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Study: Medical Cannabis May Present a "Useful Treatment Strategy" for Fibromyalgia Patients

Montreal, Canada: Cannabis products are associated with symptom relief among fibromyalgia (FM) patients, according to data published in the journal Arthritis Care & Research.

Canadian researchers assessed the efficacy of medical cannabis products (flower or extracts) over a one-year period in a cohort of patients with FM. Investigators assessed patients' levels of pain intensity, sleep quality, and depression/anxiety every three months. All of the subjects enrolled in the study were qualified to use medical cannabis products by their general practitioner.

Consistent with other studies, researchers reported an association between the consumption of medical cannabis and improvements in subjects' sleep, depression/anxiety, and pain - with the greatest reduction in pain intensity (a mean decrease of 1.7 points on a zero to 10 scale) occurring within the first six-months of treatment.

Authors reported: "Our current findings are consistent with observations of pain relief, improved sleep, and alleviation of symptoms of anxiety and depression in other studies among patients with chronic pain using medical cannabis. Although preliminary, our findings suggest that improvements in negative affect and sleep might represent potential mechanisms of action underlying pain reductions among FM patients who are using medical cannabis."

They concluded, "Medical cannabis may present a useful treatment strategy for patients with FM in light of an effect on the triad of symptoms of pain, negative affect, and sleep disturbances."

Survey data reports that fibromyalgia patients frequently consume cannabis for therapeutic purposes. A recent review of the relevant literature concluded, "[T]he 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."

Full text of the study, "Predictors of pain reduction among fibromyalgia patients using medical cannabis: A long-term prospective cohort trial," appears in Arthritis Care & Research.

Congress: Bipartisan Bill Introduced to Designate Funding for Clinical Trials on the Efficacy of State-Licensed Medical Cannabis Products

Washington, DC: Representatives Scott Peters (D-CA) and David Joyce (R-OH) have introduced legislation, the Developing and Nationalizing Key Cannabis Research Act of 2022, to provide designated funding for clinical research into the therapeutic benefits of cannabis.

The legislation authorizes the Director of the National Institutes of Health to designate "institutions of higher education as Centers for Excellence in Cannabis Research for the purpose of interdisciplinary research related to cannabis and other biomedical, behavioral, and social issues related to cannabis." This research will explicitly include clinical investigations assessing "the safety and efficacy of cannabis in providing therapeutic benefits for certain priority diseases or conditions" as well as studies evaluating "the relative risk of cannabis as compared to alcohol and tobacco," among other purposes.

To carry out this work, the measure appropriates $50,000,000 for each of fiscal years 2024 to 2028 to ten designated research centers. It also allows scientists affiliated with these designated centers to obtain state-legal cannabis products and to administer those products to subjects in clinical trials.

Under current federal law and regulations, researchers are prohibited from clinically evaluating any state-licensed products. Rather, scientists wishing to study cannabis in clinical settings must utilize cannabis provided by federally-licensed entities - of which there has been only one (the University of Mississippi) for more than 50+ years. (In May 2021, the agency announced that it had reached agreements with a handful of third-party applicants to allow them to grow cannabis for use in federally approved clinical trials. However, the US National Institute on Drug Abuse has yet to officially partner with any of these entities and there is no explicit timeline as to when they will do so.) Scientists have long complained that the quality of cannabis provided by the University of Mississippi's cultivation program is of inferior quality and that it is not representative of the products available in state-legal markets.

Last month, members of the US House of Representatives voted in favor of legislation, "The Medical Marijuana and Cannabidiol Research Expansion Act," to facilitate cannabis-specific scientific research and potential drug development. That language is anticipated to be fast-tracked to the President's desk. However, it does not authorize scientists to access cannabis flowers and other products manufactured in accordance with state-approved marijuana programs.

"This proposed legislation is long overdue," NORML's Deputy Director Paul Armentano said. "It seeks to address knowledge gaps by providing dedicated funding so that scientists can better understand the safety and efficacy of real-world products - products that are currently being consumed by patients and by others daily in the majority of states in America."

Despite federal hurdles, scientific interest and studies involving cannabis have increased significantly over the past two decades. Since 2010, scientists in the US and around the world have published an estimated 30,000 peer-reviewed papers referencing the cannabis plant or its constituents, with the annual number of total papers increasing every year. By comparison, researchers published fewer than 3,000 total papers about marijuana in the years between 1990 and 1999 and fewer than 2,000 total studies during the 1980s.

Study: Medical Cannabis Associated with Pain Mitigation, Reduced Reliance on Opioids in Patients with Advanced Cancer

Syracuse, NY: Patients with advanced cancer respond favorably to medical cannabis, according to data published in the journal Cureus.

Investigators affiliated with Upstate University Hospital in Syracuse, New York evaluated cancer patients' use of cannabis for palliative purposes. All of the participants in the trial were enrolled in the state's medical cannabis registry.

Consistent with prior data, the majority of subjects (85 percent) reported symptom improvements following their use of cannabis - with nearly half reporting reductions in their pain. Also consistent with prior studies, a significant percentage (45 percent) of subjects reported decreasing their use of opioid pain medications. Very few participants (less than four percent) experienced adverse effects from their use of medical cannabis products.

"Medical marijuana appears to have an important role in the palliation of symptoms in advanced cancers with few adverse effects," authors concluded. "Prospective studies examining this treatment modality should be prioritized."

Full text of the study, "Experience with medical marijuana for cancer patients in the palliative setting," appears in Cureus.

Survey: Middle-Aged Women Frequently Report Cannabis Use to Mitigate Menopause Symptoms

Belmont, MA: Many middle-aged women acknowledge consuming cannabis products to alleviate menopause-related symptoms, according to survey data published in the journal Menopause.

A team of researchers affiliated with McLean Hospital and with Harvard Medical School in Boston surveyed 258 women (median age: 51 years old) regarding their use of cannabis.

The majority of respondents (79 percent) said that cannabis effectively treats menopause-related symptoms. Women were most likely to report using cannabis to alleviate sleep disturbances and to regulate mood. Respondents were most likely to report consuming cannabis via smoking.

"The current study indicates that many individuals are currently using commercially available MC [medical cannabis] products as an adjunct treatment for menopause-related symptoms. ... The most commonly reported indications for MC use were menopause-related disturbance of sleep and mood/anxiety, indicating these symptoms may be salient targets for future clinical trials of cannabinoid-based therapies," authors concluded. "Future research should continue to examine MC use for menopause-related symptoms, including assessing how unique cannabinoid profiles, modes of use, and other MC use characteristics impact safety and efficacy."

Previous surveys, such as those here and here, have estimated that one-third of women consume cannabis for purposes of managing menopause-related symptoms.

Full text of the study, "A survey of medical cannabis use during peri-menopause and post-menopause," appears in Menopause.

Massachusetts: Lawmakers Advance Legislation Creating 'Social Equity Trust Fund,' Facilitating Licensing of On-Site Consumption Lounges

Boston, MA: House and Senate lawmakers have advanced legislation (S. 3096) which seeks to promote greater diversity among those participating in the state's licensed cannabis industry and that lays the groundwork for the establishment of on-site cannabis consumption facilities.

Specifically, the measure creates a "Cannabis Social Equity Trust Fund to encourage the full participation ... of entrepreneurs from communities that have been disproportionately harmed by marijuana prohibition and enforcement." Money in the fund "shall be used to make grants and loans, including no-interest loans and forgivable loans, to social equity program participants and economic empowerment priority applicants."

In addition, the bill provides guidance for the eventual licensing of on-site adult-use consumption facilities. It also calls on state officials to conduct a study and to make recommendations "to ensure that students have access to [the] medical use of marijuana" while they attend school.

To date, only a handful of states - including Alaska and Nevada - have allowances for social consumption facilities. By contrast, many states now provide allowances for qualified students to access cannabis products while on school grounds.

The bill now awaits action from Republican Gov. Charlie Baker, who reportedly favors the bill and is expected to sign it into law.

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Feds Report Significant Year-Over-Year Decline in Marijuana Seizures at the US Border

Washington, DC: Federal officials report a significant drop in the quantity of marijuana they are seizing at the US international border, according to data compiled by the US Department of Homeland Security.

According to reporting provided by borderreport.com, "Department of Homeland Security agencies in FY2021 seized 160 tons of marijuana, an average of 874 pounds a day. With three months left in the current fiscal year, agents have seized 56 tons, an average of 408 pounds a day."

The year-over-year decline in marijuana-related seizures at the border is in stark contrast to more generalized data showing a 25 percent increase in overall drug-related seizures. However, it is consistent with longstanding trends previously reported by the US Drug Enforcement Administration that determined, "In US markets, Mexican marijuana has largely been supplanted by domestic-produced marijuana."

Separate data provided earlier this year by the US Government Accounting Office reported that "most drug seizure events [at the US border] involved only US citizens (91 percent), of which 75 percent involved the seizure of marijuana and no other drugs." Of those seizures, 69 percent involved only personal use quantities of cannabis.

Additional information on drug-related border seizures is available from the US Customs and Border Protection agency.

Study: Legalization of Retail Cannabis Sales Not Linked to Any Increase in Youth Use

East Lansing, MI: The adoption of statewide laws regulating the sale of marijuana products to adults is not associated with any increase in cannabis initiation among people under the age of 21, according to data published in the journal PLoS One.

Researchers affiliated with Michigan State University assessed marijuana use trends in a nationally representative cohort of subjects in order to evaluate whether or not legalization was associated with any changes in the percentage of people initiating cannabis use for the first time.

