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FBI Report: Marijuana Arrests Plunge More Than 30 Percent in 2020

Washington, DC: The estimated number of persons arrested in the United States for violating marijuana laws declined precipitously in 2020, according to data released this week by the US Federal Bureau of Investigation.

According to the FBI…s Uniform Crime Report, police made an estimated 350,150 arrests for marijuana-related violations in 2020. This total is a 36 percent decrease from 2019, when police made an estimated 545,602 marijuana-related arrests. Not since the early 1990s has the FBI reported so few marijuana-related arrests in a single year.

US Marijuana Arrests
Marijuana arrests are down more than 50 percent from their peak in 2008, when police made over 800,000 marijuana-related arrests. Since 2012, 18 states and Washington, DC have enacted laws legalizing the possession of small amounts of cannabis by adults.

“As more states move toward the sensible policy of legalizing and regulating cannabis, we are seeing a decline in the arrest of non-violent marijuana consumers nationwide,” NORML Executive Director Erik Altieri said.

He added: “The fight for legalization is a fight for justice. While these numbers represent a historic decline in arrests, even one person being put into handcuffs for the simple possession of marijuana is too many.”

Of those arrested for cannabis-related activities, some 91 percent (317,793) were arrested for marijuana possession offenses only. Marijuana-related arrests represented 30.3 percent of all drug-related arrests in the United States in 2020.

Marijuana-related arrests were least likely to occur in western states โ€” most of which have legalized the possession of the substance โ€” and were most prevalent in the northeast, where they constituted an estimated 50 percent of all drug arrests. This will likely change going forward, as several northeastern states, including Connecticut, New Jersey, and New York have all legalized their marijuana markets in recent months.

Twin Study: Adolescent Cannabis Exposure Not an Independent Cause of Psychosis in Adulthood

Minneapolis, MN: Cannabis exposure during adolescence is not independently associated with either adult-onset psychosis or signs of schizophrenia, according to longitudinal data published in the Journal of Abnormal Psychology.

Researchers affiliated with the University of Minnesota Institute of Child Development assessed the relationship between adolescent cannabis use and adult-onset psychosis in a longitudinal co-twin control analysis. Scientists identified no dose-response relationship in models that compared the greater cannabis using twin to the lesser using co-twin with respect to psychosis-proneness in adulthood. They also reported no differing effects on subjects… levels of cannabis exposure and their later risk of schizophrenia.

Researchers reported: “Epidemiological studies have repeatedly shown that individuals who use cannabis are more likely to develop psychotic disorders than individuals who do not. It has been suggested that these associations represent a causal effect of cannabis use on psychosis, and that psychosis risk may be particularly elevated when use occurs in adolescence. … This study, however, does not support these hypotheses, suggesting instead that observed associations are more likely due to confounding by common vulnerability factors.”

They concluded, “[T]he results suggest this association is likely attributable to familial confounds rather than a causal effect of cannabis exposure. … Our results suggest that the threat of potential harm to adolescents via meaningful increases in risk of long-term psychotic illness may be overstated. … Thus, clinical and public health interventions aimed at decreasing the prevalence and burden of psychotic illnesses may benefit from focusing their attention elsewhere.”

Full text of the study, “Adolescent cannabis use and adult psychoticism: A longitudinal co-twin control analysis using data from two cohorts,” appears in the Journal of Abnormal Psychology.

Study: Enactment of Adult-Use Marijuana Laws Is Not Associated with Increased Odds of Youth Use

New York, NY: The enactment of statewide marijuana legalization policies is not associated with increases in the use of cannabis by those ages 12 to 20 years of age, according to data published in the journal JAMA Open Network.

A team of researchers affiliated with Columbia University…s Department of Epidemiology assessed trends in self-reported past-year and past-month marijuana use in a cohort of over 838,000 people residing in states with adult-use cannabis legalization laws.

Consistent with other studies, authors reported “no increases … in the odds of past-year or past-month cannabis use post-RCL [recreational cannabis laws] enactment among … individuals aged 12 to 20 years for all races and ethnicities.”

Authors did identify an uptick in self-reported use among White adults and Hispanic adults (ages 21 or older), but not among Black adults, following legalization. However, they reported that legalization was “not associated with frequent use or use disorder among cannabis users, including among members of demographic subgroups most affected by criminalization.”

Full text of the study, “Racial and ethnic differences in cannabis use following legalization in US states with medical cannabis laws,” appears in JAMA Open Network.

Use of CBD-Dominant Cannabis Products Is Associated with Decreases in Anxiety and Depressive Symptoms

Baltimore, MD: Patients who consume CBD-dominant varieties of cannabis or cannabis products experience decreased levels of anxiety and depressive symptoms than do similarly matched controls, according to data published in the journal Frontiers in Psychiatry.

Investigators affiliated with John Hopkins University in Baltimore and the University of South Carolina in Charleston assessed longitudinal trends in self-reported anxiety and depressive symptoms in a cohort of cannabis consumers and non-consumers. The majority of subjects in the study who were aware of the cannabinoid composition of their products said that they primarily consumed CBD-dominant cannabis.

Researchers reported: “Initiation of medicinal cannabis during the follow-up period [of the study] was associated with significantly decreased anxiety and depressive symptoms, an effect that was not observed in controls that never initiated cannabis use. … Adverse effects attributed by participants to cannabis product use were infrequent, were more associated with THC-dominant product use. … It is recommended that this antidepressant effect of CBD be evaluated further in placebo-controlled clinical trials.”

Full text of the study, “Antidepressant and anxiolytic effects of medicinal cannabis use in an observational trial,” appears in Frontiers in Psychiatry.

Survey: Women Increasingly Turning to Cannabis to Mitigate Symptoms of Menopause

Edmonton, Canada: Middle-aged women are frequently acknowledging using cannabis to treat symptoms associated with menopause, according to survey data presented at the annual meeting of The North American Menopause Society.

Investigators with the University of Alberta surveyed nearly 1,500 middle-aged Canadian women about their use of cannabis. Marijuana is legal for both medical and recreational purposes in Canada.

One-third of those surveyed acknowledged having used cannabis products within the past month. Among current users, 75 percent defined their use as medicinal and most said that cannabis successfully mitigated their menopause-related issues, including irritability, muscle and joint aches, and sleep disturbances.

“Our study confirmed that a large percentage of midlife women are using cannabis for symptoms that overlap with menopause, especially those women who reported more symptoms,” the study…s lead author said in a statement. “In addition, many of these women are claiming to get relief for their symptoms through the use of cannabis.”

Data from the United States, presented at last year…s conference, reported similar results. That study reported that some 27 percent of women living in California had experience using cannabis for menopause symptom management.

A press release summarizing the 2021 survey results is available online.

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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 โ€“ 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 20โ€ฏminutes 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 โ€“ 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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Review: Cannabinoids Are an “Adequate Potential Treatment Option” for Fibromyalgia Patients

Fairfield, CA: Human trials indicate that the use of either whole-plant cannabis or cannabinoids can improve various symptoms in patients with fibromyalgia (FM) and that they possess an adequate safety profile for use in treatment, according to the findings of a literature review published in the journal Cureus.

Investigators affiliated with the California Institute of Behavioral Neurosciences and Psychology reviewed 22 scientific papers specific to the use of either cannabis or synthetic cannabinoids in FM patients.

Authors concluded: “[T]he data suggest that the use of cannabinoids and cannabis carries limited side effects in the treatment of FM, and they can also improve some common and debilitating symptoms associated with FM, thus making them an adequate potential treatment option, when other treatment lines have been exhausted.”

