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Harris Poll: Two-Thirds of US Adults Favor Legalizing Marijuana

Marijuana Poll; Chicago, IL: Two-thirds of US adults favor a repeal of federal marijuana prohibition, according to nationwide polling data compiled by Harris Research.

Sixty-six percent of respondents in a nationally representative sample endorse legalizing cannabis for adults, with support being strongest among millennials (79 percent) and members of Generation X (76 percent). By contrast, just under 50 percent of Baby Boomers (those born between 1946 and 1964) backed adult-use legalization.

The results are consistent with those of other recent national polls, including those by Gallup, Morning Consult, and Quinnipiac University, showing that a supermajority of Americans believe that marijuana ought to be legalized for adults.

When asked whether cannabis should be legal for medical purposes, 84 percent of respondents answered affirmatively – a percentage that is also consistent with prior polling.

Survey: Users of CBG-Dominant Cannabis Report Efficacy for Pain, Other Conditions

Pullman, WA: Those who consume cannabis and/or cannabis preparations high in the cannabinoid cannabigerol (CBG) say that they are effective therapeutics and that they possess few adverse side-effects, according to data published in the journal Cannabis and Cannabinoid Research.

CBG acid is the parent compound precursor to the more popularized cannabinoids THC and CBD. It is typically only found in minute quantities in harvested cannabis plants. However, in recent years, specially cultivated varieties of the plant possessing higher concentrations of CBG have been reported, particularly in the pacific northwest region of the United States.

A team of researchers affiliated with Washington State University and the University of California at Los Angeles surveyed subjects who self-identified as consumers of CBG-dominant cannabis products.

A majority of survey participants said they used CBG-dominant preparations of cannabis exclusively for medical purposes. Respondents most frequently did so to mitigate symptoms of anxiety, chronic pain, depression, and insomnia.

Most respondents described their symptoms as either “much improved” or “very much improved” following their use of CBG-dominant cannabis, and three-quarters rated it as “superior” to their conventional medications.

Authors concluded: “This is the first patient survey of CBG use to document self-reported efficacy of CBG-predominant cannabis, particularly for anxiety, chronic pain, depression, and insomnia. Most respondents claimed greater efficacy of CBG over conventional pharmacotherapy … and reported a very benign adverse event profile and negligible withdrawal. … This study demonstrates that CBG-predominant cannabis and related products are available and being used by cannabis consumers and demonstrates the urgent need for randomized controlled trials of CBG-predominant cannabis-based medicines to be studied rigorously to assess safety and efficacy as a function of dose, mode of administration, and specific therapeutic indications.”

Full text of the study, “Survey of patients employing cannabigerol-predominant cannabis preparations: Perceived medical effects, adverse events, and withdrawal symptoms,” appears in Cannabis and Cannabinoid Research.

Study: Legal Cannabis Markets Experienced Far Fewer Cases of Vaping Illness

New Haven, CT: States with legal adult-use cannabis markets were far less likely to experience incidences of the vaping-related lung illness EVALI (e-cigarette or vaping product use-associated lung injury), which was responsible for several thousand hospitalizations in 2019. The US Centers for Disease Control and Prevention eventually acknowledged that vitamin E acetate – a diluting agent sometimes present in counterfeit, unregulated vape pen products – was responsible for the outbreak.

New data published in the journal Drug and Alcohol Dependence reported that cases of EVALI were more than 40 percent lower in legal cannabis states and that they were over 60 percent lower in jurisdictions that permitted home cultivation. Home grow laws were also associated with fewer incidences of consumers engaging in the use of marijuana vape pens.

Authors concluded: “Given that EVALI cases stemmed primarily from informally-sourced vaporizable marijuana concentrates, these results are consistent with crowd-out, whereby introduction of one market (legal marijuana) displaces utilization of another (informally-sourced marijuana products). Simply put, if the public can obtain products legally from reputable sources, there is less demand for illicit market products. Thus, RM [recreational marijuana] legalization could have dampened market penetration of tainted marijuana concentrates by reducing consumption of informally-sourced marijuana products more generally.”