Investigators identified an increase in the number of new adult cannabis consumers following legalization, but they reported no changes among those under 21 years of age.

They reported: "These results show consistent evidence of an increase in the occurrence of newly incident cannabis use for adults aged 21 years and older after the removal of prohibitions against cannabis retail sales. For those aged 12-20-years-old, the study estimates support the hypothesis that RCLs [recreational cannabis laws] did not affect the occurrence of newly incident cannabis use for underage persons."

The findings are consistent with those of prior studies reporting that adult-use legalization is not associated with either increased use or access among young people.

"Cannabis policy liberalization continues to be a contentious issue in the national political landscape. ... Policymakers and the voters who elect these policy-makers cannot make the best judgments in the absence of evidence, unless their decisions are to be based on potentially erroneous prejudices or beliefs," authors concluded. "The evidence from this study is not perfect, but the estimates provide an evidence base that can be judged in relation to an important question - namely, should we worry about underage cannabis use when adults are allowed to buy cannabis products in retail shops? And might the occurrence of adult-onset newly incident cannabis use increase if this policy change is made? The answer to the first question at this point seems to be that there has been no policy influence on cannabis incidence in the underage adolescent population after adults have been allowed to buy cannabis in retail shops. The answer to the second question at this point indicates a tangible uptick in the occurrence of newly incident cannabis use among adults who otherwise might never have tried cannabis. We are hopeful that voters, policymakers, and public health officials can use this evidence as they forecast what might change if cannabis policies are liberalized to permit adult purchases from retail cannabis shops in their jurisdictions."

Full text of the study, "Estimating the effects of legalizing recreational cannabis on newly incident cannabis use," appears in PLoS One.

Analysis: Labels Often Inaccurate for Hemp-Derived CBD Topical Products

Baltimore, MD: A significant percentage of hemp-derived CBD topical products contain percentages of CBD and THC that differ significantly from what is listed on their packaging, according to data published in the journal JAMA Network Open.

A team of researchers affiliated with John Hopkins University School of Medicine and the Substance Abuse Mental Health Services Administration assessed the purity of 105 commercially available hemp-derived CBD topical products.

Of the 89 products that provided information regarding the percentage of CBD available in them, only 24 percent provided accurate data. Thirty-five percent of topical products also tested positive for trace quantities of THC - including 11 percent of products that were explicitly labeled as "THC free." (Over half of the products tested made no mention of THC on the product label.)

The findings are consistent with dozens of prior studies similarly reporting that commercially available CBD products seldom provide accurate information on their packaging.

Authors concluded, "This case series found that topical cannabinoid products purchased online and at popular retail stores were often inaccurately labeled for CBD content and many contained the psychoactive cannabis constituent THC. Moreover, some products made therapeutic claims for indications not approved by the FDA. These findings highlight the need for proper regulatory oversight of cannabis and hemp products to ensure these products meet established standards for quality assurance and so that consumers are not misled by unproven therapeutic or cosmetic claims."

More than three years following the passage of federal legislation legalizing hemp production, the US Food and Drug Administration (FDA) has yet to promulgate rules regulating the marketing and sale of commercial products containing hemp-derived CBD or other cannabinoids. Survey data compiled by the National Consumers League previously determined that more than eight in ten US voters desire greater federal regulatory oversight over the labeling and marketing of commercially available CBD products.

Full text of the study, "Cannabinoid content and label accuracy of hemp-derived topical products available online and at national retail stores," appears in JAMA Network Open.

CBD Extract Shows Anti-Bacterial Activity Against Salmonella in Preclinical Model

Montgomery, AL: Whole-plant CBD extracts exhibit anti-bacterial activity against various species of salmonella, according to preclinical data published in the journal Molecules. Salmonella species are among the most common and prevalent foodborne pathogens worldwide.

A team of scientists affiliated with Alabama State University assessed the efficacy of CBD as an anti-bacterial agent against salmonella newington and salmonella typhimurium.

Researchers determined that CBD extracts inhibited salmonella bacteria cell growth in culture in a manner similar to that of the conventional antibiotic ampicillin.

They reported: "Salmonella infections are typically treated with broad-spectrum antibiotics such as ampicillin; however, the development of resistance to these treatments has become more prevalent, thus increasing the need for alternative treatments. ... These experiments confirmed that CBD has antibacterial activity against our target bacteria. Additionally, our comparative studies showed that CBD has antibacterial activity similar to ampicillin. ... These results posed the question of CBD-antibiotic co-therapy as a potential novel application."

They concluded: "Discovery and development of novel antibacterial agents such as CBD are a major step towards the future of therapeutics in a world where antibiotics are no longer efficacious and cost effective. .... This study further progresses our current knowledge on the effectiveness of CBD as an antibacterial agent and demonstrates the effectiveness of CBD against Gram-negative bacteria, S. typhimurium and S. newington. ... While this study illuminates the potential of CBD as a therapeutic and fills a void in the current literature, future work is necessary for further development of this bioactive compound as a therapeutic agent."

Initial acknowledgements in the scientific literature of cannabinoids' antibacterial properties date back over six decades. More recently, preclinical studies have demonstrated that cannabinoids can inhibit the spread of methicillin-resistant Staphylococcus aureus (a/k/a MRSA), malaria, and certain forms of dental bacteria.

Full text of the study, "Cannabis sativa CBD extract shows promising antibacterial activity against salmonella typhimurium and salmonella newington," appears in Molecules.

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Analysis: Patients with a History of Cannabis Use Less Likely to Have Medical Complications Following Spinal Fusion Surgery

New York, NY: Patients with a history of cannabis use are less likely than non-users to experience adverse medical outcomes following thoracolumbar (lower back) spinal fusion (TLF) surgery, according to data published in The Iowa Orthopedic Journal.

A team of orthopedic specialists affiliated with the State University of New York (SUNY) Downstate Health Sciences University in Brooklyn assessed the relationship between cannabis use and surgical outcomes in a cohort of 704 patients undergoing TLF surgery for adult spinal deformity (ASD). Half of the subjects in the sample identified as cannabis consumers and half did not.

Compared to non-users, cannabis consumers experienced significantly lower rates of medical complications during the 90-day period immediately after surgery. Those with a history of cannabis use were no more likely than non-users to seek post-operative readmissions.

"Compared to patients with ASD who underwent TLF without baseline cannabis use, patients with isolated baseline cannabis use were found to have no increase in odds of incurring 90-day surgical complications or readmissions or revisions two years postoperatively, though reduced odds of experiencing 90-day medical complications were observed," authors concluded. "Future prospective, randomized-controlled studies could help further characterize the impact of isolated cannabis use on the postoperative course of surgical patients undergoing complex procedures such as thoracolumbar fusion for adult spinal deformity."

Prior observational studies have similarly reported that marijuana use is associated with a decreased risk of in-hospital mortality among patients suffering from congestive heart failure, cancer, COPD, pancreatitis, HIV, burn-related injuries, traumatic brain injuries, and various other types of severe trauma.

Full text of the study, "The impact of isolated baseline cannabis use on outcomes following thoracolumbar spinal fusion: A propensity score-matched analysis," appears in The Iowa Orthopedic Journal.

Poll: Plurality of Americans Favor Federal Marijuana Legalization Mandate

New York, NY: By a margin of more than 2 to 1, Americans favor a federal mandate legalizing the adult use of marijuana nationwide, according to polling data compiled by The Economist and YouGov.com.

Forty-five percent of respondents say that the federal government should legalize the adult use of marijuana nationally. That's higher than the percentage of Americans who favor a national mandate permitting abortion (41 percent) or physician-assisted suicide (32 percent).

Twenty-one percent of respondents said that the decision whether or not to legalize marijuana should be left primarily up to the individual states. Several pieces of marijuana reform legislation currently pending in Congress, such as The MORE Act and The States Reform Act, seek to deschedule marijuana from the US Controlled Substances Act – thereby providing state governments the ability to either legalize or criminalize marijuana absent federal interference.

Only 20 percent of those surveyed agree that cannabis should be "banned nationally."

Commenting on the polling data, NORML's Deputy Director Paul Armentano said: "While a plurality of Americans favors the idea of the federal government mandating the states to adopt marijuana legalization, such an outcome remains entirely unlikely in our federalist system. Rather, issues pertaining to marijuana legalization have historically been decided, and continue to be decided, on a state-by-state basis and the best — and most practical way the federal government can respond — is to take steps to undo the past harms of federal prohibition while leaving states free to adopt their own policy alternatives."

Study: CBD Administration Associated with Reduced Cannabis/Tobacco Intake

Paris, France: Vaporizing a liquid formulation of CBD is associated with reduced cannabis/tobacco intake, according to data published in the journal Frontiers in Psychiatry.

A team of French investigators assessed the impact of vaporized CBD on daily cannabis consumption patterns in a cohort of 20 daily consumers. Nearly all of the subjects in the study smoked cannabis mixed with tobacco in joints. Prior studies have previously demonstrated that CBD administration mitigates smoker's desire for tobacco cigarettes.

Of the nine patients who completed the 12-week trial, six of them reduced their daily consumption of cannabis/tobacco joints by 50 percent.

Authors concluded: "This research provides evidence in favor of the use of CBD in CUD [patients with cannabis use disorder] … and illustrates the interest of proposing an addictological intervention targeting at the same time tobacco and cannabis dependence in users who are co-consumers. … A double-blind, randomized, multi-center, placebo-controlled clinical trial is still needed to assess the efficacy of inhaled CBD in CUD."

CBD consumption has previously been associated with reductions in alcohol intake as well as reductions in cue-induced cravings and anxiety in subjects with a history of heroin use.