Cannabis use is frequently reported by patients with fibromyalgia, and the results of several human trials indicate that cannabinoids provide therapeutic relief to patients with fibromyalgia. Most recently, observational trial data published in February reported that the long-term use of various types of cannabis preparations was associated with significant improvements in pain and other symptoms in patients with refractory fibromyalgia.

Full text of the study, “A systematic review of fibromyalgia and recent advancements in treatment: Is medicinal cannabis a new hope?” appears in Cureus.

Top Federal Drug Official Acknowledges that Adult-Use Marijuana Legalization Hasn’t Led to Jumps in Adolescent Use

Washington, DC: The enactment of statewide laws regulating the adult-use cannabis market has not led to an increase in the percentage of young people experimenting with the plant, according to comments made recently by Nora Volkow, Director of the US National Institute on Drug Abuse.

Speaking on a podcast hosted by Ethan Nadelmann, the former Director of the Drug Policy Alliance, Volkow admitted that she had initially expressed concerns that legalization would lead to an increase in the prevalence of adolescents consuming cannabis. Thus far, however, she said, “Overall, it hasn’t.”

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.

During the interview, Volkow also acknowledged that legalization has been associated with “better outcomes” in various states, and that federal laws and regulations on the cannabis plant have “hindered” scientists’ ability to research it – particularly with respect to the plant’s therapeutic efficacy.

An audio archive of the Nadelmann/Volkow interview is available online.

Commentary: Herbal Cannabis Vaporization Safer Alternative to Smoking

Toronto, Canada: Vaporizing herbal cannabis reduces consumers’ exposure to combustion-related toxins and provides a safer alternative to marijuana smoking, according to a commentary published in the Canadian Journal of Public Health.

A team of researchers with the University of Toronto’s School of Public Health opined, “Cannabis vaporizer use can reduce the emission of carbon monoxide, chronic respiratory symptoms, and exposure to several toxins while producing similar subjective effects and blood THC concentration compared with smoking cannabis, holding potential for harm reduction among habitual cannabis smokers.”

Vaporizing devices heat cannabis to the point where cannabinoid vapors form, but below the point of combustion. The results of human clinical trials assessing this technology have concluded that vaporizing herbal cannabis is a “safe and effective” cannabinoid delivery mode that does not result in exposure to combustion gases. Researchers have also reported that vaporization results in higher plasma concentrations of THC compared to those associated with smoking cannabis.

Full text of the commentary, “Are vaporizers a lower risk alternative to smoking cannabis?” appears in the Canadian Journal of Public Health.

Case Report: Cannabis Tincture Associated with Tic Reduction in Tourette Syndrome Patient

Erfurt, Germany: The administration of the proprietary cannabis tincture Nabiximols (a/k/a Sativex) is associated with a “dramatic decrease” in tic-related symptoms in a patient with Tourette Syndrome (TS), according to a case report published in the journal Tremor and Other Hyperkinetic Movements.

A pair of German researchers documented the treatment of a 25-year-old male TS patient with Nabiximols. The patient had previously reported consuming whole-plant cannabis to manage his TS symptoms. Symptoms had returned after he ceased using the plant.

Following at least twice-daily treatment with Nabiximols, the patient experienced a “marked tic reduction … without experiencing relevant side effects.” The acute effects of the drug lasted about four hours.

Authors concluded: “Based on our case, and in line with previous reports, we propose that buccal Nabiximols might be an effective addition to โ€˜acute’ or โ€˜as required’ tic treatment under specialist guidance, especially for predictable situations in the short term when severely disabling or stigmatizing tics are anticipated.”

Sativex is a whole-plant cannabis tincture containing nearly equal ratios of THC and CBD. It is available via prescription in numerous nations, but not in the United States, and it is primarily utilized for the treatment of multiple sclerosis.

Several small studies and case-reports have documented the efficacy of either inhaled cannabis or oral THC in mitigating symptoms in TS patients. In a recent survey of TS patients with experience using either herbal cannabis or oral cannabinoids, those who expressed a preference between the two products said that inhaled cannabis provided superior therapeutic benefits.

Full text of the study, “Tic reduction in adult onset Gilles De La Tourette syndrome using as required Nabiximols spray,” appears in Tremor and Other Hyperkinetic Movements.

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Study: Chronic Pain Patients Report Improved Quality of Life Following Medical Cannabis Use

Philadelphia, PA: Patients with chronic pain conditions report improvements in their health-related quality of life following the use of cannabis, according to data published in the journal Medical Cannabis and Cannabinoids.

Investigators assessed the use of cannabis in a cohort of 181 pain patients enrolled in Pennsylvania’s medical marijuana access program. Participants were surveyed at baseline and then again at two, four, and eight weeks.

During the course of the study, subjects experienced “a significant improvement in both pain scores and HRQoL [health-related quality of life.]” Patients also demonstrated “significant improvements” in managing their anxiety.

Authors concluded, “The results of this study show that MM[medical marijuana], when used for the treatment of pain, can be beneficial at improving a patient’s QoL [quality of life] along with alleviating their pain.”

Several gold-standard human trials show that cannabis can alleviate pain in various patient populations, including those with HIV, diabetes, spinal cord injury, and with treatment-resistant neuropathy (nerve pain). 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.”

Numerous observational studies also consistently report that the initiation of medical cannabis is associated with self-reported improvements in patients’ quality of life, particularly among elderly subjects.

Full text of the study, “Measuring the change in health-related quality of life in patients using marijuana for pain relief,” appears in Medical Cannabis and Cannabinoids.

Daily Marijuana Consumers Exhibit Insignificant Changes in Simulated Driving Performance After Smoking

Aurora, CO: Daily cannabis consumers display insignificant changes in simulated driving performance compared to non-users following marijuana inhalation, according to data published in the journal Accident Analysis and Prevention.

A team of researchers affiliated with the University of Colorado assessed driving simulator performance among subjects with a history of daily cannabis use, occasional cannabis use, and no history of current use. Consumers inhaled cannabis ad libitum over a 15-minute period and then engaged in simulated driving 30-minutes later. Investigators explicitly assessed consumers’ abilities to maintain lateral positioning and to maintain a specific rate of safe speed as compared to non-users.

Those with a history of occasional cannabis use exhibited a significant increase in SDLP (standard deviation in lateral positioning) following cannabis inhalation. Occasional users also drove faster than non-users, but not to a degree that reached statistical significance. By contrast, daily users displayed insignificant changes in SDLP following cannabis inhalation and drove at slightly slower speeds.

Authors reported: “In this study of the acute effects of cannabis use on driving performance among participants with a history of using cannabis daily or occasionally, we found evidence for decrements of driving performance in both groups relative to baseline for SDLP, that was of moderate size and statistical significance only in the occasional users. Small, statistically significant decreases in speed were observed in the daily use group.”

The findings are consistent with prior driving performance studies showing that acute cannabis exposure may influence SDLP performance and that more habitual consumers become tolerant to marijuana’s effects on psychomotor skills. By contrast, other studies have shown that the use of cannabis in combination with alcohol can greatly influence psychomotor performance, even among more experienced marijuana consumers.

The study’s findings also reaffirmed that elevated THC/blood levels are not necessarily predictive of either increased adverse driving performance or outcomes. Among daily users, mean THC/blood levels were six-times higher than they were for occasional users, despite only nominal differences in the two groups’ driving performance.

Full text of the study, “Simulated driving performance among daily and occasional cannabis users,” appears in Accident Analysis and Prevention.

Oral Cannabis Preparations Associated with Modest Improvements in Patients with Refractory Migraines

Modena, Italy: The long-term use of oral preparations of herbal cannabis is associated with modest improvements in patients with treatment-resistant migraines, according to observational trial data published in the journal Pain Medicine.

