen percent of patients reported that their use of cannabis products induced disease remission.

“The findings indicate that a significant proportion of IBD patients use cannabis, notice symptom relief, and prefer its therapeutic use,” the study’s authors concluded. “As interest in alternative treatments gains momentum, these results can influence future clinical trials, guide healthcare professionals in patient counseling, and be included in altering treatment modalities.”

Observational trials have previously documented that cannabis use by IBD patients is associated with fewer ER visits. In a randomized placebo-controlled trial involving 21 patients with refractory Crohn’s disease, nearly half achieved disease remission following their use of herbal cannabis. A separate placebo-controlled trial reported that herbal cannabis is associated with clinical improvements and increased quality of life in patients with mild to moderate ulcerative colitis.

Full text of the study, “Inflammatory bowel disease patients believe cannabis and cannabidiol oil relieve symptoms,” appears in Academia Medicine.

Delaware: Medical Cannabis Dispensaries To Begin Adult-Use Sales

Dover, DE: Consumers ages 21 and older can begin purchasing cannabis products from licensed retailers on Friday, August 1st – some 28 months after lawmakers approved legislation legalizing the adult-use market.

Consumers will initially be able to purchase cannabis at approximately a dozen retail locations — all of which are existing medical cannabis dispensaries that have received ‘conversion licenses’ to sell to patients and adults.

Regulators have pledged to approve additional licenses to new applicants in the coming months.

“Delaware has taken a major step forward by launching a legal adult-use cannabis market that prioritizes equity, safety, and accountability,” Democratic Governor Matt Meyer said. “This new industry will generate critical revenue to strengthen our schools, infrastructure, and public health systems, while creating real opportunities for entrepreneurs. This revenue also gives us a powerful tool to invest in the communities most impacted by the war on drugs, addressing past wrongs and ensuring that the benefits of this new market reach every corner of our state.

A Delaware State Auditor’s report estimates that adult-use sales will generate $43 million in annual tax revenue.

Survey: Patients Undergoing Opioid Maintenance Therapy Frequently Use Cannabis To Mitigate Cravings, Withdrawal Symptoms

Munich, Germany: A significant percentage of patients undergoing opioid maintenance therapy (OMT) acknowledge consuming cannabis to ease withdrawal symptoms and drug cravings, according to survey data published in the journal Brain Sciences.

German researchers affiliated with the University of Munich surveyed 128 opioid use disorder (OUD) patients receiving OMT. Forty-one percent of respondents reported using cannabis. Of those, 59 percent said that they did so “to suppress cravings for other [controlled] substances.” Thirty-nine percent said they used cannabis “to suppress opioid withdrawal symptoms.”

The findings are consistent with prior studies involving opioid-dependent subjects.

“These findings highlight a complex interaction between opioid treatment and cannabis use,” the study’s authors concluded. “Further longitudinal and placebo-controlled trials are needed to investigate the clinical and pharmacological interactions between cannabis and OMT, including effects on craving, withdrawal, and overall treatment outcomes.”

Full text of the study, “Cannabis use in opioid maintenance therapy: Prevalence, clinical correlates, and reasons for use,” appears in Brain Sciences.

Analysis: Medical Cannabis Associated With Reduced Healthcare Utilization in Chronic Pain Patients

Miami, FL: The sustained use of state-authorized medical cannabis products is associated with improved quality of life and reduced healthcare utilization among chronic pain patients, according to data published in the journal Pharmacy.

A team of researchers affiliated with the medical cannabis telehealth company Leafwell and George Mason University in Virginia assessed healthcare utilization trends in chronic pain patients with and without prior medical cannabis experience. An estimated one in three pain patients residing in medical cannabis access states report using marijuana as an analgesic agent.

Investigators determined that patients who had used medical cannabis products during the prior year reported fewer urgent care visits, fewer emergency department visits, and fewer “unhealthy days per month” than did those with no prior cannabis use history.

“The findings of this study suggest … that medical cannabis is likely an effective treatment option for patients with chronic pain,” the study’s authors concluded. “Moreover, we found that, in addition to an increase in QoL [patients’ quality of life], medical cannabis exposure is associated with lower risk of urgent care and ED visits, when comparing patients who used medical cannabis for at least one year to cannabis-naïve patients. This underscores the potential for not only QoL gains associated with medical cannabis use, but also positive downstream effects on the healthcare system resulting from treatment.”