Full text of the study, "Efficacy of inhaled cannabidiol in cannabis use disorder: the pilot study Cannavap," appears inFrontiers in Psychiatry.

Survey: Cannabis Is a "Common Treatment" for Those Living with Chronic Pain

Quebec, Canada: Nearly one-third of patients living with chronic pain conditions acknowledge using cannabis for pain management, according to data published in the Canadian Journal of Pain.

Canadian investigators assessed cannabis use trends in a cohort of 1,935 chronic pain patients residing in Quebec. (Cannabis products are legal for both medical purposes and for adult use in Canada.)

Just over 30 percent of patients in the sample said that they used cannabis explicitly for purposes of pain management.

Authors identified greater cannabis prevalence among younger patients, but they reported no significant differences between men and women with respect to how likely they were to consume the substance.

"Cannabis is thus a common treatment reported in people living with CP [chronic pain]," they concluded. "Our study re-emphasizes the importance of rapidly generating evidence on the safety and effectiveness of cannabis, in addition to age-tailored education and awareness efforts among people living with CP."

Among patients in US states where medical cannabis access is permitted, over 60 percent are qualified to use it to treat pain.

Full text of the study, "Prevalence of cannabis use for pain management in Quebec: A post-legalization estimate among generations living with chronic pain," appears in the Canadian Journal of Pain.

Colorado: Executive Order Prevents Denial of Professional Licensure to Those with Past Cannabis Convictions

Denver, CO: Those with prior in-state or out-of-state marijuana-related convictions will no longer be denied professional licensure in Colorado, under an executive order signed by Democratic Gov. Jared Polis.

The new order (Executive Order 34: Protecting Colorado's Workforce and Expanding Licensing Opportunities) states: "No one who lawfully consumes, possesses, cultivates or processes marijuana pursuant to Colorado law should be subject to professional sanctions or denied a professional license in Colorado. This includes individuals who consume, possess, cultivate or process marijuana in another state in a manner that would be legal in Colorado.

It directs the state Department of Regulatory Affairs, which oversees professional licensing for close to 1 million Coloradans in at least 50 different sectors, to "promulgate and issue rules as necessary to ensure that no person shall be subject to disciplinary action against a professional license or disqualified from professional licensure for any civil or criminal judgment, discipline or other sanction threatened or imposed under the laws of another state regarding consumption, possession, cultivation or processing of marijuana so long as the actions are lawful and consistent with professional conduct and standards of care within the state of Colorado."

The Governor said that the order was necessary in order to stimulate job growth in the state. "There is a workforce shortage in Colorado," he wrote. "Employers are having difficulty recruiting and retaining qualified employees, many of whom need professional licenses. The exclusion of people from the workforce because of marijuana-related activities that are lawful in Colorado, but illegal in other states, hinders our economy and our state."

Full text of the executive order is online.

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Marijuana Reform Advocates in Multiple States Turn in Signatures for 2022 Initiative Campaigns

Tulsa, OK: Cannabis reform advocates in four states - Arkansas, Nebraska, Oklahoma, and North Dakota - have recently submitted signatures to election officials to place legalization proposals on the 2022 ballot.

Last Wednesday, representatives with the group Oklahomans for Sensible Marijuana Laws announced that they had turned in over 164,000 signatures to the Secretary of State's office in an effort to place a binding, statewide marijuana legalization initiative (State Question 820) on the November ballot. That total is well above the number of signatures necessary (94,911) to qualify for the 2022 ballot.

The proposed measure seeks to permit adults to legally possess and home-cultivate personal use qualities of cannabis while also establishing a licensed, retail marketplace. Those with past marijuana convictions, or those who are currently incarcerated for certain cannabis-related crimes, would be able to petition the courts for either record expungement or re-sentencing consideration.

On Friday, the group Responsible Growth Arkansas submitted just over 190,000 signatures to the Secretary of State's office to place the Arkansas Adult Use Cannabis Amendment on the November ballot. The constitutional amendment seeks to establish a state-licensed retail cannabis market for those age 21 and older. It also seeks to expand the state's existing medical cannabis access program by increasing the total number of licensed dispensaries and by eliminating certain taxes. Advocates need just over 89,000 valid signatures to qualify the measure for the ballot.

Also on Friday, the group Nebraskans for Medical Marijuana turned in over 90,000 signatures each for a pair of medical cannabis legalization measures - just above the roughly 87,000 necessary to qualify them for the November ballot.

Finally, on Monday, representatives with the group New Approach ND announced that they had turned in 25,762 signatures to Secretary of State's office. That total is roughly 10,000 signatures above the number of signatures necessary (15,582) to qualify it for the 2022 ballot. The proposed measure permits adults to legally possess and home-cultivate personal use qualities of cannabis while also establishing a licensed retail marketplace.

Legalization measures in South Dakota and Maryland have already been confirmed for ballot placement in their respective states. In May, the group Legal Missouri 2022 turned in more than 385,000 signatures to state officials - more than double the total (171,592) necessary to place a constitutional amendment on the ballot legalizing marijuana.

Survey: Cannabis Effective at Mitigating Musculoskeletal Pain

San Juan, Puerto Rico: Patients suffering from musculoskeletal pain disorders report obtaining significant relief following their use of medical cannabis products, according to data published in the Journal of the American Academy of Orthopedic Surgeons.

A team of Puerto Rican investigators surveyed 184 patients with chronic pain conditions regarding their use of medical cannabis. (Lawmakers legalized patient access to certain cannabis preparations in 2015.)

Respondents suffering specifically from musculoskeletal conditions reported an average reduction of 4.47 points on the Numeric Rating Scale following cannabis administration. Eighty-nine percent of survey participants said that cannabis was "more effective" than opioids for pain management - a finding that is consistent with other studies.

Authors concluded: "This study showed that the use of medical cannabis among patients with musculoskeletal conditions effectively reduced pain levels based on their NRS reported scores. In addition, most patients using medical cannabis considered that this drug represents a better option than narcotics (e.g., opioids) for adequate pain management. Additional studies on medical cannabis should evaluate whether the experience and perspective presented through this study could translate into satisfactory and consistent clinical outcomes."

Survey data from 2020 estimated that one in five Canadian patients battling musculoskeletal disorders used cannabis to ease their pain. Among pain patients enrolled in medical cannabis access programs, most subjects report decreasing or even eliminating their use of opiates.

Full text of the study, "Patient experience and perspective on medical cannabis as an alternative for musculoskeletal pain management," appears in the Journal of the American Academy of Orthopedic Surgeons.

Study: Subjects Perceive Decreased Fatigue Following Cannabis Smoking

Albuquerque, NM: The inhalation of cannabis is associated with perceived decreases in fatigue, according to data published in the journal Medical Cannabis and Cannabinoids.

A team of researchers affiliated with the University of New Mexico assessed the effects of smoked cannabis on fatigue intensity levels in 3,922 subjects over a 3+ year period. Study participants self-administered cannabis at home and reported symptom changes in real time on a mobile software application.

"On average, 91.94 percent of people experienced decreased fatigue following consumption with an average symptom intensity reduction of 3.48 points on a zero-to-10 visual analog scale," investigators reported. They added: "While labeled plant phenotypes (‘C. indica,' ‘C. sativa,' or ‘hybrid') did not differ in symptom relief, people that used joints to combust the flower reported greater symptom relief than pipe or vaporizer users. Across cannabinoid levels, tetrahydrocannabinol, and cannabidiol levels were generally not associated with changes in symptom intensity levels."

They concluded: "Using the largest database of real-time effects of cannabis usage in the USA, we found that combusting whole, dried cannabis flower has a generally fast-acting and energetic effect for the majority of people that have symptoms of fatigue. While some user sessions resulted in increased fatigue or fatigue-related side-effect experiences, the vast majority of people reported an overall decrease in their perceived fatigue intensity levels. … Future research would benefit from investigating real-time effects of cannabis usage on behavioral and mental fatigue under altered bodily states and how different phytochemicals in the cannabis plant aggregate and/or interact in its mental and physical effects in healthy people and clinical populations."

Using similar methods, UNM researchers have previously reported that cannabis exposure is associated with real-time reductions in migraine symptoms, pain intensity, stress, depressive symptoms, and nausea, among other symptoms.

Full text of the study, "The effect of consuming cannabis flower for treatment of fatigue," appears in Medical Cannabis and Cannabinoids.

Case Report: Low Doses of THC-Rich Cannabis Extracts Show "Encouraging" Results in Patient with Alzheimer's

Foz do Iguaçu, Brazil: Cannabis microdosing is associated with cognitive and behavioral improvements in a patient with mnemonic and non-mnemonic Alzheimer's disease (AD) symptoms, according to a case report published in the Journal of Medical Case Reports.

An international team of investigators affiliated with The Federal University for Latin American Integration in Brazil and with John Hopkins University in Baltimore reported on the experimental treatment of THC-rich extracts in a 75-year-old male patient with mild-stage Alzheimer's disease. The patient had been diagnosed with AD two-years prior to his use of cannabis.

Extracts used in the trial contained an 8-to-1 ratio of THC to CBD. The patient receiving the intervention used the extracts daily for 22 months. The subject's daily dosage never exceeded 1 mg of THC per day.

Investigators reported that the patient exhibited "rapid" and "robust" symptom amelioration following his use of low doses of THC-rich extracts. Specifically, they reported, "[C]ognitive and memory enhancement lasted for more than one year following the start of treatment and remained stable while we progressively evaluate/follow up with the patient, for more than one year after the official report ended." Authors also reported improvements in the subject's quality of life and in behavioral issues, including a reduction in mood swings and aggressiveness. Follow up evaluations identified no evidence of cannabis-related toxicity or significant side effects.

