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Study: Cannabis Use Not Associated with Adverse Outcomes for Couples Undergoing IVF

Montreal, Canada: A history of marijuana use among men and women is not associated with compromised effects on IVF (in vitro fertilization) outcomes, according to data published in the Journal of Cannabis Research.

A team of researchers from Canada and Israel assessed IVF treatment outcomes among male-female, non-donor IVF patients that were either cannabis users or non-users.

Authors reported: “Our study did not show any detrimental impact of current cannabis use on any of the measured IVF outcomes. … All the reproductive outcomes of cannabis users and non-users in our study were comparable. These parameters included measures of ovarian response, sperm quality, efficiency of fertilization, early embryonic development, and implantation. In fact, the ongoing pregnancy rate per cycle start trended higher for the group of cannabis users (35.2 percent vs. 29.1 percent). This could partially relate to the female participants in the user group being younger than the non-user counterparts.”

They concluded, “The results of this study are in line with the newer studies suggesting that the use of cannabis is not associated with a compromised outcome for couples undergoing IVF.”

Other recently published studies have affirmed that a history of cannabis use does not negatively impact fertility rates in either men or women, nor does it adversely impact overall reproductive health in men.

Full text of the study, “The relationship between cannabis use and IVF outcome – a cohort study,” appears in the Journal of Cannabis Research.

Canada: Marijuana Legalization Not Associated with Upticks in Vehicular Accidents Resulting in Emergency Room Visits

Toronto, Canada: The enactment of adult-use marijuana sales in Canada is not associated with any increase in motor vehicle injuries requiring hospitalization, according to data published in the journal Drug and Alcohol Dependence.

A team of investigators affiliated with the Centre for Addiction and Mental Health and with University of British Columbia assessed emergency department records in two provinces (Alberta and Ontario) to determine trends in traffic-injury emergency department visits in the months immediately prior to and immediately after legalization.

Authors reported: “The current study found no evidence that the implementation of the Cannabis Act was associated with significant changes in post-legalization patterns of all drivers’ traffic-injury ED visits or, more specifically, youth-driver traffic-injury ED presentations. … Given that Canada’s Cannabis Act mandated that the Canadian Parliament review the public health consequences of the Act no later than 2023, the findings of the current study can provide empirical data not only for the Canadian evaluation of the calculus of harms and benefits, but also for other international jurisdictions weighing the merits and drawbacks of cannabis legalization policies.”

The Canadian data is consistent with prior studies from the United States also showing no significant changes in traffic safety in the months immediately following the enactment of adult-use legalization. However, separate assessments evaluating longer-term trends in traffic safety following legalization have yielded mixed results.

Full text of the study, “Canada’s cannabis legalization and drivers’ traffic-injury presentations to emergency departments in Ontario and Alberta, 2015-2019,” appears in Drug and Alcohol Dependence.

Delaware: Supreme Court Says Marijuana Odor Isn’t Grounds for a Warrantless Arrest

Dover, DE: Police officers may not make a warrantless arrest of a person based solely upon the odor of marijuana emanating from them, according to a ruling by the state’s Supreme Court.

In a 4-1 decision, the court determined that the smell of marijuana alone does not provide police with “reasonable grounds to believe” that either a felony has been committed or that a suspect “has committed a misdemeanor … in the officer’s presence.” Under state law, a warrantless arrest is only permissible in those two instances, or if the suspect is under 18 years of age. The possession of up to one ounce of cannabis is a civil violation in Delaware, regardless of the age of the person possessing it.

The majority of the court ruled that there was no possibility that the arresting officer could have reasonably presumed the suspect’s age at the time of the arrest or that the suspect possessed felony quantities of marijuana. The court further found no evidence that the defendant committed a crime while in the arresting officer’s presence.

The court’s ruling reverses a lower court decision and suppresses all further evidence of drug law violations that were identified following the defendant’s arrest.

The case is Juliano v. Delaware.

Survey: Patients Report Benefits of Cannabinoids for Blistering Skin Condition

Groningen, The Netherlands: The use of various preparations of whole-plant cannabinoids is associated with perceived benefits among patients with the painful skin disease epidermolysis bullosa (EB), according to survey data published in the Orphanet Journal of Rare Diseases. Epidermolysis bullosa is a rare genetic condition that results in blistering skin.