A prior analysis by Leafwell researchers concluded that state-level access to medical cannabis is associated with significant reductions in healthcare premiums.

Full text of the study, “Medical cannabis use and healthcare utilization among patients with chronic pain: A causal inference analysis using TMLE,” appears in Pharmacy.

Study: Cannabis Consumption Not Associated With Elevated Risk of Adverse Cardiovascular Events in Older Adults

San Francisco, CA: Older adults who consume cannabis are no more likely to suffer from adverse cardiovascular events, such as heart attack and stroke, as compared to non-users, according to longitudinal data published in the journal Circulation.

Researchers affiliated with the University of California, San Francisco assessed cannabis use and cardiovascular health in a cohort of 4,285 older veterans (mean age: 67.5) with a history of coronary artery disease. Approximately 25 percent of study participants (1,015 veterans) reported current cannabis use, while the remaining 3,122 participants did not. Subjects were followed for an average of 3.3 years.

Contrary to investigators’ expectations, current cannabis use was not independently associated with elevated rates of heart attack, stroke, cardiovascular death, or all-cause mortality once researchers adjusted for covariates.

“To our knowledge, the current study is the only study to examine the association of cannabis use with longitudinal cardiovascular disease outcomes among persons with established CAD [coronary artery disease],” the study’s authors concluded. “In this older cohort of veterans with CAD, smoking cannabis was not associated with the composite outcome of AMI [acute myocardial infarction], stroke, and cardiovascular death, a finding that was consistent across multiple measures of cannabis exposure.”

Although individual studies assessing cannabis use and cardiovascular health have yielded inconsistent results, a literature review of 67 papers published in The American Journal of Medicine concluded, “[M]arijuana itself does not appear to be independently associated with excessive cardiovascular risk factors.” Most recently, an analysis of over 720,000 adults published in the American Journal of Preventive Medicine (AJPM) Focus concluded that current cannabis consumers do not possess a greater risk of heart attack as compared to non-users.

Full text of the study, “Association of smoking cannabis with cardiovascular events among veterans with coronary artery disease,” appears in Circulation.

Pilot Study: Cannabis Extracts Show Promise in Adolescents With Tourette Syndrome

Sydney, Australia: The administration of plant-derived cannabis extracts containing standardized percentages of THC and CBD is associated with symptomatic improvements in adolescent patients with Tourette syndrome (TS), according to data published in the journal BJPsych Open.

Australian investigators assessed the efficacy of standardized cannabis extracts in ten teenagers (mean age: 14) with refractory TS. Study participants consumed cannabis oil once daily in the evening.

“There was positive signal of efficacy with a statistically significant improvement in parent and self-reported tics and quality of life, as well as behavioral/emotional issues,” researchers reported. “Commonly reported adverse events were tiredness and drowsiness, followed by dry mouth.”

The study’s authors concluded: “Although there is emerging evidence supporting the use of cannabis-based interventions in the management of Tourette syndrome in adults, this study uniquely contributes to the evidence on the benefits and safety of medicinal cannabis in adolescents with Tourette syndrome. … A larger scale, randomized controlled trial is needed to validate these findings.”

Separate data involving adults with TS reports that the sustained use of cannabis reduces tic frequency by as much as 75 percent, while also improving patients’ mood, anxiety, and sleep.

Full text of the study, “Medicinal cannabis for tics in adolescents with Tourette syndrome,” appears in BJPsych Open.

Study: Cannabis Extracts Relieve GI Symptoms in Fibromyalgia Patients

Baronissi, Italy: Fibromyalgia (FM) patients with gastrointestinal (GI) disorders experience symptomatic improvements following the sustained use of plant-derived cannabis extracts, according to data published in the journal Clinical and Experimental Rheumatology.

Italian researchers assessed GI symptoms in 46 FM patients prior to and following their use of cannabis extracts containing 19 percent THC and 1 percent CBD. Patients were evaluated at enrollment, at three months, and six months.

Researchers reported that cannabis dosing was associated with significant reductions in patients’ epigastric and abdominal pain. Cannabis treatment was also associated with less intense and frequent symptoms of gastric burning and bloating. A minority of patients (eight percent) experienced complete remission from their symptoms during the study.

“This study supports … medical cannabis as an alternative treatment for FM with a potential effect on FD [functional dyspepsia] and IBS [irritable bowel syndrome] patients,” the study’s authors concluded.