They concluded: "Our results are unprecedented and very encouraging. … In summary, data presented in this case report suggest that cannabinoid microdosing is a potential therapeutic for AD, with no significant side effects, although placebo-controlled clinical trials are needed to confirm and extend these data."

Prior studies and case reports assessing the use of THC in Alzheimer's disease patients have similarly reported improvements in AD symptoms, such as reduced agitation and improved sleep, following cannabinoid dosing.

Full text of the study, "Cannabinoid extract in microdoses ameliorates mnemonic and non-mnemonic Alzheimer's disease symptoms: A case report," appears in the Journal of Medical Case Reports.

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Study: Cannabis Use Not Predictive of Lack of Motivation

Corvallis, OR: Frequent cannabis use is not associated with motivation loss in adults, according to data published in the Journal of Clinical and Experimental Neuropsychology.

A team of researchers affiliated with Oregon State University assessed motivation and self-reported apathy in a cohort of regular (three times per week or more) cannabis users and controls (non-users).

Investigators identified no significant group differences in self-reported apathy after controlling for covariates (recent alcohol consumption and depressive symptoms).

Authors did report that cannabis consumers were more likely than non-users to "exert more [effort] for reward, suggesting enhanced motivation relative to healthy controls." Specifically, as reward magnitude increased, frequent cannabis users were more likely to select harder trials to complete than were controls.

Consistent with prior studies, they concluded: "The current findings do not support [the theory of] a-motivational syndrome in cannabis users; rather cannabis users displayed higher-effort decision-making in comparison to controls. ... Given the limited number of studies within the field, future research should continue using both self-report and task-based methodologies to assess motivation in cannabis users, while controlling for potential covariates, such as depression, substance use, and personality factors."

Full text of the study, "Effort-based decision making and self-reported apathy in frequent cannabis users and healthy controls: A replication and extension," appears in theJournal of Clinical and Experimental Neuropsychology.

Survey: Patients with Parkinson's Disease Report Symptomatic Relief from Cannabis

Bergen, Norway: Patients with Parkinson's disease (PD) often report symptomatic benefits from the use of cannabis, according to survey data published in the journal Acta Neurologica Scandinavica.

Norwegian investigators surveyed cannabis use patterns and related attitudes among PD patients. Consistent with prior surveys, they reported that a significant minority of PD patients consume cannabis for symptom relief. Respondents were most likely to report improvements in motor function, sleep, and pain as a result of their marijuana use.

Observational trial data has determined that cannabis inhalation is associated with improvements in tremor, rigidity, pain, sleep, and bradykinesia (slowness of movement) in patients with PD. Placebo-controlled trial data has also determined that acute CBD administration (300mg) is associated with a statistically significant reduction in experimentally-induced anxiety and tremor in PD patients.

Full text of the study, "Cannabis use in Parkinson's disease: A nationwide online survey," appears inActa Neurologica Scandinavica.

Clinical Trial: CBD Administration Ineffective for Restless Legs Syndrome

Manaus, Brazil: The administration of oral doses of CBD is ineffective at reducing the severity of restless legs syndrome (RLS) in patients with Parkinson's disease (PD) and REM sleep behavior disorder (RBD), according to clinical trial data published in the journal Cannabis and Cannabinoid Research.

Brazilian researchers compared the use of CBD versus a placebo over a 14-week period. Patients in the CBD arm of the trial received up to 300mgs of cannabidiol.

Patients who were administered CBD demonstrated no improvements compared to those receiving placebo.

"CBD showed no reduction in the severity of RLS manifestations in patients with PD and RBD," authors concluded.

By contrast, a series of case reports pub lished in 2020 and in 2017 reported that cannabis inhalation is associated with perceived efficacy in patients with refractory restless legs syndrome.

Full text of the study, "Cannabidiol for restless legs syndrome/Willis-Ekbom disease in Parkinson's disease patients with REM sleep behavior disorder: A post hoc exploratory analysis of a phase 2/3 clinical trial," appears in Cannabis and Cannabinoid Research.

California: Governor Signs Legislation Reducing Cannabis Tax Burden

Sacramento, CA: Democratic Gov. Gavin Newsom signed budget legislation late last week that reduces various marijuana-specific taxes.

Specifically, the legislation eliminates the cultivation tax on licensed growers and caps any further increase in the excise tax for three years, among other changes.

According to an economic analysis published this spring by The Reason Foundation, regulatory costs, high taxes, and municipal bans on cannabis retailers have significantly inhibited the growth of the licensed marijuana marketplace in California. The analysis estimated that California imposes an effective tax rate of as much as $92 per ounce. This amount is higher than the tax burden imposed on retail cannabis transactions in other states.

California NORML Director Dale Gieringer, who authored the study's forward, recommended at that time that lawmakers impose "substantive tax cuts" in order to "reduce demand for the illicit market, while still retaining reasonable revenues" for state-licensed retailers. Following last week's bill signing, he added, "The budget bill is a helpful start, but much more needs to be done to make legal cannabis more readily accessible to consumers who now rely on the unregulated market."

District of Columbia: Mayor Signs Legislation Allowing Adults Access to Medical Cannabis Dispensaries Following 'Self-Certification' Process

Washington, DC: Mayor Muriel Bowser has signed legislation legislation removing the requirement that adults seeking to purchase cannabis products from licensed DC medical cannabis dispensaries must obtain a recommendation from a licensed physician. Members of the DC City Council had previously voted unanimously in favor of legislation, known as the Medical Marijuana Self-Certification Emergency Amendment Act of 2022.

The measure permits individuals age 21 or older to "self-certify ... that they are utilizing cannabis for medical purposes" when they register with local regulators for a medical cannabis identification card. Once registered, self-certified adults may access any of the District's seven licensed medical cannabis dispensaries.

Councilmembers Mary Cheh and Kenyan McDuffie, who sponsored the measured, said that the legislation is needed to dissuade residents from patronizing the unregulated marketplace. "Due to the lower barriers to access in the gray market, a significant number of medical marijuana patients have shifted from purchasing their medical marijuana from legal medical dispensaries to the illicit gray market, creating a significant risk to the long-term viability of the District's legal medical marijuana industry," they said. "If this trend continues, it is possible that gray market sales could wipe out the District's legal marijuana dispensaries. Given the... benefits that regulated and safe legal dispensaries provide to medical marijuana users in the District, it is vital that the industry survive until the District can stand up a regulated recreational market and transition toward full regulation of recreational marijuana products."

Under District law, adults may possess and home-cultivate limited amounts of cannabis for their own personal use. However, Congressional action has prohibited the City Council from passing municipal legislation to provide adults with retail cannabis access.

Because the self-certification bill was enacted as "emergency legislation," it is not subject to Congressional review.

In June, DC Councilmembers passed separate legislation, the Cannabis Employment Protections Amendment Act of 2022, protecting those who use cannabis from facing discrimination in the workplace. That bill currently awaits action by the mayor.

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Congress: House Appropriations Committee Approves Amendment to Protect Legal State Marijuana Programs

Washington DC: The House Committee on Appropriations voted this week to approve an amendment that would prevent the Department of Justice from interfering with legal adult-use marijuana programs as part of the Commerce, Justice, Science, and Related Agencies appropriations legislation for Fiscal Year 2023.

The bipartisan amendment, introduced by Reps. Barbara Lee (D-CA) and David Joyce (R-OH), with the non-committee support of past champions Reps. Earl Blumenauer (D-OR), Tom McClintock (R-CA), and Eleanor Holmes Norton (D-DC), would bar the DOJ from using resources to interfere with the ability of states, territories, tribal governments, or the District of Columbia to implement laws and regulations governing the legal and regulated production, sale, and use of cannabis by adults or to target people acting in compliance with those laws.

This amendment was approved by the full House of Representatives as part of the annual spending omnibus for the last two years but has yet to be included in the final legislation. Since 2014, members of Congress have passed annual spending bills that have included a provision protecting those who are in compliance with state medical cannabis programs from undue prosecution by the Department of Justice. That provision has been included in the base appropriations legislation since 2018.

"As federal lawmakers steadily work to determine the best way to finally end marijuana prohibition and undo the damage it has caused, the people involved in regulated cannabis programs in the growing number of states that are leading the way on this issue deserve to know whether the federal government will actively get in the way of their continued successes," said NORML Political Director Morgan Fox. "Including these protections in the federal budget will go a long way toward giving individuals, businesses, and state governments some peace of mind while signaling to the vast majority of Americans who support legalizing and regulating cannabis that their elected representatives are actually listening to them."

"Congress must honor the will of the voters and prevent wasteful Department of Justice prosecution of those complying with their respective state's or tribe's cannabis regulations," said Congressman Blumenauer. "I have spearheaded the work to develop this language, which protects the state and tribal-legal programs that have been enacted laws to end prohibitionary policies and allow the development of both adult-use and medical marijuana programs. I appreciate the partnership and leadership of my colleagues, Representatives McClintock, Lee, Joyce, and Norton to move this important language forward today."

Official DOJ internal guidance to de-prioritize prosecutions of people acting in compliance with state cannabis laws was in place from 2013 until 2018 when former Attorney General Jeff Sessions rescinded the Cole Memo. As recently as April, Attorney General Merrick Garland has reiterated his position that it is a waste of DOJ resources to interfere with state cannabis programs. Unfortunately, such guidance has not been officially renewed under the current Administration and does not carry the force of law, and federal prosecutors have a great deal of discretion in terms of the cases they pursue.