The findings are consistent with those of several other studies also concluding that EVALI cases were largely concentrated in states where consumers did not have legal access to cannabis products.

Full text of the study, “State marijuana policies and vaping associated lung injuries in the US,” appears in Drug and Alcohol Abuse.

Analysis: THC Levels Not Indicative of Driving Impairment

New Haven, CT: The presence of THC concentrations in either blood or saliva is an unreliable predictor of impaired driving performance, according to a literature review published in the journal Frontiers in Psychiatry.

Researchers affiliated with Yale University assessed multiple papers specific to the issue of marijuana and driving performance. Consistent with prior reviews, authors reported that the presence of THC in bodily fluids is not a consistent predictor of impairment and that state-imposed per se limits for THC are not evidence-based.

Authors reported, “While legislators may wish for data showing straightforward relationships between blood THC levels and driving impairment that parallel those of alcohol, the widely different pharmacokinetic properties of the two substances … make this goal unrealistic.”

They added: “[S]tudies suggest that efforts to establish per se limits for cannabis-impaired drivers based on blood THC values are still premature at this time. Considerably more evidence is needed before we can have an equivalent ‘BAC for THC.’ The particular pharmacokinetics of cannabis and its variable impairing effects on driving ability currently seem to argue that defining a standardized per se limit for THC will be a very difficult goal to achieve.”

Researchers concluded: “Until there is more evidence-based consensus of opinion on meaningful thresholds for per se laws, we would recommend against reliance on such legislation. This is particularly the case given the significant inconsistencies in threshold values currently determined by different states in the US, and the rather weak scientific basis for such decisions. Any such laws cannot claim to be strongly based on current scientific evidence, which suggest collectively that standard based on detectable blood THC levels are not useful.”

Their findings are consistent with those of numerous other studies and expert review panels concluding that the presence of THC is an unreliable indicator of either recent cannabis exposure or impairment of performance. A 2019 report issued by the Congressional Research Service similarly determined: “Research studies have been unable to consistently correlate levels of marijuana consumption, or THC in a person’s body, and levels of impairment. Thus, some researchers, and the National Highway Traffic Safety Administration, have observed that using a measure of THC as evidence of a driver’s impairment is not supported by scientific evidence to date.”

NORML has long opposed the imposition of THC per se thresholds for cannabinoids in traffic safety legislation, opining: “The sole presence of THC and/or its metabolites in blood, particularly at low levels, is an inconsistent and largely inappropriate indicator of psychomotor impairment in cannabis consuming subjects. … Lawmakers would be advised to consider alternative legislative approaches to address concerns over DUI cannabis behavior that do not rely solely on the presence of THC or its metabolites in blood or urine as determinants of guilt in a court of law. Otherwise, the imposition of traffic safety laws may inadvertently become a criminal mechanism for law enforcement and prosecutors to punish those who have engaged in legally protected behavior and who have not posed any actionable traffic safety threat.”

In recent months, lawmakers in two states – Indiana and Nevada – have rolled back their THC per se laws.

The study’s authors acknowledged that acute cannabis-induced intoxication can influence driving behavior, but also recognized that “the relative risk of such impaired driving is significantly lower than other legislated drug use while driving, such as that resulting from alcohol.”

Full text of the study, “Cannabis and Driving,” appears in Frontiers in Psychiatry.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Kansas City, MO: City Council Approves Measure Eliminating Pre-Employment Marijuana Testing for Most City Workers

Members of the Kansas City, Missouri city council approved a local ordinance that will prevent pre-employment marijuana testing for most prospective government employees.

Ordinance No. 210627, which was approved with an 11 to 1 vote, says, “It shall be unlawful for the City of Kansas City to require a prospective employee to submit to testing for the presence of marijuana in the prospective employee’s system as a condition of employment.”

Kansas City Mayor Quentin Lucas, who sponsored the measure, said, “Opportunities should not be foreclosed unnecessarily. Glad to see passage of our law eliminating pre-employment screening for marijuana at Kansas City government for most positions. One step of many in becoming a fairer city.”