A team of Italian investigators assessed the use of herbal cannabis tinctures in a cohort of 32 patients with chronic, refractory migraines. Subjects took one of three varieties of tinctures (high THC/low CBD, high CBD/low THC, nearly equal rations of THC and CBD) daily for a period of six months.

Inconsistent with several other recent studies – such as those here and here – cannabis use was not associated with any reduction in the number of days during which patients experienced migraines. Consistent with other studies, the use of herbal cannabis tinctures reduced patients pain intensity, their need for prescription analgesics, and their use of prescription migraine rescue medications. Cannabinoid tinctures were also associated with reduced incidences of nausea and vomiting.

Authors concluded: “The observed improvements in the NRS [numeric rating scale] score, AC [analgesic consumption], and NDM [number of days on medication] may suggest a role of the oral cannabinoid preparations in patients with CM and a high analgesic consumption. … In order to clearly establish the real magnitude of the effect of oral cannabinoid preparations in the treatment of CM, randomized, placebo-controlled studies with big samples are needed.”

Several prior studies have reported 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, “Oral cannabinoid preparations for the treatment of chronic migraine: A retrospective study,” appears in Pain Medicine.

Brain Study: Cannabis Use Not Correlated with Changes in White Matter Integrity

Rotterdam, The Netherlands: Subjects with a history of cannabis use, including near-daily consumption, possess no significant differences in white matter integrity when compared to those with no history of marijuana exposure, according to data published in the journal Addiction Biology.

A team of investigators from The Netherlands and from Australia performed MRIs to compare whole-brain white matter microstructure in a cohort of 39 near-daily cannabis users and 28 closely matched controls. The integrity of white matter microstructure is correlated with cognitive performance.

Consistent with prior studies, authors reported: “White matter microstructure did not differ between cannabis users and controls and did not covary with recent cannabis use, dependence severity, or duration of use.”

Investigators concluded, “These findings suggest that long-term near-daily cannabis use does not necessarily affect white matter microstructure.” Nonetheless, they cautioned that adolescents may be susceptible to possible changes in brain morphology.

Full text of the study, “The relation between cannabis use, dependence severity and white matter microstructure: A diffusion tensor imaging study,” appears in Addiction Biology.

Clinical Trial: CBD Dosing Associated with Transient Improvements in Sleep Satisfaction

Sรฃo Paulo, Brazil: The administration of CBD is associated with temporary improvements in sleep satisfaction in patients with REM sleep behavior disorder (RBD), according to the results of a randomized, placebo-controlled study published in the journal Movement Disorders. Patients diagnosed with RBD experience violent arm and leg movements during REM sleep. These movements are typically associated with vivid nightmares.

Brazilian researchers compared the use of CBD versus placebo in a cohort of 33 patients with RBD and Parkinson’s disease.

Compared to placebo, CBD administration at 300mgs was associated with temporary improvements in subjects’ average sleep satisfaction. However, CBD dosing was not associated with any significant reduction in patients’ RBD frequency.

Several prior studies have reported promising results for the use of either cannabis or cannabinoids to mitigate various sleep-related disorders, including insomnia, sleep apnea, and nightmares.

Full text of the study, “Cannabidiol for rapid eye movement sleep behavior disorder,” appears in Movement Disorders.

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Study: Medical Cannabis Treatment Associated with Sustained Relief, Decreased Use of Analgesics in Chronic Pain Patients

Haifa, Israel: Patients diagnosed with chronic pain experience sustained relief from the use of medical cannabis, and many of them reduce or eliminate their use of analgesic drugs over time, according to longitudinal data published in the European Journal of Pain.

A team of Israeli investigators evaluated the safety and efficacy of medical cannabis treatment over a one-year period in patients with chronic pain. Most subjects in the study consumed cannabis via smoking.

Following treatment, subjects’ average pain intensity declined from baseline by 20 percent. Nearly half of the subjects who had been using analgesic medications at the start of trial were no longer using them by the study’s end.

Authors reported: “Forty-three percent of the patients who had been using analgesic medications prior to MC [medical cannabis] treatment initiation were no longer using them. This was true for all classes of analgesic drugs including over the counter analgesics, non-steroidal anti-inflammatory drugs, anticonvulsants and antidepressants. As for opioid use, 24 percent and 20 percent of the participants who had been using weak or strong opioids, respectively, at baseline stopped using them by the time they reached the 12-month follow-up.’

They concluded, “This prospective study provides further evidence for the effects of medical cannabis on chronic pain and related symptoms, demonstrating an overall mild-to-modest long-term improvement of the tested measures and identifying possible predictors for treatment success.’

Full text of the study, “Medical cannabis treatment for chronic pain: Outcomes and prediction of response,’ appears in the European Journal of Pain.

Clinical Trial: Sublingual Administration of CBD Is Effective in Patients with Diabetic Neuropathy

West Bloomfield, MI: The administration of a proprietary, water-soluble CBD tablet mitigates neuropathic foot pain compared to placebo, according to randomized clinical trial data published in the Journal of Diabetes & Metabolism.

Researchers affiliated with Pure Green Pharmaceuticals assessed the efficacy of sublingual CBD tablets (20mg) versus placebo in a cohort of subjects with painful diabetic peripheral neuropathy (pDPN) pain in their feet. Subjects were administered either the active drug or a placebo three times per day for 28 days.

Those taking the active drug reported significant reductions in pain compared to placebo and no adverse side-effects. Subjects taking CBD also reported improvements in their sleep quality and reduced levels of anxiety.

Authors concluded: “This 28-day trial revealed statistically and clinically significant improvement in pain and a clinically significant improvement in sleep quality and in anxiety reduction for those in the CBD treatment group. Additionally, subjects taking CBD affirmed these results by having a statistically significant greater response to treatment as compared with subjects taking placebo. The benefit of this study demonstrates that the sublingual 20 mg CBD tablet should be considered as a safe and effective treatment for pDPN.’

Numerous placebo-controlled clinical trials similarly document the ability of whole-plant cannabis to mitigate neuropathic pain in a wide range of patient populations, including in subjects with HIV and diabetes.

Full text of the study, “Cannabidiol for the treatment of painful diabetic peripheral neuropathy of the feet: A placebo-controlled, double-blind, randomized trial,’ appears in the Journal of Diabetes & Metabolism.

Marijuana Legalization Laws Don’t Undermine Tobacco Smoking Prevention Efforts

Columbus, OH: State-level changes to the legal status of cannabis have not limited the effectiveness of anti-tobacco smoking efforts targeting young adults, according to data published in the journal Nicotine & Tobacco Research.

A team of investigators with Ohio State University and with Purdue University in Indiana assessed the impact of medical cannabis access laws and adult-use legalization laws on cigarette smoking patterns among young adults.

They reported, “Cannabis policy liberalization is not associated with individual-level patterns of cigarette use.’

Authors concluded: “[T]he liberalization of cannabis laws does not disrupt gains made through the implementation of tobacco control policies. Also, we see no evidence that liberalized cannabis policies are directly associated with increased smoking behaviors among young adults. Within a context of rapidly changing cannabis policies throughout the U.S. and several countries, these results provide positive news that newly implemented cannabis laws may not adversely affect tobacco control efforts that have reduced cigarette use among young people.’

The findings differ from those of an unpublished working paper by a pair of students at the University of Texas, Dallas which contends that cigarette sales have slightly increased in some adult-use legalization states.

Full text of the study, “Further consideration of the impact of tobacco control policies on young adult smoking in light of the liberalization of cannabis policies,’ appears in Nicotine & Tobacco Research.

Survey: Over 90 Percent of Chronic Pain Patients Report Mitigating Their Use of Opioids

Tel Aviv, Israel: The overwhelming majority of pain patients provided medical cannabis treatment report either reducing or ceasing their use of opioid medications, according to data published in the Journal of Addictive Diseases.