There are currently 19 states as well as the District of Columbia and several territories where cannabis is legal for adults, and 37 states have effective medical cannabis laws. National and state polling shows significant majority support for making cannabis legal.

Survey: Consumers Most Likely to Self-Medicate with Cannabis to Alleviate Anxiety, Pain, and Depression

Quebec City, Canada: Canadians who consume cannabis for purposes of self-medication most frequently report doing so to address pain, anxiety, sleep disturbances, and depression, according to data published in the Journal of Cannabis Research.

Canadian researchers surveyed 489 subjects who purchased cannabis products at adult-use retailers, but who acknowledged doing so to self-medicate. Consistent with prior data, respondents were most likely to report consuming cannabis products to mitigate anxiety (70 percent), improve sleep (56 percent), alleviate pain (53 percent), and address feelings of depression (37 percent). Subjects were also likely to acknowledge using cannabis to alleviate muscle spasticity, migraine, nausea, and symptoms of post-traumatic stress.

Survey respondents typically reported using cannabis flower and selecting products dominant in THC. However, those respondents that exclusively defined their cannabis use as medical-only expressed a preference for CBD-dominant products.

In contrast with other surveys, most respondents acknowledged reporting their cannabis use to their health care professionals.

The results of another recent survey, published in the journal Complimentary Therapies in Clinical Practice, similarly determined that patients certified to use medical cannabis in the US most commonly do so to treat symptoms of pain, anxiety, post-traumatic stress, and depression. The results of yet another recent survey, conducted by Harris Polling, also found that consumers most often report consuming cannabis to reduce stress, improve sleep, and mitigate anxiety.

Separate survey data compiled in April reported that 21 percent of US Medicare recipients acknowledge consuming cannabis for therapeutic purposes, typically to address symptoms associated with chronic pain, anxiety, and depression.

Full text of the study, "A description of self-medication with cannabis among adults with legal access to cannabis in Quebec, Canada," appears in the Journal of Cannabis Research.

Analysis: Flower Continues to Dominate US, Canadian Marijuana Markets

Santa Monica, CA: Cannabis consumers in the United States and Canada predominantly consume marijuana flower instead other product formulations, according to data published in the International Journal of Drug Policy.

Investigators affiliated with the RAND Drug Policy Research Center in California and the University of Waterloo in Ontario, Canada assessed cannabis consumption patterns in the US and in Canada in a cohort of more than 40,000 subjects.

Consistent with prior surveys, they reported, "Dried flower was the most commonly used product" among consumers – regardless of whether those consumers patronized either the licit or illicit marketplace. However, investigators acknowledged that the popularity of other formulations of cannabis, particularly vape oils and edibles, had increased in recent years – especially in markets where cannabis products are legally available from licensed retailers.

Authors concluded: "The current study provides one of the most comprehensive assessments of cannabis consumption at the population level in Canada and the US to date. The findings highlight the rapidly evolving nature of the cannabis product market, including notable shifts in the types of cannabis products used by consumers. ... Although dried flower continues to dominate the market, it has begun declining with a notable shift towards increasing popularity of processed cannabis products."

Full text of the study, "Trends in the use of cannabis products in Canada and the USA, 2018 – 2020: Findings from the International Cannabis Policy Study," appears in the International Journal of Drug Policy.

Study: Cannabis Use by College Students Seldom Tied to Negative Consequences Absent Concurrent Use of Other Substances

Gainesville, FL: College students who consume cannabis, but not other controlled substances, do not appear to be at significant risk of suffering from either substance use disorder or low academic achievement, according to data published in the Journal of American College Health.

A team of investigators affiliated with the University of Florida at Gainesville assessed the relationship between college students' self-reported use of marijuana and other substances and academic outcomes.

They reported that those students who consumed cannabis – but who did not also consume either alcohol, cigarettes, or other substances – were less likely to report problems associated with substance abuse, skipping class, or poor grades than were those who were polysubstance users.

Authors determined: "The cannabis-only users reported experiencing the least amount of cannabis-related consequences and CUD [cannabis use disorder] symptoms but used cannabis on more days in the past month than any other group except the all-substance user group (CACS-cannabis, alcohol, cigarettes and other substance users). ... These findings may indicate that although cannabis-only users use more frequently than other groups, this group may be at lower risk for negative consequences associated with use compared to all-substance users. This is in line with previous findings showing that polysubstance use is related to more negative consequences compared to single use."

They concluded: "Overall, the current findings suggest that (1) alcohol use is prevalent among cannabis-using college students and (2) concurrent polysubstance use of four or more substances is associated with increased risk of cannabis-and academic-related problems including CUD symptom severity, skipping classes, and lower GPA. When addressing cannabis use among college students, clinicians should assess and target multiple substances in addition to cannabis. Risks associated with sole cannabis use were low compared to concurrent substance use. Hence, efforts aimed at preventing the initiation of additional substance use may be warranted."

Full text of the study, "Independent and concurrent cannabis use with alcohol, cigarettes, and other substances among college students: Rates and consequences," appears in the Journal of American College Health.

Analysis: Labels of Hemp-Derived CBD Products Often Provide Inaccurate Information

Lexington, KY: Commercially available CBD products are often labeled in ways that misrepresent the true percentage of cannabinoids available in them, according to data published in the Journal of Cannabis Research.

Researchers affiliated with the University of Kentucky College of Medicine lab-tested 80 commercially available hemp-derived CBD products. Products were acquired either online on at brick and mortar retail stores.

Consistent with dozens of other analyses, authors reported that a significant percentage of the products tested (46 percent) contained CBD concentrations that were significantly different than the concentration listed on the label.

Authors reported: "These data suggest that additional regulation is required to ensure label accuracy as nearly half of the products in this study were not properly labelled (i.e., not within a +/- 10 percent margin of error). Consumers and practitioners should remain cautious of unregulated and often-mislabeled CBD products due to the risks of taking too much CBD (e.g., drug-drug interactions, liver enzyme elevations, increased side effects) and the consequences of taking too little (e.g., no clinical benefits due to underdosing)."

They concluded: "The findings reported here emphasize the continued need for clear and consistent regulation from federal and state agencies to ensure label accuracy of CBD products and subsequent enforcement. These results also indicate the need for continued development of good manufacturing practices and testing standards. As consumers are taking CBD products for an ever-increasing range of conditions, independent of medical guidance, the accuracy of content labeling is important for the safety of the consumer."

More than three years following the passage of federal legislation legalizing hemp production, the US Food and Drug Administration (FDA) has yet to promulgate rules regulating the marketing and sale of commercial products containing hemp-derived CBD or other cannabinoids. Survey data compiled by the National Consumers League previously determined that more than eight in ten US voters desire greater federal regulatory oversight over the labeling and marketing of commercially available CBD products.

Full text of the study, "Label accuracy of unregulated cannabidiol (CBD) products: Measured concentration vs. label claim," appears in the Journal of Cannabis Research.

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Analysis: Cannabis Consumers Less Likely to Be Diagnosed with Liver Cancer

Cleveland, OH: Adults with a recent history of cannabis use are twice less likely to be diagnosed with hepatocellular carcinoma (the most common type of liver cancer) than are those with no history of use, according to data published in the scientific journal Cureus.

A team of researchers affiliated with the Cleveland Clinic and with Georgetown University Hospital in Washington, DC assessed the relationship between cannabis consumption and HCC in a cohort of over one million subjects.

Investigators reported that those who reported current cannabis use were "55 percent less likely to have HCC compared to non-cannabis users."

Authors concluded: "To the best of our knowledge, this is the first and largest population-based cross-sectional study of hospitalized patients to explore the association between cannabis use and HCC. ... Due to the cross-sectional structure of our study, we are unable to draw direct causation effects. Hence, we suggest prospective clinical studies to further understand the mechanism by which various active ingredients, particularly CBD in cannabis, may possibly regulate hepatocellular carcinoma development."

Cannabinoids possess anti-cancer activity in cellular models and a limited number of case reports have documented antineoplastic activity in patients. Observational data has also shown an association between cannabis use and a reduced risk of head and neck cancers.

Numerous human studies have also shown an inverse relationship between cannabis consumption and various types of liver diseases.

Full text of the study, "Lower rates of hepatocellular carcinoma observed among cannabis users: A population-based study," appears in Cureus.

SCOTUS: Justices Decline to Weigh in on Whether Medical Cannabis Costs Can Be Reimbursed by Employers

Washington, DC: Justices on the US Supreme Court have declined to weigh in on the issue of whether employees can be reimbursed for their medical marijuana-related costs through their workers' compensation insurance plans.

Litigants sought the Court's intervention following divergent opinions from several state supreme courts. Empire State NORML and two other groups – the New York City Cannabis Industry Association and the Hudson Valley Cannabis Industry – had filed a friend-of-the-court (amicus) brief urging justices to take the case and to use it as an opportunity to settle broader conflicts between state and federal marijuana laws.

The denial of certiorari indicates that most justices did not believe that the lower court decisions merited review by the high court.

David C. Holland, Esq, the Executive and Legal Director of Empire State NORML and the author of the brief said: "By failing to take up the case, SCOTUS only further exacerbated the split between the highest state courts as it continues to evade the fundamental question with regard to cannabis' medical validity, a key factor in the Schedule I designation. Empire State NORML and the New York and Hudson Valley Cannabis Industry Associations will continue to advocate for those cases that will eventually bring resolution to the issue once and for all."