Certain government positions would be excluded from the protections under this law, such as law enforcement; positions requiring a commercial drivers license; those caring for children, medical patients, disabled or other vulnerable individuals; and positions “where the employee could significantly impact the health or safety of other employees or members of the public.”

Members of the council approved a municipal ordinance last year repealing all local penalties specific to activities involving the personal possession of marijuana. The Kansas City Mayor’s Office has also launched an online system to facilitate the process of pardoning those with low-level marijuana convictions.

Kansas City’s measure is similar to other municipal laws that have recently been enacted in several other cities, including Philadelphia, Atlanta, New York, and Washington, DC, limiting employers’ abilities to drug test certain employees for off-the-job marijuana exposure.

Bill to End Marijuana Prohibition to Receive Committee Vote In US House

Last night, we sent you a message about the SAFE Banking Act passing the House of Representatives as part of the NDAA.

Today, we have an even better bit of news to share with you: The MORE Act, which repeals federal marijuana criminalization, is set to be voted on by members of the powerful House Judiciary Committee NEXT WEEK.

This is an all-hands-on-deck moment. We need to push as many members of Congress to co-sponsor and publicly support the advancement of this bill. That is why we need you to send your Representative a message NOW!

For those who need a refresher, here’s what you need to know about the MORE Act:

– It removes marijuana from the federal Controlled Substances Act – thereby eliminating the existing conflict between state and federal marijuana laws and providing states with the authority to be the primary arbiters of cannabis policy within their own jurisdictions.
– It facilitates the expungement of low-level federal marijuana convictions, and incentivizing state and local governments to take similar actions;
– It creates pathways for ownership opportunities in the emerging regulated industry as well as other sectors of the economy for local and diversely-reflective entrepreneurs who have been impacted under prohibition through the Small Business Administration grant eligibility;
– It allows veterans, for the first time, to obtain medical cannabis recommendations from their VA doctors;
– It removes the threat of deportation for immigrants accused of minor marijuana infractions or who are gainfully employed in the state-legal cannabis industry;
– It provides critical reinvestment grant opportunities for communities that have suffered disproportionate rates of marijuana-related enforcement actions.
During the last Congressional session, NORML members drove in hundreds of thousands of messages in support of the MORE Act. We cannot let up. We need you to send a message to your lawmakers now.

Thanks for showing up, standing up, and speaking out.

Next Week: House Judiciary Committee to Advance Historic MORE Act

Members of the House Judiciary Committee have scheduled a hearing next week to mark up HR 3617: The Marijuana, Opportunity, Reinvestment, and Expungement (MORE) Act of 2021. The Act repeals the long-standing federal prohibition of marijuana – thereby ending the existing state/federal conflict in cannabis policies and providing state governments with greater authority to regulate marijuana-related activities, including retail sales.

“We are excited to see Chairman Nadler and House Leadership move forward once again with passing the MORE Act. Public support and sound public policy demand the repeal of federal marijuana prohibition, Congressional action on this legislation is long overdue. The days of our failed federal policy of prohibition are numbered,” said NORML Political Director Justin Strekal.

While House members deliberate over the MORE Act, members of the Upper Chamber continue to review public comments regarding The Cannabis Administration and Opportunity Act, introduced by Senators Cory Booker, Ron Wyden, and Majority Leader Chuck Schumer.

What the MORE Act Does: The legislation’s provisions remove marijuana from the federal Controlled Substances Act – thereby eliminating the existing conflict between state and federal marijuana laws and providing states with the authority to be the primary arbiters of cannabis policy within their own jurisdictions.