A team of Israeli investigators affiliated with Tel Aviv University assessed the relationship between cannabis and opioids in a cohort of patients with non-cancer specific chronic pain. All of the patients enrolled in the study were prescribed medical cannabis therapy in accordance with Israel’s medical cannabis access laws.

Among those patients who reported using opioids at baseline, 93 percent either “decreased or stopped [using] opioids following cannabis initiation’ – a finding that is consistent with dozens of other studies.

Full text of the study, “Risk and benefit of cannabis prescription for chronic non-cancer pain,’ appears in the Journal of Addictive Disorders.

Case Report: Cannabis Associated with Improvements in a Patient with Refractory Stuttering

Warsaw, Poland: The use of herbal cannabis is associated with marked improvements in a patient with treatment-resistant stuttering, according to a case report published in the journal Cannabis and Cannabinoid Research.

A team of investigators affiliated with the Medical University of Warsaw (Poland) and with Hannover Medical School (Germany) presented the case of a 20-year-old male patient with refractory stuttering. Following the daily administration of vaporized plant cannabis, the patient exhibited sustained improvements in speech fluency and also reported benefits to his overall quality of life. The patient did not report any adverse side effects from cannabis over the one-year observational period.

Authors reported: “[T]his is the first case report of a patient suffering from impairing and treatment-resistant stuttering, who markedly improved after treatment with medicinal cannabis. Based on patient’s self-report and reports of family and friends, as well as several established assessments, use of cannabis resulted not only in an improvement of stuttering but also remission of (social) anxiety, and reduced depression and stress, as well as improved sleep, attention, concentration, self-confidence, social life, and overall quality of life without any side effect. Importantly, treatment effects did not decrease over time.’

They concluded, “Medicinal cannabis could be effective in treatment of refractory stuttering, but these preliminary data have to be confirmed in controlled studies.’

While this is the first case report specific to the efficacy of cannabis in the case of a patient with a stuttering disorder, several prior studies have documented the ability of THC to improve symptoms in patients with Tourette Syndrome.

Full text of the study, “Cannabis improves stuttering: Case report and interview with the patient,’ appears in Cannabis and Cannabinoid Research.

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Analysis: Adult-Use Legalization Laws Not Linked to Increases in Violent Crime, Problematic Substance Abuse

Cambridge, MA: The enactment of state-level, adult-use marijuana legalization laws is not associated with increases in either drug treatment admissions, violent crime, or overdose deaths, according to a comprehensive analysis published by the National Bureau of Economic Research.

A team of economists reviewed nationally representative data across all 50 states and the District of Columbia to “comprehensively explore the broader impacts of RMLs [recreational marijuana laws], providing some of the first evidence on how marijuana legalization is affecting illicit drug use, heavy alcohol use, arrests for drug and non-drug offenses, and objectively-measured adverse drug-related events including drug-related overdose deaths and admissions into substance abuse treatment services.”

They determined: “We find little compelling evidence to suggest that RMLs result in increases in illicit drug use, arrests for part I [violent] offenses, drug-involved overdoses, or drug-related treatment admissions for addiction. … Our findings provide key evidence evaluating the ongoing, occasionally contentious, political debate on legalizing marijuana use, and inform whether recreational marijuana use is a โ€˜gateway’ to addiction to harder drugs and criminal behavior.”

The study’s findings are consistent with those others – such as those here and here – which have similarly reported that changes in the state-legal status of cannabis are not associated with any significant adverse effects on overall health and safety.

Full text of the study – “Is recreational marijuana a gateway to harder drug use and crime?” – is available from the National Bureau of Economic Research.

Cannabis Use Not Independently Linked to Increased Risk of Ischemic Stroke in Young Adults

Baltimore, MD: Those with a history of cannabis use do not possess an increased risk of early-onset ischemic stroke, according to the findings of a population-based case-control study published in the journal Stroke.

Researchers with the University of Maryland School of Medicine assessed the relationship between cannabis and stroke risk in a cohort of 1,564 subjects between the ages of 15 to 49. Investigators said that their study was “the largest case-control study to date” evaluating the association between marijuana and ischemic stroke risk.

They reported, “After adjusting for other risk factors, including the amount of current tobacco smoking, marijuana use was not associated with ischemic stroke, regardless of the timing of use in relationship to the stroke, including ever use, use within 30 days, and use within 24 hours.”

Authors concluded, “These analyses do not demonstrate an association between marijuana use and an increased risk of early-onset ischemic stroke.”

Results of a 2020 study published in the journal Neurology: Clinical Practice similarly reported that recent exposure to cannabis was not associated with an increased risk of hospitalization due to acute ischemic stroke.

Other studies have yielded inconsistent results with respect to the degree with which a history of cannabis use may play a role in the risk of ischemic stroke. NORML has cautioned that those patients with a history of cardiovascular disorders may be at an elevated risk of suffering from adverse events due to the use of cannabis.

Full text of the study, “Marijuana use and the risk of early ischemic stroke: The stroke prevention in young adults study,” appears in Stroke.

Medical Cannabis Patients Show Sustained Improvements in Cognitive Performance

Belmont, MA: The use of cannabis products, particularly CBD-dominant products, is associated with sustained improvements in cognitive performance, according to longitudinal data published in the Journal of the International Neuropsychological Society.

A team of Harvard investigators assessed executive function in a cohort of medical cannabis patients prior to their use of marijuana and then again at three months, six months, and at twelve months. Patients enrolled in the study possessed little-to-no prior experience with cannabis.

Researchers reported that subjects showed improved cognitive performance within three months of treatment and that these improvements were sustained throughout the 12-month trial period. Improvements in executive function were correlated with clinical improvements in patients’ mood, anxiety, and sleep. The use of CBD-dominant products was most closely associated with participants’ changes in mood and anxiety.

Authors concluded: “In a 12-month longitudinal, observational study, patients using MC [medical cannabis] for various medical conditions exhibited improved executive function and stable verbal learning and memory within the context of improvements on measures of mood, anxiety, and sleep relative to baseline. [I]mprovement of clinical state over time was significantly associated with increased CBD exposure. … Future investigations examining the impact of individual cannabinoids and age of onset of use are warranted to clarify the implications of MC use. Ultimately, for MC patients, it is imperative to understand the relationship between these variables in order to maximize the therapeutic potential of cannabis while minimizing potential risk and harms.”

A 2020 study published in the journal AIDS Care also reported that HIV patients with a history of cannabis use exhibited better neurocognitive performance than similarly matched patients with no history of consumption.

Full text of the study, “An observational, longitudinal study of cognition in medical cannabis patients over the course of 12-months of treatment: Preliminary results,” appears in the Journal of the International Neuropsychological Society.

Enactment of Adult-Use Marijuana Legalization Associated with Immediate, But Temporary Reductions in Opioid-Related Emergency Room Visits

Boston, MA: The enactment of adult-use marijuana legalization laws is associated with immediate reductions in opioid-related emergency department (ED) visitation rates among men, according to data published in the journal Health Economics.

A team of investigators from the Harvard Pilgrim Health Care Institute and the University of Pittsburgh assessed the relationship between marijuana legalization and opioid-related ED visitation rates in 29 states over a six-year period (2011-2017). Four of those states enacted adult-use access during the study period, and researchers compared trends in these legal states with trends in the remaining 25 states.

Authors reported that ED visit rates fell nearly eight percent among males (ages 24 to 44) during the first six-months following the enactment of legalization laws. However, these reductions dissipated in the months that followed and were no longer significant within one year.

“Our results indicate that RCLs [recreational marijuana laws] may only affect a temporary reduction in opioid-related ED visits,” they concluded. “While cannabis liberalization may offer some help in curbing the opioid crisis, our results suggest that it is not a panacea.”