In 2021, courts in three separate states upheld employees' ability to be financially reimbursed for their use of medical cannabis, while the court in another state ruled against the issue.

Currently, five states - Connecticut, New Hampshire, New Jersey, New Mexico, and New York – explicitly allow for employees to have their medical cannabis expenses reimbursed. By contrast, seven states expressly prohibit workers' compensation insurance from reimbursing medical marijuana-related costs: Maine, Massachusetts, Minnesota, Florida, North Dakota, Ohio, and Washington.

In all other jurisdictions, the law is either silent on the issue or states that insurers are "not required" to reimburse employees who are injured on the job for the costs related to their use of medical cannabis.

Survey: Over 80 Percent of Americans Support Uniform Quality Controls for Cannabis Products

Washington, DC: More than eight in ten Americans believe that there should be uniform standards in place regulating the manufacturing of commercially available cannabis products, according to national polling data commissioned on behalf of the regulatory compliance group SIPCA and the Foundation of Cannabis Unified Standards (FOCUS).

Most respondents (72 percent) said that cannabis products should be grown and produced using "consistent product safety standards (regardless of which state they are legally purchased in)," and 84 percent support the notion of the "federal government setting standards for product safety and quality that must be met for any cannabis products produced or sold in the United States."

Because cannabis remains classified as a Schedule I illicit substance under federal law, regulations governing the manufacturing and testing of marijuana products vary from state to state.

Separate polling has similarly shown that a majority of Americans desire greater regulatory authority over the safety and quality of hemp-derived CBD products, most of which are currently subject to little or no federal or state regulatory oversight.

"The U.S. has a plethora of consumer protection laws and organizations, at both the federal and state level, that regulate consumer affairs. So, it is understandable that Americans expect these same consumer protections in cannabis, like they do for everything they purchase," said Lezli Engelking, President & Founder of FOCUS. "The lack of protections for cannabis consumers is simply one more example of the extreme risks to public health and safety Americans are exposed to [because of] the lack of action around cannabis at the federal level."

Consistent with other national polls, a super-majority of respondents (78 percent) to the SIPCA/FOCUS poll agreed that marijuana should be legalized under federal law.

More information on the SIPCA/FOCUS polling data is available online.

Review: Cannabis Provides Benefits for Migraine Sufferers

Tucson, AZ: Cannabis preparations likely provide for the prophylactic and abortive treatment of migraines, according to a review of the relevant literature published in the journal Frontiers in Neurology.

A team of investigators with the University of Arizona reviewed the findings of 12 previously published studies involving 1,980 participants.

Authors reported evidence of plant cannabinoids' ability to reduce migraine frequency and to abort the onset of migraine headaches. The use of various preparations of cannabis was also associated with significant reductions in migraine-induced vomiting, pain, and nausea.

They concluded: "[T]here is some evidence for MC's [medical cannabis'] beneficial effect on treating migraine in adults. However, further research is needed to assess effective dosing and safety critically. Mindful of the upsurge of interest in MC use to treat migraines, there is an urgent need to implement well-designed studies to evaluate the effectiveness and safety of medical marijuana for treating adults with migraines."

The results of a prior literature review, which assessed 34 scientific papers on cannabis and migraine, similarly identified "encouraging data on medicinal cannabis' therapeutic effects on alleviating migraines in all of the studies reviewed."

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, "Cannabis for the treatment of migraine in adults: A Review of the evidence," appears in Frontiers in Neurology.

Colorado: Youth Marijuana Use Declines Sharply Among Teens

Denver, CO: The percentage of young people who acknowledge consuming cannabis and having ready access to it declined sharply between 2020 and 2021, according to statewide data provided by the Colorado Department of Public Health and Environment (CDHPE).

Researchers reported a 35 percent year-over-year decline in the percentage of teens who admitted having consumed cannabis products within the past 30 days. They also reported a 22 percent drop in the percentage of teens who said that they could easily access cannabis. There was a 50 percent drop in the percentage of teens who admitted having driven after using cannabis.

"These data are consistent with other surveys showing that marijuana regulation policies can be implemented in a manner that provides access for adults while simultaneously limiting youth access and misuse," NORML's Deputy Director Paul Armentano said. "These findings ought to reassure lawmakers and others that cannabis access for adults can be regulated in ways that do not inadvertently impact young people's habits."

Nationwide, there was a 38 percent year-over-year reduction in self-reported marijuana use among eighth graders, a 38 percent decline among 10th graders, and a 13 percent decrease among 12th graders, according to data provided by the University of Michigan's annual Monitoring the Future survey.

Since Coloradoans legalized adult-use marijuana sales, lifetime cannabis use has fallen an estimated 30 percent among high-schoolers and an estimated 40 percent among middle-schoolers. Adult-use legalization in other states has also failed to overlap with any significant uptick in either young people's use of cannabis or access to marijuana products.

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Study: Aerosolized Cannabis Significantly Reduces Pain Levels, Improves Quality of Life in Neuropathy Patients

Haifa, Israel: The administration of aerosolized cannabis via a novel inhaler is associated with long-term pain reductions in patients with neuropathy and other chronic conditions, according to data published in the journal Pain Reports.

Israeli investigators assessed the efficacy of cannabis delivered via a novel metered selective dose inhaler (The Syqe Inhaler) in a cohort of chronic pain patients. The mean daily stable dose used by patients in the study was 1.5 mg of aerosolized delta-9-THC.

Use of the inhaler over a period of several months was associated with reduced pain scores and improvements in patients' quality of life. Some patients reported mild side-effects (typically dizziness and sleepiness) at the onset of the study, but few participants continued to report these effects throughout the duration of the trial.

Authors concluded: "Medical cannabis treatment with the Syqe Inhaler demonstrated overall long-term pain reduction[s], quality of life improvement[s], and opioid-sparing effect[s] in a cohort of patients with chronic pain, using just a fraction of the amount of MC [medical cannabis] compared with other modes of delivery by inhalation. These outcomes were accompanied by a lower rate of AEs [adverse events] and almost no AE reports during a long-term steady-state follow-up. Additional follow-up in a larger population is warranted to corroborate our findings."

According to recently compiled survey data, nearly one in three chronic pain patients report using cannabis for treatment management. Among patients in US states where medical cannabis access is permitted, over 60 percent are qualified to use it to treat pain.

Full text of the study, "Long-term effectiveness and safety of medical cannabis administered through the metered-dose Syqe Inhaler," appears in Pain Reports.

Randomized Controlled Trial: Topical CBD Treatment Provides Relief in Arthritis Patients

Charlottesville, VA: The administration of a topical formula containing hemp-derived CBD is associated with significant improvements in patients with thumb basal joint arthritis, according to randomized clinical trial data published in the Journal of Hand Surgery.

Researchers with the University of Virginia School of Medicine assessed the twice-daily application of 1 ml of topical CBD (6.2 mg/ml) with shea butter versus placebo in 18 patients with symptomatic thumb basal joint arthritis.

Investigators reported, "Cannabidiol treatment resulted in improvements from baseline among patient-reported outcome measures, including Visual Analog Scale pain; Disabilities of the Arm, Shoulder, and Hand; and Single Assessment Numeric Evaluation scores, compared to the control arm during the study period."

They concluded, "In this single-center, randomized controlled trial, topical CBD treatment demonstrated significant improvements in thumb basal joint arthritis-related pain and disability without adverse events."

The results contrast those of a 2021 Danish study reporting that the oral administration of synthetic CBD did not mitigate pain in patients with hand osteoarthritis.

Canadian survey data published earlier this month in the journal Clinical and Experimental Rheumatology reported that one in five patients with arthritis acknowledge using cannabis therapeutically.

Full text of the study, "A randomized controlled trial of topical cannabidiol for the treatment of thumb basal joint arthritis," appears in the Journal of Hand Surgery.

Analysis: Cannabis Use Inversely Associated with Obesity in Hep C Patients

Paris, France: Cannabis use is inversely associated with obesity in patients with chronic hepatitis C virus (HCV) infection, according to data published in the Journal of Cannabis Research.

A team of French researchers assessed the relationship between lifetime cannabis use and obesity in a cohort of over 6,300 HCV patients.

Authors reported, "[F]ormer and, to a greater extent, current cannabis use were consistently associated with smaller waist circumference, lower BMI, and lower risks of overweight, obesity, and central obesity in patients with chronic HCV infection. … To our knowledge, this is the first time that such associations have been highlighted for HCV-infected patients."

The study's findings are consistent with those of analyses of other cohorts – such as those here, here, and here – reporting that marijuana use is typically associated with lower BMI and with lower rates of obesity.

Full text of the study, "Cannabis use as a factor of lower corpulence in hepatitis C-infected patients: Results from the ANRS C022 Hepather cohort," is available in the Journal of Cannabis Research.

Study: Regular Cannabis Consumers Perform Better Than Occasional Users on Distracted Driving Tasks

Aurora, CO: Those with a history of frequent cannabis use exhibit only minor changes in driving performance shortly following marijuana smoking, according to driving simulator data published in the journal Traffic Injury Prevention.

Investigators with the University of Colorado, Anschutz Medical Campus and the University of Iowa assessed driving simulated performance in a cohort of frequent and infrequent cannabis consumers. Participants provided their own cannabis, which contained between 15 and 30 percent THC. Following cannabis smoking ad-libitum, subjects completed a series of distracted driving scenarios.

Authors reported: "Those with a pattern of occasional use were significantly more likely to experience a lane departure during distraction periods after acute cannabis use relative to baseline, while those with daily use did not exhibit a similar increase." Consistent with other studies, researchers further acknowledged, "Participants with a pattern of daily use decreased their speed, which may be interpreted as a drug effect or as a compensatory strategy."