FURTHER: The MORE Act would also make several other important changes to federal marijuana policy, including:

– Facilitating the expungement of low-level federal marijuana convictions, and incentivizing state and local governments to take similar actions;
– Creating pathways for ownership opportunities in the emerging regulated industry as well as other sectors of the economy for local and diversely-reflective entrepreneurs who have been impacted under prohibition through the Small Business Administration grant eligibility;
– Allowing veterans, for the first time, to obtain medical cannabis recommendations from their VA doctors;
Removing the threat of deportation for immigrants accused of minor marijuana infractions or who are gainfully employed in the state-legal cannabis industry;
– Providing critical reinvestment grant opportunities for communities that have suffered disproportionate rates of marijuana-related enforcement actions.

Following action by the House Judiciary Committee, the MORE Act would require further consideration or waiver by the various jurisdictional committees before receiving a floor vote.

Key Facts Underscoring Marijuana Policy Reform Efforts:

According to the FBI UCR, over 545,000 Americans were arrested for marijuana-related crimes in 2019 alone. Over 90% of those arrested were charged with mere possession.

According to a recent report by the ACLU, Black Americans are 3.6 times more likely to be arrested for cannabis-related crimes than white Americans.
The state-legal cannabis industry employs over 321,000 full-time workers; that is over six times the number of jobs specific to the coal industry.
While the substance is not without harm, cannabis is objectively less harmful than legal and regulated alcohol and tobacco.

National Polling

Quinnipiac University, April 2021

Question: Do you think that the use of marijuana should be made legal in the United States, or not?

– Overall: 69% Yes – 25% No
– Democrat: 78% Yes – 17% No
– Republicans: 62% Yes – 32% No
– Independents: 67% Yes – 28% No
– Gallup Polling, Nov. 2020

Question: Do you think the use of marijuana should be made legal, or not?

– Overall: 68% Yes – 32% No
– Democrat: 83% Yes – 16% No
– Republicans: 48% Yes – 52% No
– Independents: 72% Yes – 27% No

Pew Research Center, April 2021

Question: Which comes closer to your view about the use of marijuana by adults?

– 60% It should be legal for medical AND recreational use
– 31% It should be legal for medical use ONLY
– 8% It should NOT be legal

Breakdown:

– 12% of Republicans say marijuana should NOT be legal
– 5% of Democrats say marijuana should NOT be legal

History of the MORE Act:

On December 4th of 2020, Members of the House of Representatives voted to approve the MORE Act, HR 3884, by a margin of 228 to 164. However, under the leadership of then-Majority Leader Mitch McConnell (K-KY), the full Senate did not consider the legislation prior to the close of the 116th Congressional session.

HR 3884 was carried in the 116th Congress by House Judiciary Committee Chairman Jerry Nadler and in the Senate by Vice President Kamala Harris.

House Judiciary Committee Chairman Jerry Nadler, along with Cannabis Caucus co-chairs Earl Blumenauer and Barbara Lee, Judiciary Crime Subcommittee Chairwoman Sheila Jackson Lee, House Democratic Caucus Chairman Hakeem Jeffries, and Small Business Committee Chairwoman Nydia Velรกzquez reintroduced the 2021 version of the bill in May.

Kamala Harris is now Vice President of the United States and is unable to reintroduce companion legislation. In July, Senate Majority Leader Schumer, along with Finance Committee Chairman Ron Wyden and Judiciary Committee’s Senator Cory Booker introduced a discussion draft for public comment of forthcoming legislation, The Cannabis Administration and Opportunity Act, that seeks to similarly remove cannabis from the Controlled Substances Act.

House Advances SAFE Banking Act as Part of the Must-Pass NDAA

NORML Supports Swift Enactment; Stresses Need for Further Federal Reforms

Washington, DC: The NDAA funding package passed by the US House of Representatives includes the provisions of the Secure and Fair Enforcement (SAFE) Banking Act, which allows state-licensed marijuana-related businesses to engage freely in relationships with banks and other financial institutions. The language was offered as an amendment to the bill by Representatives Ed Perlmutter (D), Earl Blumenauer (D), Barbara Lee (D), Nydia Velazquez (D), David Joyce (R), and Steve Stivers (R).