The study’s lead investigators added: “We can’t definitively conclude from the data why these laws are associated with a temporary downturn in opioid-related emergency department visits but, based on our findings and previous literature, we suspect that people who use opioids for pain relief are substituting with cannabis, at least temporarily. … [T]his is good news for state policymakers. States can fight the opioid epidemic by expanding access to opioid use disorder treatment and by decreasing opioid use with recreational cannabis laws. These policies aren’t mutually exclusive; rather, they’re both a step in the right direction.”

Full text of the study, “Recreational cannabis laws and opioid-related emergency department visit rates,” appears in Health Economics.

Study: Experienced Cannabis Consumers Self-Titrate Higher Potency Products

Pullman, WA: Subjects consuming high-potency cannabis concentrates perform similarly on measurements of cognitive performance as do those inhaling lower-potency cannabis flowers, according to data published in the journal Scientific Reports.

A team of investigators affiliated with Washington State University assessed the impact of high-potency concentrates (above 60 percent THC) and lower potency flower (around 20 percent THC) on cognitive performance in a group of experienced marijuana consumers. Users’ performance was measured against that of 20 sober participants.

Researchers reported that cannabis consumers scored similar to controls on a number of measurements, including on tasks involving decision-making and prospective memory.

Cannabis users did not perform as well as controls on tests involving verbal recall and false memories. However, subjects consuming high-potency THC products performed no worse on those tests than did those subjects who ingested less potent products. Researchers attributed this latter result to the fact that those participants who consumed concentrates ingested significantly lesser quantities – thereby achieving similar levels of intoxication as did those who consumed lower potency flower.

Authors concluded: “[P]articipants randomly assigned to use a cannabis concentrate self-titrated after significantly fewer puffs yet reported comparable levels of intoxication and demonstrated equivalent levels of impairment as those who inhaled the flower products. [While] there has been concern and speculation that extremely high-potency cannabis concentrates will magnify harms, … [these] results failed to support our hypothesis that concentrates would exacerbate cognitive impairments.”

The authors’ conclusions are consistent with those of prior experimental studies showing that subjects exposed to higher-potency cannabis tend to self-titrate their intake accordingly.

The study’s findings come at a time when some state lawmakers are calling for the imposition of arbitrary caps on the percentage of THC available in certain retail cannabis products. Those opining in favor of these restrictions have claimed that there are greater adverse effects associated with the use of higher potency products. NORML has pushed back against the imposition of THC caps – arguing that proponents’ concerns are not evidence-based and that banning the sale of more potent products will only serve to expand the growth of the illicit marijuana market.

Full text of the study, “Acute effects of high-potency cannabis flower and cannabis concentrates on everyday life memory and decision making,” appears in Scientific Reports.

Animal Data: CBD Administration Mitigates Symptoms of Nicotine Withdrawal

San Diego, CA: The administration of cannabidiol reduces nicotine withdrawal symptoms in animals, according to preclinical data published in the journal Psychopharmacology.

Researchers with the University of California, San Diego assessed the use of CBD or placebo in nicotine-dependent rats during periods of acute and protracted abstinence.

Investigators reported that CBD dosing “prevented” rats from exhibiting various signs of nicotine withdrawal. These findings “suggest that using CBD as a strategy to alleviate withdrawal symptoms upon nicotine cessation may be beneficial,” they concluded.

Separate animal models have demonstrated the ability of CBD to reduce cravings for alcohol and cocaine, while human studies have reported associations between CBD intake and reduced desires for alcohol, cocaine, heroin, tobacco, and cannabis.

Full text of the study, “Cannabidiol reduces withdrawal symptoms in nicotine-dependent rats,” appears in Psychopharmacology.

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Senate Leader Unveils Long-Awaited Marijuana Descheduling Plan

Washington, DC: United States Senate Leader Chuck Schumer (D-NY), along with Senators Cory Booker (D-NJ) and Ron Wyden (D-OR) unveiled draft legislation repealing the federal prohibition of marijuana at a press conference on Wednesday.

The draft legislation, titled the Cannabis Administration and Opportunity Act, makes numerous changes to federal marijuana laws while providing deference to states' cannabis policies.

Upon introducing the legislation, Sen. Schumer said: "This is monumental because at long last we are taking steps in the Senate to right the wrongs of the failed war on drugs. ... I will use my clout as Majority Leader to make this [legislation] a priority in the Senate. ... It makes eminent sense to legalize marijuana."

NORML Executive Director Erik Altieri said: "The days of federal prohibition are numbered. These actions by Senate Majority Leader Schumer and Senators Booker and Wyden reflect the fact that the supermajority of Americans is demanding that Congress take action to end the cruel and senseless policy of federal prohibition. It is time for legislators to comport federal law with the laws of the growing number of states that have legalized the plant, and it is time for lawmakers to facilitate a federal structure that allows for cannabis commerce so that responsible consumers can obtain high-quality, low-cost cannabis grown right here in America without fear of arrest and incarceration."

NORML Political Director Justin Strekal added: "Our main priority is to ensure that Americans who choose to responsibly consume cannabis are no longer discriminated against under the law. "With one in eight Americans choosing to consume on a semi-regular basis, including nearly one in four veterans, we must end the practice of arresting over 500,000 Americans every year and denying countless others employment, housing, and other civic rights if we are truly to be the โ€˜Land of the Free'. The federal government can take great strides toward rectifying this situation by advancing the Cannabis Administration and Opportunity Act through the legislative process."

Specifically, the Cannabis Administration and Opportunity Act directs the US Attorney General to remove marijuana from the federal Controlled Substances Act -- thereby allowing states to either maintain or establish their own cannabis regulatory policies free from undue federal interference. Under this scheme, state governments - if they choose to do so - can continue to impose criminal penalties for marijuana possession offenses. However, states would not be permitted to prohibit the interstate commerce of legal cannabis products transported through their borders.

The proposal also mandates for the expungement of the records of anyone convicted of a federal, non-violent marijuana offense. The expungements must take place within one year of the law's enactment.

The Act also forbids federal officials from taking discriminatory actions against those who legally use cannabis. It prohibits "individuals from being denied any federal public benefit ... on the basis of [the] use or possession of cannabis." It also, for the first time, permits physicians associated with the US Department of Veterans Affairs to make recommendations to their patients to access medical cannabis.

The proposal transfers primary agency jurisdiction over cannabis regulation from the US Drug Enforcement Administration to the Food and Drug Administration and to the Alcohol and Tobacco Tax and Trade Bureau in manner similar to the ways in which these agencies already oversee alcohol and tobacco products. A federal excise tax of 10 percent would be imposed within the first year of the law's enactment. Medical cannabis access programs, which are operational in the majority of US states, would not be disrupted under this federal plan.

Pending language in the US House of Representatives, the Marijuana Opportunity, Reinvestment, and Expungement (MORE) Act of 2021, similarly removes (deschedules) cannabis from the CSA and facilitates the expungement of past federal marijuana-related crimes. House lawmakers passed a previous version of the MORE Act in December by a vote of 228 to 164, marking the first time that a chamber of Congress ever advanced legislation to end the federal prohibition of cannabis. Senate lawmakers, however, failed to take up the bill.

Senators are seeking feedback on the draft legislation through September 1. Public comments may be provided to Cannabis_Reform@finance.senate.gov. In an interview with the publication Politico in April, Sen. Schumer pledged that he would hold a floor vote on the bill "sooner or later" this term. The Senate has never held a floor vote on legislation pertaining to descheduling cannabis.