Separate studies have previously reported that repeated cannabis exposure is associated with either partial or even full tolerance in particular domains, including cognitive and psychomotor performance.

The study's authors concluded: "The results provide evidence that a pattern of occasional use was associated with performing worse after acute cannabis smoking as it relates to lane departures. Those with a pattern of occasional use also behave differently with respect accelerator position, and there was a trend that those with a pattern of daily use decreased the speed. This would be consistent with the hypothesis of tolerance, with individuals with daily use being somewhat less affected by or better able to mitigate the effects of acute cannabis smoking. This may indicate that those who use daily may perceive a potential adverse impact of acute cannabis use on driving performance and may attempt to compensate by slowing down to have more time to react to changes in the roadway. Further research is needed to understand the effects during longer and more complex secondary tasks."

Though not a primary focus of the study, investigators did assess subjects' baseline THC/blood levels upon their admission to the lab. Consistent with prior research, those subjects who reported daily cannabis use tested positive for THC in their blood (mean THC blood level: 5ng/ml) despite having abstained from marijuana for at least the past 12 hours.

NORML has long advocated against the imposition of THC blood thresholds as predictors of impairment, and per se traffic safety limits in particular, because they are not consistently correlated with changes in subjects' performance and because residual THC levels may linger in blood for several hours or even days post-abstinence. Alternatively, NORML has called for the expanded use of performance-based tests, like DRUID.

Full text of the study, "Influence of cannabis use history on the impact of cannabis smoking on simulated driving performance during a distraction task," appears in Traffic Injury Prevention.

Analysis: Medical Cannabis Access Positively Correlated with Traffic Safety

Philadelphia, PA: The enactment of medical cannabis access laws is associated with reductions in auto insurance premiums and improvements in overall traffic safety, according to data published in the journal Health Economics.

A team of economists associated with Temple University in Philadelphia, the University of Arkansas, Little Rock and Eastern Kentucky University assessed the relationship between legalized medical cannabis access (via licensed dispensaries) and auto insurance premiums between the years 2014 and 2019.

Researchers reported that medical access was associated with a decrease in auto premiums. "We estimate that legalizing medical cannabis reduces annual auto insurance premiums by $22 per household, a reduction of 1.7 percent for the average household," they wrote. "The effect is stronger in areas directly exposed to a dispensary, suggesting increased access to cannabis drives the results. In addition, we find relatively large declines in premiums in areas with relatively high drunk driving rates prior to medical cannabis legalization. This latter result is consistent with substitutability across substances that is argued in the literature."

They concluded: "While this [$22] reduction may be inconsequential to an individual policy-holder, the aggregate effects are economically meaningful. For just the policyholders in our switching states, we estimate a combined annual reduction in premiums of $500 million. Extending our results to other states, we find that medical cannabis legalization has reduced auto insurance premiums by $1.5 billion in all states that have currently legalized, with the potential to reduce premiums by an additional $900 million if the remaining states were to legalize. Because auto insurance premiums are directly tied to property damage and health outcomes, we find evidence of a positive social impact of medical cannabis on auto safety."

The study's findings are consistent with those of prior analyses similarly reporting a decrease in traffic fatalities following the implementation of medical cannabis access, including reductions in motor vehicle accidents involving drivers under the influence of alcohol and opioids.

Full text of the study, "Medical cannabis and automobile accidents: Evidence from auto insurance," appears in Health Economics.

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Study: Long-Term Cannabis Use Associated with Reduced Prescriptions, Improved Symptoms in Cancer Patients

Haifa, Israel: The use of cannabis products over a six-month period is associated with statistical improvements in cancer-related symptoms as well as significant reductions in subjects’ use of prescription painkillers, according to longitudinal data published in the journal Frontiers in Pain Research.

Israeli researchers assessed the long-term use of cannabis in a cohort of several hundred oncology patients.

Consistent with studies of other patient cohorts, cannabis use was associated with symptom mitigation, improved quality of life, and reduced prescription drug use. Among those participants who completed the trial, nearly half ceased their use of analgesics.

Authors concluded: "The main finding of the current study is that most cancer comorbid symptoms improved significantly during six months of MC [medical cannabis] treatment. ... Additionally, we found that MC treatment in cancer patients was well tolerated and safe. ... In conclusion, this prospective, comprehensive and large-scale cohort demonstrated an overall mild to modest long-term statistical improvement of all investigated measures including pain, associated symptoms and, importantly, reduction in opioid (and other analgesics) use."

Full text of the study, "The effectiveness and safety of medical cannabis for treating cancer related symptoms in oncology patients," appears inFrontiers in Pain Research.

Clinical Trial: CBD-Rich Cannabis Extracts Safe and Effective in Pediatric Patients with Autism Spectrum Disorder

João Pessoa, Brazil: The administration of CBD-rich cannabis extracts is safe and effective in mitigating symptoms in children with autism spectrum disorder (ASD), according to placebo-controlled, randomized clinical trial data published in the journal Trends in Psychiatry and Psychotherapy.

Brazilian researchers evaluated the use of CBD extracts versus placebo in 60 children (ages 5 to 11) with ASD over a 12-week period.

Compared to the placebo group, subjects receiving CBD extracts experienced significant improvements in their ability to engage in social interactions. They also experienced reduced anxiety and agitation. Only a minority of subjects administered CBD exhibited adverse events, namely dizziness and insomnia.

The study’s findings are consistent with those of other trials similarly reporting improvements in patients’ ASD symptoms following their use of cannabinoid products. Survey data published in October by the publication Autism Parenting Magazine reported that 22 percent of US caregivers or parents have provided CBD to an autistic child. Survey data from the United Kingdom recently reported that autistic adults were nearly four times as likely as controls to report having used CBD within the past year.

Full text of the study, "Evaluation of the efficacy and safety of cannabidiol-rich cannabis extract in children with autism spectrum disorder: Randomized, double-blind and controlled placebo clinical trial," appears inTrends in Psychiatry and Psychotherapy.

Survey: One in Five Patients with Arthritis Acknowledge Using Medical Cannabis

Toronto, Ontario: Arthritis patients frequently reported consuming cannabis for symptomatic relief, according to survey data published in the journal Clinical and Experimental Rheumatology.

A team of Canadian investigators surveyed 799 patients at eight rheumatology clinics in Ontario. (Cannabis is legal in Canada for both medical purposes and for adults.)

Just over 20 percent of those surveyed acknowledged either having consumed cannabis within the past two years or being current users of cannabis products. Compared to non-users, those who consumed cannabis were more likely to be younger and were more likely to report suffering from severe pain.

Cannabis consumers reported using it to treat pain, anxiety, and to promote sleep. Seventy-eight percent of them reported medical cannabis to be "at least somewhat effective" at mitigating their symptoms.

The study’s findings are consistent with French survey data, published in 2021, which reported that "nearly 20 percent of patients suffering from rheumatologic diseases actively consume cannabis."

Longitudinal data published in April reported that osteoarthritis patients decrease their daily opioid intake and experience improvements in their overall quality of life following the initiation of medical cannabis therapy. Authors of the study concluded: "Our findings indicate that providing access to MC [medical cannabis], helps patients with chronic pain due to OA [osteoarthritis] reduce their levels of opioid usage in addition to improving pain and QoL [quality of life]. Furthermore, a majority of patients did not feel intoxicated or high from MC, and of those who did, only a small percentage said it interfered with their daily activities. ... Our findings support the literature in that MC reduces the use of opioids for the treatment of chronic pain."

Full text of the study, "Medical cannabis use by rheumatology patients in routine clinical care: Results from the Ontario Best Practices Research Initiative," appears in Clinical and Experimental Rheumatology.

Ninth Circuit Rules on Legal Status of Hemp-Derived Delta-8 THC Products

San Francisco, CA: A three judge panel for the Ninth Circuit Court of Appeals has rejected arguments that delta-8 THC products which are chemically synthesized from hemp-derived CBD fall beyond the scope of the 2018 Farm Bill.

Plaintiffs in the case were asking the court to protect trademarks for their proprietary delta-8 THC products. Defendants in the case argued that the company’s trademarks were not protectible because the 2018 Farm Bill was never intended to legalize such products for human consumption.

The three-judge panel was unpersuaded by the defendant’s arguments, opining: "[The defendant] is effectively asking us to recognize the following limitation: that substances legalized by the Farm Act must be somehow suited for an industrial purpose, not for human consumption. ... [But] this limitation appears neither in hemp’s definition, nor in its exemption from the Controlled Substances Act. ... Regardless of the wisdom of legalizing [ingestible] delta-8 THC products, this Court will not substitute its own policy judgment for that of Congress. If [the defendant] is correct, and Congress inadvertently created a loophole legalizing vaping products containing delta-8 THC, then it is for Congress to fix its mistake."

The Court also rejected the argument that delta-8 THC products were outside of the scope of the Act because many such products are the result of a chemical synthesis and are not extracted directly from hemp plants (which contain only nominal amounts of delta-8 THC). Judges opined that the process used to manufacture the end product was irrelevant as long as it was initially sourced from either hemp or hemp-derived CBD. "[T]he source of the product - not the method of manufacture - is the dispositive factor for ascertaining whether a product is synthetic," it ruled.

Provisions of the 2018 Act explicitly legalize the possession of cannabinoids "that are naturally occurring constituents" of hemp, but it "does not impact the control status of synthetically derived" cannabinoids.