Survey data shows that FM patients frequently consume cannabis to mitigate disease symptoms and to reduce their reliance on prescription medications.

Full text of the study, “The effect of medical cannabis on gastrointestinal symptoms in fibromyalgia and disorders of gut-brain interaction: A patient-centered real-world observational study,” appears in Clinical and Experimental Rheumatology.

Analysis: Hair Follicle Testing Detects Passive Exposure to Cannabis Smoke

Bologna, Italy: Subjects exposed to second-hand cannabis smoke, even for brief periods, can test positive for THC on a hair follicle test, according to data published in the journal Forensic Science International.

A team of Italian investigators assessed the ability of hair tests to detect THC in subjects exposed to side-stream cannabis smoke. Study participants were exposed to second-hand smoke from a single marijuana cigarette for 15 minutes in a non-ventilated environment.

Subjects’ hair samples tested positive for THC following passive exposure, with male subjects possessing higher THC values than women. All subjects tested negative for THC metabolites in their urine.

“Our study showed that hair contamination could arise in vivo even after short single exposures to cannabis, … underlining the need for a careful interpretation of results of hair analysis in forensic toxicology,” the study’s authors concluded.

NORML has consistently criticized the use of drug detection tests, such as blood testing, oral fluid tests, urinalysis, and hair testing, in the workplace and elsewhere because they cannot accurately determine behavioral impairment or recent drug ingestion.

Full text of the study, “Analysis of delta-9-tetrahydrocannabinol and cannabidiol on hair after single and repeated short in vivo passive exposures to low- and high-delta-9-THC cannabis,” appears in Forensic Science International.

Study: Marijuana Extracts Mitigate Chronic Pain in Cannabis-Naïve Subjects

Cologne, Germany: The sustained use of plant-derived cannabis extracts significantly reduces pain and improves mental health in patients with or without a history of marijuana use, according to observational data published in the journal Advances in Therapy.

German investigators assessed the safety and efficacy of cannabis extracts containing equal percentages of THC and CBD in a cohort of 64 patients with inadequately treated chronic pain. The cohort included 35 cannabis-naïve patients. Study participants were observed for six months.

Researchers “observed a substantial reduction in patient-reported pain intensity over time in both groups,” with pain scores falling most significantly (by 60 percent) in the cannabis-naïve subgroup. No serious adverse events were reported.

“Our findings indicate that treatment with medicinal cannabis improves both physical and mental health in patients with chronic pain,” the study’s authors concluded. “The results suggest that medicinal cannabis might be a safe alternative for patients who are inadequately treated with conventional therapies.”

Separate data published in the Journal of the American Medical Association reports that nearly one in three patients with chronic pain use cannabis as an analgesic agent and many of those who do substitute it in place of opioids.

Full text of the study, “An observational study on improving pain and quality of life with the Cannamedical hybrid cannabis extract,” appears in Advances in Therapy.

Survey: Many Consumers Substitute Cannabis for Prescription Medications

Los Angeles, CA: Most consumers acknowledge using cannabis in place of pharmaceutical medications, according to survey data compiled by the telehealth platform NuggMD.

Of the 485 subjects surveyed, more than 79 percent said that they consumed cannabis, at least in part, as an alternative to prescription medications. Notably, most respondents did not participate in state-sanctioned medical marijuana access programs. The findings, which are consistent with numerous other surveys, indicate that many consumers use cannabis for therapeutic purposes, even if they do not self-identify as patients.

Many longitudinal studies report a decline in patients’ use of conventional medicines, specifically opioids, anti-anxiety drugs, and sleep aids, following their use of cannabis. Consumers also frequently report substituting cannabis for alcohol, tobacco, and other controlled substances.

Study: Low-Dose Cannabis Extracts Reduce Chronic Pain, Patients’ Reliance on Analgesic Medications

Puerto Madryn, Argentina: Chronic pain patients experience sustained symptomatic improvements following the use of low-dose, plant-derived cannabis extracts, according to data published in the Journal of Pain & Palliative Care Pharmacotherapy.

Argentinian investigators assessed the adjunctive use of cannabis extracts in a cohort of 88 patients diagnosed with either musculoskeletal, neuropathic, or oncological pain. Extracts contained no more than 5 ng/ml THC and 2 ng/ml CBD. Study participants consumed extracts sublingually for six months.