This vote marks the fifth time that House members have advanced SAFE Banking legislation in recent years. House members last approved the measure in April as a stand-alone bill by a vote of 321 to 101. At that time, all Democrats and just over half of Republicans in the House voted for the bill.

“Enactment of the SAFE Banking Act would improve public safety and business efficiency in the 36 states that currently permit some form of retail marijuana sales,” said NORML Political Director Justin Strekal, “The Senate should ensure this provision remains in the final version of this funding package and approve it swiftly.”

Strekal added: “The SAFE Banking Act is only the first step toward making sure that state-legal marijuana markets operate safely and efficiently. The sad reality is that those who own or patronize these currently unbanked businesses would still be recognized as criminals in the eyes of the federal government and by federal law. This situation can only be rectified by removing marijuana from the list of controlled substances.”

Currently, thousands of state-licensed cannabis businesses are unable to partner with the banking industry due to federal restrictions. They are unable to accept credit cards, deposit revenues, access loans, or write checks to meet payroll or pay taxes. This situation is untenable. No industry can operate safely, transparently, or effectively without access to banks or other financial institutions. Congress must move to change federal policy so that this growing number of state-compliant businesses, and their consumers, may operate in a manner that is similar to other legal commercial entities.

For these reasons, NORML has long advocated that federal lawmakers vote “Yes” on The SAFE Banking Act.

The NDAA now advances to the Senate for consideration.

In an exchange on Tuesday with Politico reporter Natalie Fertig, Republican Senate co-lead of the SAFE Banking Act Senator Kevin Cramer said “(I)f it’s a vehicle that can carry it, I think it’d be fine. … Any vehicle’s good that gets it to pass it.”

Analysis: Growing Number of States Allow Reimbursement of Medical Cannabis Costs by Workers’ Compensation Insurance

Medical Marijuana
A limited but growing number of states permit eligible patients to be reimbursed for their medical cannabis-related costs through their workers’ compensation insurance (WCI) plans, according to a just-published analysis of state policies conducted by the National Institute for Occupational Safety and Health.

NORML’s Deputy Director Paul Armentano said that these policy changes are further evidence of the legitimacy and social acceptance of medical cannabis. “For millions of patients, cannabis is a legitimate therapeutic option. More and more, our laws and regulations are recognizing this fact and evolving their policies accordingly.”

Researchers affiliated with the federal agency assessed rules and regulations in 36 states permitting medical cannabis access. They identified six states – Connecticut, Minnesota, New Hampshire, New Jersey, New Mexico, and New York – that explicitly allow for employees to have their medical cannabis expenses reimbursed. In three of those states – New Hampshire, New Jersey, and New York – reimbursements were ordered as a result of state Supreme Court rulings issued earlier this year.

By contrast, authors identified six states where workers’ compensation insurance is expressly prohibited from reimbursing medical marijuana-related costs: Maine, Massachusetts, 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.

Authors said that they expected the number of states permitting marijuana-related compensation to increase in the coming years “as more workers petition state courts and administrative agencies for cannabis WCI reimbursement.”

An abstract of the study, “Review of cannabis reimbursement by workers’ compensation insurance in the US and Canada,” appears in the American Journal of Industrial Medicine.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

The case is Juliano v. Delaware.

Survey: Patients Report Benefits of Cannabinoids for Blistering Skin Condition

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

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

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

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

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

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

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

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

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

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

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

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

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Study: No Rise in Youth Marijuana Use Following Legalization

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

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

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

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

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

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

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

Analysis: Medical Cannabis Provides Benefits to Migraine Patients

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

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

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

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

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

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

Case Series: Cannabis Plant Extracts Effective in Mitigating Chronic Pain

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

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

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

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

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

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

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

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

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

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

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

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

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Review: Cannabinoids Are an “Adequate Potential Treatment Option” for Fibromyalgia Patients

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

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

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

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

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

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

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

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

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

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

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

Commentary: Herbal Cannabis Vaporization Safer Alternative to Smoking

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Several gold-standard human trials show that cannabis can alleviate pain in various patient populations, including those with HIV, diabetes, spinal cord injury, and with treatment-resistant neuropathy (nerve pain). A 2017 review of over 10,000 peer-reviewed scientific papers by the National Academies of Sciences, Engineering, and Medicine acknowledged, “In adults with chronic pain, patients who [are] treated with cannabis or cannabinoids are more likely to experience a clinically significant reduction in pain symptoms. … There is conclusive or substantial evidence that cannabis is effective for the treatment of chronic pain in adults.”