NORML has expressed caution regarding the safety of commercially available, hemp-derived delta-8 THC products because neither the products nor their manufacturing processes are regulated. Lab analyses of unregulated delta-8 products have consistently found them to contain lower levels of the compound than advertised on the products’ labels. Some products have also been found to possess heavy metal contaminants and unlabeled cutting agents.

In response to the ruling, attorney Garrett Graff - whose firm specializes in issues related to hemp - told New Frontier Data: "I’m not sure that this opinion will change the cannabinoid landscape all that much. Companies selling hemp-derived cannabinoids such as delta-8 THC were already emboldened to do so, despite the regulatory uncertainties. These companies didn’t necessarily need the court’s opinion to feel emboldened to do so. That said, even with this court’s position under federal law, this opinion does not necessarily change the laws of states which have affirmatively regulated (or prohibited) delta-8 THC and other intoxicating cannabinoids. Those state-level regulations still present potential legality challenges."

While several states have recently moved to prohibit the sale of hemp-derived delta-8-products, several others remain largely silent on the issue.

The case is AK Futures LLC v. Boyd Street Distro, LLC.

Study: High Doses of CBD Do Not Impact Cognitive Function, Simulated Driving Performance

Sydney, Australia: The oral administration of up to 1500 mg of CBD does not induce feelings of intoxication and is not associated with changes in simulated driving performance, according to data published in the Journal of Psychopharmacology.

A team of Australian researchers assessed the impact of varying dosages of CBD (ranging from 15 mg to 1500) versus placebo in 17 subjects. Study participants engaged in a series of simulated driving tests at approximately one hour and four hours after dosing. Investigators separately assessed subjects’ cognitive performance via their completion of a variety of computerized tasks. Participants were also asked whether they felt either "stoned" or "sedated" at any time during the trial.

Consistent with prior research, authors reported that CBD administration was not associated with either weaving or any other significant changes in simulated driving performance. Participants also failed to show any significant differences in either cognitive function or in their subjective feelings of well-being following CBD dosing.

Authors concluded: "The results of this study suggest that acute, oral CBD treatment at doses up to 1500 mg does not induce feelings of intoxication and is unlikely to impair cognitive function or driving performance. However, further research is required to confirm no effect of CBD on safety-sensitive tasks in the hours immediately post-treatment and with chronic administration."

Full text of the study, "Effects of cannabidiol on simulated driving and cognitive performance: A dose-ranging randomized controlled trial," appears in the Journal of Psychopharmacology.

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Survey: Super-Majority of Americans Oppose Federal Marijuana Prohibition

Washington, DC: Only two in ten Americans support the federal criminalization of marijuana, according to nationwide polling data compiled by YouGov.com.

Pollsters asked respondents whether cannabis use ought to be either "legalized nationally, left up to the states, or banned nationally."

Forty-five percent of those surveyed said that it should be legalized nationwide. Twenty-one percent of respondents said the decision to legalize cannabis should be left up to each individual state. Only 20 percent of those surveyed said they supported maintaining federal cannabis prohibition.

Democrats were far more likely than Republicans to support a policy of nationwide legalization.

Several pieces of legislation – including the Marijuana Opportunity, Reinvestment, and Expungement (MORE) Act and the States Reform Act – are pending in Congress to repeal federal marijuana prohibition, thereby permitting state governments to decide their own cannabis policies free from undue federal interference.

Study: Young Adults' Consumption of Alcohol, Cigarettes, Other Substances Fell Following Marijuana Legalization

Seattle, WA: Retail cannabis sales are associated with decreases in the use of alcohol, cigarettes, and pain medications by young adults, according to data published in the Journal of Adolescent Health.

Researchers with the University of Washington assessed trends in alcohol, nicotine, and non-prescribed pain reliever use among a cohort of over 12,500 young adults (ages 18 to 25) in Washington State following adult-use cannabis legalization.

They reported, "Contrary to concerns about spillover effects, implementation of legalized nonmedical cannabis coincided with decreases in alcohol and cigarette use and pain reliever misuse." Researchers did find that the prevalence of past-month e-cigarette use increased post-legalization.

Authors concluded, "Our findings add to evidence that the legalization of nonmedical cannabis has not led to dramatic increases in the use of alcohol, cigarettes, and nonprescribed opioids. … The findings indicate that the most critical public health concerns surrounding cannabis legalization and the evolution of legalized cannabis markets may be specific to cannabis use and related consequences."

Commenting on the study's findings, NORML's Deputy Director Paul Armentano said: "Real-world data from legalization states disputes longstanding claims that cannabis is some sort of 'gateway' substance. In fact, in many instances, cannabis regulation is associated with the decreased use of other substances, including many prescription medications."

Numerous prior studies, including those conducted by The RAND Corporation and the National Academy of Sciences, have disputed the so-called 'gateway theory' - concluding, "[M]arijuana has no causal influence over hard drug initiation."

According to nationwide polling compiled by YouGov.com, a majority of Americans no longer agree with the notion that "the use of marijuana leads to the use of hard drugs."

Full text of the study, "Trends in alcohol, cigarette, e-cigarette, and nonprescribed pain reliever use among young adults in Washington state after legalization of nonmedical cannabis," appears in the Journal of Adolescent Health.

Delaware: Lawmakers Advance Legislation Eliminating Marijuana Possession Penalties

Dover, DE: Majorities of lawmakers in the House and Senate have approved legislation, House Bill 371, eliminating penalties for the possession of up to one ounce of cannabis by adults.

House members voted 26 to 14 and Senate members voted 13 to 7 to advance the legislation. Virtually all Democrats voted for the measure while the majority of Republicans decided against it.

A spokesperson for Democratic Gov. John Carney said that he will review the bill, but that the Governor remains largely opposed to legalization. Governor Carney has previously expressed concerns that cannabis may act as a so-called 'gateway drug' and has said that he doesn't believe that legalizing it is a "good idea."

However, in recent years, the Governor has nonetheless signed various marijuana reform bills into law – including legislation removing criminal penalties for cannabis possession for minors as well as legislation expanding the pool of health care practitioners eligible to provide medical marijuana authorizations.

NORML's Executive Director Erik Altieri said, "We applaud the Delaware legislature for passing this important legislation. The overwhelming majority of Delaware residents support ending their state's failed prohibition on marijuana, and Governor Carney should respect the will of the people."

Laura Sharer, Executive Director of Delaware NORML added: "The collateral consequences of the thousands of cannabis possession offenses that occur every year in Delaware extend far beyond fines. It's time to right these immense wrongs. We can now work to accept cannabis use as an issue of personal choice, not criminal behavior."

Separate legislation (HB 372) that seeks to legalize and regulate the retail sale of marijuana and marijuana products is still pending before lawmakers. Previous attempts to pass legislation to regulate and tax marijuana sales stalled in the Senate, which requires a three-fifths majority vote to approve any measure that establishes new taxes.

Clinical Trial: Topical CBD Ointment Efficacious for Psoriasis

Bangkok, Thailand: The topical application of an ointment containing 2.5 percent CBD improves symptoms of psoriasis, according to the findings of a randomized, placebo-controlled study published in the Journal of the European Academy of Dermatology and Venerology.

A team of investigators affiliated with King Chulalongkorn University Hospital and Thammasat University Hospital in Thailand assessed the twice daily application of either CBD or placebo over a 12-week period in 51 patients with mild plaque-type psoriasis.

Areas treated with CBD showed significant improvements compared to areas treated with the placebo. Researchers did not identify any adverse effects attributable to the use of CBD.

"Our results indicated a trend of favorable response in the treatment with CBD, which has emerged as a therapeutic option for psoriasis," authors concluded. "These outcomes will pave the way for future studies on [the] therapeutic effects of CBD."

Prior studies have previously shown that CBD may reduce certain types of skin inflammation, including erythema, pruritis, and acne.

Full text of the study, "Topical cannabidiol-based treatment for psoriasis: A dual-centered randomized, placebo-controlled study," appears in theJournal of the European Academy of Dermatology and Venerology.

Analysis: Reduced Taxes, Fewer Regulatory Burdens Would Promote Better Growth in California's Licensed Cannabis Market

Los Angeles, CA: Regulatory costs, high taxes, and municipal bans on cannabis retailers have significantly inhibited the growth of the licensed marijuana marketplace in California, according to a report issued by the Reason Foundation.

The analysis estimated that California imposes an effective tax rate of as much as $92 per ounce. This amount is higher than the tax burden imposed on retail cannabis transactions in other states.

The report's author also highlighted that California has a "paucity of legal retailers" as compared to other adult-use states. This is because the majority of localities in California prohibit such establishments. While Colorado has "one legal retailer per 13,838 residents" and "Oregon boasts one retailer per 6,145 residents," California has "one legal retailer per 29,282 residents, indicating a dramatic undersupply of legal retailers in the Golden State."

California NORML Director Dale Gieringer, who authored the report's foreword wrote: "California's legal industry has been hard pressed to compete with untaxed, unregulated providers on the underground market. So dire is the current situation that advocates now fear that the cannabis industry in California faces an 'existential crisis' in the absence of meaningful tax reform."

He concluded, "Substantive tax cuts therefore seem to be a feasible strategy for reducing demand for the illicit market, while still retaining reasonable revenues for the state programs funded in Prop. 64."

Following the report's release, Democratic Gov. Gavin Newsom proposed eliminating the marijuana cultivation tax. Doing so requires support from two-thirds of the state legislature.

Full text of the report, "The Impact of California Cannabis Taxes on Participation Within the Legal Market," is available from the Reason Foundation.

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