Study: Youth Cannabis Exposure Not Associated with Residual Cognitive Deficits

Berlin, Germany: Adolescents with moderate exposure to cannabis show no decline in neurocognitive skills compared to controls, according to longitudinal data published in the journal Cognitive Development.

An international team of investigators from Canada, France, Germany, Ireland, and the United States examined the relationship between adolescent marijuana use at age 14 and cognitive performance at age 19. Researchers reported that those subjects with light-to-moderate cannabis use after age 15 demonstrated little difference in neurocognitive performance compared to non-users.

Authors determined: "Our data suggests that decision-making is not impaired when cannabis is used in moderation, and onset of use occurs after the age of 15. ... [A]fter controlling for confounders, we found no evidence of effects of cannabis on the remaining neurocognitive variables such as attention, working memory, short-term memory and risk-taking."

They concluded, "In summary, we find no evidence to support the presumption that cannabis consumption leads to a decline in neurocognitive ability."

Full text of the study, "Residual effects of cannabis use on neuropsychological functioning," appears in Cognitive Decline. Additional information is available from NORML's fact sheet, "Marijuana Exposure and Cognitive Performance."

Study: Adolescent Cannabis Use Not Independently Predictive of Depression, Suicidal Ideation

Quebec, Canada: Cannabis use by adolescents is not independently predictive of either depression or suicidal ideation, according to longitudinal data published in the Journal of Affective Disorders.

A team of Canadian investigators examined the relationship between cannabis use at age 15 and the likelihood of depressive symptoms and suicidal ideation at age 20 in a cohort of over 1,600 adolescents.

Researchers reported that cannabis use was not independently associated with a greater risk of suicidal thoughts at young adulthood after investigators controlled for subjects' use of alcohol, tobacco, and other substances. In addition, researchers reported that adolescents who suffered from depression were more likely to use cannabis later in life, not vice-versa.

Authors concluded: "This population-based study is the first, to our knowledge, to examine the temporal relation between cannabis use, depression and suicidal ideation simultaneously over five years during adolescence. Depression (but not suicidal ideation) predicted weekly cannabis use throughout adolescence. Weekly cannabis use predicted suicidal ideation (but not depression), but this association was no longer significant after taking into account other substance use including alcohol, tobacco and other drugs consumption. ... These findings highlight the importance of targeting depressive symptoms during this sensitive developmental period in an attempt to offset the potential increased use of cannabis over time."

In June, NIH researchers published data in the Journal of the American Medical Association highlighting an association between frequent cannabis use and elevated levels of suicidal ideation in young adults. However, authors of the study neither controlled for the use of other drugs, nor did they assess whether the relationship was bidirectional.

Full text of the study, "Cannabis use, depression and suicidal ideation in adolescence: Direction of associations in a population-based cohort," appears in the Journal of Affective Disorders.

Trends in Alcohol Purchases Mixed Following States' Enactment of Marijuana Legalization

Minneapolis, MN: Trends in alcohol sales are inconsistent following the enactment of statewide marijuana legalization laws, according to data published in the Journal of Cannabis Research.

A pair of researchers affiliated with the University of Minnesota assessed trends in households' alcohol purchases in marijuana legalization states (Colorado, Oregon, and Washington) compared to control states.

In two states - Colorado and Oregon - alcohol purchased decreased compared to control states. In Washington, sales of spirits increased compared to control states.

"Results suggest that alcohol and cannabis are not clearly substitutes nor complements to one-another," authors concluded. They added: "Alcohol may substitute or complement cannabis depending on subgroup characteristics, including any history of substance abuse or age. ... As cannabis becomes legalized and more widely available across the USA, there is a greater need to understand any unintentional consequences these policy changes may have for alcohol-related harms and public health problems more broadly."

Numerous studies have sought to resolve whether cannabis and alcohol are more likely to act as substitutes or as complements. A 2020 review of the relevant literature identified 30 studies finding that cannabis acted as a substitute for alcohol and 17 studies finding that the two substances act as complements. Authors of the study concluded, "We identified stronger support for substitution than complementarity, though evidence indicates different effects in different populations and to some extent across different study designs."

Most recently, data published in January in the journal Addiction reported that heavy drinkers significantly reduced their alcohol intake on days when they used cannabis.

Full text of the study, "Recreational cannabis legalization and alcohol purchasing: A difference-in-difference analysis," appears in the Journal of Cannabis Research.

Clinical Trial: Cannabis Extracts Effective for Refractory Chemotherapy-Induced Nausea

Sydney, Australia: The adjunctive use of cannabis extracts significantly reduces symptoms in patients with treatment-resistant chemotherapy-induced nausea, according to clinical trial data published in the journal Annals of Oncology.

Australian researchers compared cannabis extracts (oral capsules containing 2.5mg of THC and 2.5mg of CBD) versus placebo in a cohort of 72 patients with chemotherapy-induced nausea and vomiting (CINV).

Researchers reported that the adjunctive use of cannabis extracts was associated with reductions in patients' nausea and vomiting, and also with improvements in subjects' overall quality of life. Although the majority of patients did report side-effects, these effects were largely limited to non-serious events such as sedation and dizziness.

They concluded: "The oral THC:CBD cannabis extract was active and tolerable in preventing CINV, when combined with guideline-consistent antiemetic prophylaxis for a study population with refractory CINV. ... Further research is necessary to determine the significance and durability of improvements observed in specific AQOL-8D [quality of life] dimensions."

Cannabis extracts containing equal ratios of THC and CBD are already available in many countries by prescription under the brand name Sativex. The substance is not legally available in the United States. By contrast, oral synthetic THC, marketed under the brand name Marinol, is FDA-approved in the US for the treatment of nausea and vomiting associated with cancer chemotherapy.

Full text of the study, "Oral THC;CBD cannabis extract for refractory chemotherapy-induced nausea and vomiting: A randomized, placebo-controlled, phase II crossover trial," appears in Annals of Oncology.

Survey: Medical Cannabis Frequently Used as a Substitute for Prescription Medicines

Aarhus, Denmark: Europeans who consume cannabis for medical purposes frequently report using it to replace prescription medications, according to survey data published in The Harm Reduction Journal.

A team of Dutch researchers surveyed over 2,800 medical cannabis consumers. Over half of respondents (56 percent) reported using cannabis "for the purpose of replacing a prescribed drug."

Those who reported engaging in drug substitution were most likely to do so for pain medications, specifically opioids, as well as for anti-depressants, and arthritis medications.

Forty-six percent of respondents said that their use of medical cannabis led them to "substantially decrease" their use of prescription medications, while 38 percent reported ceasing their use of at least one prescription medicine. Sixty-six percent of respondents perceived cannabis to be "much more effective" than prescription drugs and 86 percent said that it possessed a more favorable side-effect profile.

Numerous studies of North American patients have reported similar findings.

Authors concluded: "Findings from our sample show that most substitution users find CaM [cannabis as medicine] more effective in managing their condition(s) compared to prescription drugs, and that an overwhelming majority found CaM to have a better side effect profile compared to the prescription drugs that they had been prescribed for their condition(s). ... Findings from our study add to the growing body of research indicating that from a user perspective, CaM has a substantial substitution effect for a variety of prescription drugs, most notably opioids."

Full text of the study, "Exploring the use of cannabis as a substitute for prescription drugs in a convenience sample," appears in the Harm Reduction Journal.

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Feds: Marijuana Trafficking Convictions Have Fallen Dramatically Following Statewide Legalization

Washington, DC: The federal government is prosecuting and convicting fewer people for violating marijuana trafficking laws, according to data provided by the United States Sentencing Commission (USSC).

According to a new fact sheet issued by the Commission, just over 1,000 people were sentenced federally in 2020 for violating marijuana trafficking laws. That’s down 67 percent since 2016, and over 80 percent since 2012 โ€“ when Colorado and Washington became the first two states to legalize and regulate the adult-use marijuana market.