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Several prior studies have reported that those suffering from migraines often turn to cannabis for symptomatic relief, and many patients say that it is more effective than prescription medications.

Full text of the study, “Oral cannabinoid preparations for the treatment of chronic migraine: A retrospective study,” appears in Pain Medicine.

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

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

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

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

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

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

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

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

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

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

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

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

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Clinical Trial: Use of CBD Associated with Greater Emotional Wellness

Sao Paulo, Brazil: The daily administration of CBD is associated with lower levels of emotional exhaustion, anxiety, and depression, according to clinical trial data published in JAMA Psychiatry.

A team of investigators affiliated with the University of Sรฃo Paulo in Brazil evaluated the safety and efficacy of CBD treatment in a cohort of 120 frontline health care professionals. Half of the study’s participants received 300mgs of CBD daily for a period of four weeks. Others did not receive the substance.

Those undergoing CBD treatment exhibited fewer signs of emotional exhaustion and burnout as compared to those subjects who did not. CBD consumption was also associated with less anxiety and depression. However, five of the subjects assigned to use CBD had to eventually drop out of the trial after suffering from serious adverse events, including elevated liver enzymes.

“This randomized clinical trial found that the efficacy and safety of daily treatment with CBD, 300 mg, for 4 weeks combined with standard care was superior to standard care alone for reducing the symptoms of emotional exhaustion, anxiety, and depression among frontline health care professionals working with patients with COVID-19,” authors concluded. “Cannabidiol may act as an effective agent for the reduction of burnout symptoms among a population with important mental health needs worldwide.”

Full text of the study, “Efficacy and safety of cannabidiol plus standard care vs standard care alone for the treatment of emotional exhaustion and burnout among frontline health care workers during the COVID-19 pandemic: A Randomized clinical trial,” appears in JAMA Psychiatry.

Study: Medical Cannabis Laws Associated with Declines in Youth Cigarette Use

Irvine, CA: The enactment of medical cannabis access laws is associated with reduced rates of cigarette smoking among young people, according to data published in the journal Cannabis.

A team of researchers affiliated with the University of California at Irvine and with Pennsylvania State University assessed the relationship between medical cannabis legalization laws and cigarette initiation among adolescents.

They concluded: “Our results indicate lower odds of initiating cigarettes, in every age group (8 years old or younger, 9-10, 11-12, 13-14, 15-16, 17 years old or older) in states with MMLs [medical marijuana laws] when compared to non-MML states. … Further research should evaluate how MMLs and recreational marijuana policies are associated with e-cigarette initiation and use.”

Data published recently in the journal Nicotine & Tobacco Research reported that the passage of adult-use marijuana laws is not associated with any uptick in youth tobacco use.

Full text of the study, “State medical marijuana laws and initiation of cigarettes among adolescents in the US, 1991-2015,” appears in Cannabis.

California: Retailers Not Selling Cannabis to Underage Patrons

San Diego, CA: Marijuana retailers in California consistently check IDs prior to making cannabis sales, according to data published in the journal JAMA Pediatrics.

A pair of researchers affiliated with the University of California at San Diego and with UCLA assessed retailers’ compliance with the state’s minimum age laws.

Consistent with prior studies, investigators identified virtually no incidences of retailers selling cannabis to patrons without first validating that they were age 21 or older.

They reported, “California laws further require ID check before any purchase, and overall compliance with this rule was high at 678 [out of 700 eligible] RCDs [recreational cannabis dispensaries] (96.8 percent).”