Sixty-five percent of patients experienced pain reductions of greater than 50 percent following cannabis treatment. Additionally, most participants reported improved sleep and a decrease in anxiety. Twenty-six percent of patients reduced their use of traditional analgesic medications – a finding consistent with other studies.

Most patients reported either mild or no adverse side effects. None of the study’s participants experienced psychoactive effects following cannabis dosing.

“We observed an important decrease in pain between the first and last consultation, at relatively low doses (~ 4 mg/day for THC and ~ 2 mg/day CBD),” researchers reported. “Similar trends were found for all life quality-associated parameters studied, except appetite, and side effects were mild, implying that significant pain reduction can be effectively and consistently obtained from herbal full-spectrum preparations.”

The study’s authors concluded: “No participants increased or added analgesic or anti-inflammatory drugs during the study. … Cannabis herbal preparations for the treatment of chronic pain may not only benefit patients from a safe and effective therapeutic option, but health care systems could increase sustainability and reduce hospitalization due to adverse effects.”

Full text of the study, “Effectiveness of full spectrum cannabis extracts in the treatment of chronic pain: An open label study,” appears in the Journal of Pain & Palliative Care Pharmacotherapy.

Analysis: Botanical Cannabis Products Often Possess Less THC Than Advertised

Boulder, CO: Botanical cannabis products sold in Colorado frequently contain lesser amounts of THC than what is advertised on the products’ labels, according to data published in the journal Nature: Scientific Reports.

Investigators affiliated with the University of Colorado at Boulder purchased 281 cannabis products, including loose flower, pre-rolls, and concentrates, from state-licensed dispensaries. All products were independently lab-tested for THC and CBD potency.

Consistent with prior studies, THC potency was over-labeled in a significant percentage of the herbal cannabis products. By contrast, most (96 percent) concentrates were accurately labeled.

The study’s authors concluded: “This study found THC potency labeling to be accurate within ± 15 percent for almost all tested cannabis concentrate products, whereas flower products more frequently did not meet this accuracy threshold. Both product types reported higher THC potency values on the label than what was observed. Continued investigation into labeling inaccuracies and more consistent, rigorous testing moving forward is indicated, particularly for flower products, across various legal cannabis markets.”

Full text of the study, “Accuracy of labelled THC potency across flower and concentrate cannabis products,” appears in Nature: Scientific Reports.

Study: Low-THC Cannabis Extracts Improve Symptoms in Children with Rett Syndrome

Melbourne, Australia: Pediatric patients diagnosed with Rett syndrome (RTT) show improvements in alertness, communication skills, anxiety, and other symptoms following the daily use of specially formulated plant-derived cannabis extracts, according to open-label clinical trial data published in the Journal of Pediatrics and Child Health.

Australian investigators assessed the twice-daily use of cannabis extracts containing CBD and THC in a cohort of 11 girls with RTT. Subjects were assessed at baseline and 12 weeks. Rett Syndrome is a rare genetic disorder associated with developmental delays, seizures, loss of speech and motor coordination, and involuntary/repetitive movements, among other symptoms.

“Oral administration of [cannabis extracts] for 12 weeks was associated with significant improvements in core RTT symptoms, including mental alertness, communication skills, socialization/eye contact, attentiveness, and anxiety,” researchers reported. “[Cannabis] administration also demonstrated improvements in key secondary outcomes, such as overall clinical severity, quality of life, and a reduction in caregiver burden.”

Investigators also reported improvements in patients’ breathing, mood, and teeth grinding.

The study’s authors concluded: “RTT is associated with a range of complex clinical manifestations. … This Phase I/II study of [plant-derived cannabis extracts] in RTT provides an encouraging foundation for further studies in this population. The improvements observed in clinical outcomes and caregiver burden justify ongoing research and confirm [that cannabis extracts are] a potential adjunct therapy for RTT.”

Full text of the study, “Full-spectrum medicinal cannabis plant extract 0.08% THC improves symptoms of Rett syndrome: An open-label study,” appears in theJournal of Pediatrics and Child Health.

Hawaii: Governor Signs Medical Cannabis Expansion Bill Despite Privacy Concerns

Honolulu, HI: Democratic Gov. Josh Green has signed legislation (HB 302) into law expanding the pool of patients eligible for medical cannabis. Governor Green’s signature came weeks after he signaled his intention to veto the bill due to concerns that separate provisions might put patients’ privacy at risk.