“These trends illustrate the fact that state-legal domestic cannabis production has supplanted the foreign market and that marijuana law enforcement is becoming less of a federal priority in an age where the majority of Americans believe that cannabis ought to be legal,” NORML’s Deputy Director Paul Armentano said. “It is vital that Congress take action to amend federal law in a manner that comports with this reality.”

Overall, fewer than seven percent of all federal drug trafficking cases in 2020 involved marijuana, the USSC reported. Eighty-eight percent of marijuana trafficking prosecutions resulted in a prison sentence.

Additional information is available on the USSC.gov website.

Study: Marijuana Legalization Not Associated with Changes in Marijuana Use Among High-Risk Youth

Toronto, Canada: The enactment of adult-use marijuana legalization in Canada is not associated with changes in either cannabis use or perceived access among high-risk youth, according to data published in the Journal of Substance Abuse Treatment.

A pair of researchers affiliated with the University of Toronto assessed cannabis use patterns immediately prior to and following legalization in a cohort of young people who had been enrolled in a substance abuse treatment program. All of the 269 participants in the study had a history of marijuana use.

Investigators determined: “[A]s a whole, cannabis use patterns did not change with legalization across a range of cannabis use and polysubstance use behaviors, nor did the perception of ease of access or safety of the source of cannabis.” Authors also reported “no change in mental health symptomatology or substance use dependence” following legalization.

They concluded, “Cannabis use does not appear to have changed substantially in the short-term following legalization among youth seeking services for substance use disorders, whether or not the youth have reached the age of majority.”

Full text of the study, “Legalization of cannabis use in Canada: Impacts on the cannabis use profiles of youth seeking services for substance use,” appears in the Journal of Substance Abuse Treatment.

Clinical Trial: Single Dose of CBDV Modulates Atypical Brain Circuitry in Patients with Autism Spectrum Disorder

London, United Kingdom: The administration of the phytocannabinoid CBDV (cannabidivarin) modulates brain chemistry in autistic patients in a manner that is typically associated with better patient outcomes, according to clinical data published in the journal Molecular Autism.

An international team of investigators from Germany, Spain, the Netherlands, and the United Kingdom assessed the administration of CBDV versus placebo in a cohort of male patients with autism spectrum disorder (ASD). Researchers reported that CBDV dosing led to brain changes in the striatum that are typically associated with the mitigation of ASD symptoms.

Authors concluded: “A single dose of CBDV was sufficient to shift atypical striatal FC [functional connectivity] in the mature autistic brain towards the profile found at baseline in neurotypicals. … Future studies are required to determine whether modulation of striatal FC is associated with a change in ASD symptoms.”

Several observational trials have documented behavioral improvements in ASD patients administered whole-plant cannabis extracts. Most recently, a 2021 review of the relevant literature summarized: “Cannabis products [have been demonstrated to] reduce the number and/or intensity of different symptoms, including hyperactivity, attacks of self-mutilation and anger, sleep problems, anxiety, restlessness, psychomotor agitation, irritability, aggressiveness perseverance, and depression. Moreover, they [are associated with an] improvement in cognition, sensory sensitivity, attention, social interaction, and language.”

Authors of the review concluded, “Cannabis and cannabinoids may have promising effects in the treatment of symptoms related to ASD and can be used as a therapeutic alternative in the relief of those symptoms.”

Full text of the study, “Modulation of striatal functioning connectivity differences in adults with and without autism spectrum disorder in a single-dose randomized trial of cannabidivarin,” appears in Molecular Autism.

Study: Legal Marijuana Farms Are Not a Drain on Water Resources

Berkeley, CA: Licensed outdoor marijuana farms in northern California do not put undue strain on limited water resources, according to data published in the Journal of Environmental Management.

A team of researchers affiliated with the University of California, Berkeley and with the State of California, North Coast Regional Water Quality Control Board assessed irrigation patterns among licensed cannabis farms.

Authors stated that cannabis farming isn’t “particularly thirsty relative to other crops.” They estimated that “legal outdoor [cannabis] production uses about the same amount of water as a crop like tomatoes” and about 33 times less water than almonds.

The study’s findings run counter to previous claims that cannabis farming placed undue strain on the state’s limited water supply.

Because the University study only assessed water use among legally licensed farms, the authors cautioned that their findings may not be applicable to illicit growing practices. A prior study, published by New Frontier Data in partnership with the Resource Innovation Institute and the University of California, Berkeley similarly concluded that cannabis is among the most “water-economical” of California’s top revenue crops.

Full text of the study, “Water storage and irrigation practices for cannabis drive seasonal patterns of water extraction and use in northern California,” appears in the Journal of Environmental Management.

Clinical Trial: Oral CBD Dosing Doesn’t Consistently Mitigate Experimental Pain in Healthy Volunteers

New York, NY: The administration of oral CBD is not consistently associated with analgesia in healthy volunteers exposed to experimentally-induced pain, according to clinical data published in the British Journal of Clinical Pharmacology.

Researchers affiliated with Columbia University assessed the administration of various doses of purified CBD (200, 400, or 800mg) versus placebo in subjects exposed to experimental pain conditions.

Investigators reported that CBD “failed to consistently affect pain threshold and tolerance … relative to placebo.” In some cases, CBD dosing was associated with increases in subjects’ perceptions of pain.

Authors concluded: “CBD did not elicit consistent dose-dependent analgesia and in fact increased pain on some measures. Future studies exploring CBD-induced pain relief should consider using a more extensive pain assessment paradigm in different participant populations.”

Other studies have documented the anti-inflammatory effects of CBD, which may be useful in the treatment of chronic pain in certain pain populations. Moreover, the inhalation of whole-plant cannabis is well-established as an analgesic agent in various populations, particularly those suffering from neuropathy.

Full text of the study, “The dose-dependent analgesic effects, abuse liability, safety and tolerability of oral cannabidiol in healthy humans,” appears in the British Journal of Clinical Pharmacology.

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Study: Marijuana Use Not Associated with Deleterious Effects on Male Sexual Function

* Note @WeedConnection Does Not Need A Study To Confidently State The Headline iS Correct
** Based On Personal Experience; Interviewing & Witnessesing Old Stoners Pop Out Babies iN Old Age

Winnipeg, Canada: Cannabis use does not appear to have any significant adverse effects on either male reproductive health or sexual function, according to longitudinal data published in the Canadian Urological Association Journal.

A team of Canadian investigators assessed male reproductive health in a cohort of nearly 8,000 subjects over a ten-year period.

Authors reported that subjects with a history of cannabis use “had a higher mean Sexual Health Inventory for Men (SHIM) score and mean total testosterone than non-users.”

They concluded, “[T]he present study provides compelling evidence against significant deleterious effects of cannabis use on male sexual function. Further studies, particularly large randomized controlled trials, are needed to establish causation of cannabis use on levels of testosterone and other reproductive hormones, semen parameters, sexual function, and fertility.”

Full text of the study, “The impact of cannabis use on male sexual function: A 10-year single-center experience,” appears in the Canadian Urological Association Journal.

Supreme Court Justice Questions Whether Federal Marijuana Ban Should Remain in Place

Washington, DC: United States Supreme Court Justice Clarence Thomas has called into question the US government’s authority to impose federal prohibitions on the state-licensed production and sale of cannabis.

In a written opinion issued on Monday, Thomas wrote, “The Federal Government’s current approach is a half-in, half-out regime that simultaneously tolerates and forbids local use of marijuana.” Specifically, Thomas referred to legislation passed by Congress every year since 2015 prohibiting the Justice Department from interfering in states’ medical cannabis access programs. “This contradictory and unstable state of affairs strains the basic principle of federalism,” he wrote.