A team of investigators from the Netherlands and from the United States surveyed EB patients on five continents who reported using cannabis preparations to treat their illness. Patients reported using cannabinoids as topical agents in addition to inhaling cannabis flowers and consuming marijuana-infused edible products.

Authors reported that cannabis preparations improved subjects “perception of pain, pruritus, wound-healing, and well-being … and reduced concomitant medication use.” They concluded, “Future prospective controlled clinical studies are warranted to elucidate the potential role of CBMs (cannabis-based medicines) in EB treatment.”

Case reports have previously documented the efficacy of both topical and oral cannabinoid preparations for the treatment of EB symptoms. Other case reports have also documented the use of cannabinoids in patients with intractable leg ulcers and pruritus.

Full text of the study, “Cannabinoid use and effects in patients with epidermolysis bullosa: An international cross-sectional survey study,” appears in the Orphanet Journal of Rare Diseases.

Clinical Trial: CBD Administration Associated with Short-Term Improvements in Verbal Recall

Basel, Switzerland: The administration of CBD is associated with short-term improvements in verbal recall in healthy subjects, according to randomized trial data published in the Journal of Psychiatric Research.

A team of Swiss researchers compared the effects of vaporized CBD versus placebo on verbal episodic memory performance in a cohort of 34 young adult subjects (ages 18 to 30).

They reported that those provided CBD exhibited better verbal recall than those provided with a placebo.

Investigators determined: “The present study revealed an average increase of recalled words 20 minutes after vaping CBD compared to placebo condition by 10 percent. Importantly, we did not detect medication effects on attention or working memory performance, suggesting that CBD has no negative impact on these basic cognitive functions.”

They concluded: “CBD might prove useful to enhance disease-related memory impairments being present in psychiatric disorders, neurodegenerative disorders, as well as in stress and stress-related exhaustion related to episodic memory deficits. … [W]hile further research is needed to identify dose-response and time-response relationships, our results show that CBD can improve episodic memory, a drug effect with possible therapeutic potential.”

Full text of the study, “Cannabidiol enhances verbal episodic memory in healthy young participants: A randomized clinical trial,” appears in the Journal of Psychiatric Research.

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Study: No Rise in Youth Marijuana Use Following Legalization

Bozeman, MT: Neither the enactment of medical marijuana or adult-use legalization laws have led to an uptick in young people’s consumption of cannabis, according to data published in the Journal of the American Medical Association.

A team of researchers analyzed data compiled from the Youth Risk Behavior Survey for the years 1993 to 2017.

They reported that the adoption of medical cannabis access laws was associated with slight reductions in self-reported marijuana use by young people. The enactment of adult-use legalization laws was associated with no statistically significant changes in youth use patterns.

Authors concluded, “Consistent with estimates from prior studies, there [is] little evidence that RMLs [recreational marijuana laws] or MMLs [medical marijuana laws] encourage youth marijuana use.”

To date, dozens of federal and state-specific surveys have failed to identify any independent link between the legalization of cannabis for either adult-use or medical purposes and any rise in the percentage of teens using it. Moreover, data published in 2019 in the journal JAMA Pediatrics reported that the enactment of laws regulating the use of cannabis by adults is associated with declines in self-reported marijuana use by young people. Separate data compiled by the US Centers for Disease Control has reported that the number of adolescents admitted to drug treatment programs for marijuana-related issues has fallen precipitously in states that have legalized and regulated the adult-use market.

In a recent interview, Nora Volkow, Director of the US National Institute on Drug Abuse similarly acknowledged that statewide legalization laws have not led to an increase in the prevalence of adolescents consuming cannabis.

Full text of the study, “Association of marijuana legalization with marijuana use among US high school students, 1993-2019,” appears in JAMA Open Network.

Analysis: Medical Cannabis Provides Benefits to Migraine Patients

Miami, FL: The inhalation of medical cannabis is associated with decreases in migraine frequency and in migraine-related pain, according to a literature review published in the journal Cureus.

A team of investigators affiliated with Larkin Community Hospital in Miami reviewed 34 scientific papers assessing the use of cannabis for migraine management.