Studies from other states where marijuana sales are legal, such as Colorado and Oregon, have similarly reported exceptionally high compliance rates among licensed facilities.

Full text of the study, “Assessment of recreational cannabis dispensaries’ compliance with underage access and marketing restrictions in California,” appears in JAMA Pediatrics.

Michigan: Most Residents Live Within 20 Minutes of a Marijuana Retailer

East Lansing, MI: A supermajority of Michigan residents live in close proximity to a licensed marijuana retail establishment, according to a geographic analysis by the Anderson Economic Group.

Their report indicates that adult-use retail stores are integrated throughout most of the state. “Over 80 percent of Michiganders now live within a 20-minute drive of an adult-use retail store,” said Brian Peterson, AEG director of public policy and economic analysis. “Our analysis shows that the retailers have established themselves across the state in order to meet consumer demand for cannabis.”

The Michigan experience differs from that of some other states, like California, where a majority of cities have prohibited the establishment of local retail stores. In New Jersey, where commercial sales are expected to begin next year, nearly half of cities and towns have opted out of permitting local marijuana businesses.

Nearly 750 commercial retailers are currently operating in Michigan. About 55 percent of retailers cater to medical cannabis patients, while the remaining 45 percent of stores are adult-use facilities.

Full text of the AEG analysis is online.

Maine: Non-Residents Eligible for Commercial Marijuana Licenses

Augusta, ME: A federal court judge has struck down regulations barring out-of-state companies from operating marijuana dispensaries.

At issue was a 2011 rule mandating that licensed medical cannabis retailers must be in-state residents. In her ruling, US District Court Judge Nancy Torres opined that Maine’s medical cannabis industry is not “wholly interstate” – as dispensaries are permitted to sell to those from other states. Therefore, she determined that it was inconsistent for the law to provide preferences to in-state residents wishing to sell medical cannabis.

Earlier this year, state officials set aside a separate regulation mandating that applicants seeking adult-use sales licenses must be in-state residents.

Going forward, out-of-state residents will be able to seek licensure to operate both medical cannabis and/or adult-use retail facilities.

The full text of the ruling, Northeast Patients Group v. Maine Department of Administrative and Financial Services, is available online.

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Study: Combined Administration of Oral THC and PEA Effective in Patients with Refractory Tourette’s Syndrome

New Haven, CT: The combined administration of oral THC (dronabinol) and the endogenous compound PEA (palmitoylethanolamide) is associated with symptomatic improvements in patients with treatment-resistant Tourette’s syndrome (TS), according to observational trial data published in the Journal of Neuropsychiatry and Clinical Neurosciences.

A team of Yale University researchers assessed the use of THX-110 (a proprietary combination of THC and PEA) over a period of 12 weeks in a cohort of patients with refractory TS.

Authors reported that participants’ tic symptoms improved within one week of treatment and continued to improve over time. Treatment with THX-110 was well-tolerated by the majority of subjects.

They concluded: “THX-110 treatment led to an average improvement in tic symptoms of roughly 20 percent, or a 7-point decrease in the YGTSS [Yale Global Tic Severity Scale] total tic score. … Our open trial of THX-110 treatment supports an emerging body of evidence suggesting that cannabinoid compounds may be effective for the treatment of Tourette’s syndrome.”

Full text of the study, “A Phase-2 pilot study of a therapeutic combination of delta-9-tetrahydrocannabinol and palmitoylethanolamide for adults with Tourette’s syndrome,” appears in the Journal of Neuropsychiatry and Clinical Neurosciences.

Analysis: Legal Cannabis Sales Projected to Reach $43 Billion By 2025

Washington, DC: Retail marijuana sales in the United States are projected to reach $43 billion per year by 2025, according to an economic analysis by New Frontier Data.

Legal marijuana sales have increased to historic levels in recent months, with sales totaling nearly $6 billion in the first quarter of this year. Retail sales are projected to increase in the coming months as additional states – such as New Jersey and New York – begin licensing cannabis retailers.