Thomas further acknowledged that times have changed significantly since 2005, when the Supreme Court ruled 6 to 3 (in Gonzalez v Raich) that federal law prohibited any state-sanctioned use of marijuana as a medicine – even in instances where there was no interstate commerce. Thomas was among the judges who dissented in that case.

He wrote: “Whatever the merits of Raich [were] when it was decided, federal policies of the past 16 years have greatly undermined its reasoning. … Suffice it to say, the Federal Government’s current approach to marijuana bears little resemblance to the watertight nationwide prohibition that a closely divided Court found necessary to justify the Government’s blanket prohibition in Raich. If the Government is now content to allow States to act โ€˜as laboratories’ โ€˜and try novel social and economic experiments,’ then it might no longer have authority to intrude on โ€˜[t]he States’ core police powers . . . to define criminal law and to protect the health, safety, and welfare of their citizens.’ A prohibition on intrastate use or cultivation of marijuana may no longer be necessary or proper to support the Federal Government’s piecemeal approach.”

Thomas issued his comments while presiding over the appeal of a case (Standing Akimbo LLC et al v United States) challenging the federal ban on tax deductions for state-licensed cannabis businesses.

In response to Justice Thomas’ comments, NORML’s Executive Director Erik Altieri said: “Justice Thomas’ comments reflect what has been obvious to the vast majority of Americans for some time now. With nearly half of all Americans residing in a state where the use of marijuana by adults is completely legal, it is both absurd and problematic for the federal government to continue to define cannabis as a prohibited Schedule I controlled substance. This intellectually dishonest position is in conflict with the available science and the current cultural landscape, and it complicates the ability of states to successfully regulate and oversee state-legal marijuana businesses.”

Altieri concluded, “It is time for Congress to end this untenable situation by removing cannabis from the Controlled Substances Act so that states can make their own decisions with regard to marijuana and marijuana commerce free from undue federal interference.”

Mexico: Court Moves to Abolish Laws Prohibiting Personal Use of Marijuana

Mexico City, Mexico: Justices on Mexico’s highest court moved this week to permit adults to possess and cultivate small quantities of marijuana without penalty.

In 2018, members of the Supreme Court of Justice determined that the sections of the federal law criminalizing the private use and cultivation of cannabis by adults were unconstitutional. At that time, the majority opined, “The effects caused by marijuana do not create an absolute prohibition on its consumption.”

Justices gave Mexican lawmakers until April 30, 2021 to enact legislation regulating the use of cannabis by adults. However, House and Senate lawmakers did not agree on a plan prior to the deadline.

On Monday, a majority of the Court mandated that officials with Mexico’s Health Department begin issuing permits to members of the public ages 18 and older who wish to either possess or grow personal use quantities of cannabis. Activities involving commercial activities remain illegal.

“With these actions by the Court, the United States has become an island of federal marijuana prohibition in North America,” NORML’s Deputy Director Paul Armentano said.

Canada legalized its marijuana market in 2018. Mexican lawmakers in 2009 decriminalized the possession of small amounts of cannabis (5 grams or less) and other substances.

Additional information is available from the Court.

Marijuana Use Not Associated with Increased Risk of Atherosclerosis

Bern, Switzerland: The cumulative use of cannabis over a 20-year period is not independently associated with an increased risk of atherosclerosis (hardening of the arteries), according to longitudinal data published in The American Journal of Medicine.

An international team of investigators from Switzerland and the United States assessed the relationship between the use of tobacco and/or cannabis and the risk of subclinical atherosclerosis in a cohort of 3,257 subjects.

Authors reported that lifetime exposure to tobacco over a 20-year period was “strongly associated” with subclinical atherosclerosis, whereas the cumulative use of cannabis alone was not – a finding that is consistent with prior research.

They concluded, “This study adds to the growing body of evidence that there might be no association between the average population level of marijuana use and subclinical atherosclerosis.”

Previous research published by several of the same investigators reports that the cumulative use of cannabis is not associated with an increased risk of either cardiovascular disease or coronary heart disease in middle-age subjects.

Other analyses of nationally representative samples of recreational marijuana consumers have reported inconsistent results regarding the relationship between cannabis and adverse cardiovascular events. A 2021 study of 57,000 US adults concluded, “After controlling for several confounding variables, we found that there was a decrease in the prevalence of cardiovascular events with marijuana use (Odds Ratio: 0.74).” By contrast, a 2020 review of nearly 134,000 US adults reported, “Frequent marijuana smoking is associated with significantly higher odds of stroke and myocardial infarction or coronary artery disease, with a possible role in premature cardiovascular disease.” More recently, the results of a 2021 literature review of 67 studies published in The American Journal of Medicine concluded, “[M]arijuana itself does not appear to be independently associated with excessive cardiovascular risk factors.” Authors did caution, however, that “it can be associated with other unhealthy behaviors such as alcohol use and tobacco smoking that can be detrimental” to cardiovascular health.

Full text of the study, “Cumulative marijuana use and carotid intima-media thickness at middle age: the CARDIA study,” appears in The American Journal of Medicine.

Clinical Trial: Cannabis Extracts Improve Quality of Life in Glioma Patients

Sydney, Australia: The daily administration of plant-derived cannabis extracts is well-tolerated and improves the overall quality of life in patients with glioma (brain cancer), according to clinical trial data published in the journal Frontiers in Oncology.

A team of Australian researchers assessed the daily administration of cannabis extracts containing either a 1 to 1 ratio of THC and CBD or a 4 to 1 ratio of THC and CBD in 83 patients with glioma. Subjects in the trial consumed the extracts for a period of at least four weeks.

Investigators reported that subjects responded most favorably to extracts containing equal ratios of THC and CBD.

They concluded: “This study provides robust evidence that medicinal cannabis administered to this patient population is safe, well tolerated, and can provide symptomatic relief to these patients. … [It] suggests that cannabis, especially a 1:1 CBD/THC mixture can be helpful for many of the symptoms impacting QoL [quality of life] in this patient population, especially sleep disturbance. As such, MC [medical cannabis] may be a valuable potential therapy for maintaining the best QoL and daily function for this poor prognosis population, [while] also assisting patients during anticancer and potential life extending therapies.”

Full text of the study, “A phase II randomized clinical trial assessing the tolerability of two different ratios of medicinal cannabis in patients with high grade gliomas,” appears in Frontiers in Oncology.

Study: CBD-Rich Cannabis Products Associated with Improvements in Pain, Anxiety, and Depression in Patients with More Severe Symptoms

Montreal, Canada: The long-term use of CBD-rich cannabis products is associated with overall improvements in patients with moderate to severe anxiety, pain, and depression, according to data published in the Journal of Cannabis Research.

A team of Canadian researchers assessed the use of lab-tested, CBD-rich products over a six-month period in a cohort of 279 subjects with mild to severe symptoms. Patients with more severe symptoms exhibited clinical benefits following the use of CBD, whereas those subjects with mild symptoms experienced little overall change in their symptoms.

“This study on CBD-rich products demonstrates the potential of RWE (real-world evidence) for the advancement of medical cannabis research and practice guidelines, especially in a world where CBD use is exponentially increasing but scientific data are limited. It revealed that CBD-rich treatments have a beneficial impact on patients with self-reported moderate or severe symptoms of pain, anxiety, or depression and overall wellbeing but not in patients with mild symptoms. … The results of this study contribute to address the myths and misinformation about CBD treatment and demand further investigation.”

Full text of the study, “Cannabidiol use and effectiveness: Real-world evidence from a Canadian medical cannabis clinic,” appears in the Journal of Cannabis Research.

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