The new law, which took immediate effect, permits medical providers to issue cannabis authorizations to any patient for whom they believe “the benefit of the medical use of cannabis would likely outweigh the health risks.” It also allows patients to receive authorizations via telehealth appointments.

Separate provisions in the law provide the Health Department with the authority to inspect a qualifying patient’s medical records without a warrant. Health providers who refuse to turn over their records when ordered to do so could have their ability to issue medical cannabis authorizations suspended. Governor Green had previously cautioned that the new inspection provisions “may deter patients from participating in the medical cannabis program.”

Hawaii legalized medical cannabis access in 2000, becoming the first state to do so legislatively. About 30,000 patients currently participate in the access program.

Analysis: Cannabis Use by Pancreatitis Patients Associated With Reduced In-Hospital Mortality, Lower Cancer Risk

Nashville, TN: Pancreatitis patients who consume cannabis are less likely to die while hospitalized and possess better overall health outcomes as compared to non-users, according to data published in the Journal of Gastrointestinal and Liver Disease.

An international team of researchers from the United States and India assessed the relationship between cannabis use and inpatient outcomes in a cohort of more than 907,000 hospitalized patients with chronic pancreatitis (CP).

After adjusting for confounders, cannabis use was associated with decreased odds of mortality (odds raMJ tio [OR]: 0.47), ICU admission (OR=0.71), deep vein thrombosis (OR=0.71), pulmonary embolism (OR=0.62), and pancreatic cancer (OR=.73).

“Our study reports [that] cannabis use among hospitalized patients with chronic pancreatitis [is] associated with improved in-hospital outcomes as well as lower odds of developing pancreatic cancer,” the study’s authors concluded. “Future research …. [should] aim to identify the exact mechanism by which cannabis exerts its effects on the pancreas and other organ systems is required.”

The findings are consistent with those of a 2019 study, which similarly reported that acute pancreatitis patients with a history of cannabis use had “significantly lower in-patient mortality” and shorter hospital stays than non-users.

Typically, patients with CP are at a higher risk of complications due to their compromised immune system.

Other studies have also linked cannabis use with decreased in-hospital mortality, specifically among patients with rheumatoid arthritis, acute myocardial infarction, cancer, chronic obstructive pulmonary disease, gastroparesis, HIV, burn-related injuries, traumatic brain injuries, and various other types of severe trauma.

Full text of the study, “Cannabis use and outcomes in patients with chronic pancreatitis: A national inpatient sample analysis,” appears in the Journal of Gastrointestinal and Liver Disease.

Idaho: Mandatory Minimum Penalties for Minor Marijuana Violations Take Effect

Boise, ID: Legislation took effect this week imposing new mandatory fines for people convicted of minor marijuana possession offenses.

Under the new law, offenders must pay a minimum fine of $300. Those convicted may also face up to one year in jail.

Republican Gov. Brad Little signed the legislation into law in February. Lawmakers claimed the mandatory fines are necessary because too many judges were refusing to impose fines for first-time offenders. Idaho is the only state to impose mandatory minimum penalties for first-time, low-level marijuana possession offenders.

Between 2018 and 2023, Idaho police made over 31,000 marijuana-related arrests. Over 94 percent of those arrests were for marijuana possession, not sales. Approximately half of all drug-related arrests in Idaho are marijuana-related.

Idaho lawmakers also passed a resolution this session providing the legislature with exclusive authority to decide marijuana policy. The resolution will appear as a ballot question next year.

Florida: New Law Suspends Medical Cannabis Access to Those With Certain Drug Convictions

Tallahassee, FL: Republican Gov. Ron DeSantis has signed legislation (SB 2514) into law suspending the registrations of medical cannabis patients and caregivers who have certain drug-related convictions on their records.

The new provisions are included in a Health and Human Services appropriations bill. The language reads, “The Department shall immediately suspend the registration” of any patient or caregiver convicted of “trafficking in the sale, manufacture, or delivery of, or possession with intent to sell, … of a controlled substance.”

Those who have their registrations revoked may reapply to participate in the program after they have “completed all terms” related to their conviction.

An earlier version of the bill sought to revoke registrations for any patient or caregiver convicted of even minor drug-related offenses, including those specific to the purchase of more than ten grams of marijuana. That language was eventually amended in a conference committee.