The New Frontier Data analysis estimates that by 2025, “42 percent of total annual US cannabis demand will be met by legal purchases in regulated marketplaces.”

Of the $43 billion in projected annual sales in 2025, analysts estimate that roughly 62 percent of transactions will involve adult-use purchases while the remaining 38 percent will be medical cannabis sales.

For more information, see the NORML fact sheet ‘Marijuana Regulation: Impact on Health, Safety, Economy.’

Israel: Politicians Narrowly Reject Measure Depenalizing Cannabis Possession

Jerusalem, Israel: Members of the Israeli Parliament have narrowly defeated legislation that sought to depenalize activities involving the possession and cultivation of cannabis by adults.

The proposal sought to eliminate criminal and civil penalties involving the possession of up to 50 grams of cannabis and/or the home-cultivation of personal use quantities of the plant. The legislation failed in the Israeli Knesset (Parliament) by a vote of 55 to 52.

Lawmakers decriminalized low-level marijuana possession offenses in 2017 – subjecting first-time and second-time offenders to a fine-only penalties. The production and prescribed use of medical cannabis is permitted nationwide.

Additional information on Israeli cannabis laws is available on Lexology.

Survey: Many Patients with Spine-Related Pain Turning to CBD

New York, NY: An estimated one-in-four patients with spine-related pain report using CBD to combat their symptoms, according to survey data published in the International Journal of Spine Surgery.

Researchers anonymously surveyed patients at a spinal surgery clinical in New York over a four-week period.

Twenty-five percent of respondents acknowledged either using or having used CBD for symptom control. Nearly half (46 percent) of users reported that it mitigated their pain. Thirty-three percent said that the use of CBD improved sleep and 20 percent said that it reduced their anxiety. By contrast, nearly 25 percent of users reported no therapeutic benefits from CBD.

Authors concluded: “This is the first study, to our knowledge, to examine the consumption patterns and perceived effects of CBD in patients with spinal pathology. This investigation demonstrates that CBD is a prevalent alternative therapy used by many patients with spine-related symptoms. As the popularity of the supplement is only expected to increase over time, spine surgeons must educate themselves on the evidence behind the use of CBD, understand its legal status, and be aware of the potential for mislabeling of ingredients.”

Full text of the study, “Prevalence of cannabidiol use in patients with spine complaints: Results of an anonymous survey,” appears in the International Journal of Spine Surgery.

New Hampshire: Governor Signs Law Expanding Patients’ Medical Cannabis Access

Concord, NH: Republican Gov. Chris Sununu has signed legislation into law expanding the pool of patients eligible for medical cannabis access.

House Bill 605 permits physicians to recommend cannabis therapy to patients with opioid use disorder. Some studies have shown that the use of cannabis is associated with greater rates of treatment retention in patients with OUD and that cannabinoids may mitigate opioid-related cravings.

Separate provisions in the law permit non-resident patients who possess a valid registration from another state to legally possess and purchase limited quantities of medical cannabis from dispensaries in New Hampshire.

The new law takes effect in early October. Additional information is available from the NORML fact sheet, ‘Relationship Between Marijuana and Opioids.’

Alaska: Regulatory Change Permits for Greater THC Levels in Edible Products

Juneau, AK: Regulatory changes set to take effect on September 1, 2021 will allow adult-use cannabis retailers and manufacturers to provide edible products containing elevated quantities of THC.

The new rules raise the amount of THC permissible in a single serving of an adult-use edible product from 5mg of THC to 10mg. Multi-serving products will be permitted to contain up to 100mgs of THC – twice the amount previously permitted under the law. The regulatory changes were codified on August 2.

The rule change comes at a time when lawmakers in a handful of states have recently debated imposing new rules lowering the amount of THC permissible in certain products. Specifically, recently passed legislation in Colorado reduced the quantity of THC concentrates that younger patients may purchase in a single day, and called on public health officials to consider making further recommendations regarding the availability of higher-potency THC products.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Marijuana Legalization Laws Don’t Undermine Tobacco Smoking Prevention Efforts

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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