Researchers reported “encouraging data on medicinal cannabis’ therapeutic effects on alleviating migraines in all of the studies reviewed.” They added: “Beneficial long-term and short-term effects of medicinal cannabis were reported. It was effective in decreasing daily analgesic intake, dependence, and level of pain intensity. Some patients experienced a prolonged and persistent improvement in their health and well-being (both physically and mentally) after long-term use of medicinal cannabis. Overall, patients reported more positive effects rather than adverse effects with medical cannabis use.”

Authors concluded: “[T]here is a consensus for the indication of medical marijuana therapy when first and second-line treatment fails. … Further research should be performed once cannabis becomes legalized to determine a favorable delivery method, dose, and strain for migraine and chronic headache management and possible long-term effects of medical cannabis use.”

Numerous surveys of patients report that those suffering from migraines often turn to cannabis for symptomatic relief, and many patients say that it is more effective than prescription medications.

Full text of the study, “Medical cannabis, headaches, and migraines: A review of the current literature,” appears in Cureus.

Case Series: Cannabis Plant Extracts Effective in Mitigating Chronic Pain

London, United Kingdom: The use of sublingual oils containing whole-plant cannabis extracts are safe and effective in patients diagnosed with chronic pain, according to clinical outcome data published in the Journal of Clinical Pharmacology.

British researchers affiliated with London’s Imperial College assessed the use of cannabis extracts over a six-month period in 110 subjects.

Investigators reported that the administration of cannabis oils was associated with “significant improvements” in patients’ pain conditions over the study period. Adverse events associated with the extracts were described as “being mild or moderate in intensity.”

They concluded: “Treatment of chronic pain with [whole-plant cannabis] oils was associated with an improvement in pain-specific outcomes, HRQoL [health-related quality of life] and self-reported sleep quality. Relative safety was demonstrated over medium-term prescribed use. Whilst these findings must be treated with caution considering the limitations of study design, they can inform future clinical trials.”

Several randomized, placebo-controlled trials have previously demonstrated the safety and efficacy in herbal cannabis in the treatment of chronic pain, particularly neuropathy. A 2017 review of over 10,000 peer-reviewed scientific papers by the National Academies of Sciences, Engineering, and Medicine acknowledged, “In adults with chronic pain, patients who [are] treated with cannabis or cannabinoids are more likely to experience a clinically significant reduction in pain symptoms. … There is conclusive or substantial evidence that cannabis is effective for the treatment of chronic pain in adults.”

Full text of the study, “Clinical outcome data of first cohort of chronic pain patients treated with cannabis-based sublingual oils in the United Kingdom – Analysis from the UK Medical Cannabis Registry,” appears in Journal of Clinical Pharmacology.

Survey: Most Physicians “Insufficiently Prepared” to Discuss Cannabis-Related Health Issues

Ann Arbor, MI: Physicians report possessing limited knowledge about cannabis, particularly with respect to advising patients on medical marijuana treatment plans, according to data published in the journal Cannabis and Cannabinoid Research.

A pair of researchers with the University of Michigan at Ann Arbor anonymously surveyed 244 practicing physicians. All of the participants practiced in a state where both the use of cannabis for medical and for recreational purposes was legal.

Consistent with prior surveys of health care professionals, the majority of respondents said that they possessed little or no formal knowledge about either cannabis or individual cannabinoids, and 64 percent said that they were “somewhat uncomfortable or very uncomfortable in integrating cannabis into their patients’ treatment regimens.”

Authors concluded: “We show that physicians from a university-affiliated health system in a state with legal recreational and medical cannabis have generally low levels of factual knowledge about medical cannabis. … Our results highlight the mismatch between physician knowledge and medical cannabis policy. Despite numerous long-standing medical cannabis laws (11 years in the state of the current study), physician training and education has insufficiently prepared physicians on cannabis-related knowledge. This is especially true for dosing, as most respondents were unsure about effective doses (in mg) of THC or CBD. … This lack of knowledge has contributed to general discomfort with integrating cannabis into medical practice. This discomfort likely pushes patients to turn to other sources to obtain cannabis-related knowledge, including the popular press, personal research, or from dispensary staff who receive little or no medical training. As such, more comprehensive training is necessary for physicians to bridge the gap between cannabis policy and clinical care.”

Full text of the study, “Assessing health care providers’ knowledge of medical cannabis,” appears in Cannabis and Cannabinoid Research.

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