NORML generated hundreds of emails to lawmakers opposing the new restrictions, opining: “Patients do not lose their access to opioids and other traditional medications based on past convictions. They should not lose their access to medical cannabis either.”

Some 900,000 Floridians are registered in the state’s medical cannabis access program.

Arkansas: Hemp Ban Not Preempted by Federal Law, Federal Court Rules

Little Rock, AR: An Arkansas law prohibiting the sale of hemp-derived intoxicating products is not preempted by the 2018 federal Farm Bill, according to a ruling issued last week by the Eighth Circuit Court of Appeals.

Plaintiffs challenged the 2023 law (Arkansas Act 629), which restricts the sale of hemp-derived intoxicating cannabinoids that are the result of a chemical synthesis, such as products high in concentrations of delta-8-THC. The Court rejected plaintiffs’ arguments, opining that federal law “facilitates” but does not mandate states to regulate hemp-related products.

“Just because states may legalize hemp under the 2018 Farm Bill does not mean they must,” the Court determined.

The decision is similar to rulings issued earlier this year by federal courts in Alaska and Virginia, which also determined that state governments retain the ability to restrict the sales of hemp-derived intoxicating products. In Alabama, a Montgomery Circuit Court judge also recently upheld that state’s newly imposed ban on smokable hemp products.

Nearly half of all US states impose severe restrictions on the retail sale of delta-8-THC and similar products, according to reporting provided by Courthouse News Service. However, Republican Governors in Florida and Texas have recently vetoed legislation that sought to impose similar bans.

The case is Bio Gen LLC et al. vs Sarah Huckabee Sanders et al.

Ohio: Lawmakers Pause Effort To Roll Back Voter-Approved Marijuana Legalization Law

Columbus, OH: Legislation modifying the state’s voter-approved adult-use marijuana law has stalled ahead of lawmakers’ summer recess.

Lawmakers recently cancelled a pair of scheduled votes on a substitute version of Senate Bill 56 after legislators raised numerous concerns about its language. In recent months, NORML has generated over 17,000 messages to lawmakers opposing the bill.

The amended bill makes numerous changes to existing law, including placing a cap on the total number of state-licensed cannabis retailers permitted statewide, imposing THC potency limits, and criminalizing the possession of any marijuana products obtained from out of state. It also prohibits the sale of hemp-derived intoxicating products in outlets other than state-licensed dispensaries.

Fifty-seven percent of Ohio voters approved Issue 2 in 2023. Regulators implemented the law as written in 2024, following a failed attempt by some of the state’s leading Republicans to pass legislation that would have gutted many of its key provisions.

Study: No Significant Link Between Current Marijuana Use and Increased Risk of Heart Attack

Oklahoma City, OK: Adults who acknowledge having used cannabis within the past 30 days do not possess a significantly elevated risk of heart attack as compared to non-users, according to data published in the American Journal of Preventive Medicine (AJPM) Focus.

A pair of researchers affiliated with the University of Oklahoma Hudson College of Public Health assessed the relationship between marijuana use and asthma, depression, and myocardial infarction in a representative sample of 729,240 individuals.

Unadjusted models determined that current marijuana consumers possessed a decreased risk of heart attack and an increased risk of asthma; however, these associations became non-significant once investigators adjusted for covariates (e.g., age, pre-existing health conditions, etc.).

These findings “seem to support previous studies showing that marijuana use was not associated with MI [myocardial infarction],” the study’s authors concluded.

Researchers did identify a statistically significant link between current cannabis use and depression, but they cautioned that this result “does not indicate a causal association.”

Although individual studies assessing cannabis use and cardiovascular health have yielded inconsistent results, a literature review of 67 papers published in The American Journal of Medicine concluded, “[M]arijuana itself does not appear to be independently associated with excessive cardiovascular risk factors.”

Full text of the study, “The association between marijuana use and myocardial infarction, asthma, and depression in racial and sexual minorities: BRFSS 2016-2022,” appears in AJPM Focus.

Survey: Over One in Three Californians Report Current Cannabis Use, Most Say They Obtain It From Licensed Dispensaries

San Diego, CA: Over one-third of California adults acknowledge having consumed cannabis within the past three months, and most say that they obtain it primarily from state-licensed dispensaries, according to survey data published in the journal Cannabis and Cannabinoid Research.

Researchers with the University of California at San Diego surveyed over 5,000 California adults. Respondents were demographically matched to the 2020 California census.

Thirty-seven percent of respondents reported currently consuming cannabis products, while 33 percent said that they were former consumers. Over three quarter of current consumers said that they obtained marijuana products primarily from licensed dispensaries – a finding that the study’s authors acknowledged is “in contrast to public reporting regarding the strong presence of the illicit marketplace” in California.

Current consumers said that their cannabis use positively impacted their lives, with participants reporting improved emotional (82 percent), mental (81 percent), and physical (62 percent) health. More than half of consumers acknowledged using cannabis in place of a prescription medication – a finding that is consistent with other surveys.

California voters approved a ballot measure regulating the adult-use marijuana market in 2016.

Full text of the study, “Cannabis use in California following legalization of recreational use,” appears in Cannabis and Cannabinoid Research.

Clinical Trial: FDA-Approved CBD Formulation Associated With Clinically Evident Improvements in Autistic Boys

San Diego, CA: The adjunctive use of CBD in the form of the plant-derived FDA-approved drug Epidiolex is associated with symptomatic improvements in autistic boys with severe behavioral problems, according to clinical trial data published in the Journal of Autism and Developmental Disorders.

Investigators affiliated with the University of California at San Diego assessed CBD treatment versus placebo in a cohort of 39 autistic boys ages 7 to 14. Clinicians observed participants on either a weekly or biweekly basis throughout the study period but were unaware of which participants were consuming CBD or placebo until after the study’s conclusion.

“Blinded clinical impressions showed almost two-third of the participants had behavioral improvements with CBD,” researchers reported. “Reductions in aggressive behaviors and hyperactivity were observed most frequently, with improvements in communication being seen in almost 30 percent. Since many of the participants were non-speaking at the onset of the study, this was a notable change, with several of the children beginning to use words for the first time.”

Investigators did not identify significant differences between CBD treatment and placebo on other outcome measures – a result that they attributed to the study’s small sample size and a greater than expected placebo effect. They acknowledged that Epidiolex possesses an acceptable safety profile and is well-tolerated in this patient population. (Epidiolex was approved by the FDA in 2018 specifically for the treatment of Dravet Syndrome and Lennox-Gastaut Syndrome, two rare forms of childhood epilepsy.)

“Despite the limitations, this study provides valuable new information about a potential role of CBD in improving behavior in a subset of children with autism, as well as the strong role the placebo effect plays in this condition,” the study’s authors concluded.

Several other placebo-controlled trials and observational studies have shown that the use of cannabinoids can improve symptoms and provide quality-of-life benefits to patients with autism.

Full text of the study, “Cannabidiol treatment for severe problem behaviors in autistic boys: A randomized clinical trial,” appears in the Journal of Autism and Developmental Disorders.

Case Report: Topical Application of Hemp Seed Oil Mitigates Eczema Symptoms

Katowice, Poland: The daily application of hemp seed oil is associated with reduced inflammation, itching, and other symptoms associated with eczema, according to the results of a case study published in the journal Current Issues in Pharmacy and Medical Sciences.

Polish researchers reported on an eczema patient’s progress after using cannabis seed oil topically for three months. The patient applied the oil once daily prior to going to sleep.

“In our observational study, regular, 3-month application of the emulsion based on cannabis sativa L. oil considerably reduced inflammation, erythema, pruritus, xerosis and scaling of the skin, soothing excoriations and lichenification (hardening of the skin),” the study’s authors concluded.

A prior observational study similarly reported that the topical application of the plant-derived cannabinoids CBD and CBG (cannabigerol) reduced itching and other related symptoms in eczema patients.

Topical application of cannabinoids, particularly CBD, has demonstrated benefits in the treatment of a variety of skin-related conditions, including, leg ulcers, skin ulcers of the fingertips, psoriasis, erythema, pruritus, and acne. It has also been associated with wound healing in patients with refractory leg ulcers and with the rare skin blistering disease epidermolysis bullosa. The application of hemp seed oil has been shown to accelerate wound healing in animal models.

Full text of the study, “Topical use of cannabis sativa L.-based emulsion for management of atopic dermatitis persisting from infancy in a 23-year-old male – a case study,” appears in Current Issues in Pharmacy and Medical Sciences.