Tag: Tuesday

Analysis: Cannabis Legalization Laws Associated With Lower Crime Rates

Fairfield, CT: The enactment of laws legalizing cannabis for either medical or adult-use purposes is associated with declining crime rates over time, according to findings published in the scientific journal Economic Modeling.

Researchers affiliated with the Jack Welch College of Business at Sacred Heart University in Connecticut and Barnard College in New York evaluated the relationship between statewide cannabis policies and crime rates nationwide.

Consistent with prior studies, they reported that liberalized marijuana laws were associated with reductions in overall criminal activity. Specifically, the adoption of medical cannabis legalization is associated with reduced property crime, whereas adult-use legalization is associated with decreases in violent crime. These trends become more pronounced over time.

“The overarching result from our [study] is that medical legalization reduces property crime, while recreational legalization reduces violent crime. Such effects support the … hypothesis that legalization drives out crime,” the study’s authors concluded. “The diverse and potentially time-varying impacts of medical and recreational legalization raise a cautionary note for policymakers: those considering legalization should wait a few years before pronouncing on the cost-benefit impact, focus on the specific type of legalization, and study closely the outcomes from similar states.”

Previous studies have similarly determined that cannabis legalization is associated with improvements in police clearance rates, particularly for those cases involving violent offenses.

Full text of the study, “How does marijuana legislation affect crime? Medical and recreational laws across 50 states,” appears in Economic Modeling.

Canada: Alcohol Sales Continue Historic Decline While Cannabis Sales Rise

Ottawa, Ontario: Sales of alcohol and cannabis in Canada are on opposite trajectories, according to data provided by Statistics Canada, the national statistical agency of the Canadian government.

For the fiscal year ending March 31, 2025, sales of adult-use cannabis products increased 6.5 percent. By contrast, alcohol sales revenue declined by 1.6 percent.

Canadians purchased $5.5 billion worth of cannabis products in the last fiscal year, with sales of herbal cannabis products comprising approximately 60 percent of all sales.

Canada legalized the adult-use marijuana market in 2018.

Data from several US jurisdictions, including California, have identified a relationship between legal cannabis access and decreasing alcohol consumption. Survey data published in 2024 in The Harm Reduction Journal found that 60 percent of cannabis consumers acknowledge using it to reduce their alcohol intake.

Complete data sets are available from Statistics Canada.

Study: Plant-Derived Cannabis Extracts More Effective Than Dronabinol in Elderly Patients With Chronic Pain

Nürnberg, Germany: Plant-derived cannabis extracts containing standardized percentages of CBD and THC are more effective and tolerable than dronabinol (synthetic oral THC) in older pain patients, according to data published in the Journal of Pain Research.

German researchers assessed the efficacy of CBD-dominant extracts versus dronabinol in matched cohorts of 484 elderly (age 65 or older) patients with either chronic or refractory pain conditions. Study participants consumed the products for 24 weeks.

Both treatments were associated with “clinically relevant improvements” in patients’ pain disability, sleep, quality of life, psychological well-being, and use of analgesics. However, patients consuming plant-derived extracts exhibited greater overall levels of improvement. Participants taking dronabinol were also more likely to drop out of the study.

The study’s authors concluded: “To our knowledge, [this study] represents the first large real-world evaluation of oral cannabis-based medicines (CBM) specifically in older patients with chronic pain. Over a 24-week observation period, both CBD > THC and THC/DRO [dronabinol] therapies were associated with clinically relevant improvements. … However, the extent of improvement and the rates of ADR [adverse drug reaction]-related discontinuations differed between the two treatment groups, with CBD > THC being associated with more favorable outcomes. These findings expand the limited evidence based on the use of CBM in elderly patients and complement previous clinical and observational studies on cannabinoids in pain medicine.”

Survey data finds that seniors are increasingly turning to cannabis, typically for medical purposes. Most older adults acknowledge holding positive perceptions about cannabis, and several recent studies show that its use is frequently associated with quality of life improvements among seniors.

Full text of the study, “CARE – A retrospective, dual-cohort, 24-week real-world study from the German pain E-registry on the effectiveness and safety of CBD-dominant oral cannabis extracts versus THC/dronabinol in older patients with chronic pain,” appears in the Journal of Pain Research.

Colorado: Data Finds No Evidence of Underage Cannabis Sales at Licensed Retailers

Denver, CO: Employees at licensed cannabis retailers strictly enforce the state’s minimum age requirements and nearly always deny entry to those without proper identification, according to data provided by state regulators.

Annual data provided by Colorado’s Marijuana Enforcement Division finds that retailers denied entry 99 percent of the time to patrons lacking proper proof of age. That result is consistent with data from other adult-use states, including California and Washington, finding that state-licensed cannabis retailers are more likely than alcohol proprietors to deny those without proper ID entry to their facilities.

Commenting on the findings, NORML’s Deputy Director Paul Armentano said, “Regulation works. Illicit marijuana providers don’t ask for or check for ID, but licensed businesses most certainly do. States’ real-world experience with adult-use marijuana legalization affirms that it is being implemented in a way that provides regulated access for adults while simultaneously limiting youth access and misuse.”

Federally funded survey data compiled by the University of Michigan in December reports that marijuana use by adolescents has fallen dramatically since states began regulating adult-use cannabis markets and now stands at or near historic lows.

Study: Adult-Use Cannabis Legalization Significantly Disrupts Unregulated Markets

New York, NY: The adoption of statewide adult-use marijuana legalization laws is associated with declines in illicit market cannabis seizures by law enforcement and likely reduces the size of the unregulated marketplace, according to data published in the International Journal of Drug Policy.

Researchers affiliated with Columbia University and New York University assessed the relationship between legalization laws and annual changes in cannabis seizures by state and federal law enforcement from 2010 to 2023.

Investigators determined that adult-use legalization “was associated with a significant decrease in cannabis seizures,” both in the short-term and long-term.

The study’s authors concluded: “Findings showed a 45 percent relative reduction in mean counts of state law enforcement cannabis seizures in states that adopted RCL [recreational cannabis laws] in addition to MCL [medical cannabis laws], even after controlling for secular trends and pre-existing state differences. … Taken together, findings from this study support the possibility that RCLs, beyond only MCLs, may help to reduce the size of the illegal cannabis market.”

In Canada, which legalized marijuana sales nationwide in 2018, nearly 80 percent of cannabis consumers have transitioned from unregulated markets to the legal market. According to a 2023 survey of US consumers, 52 percent of adults residing in legal states said that they primarily sourced their cannabis products from retail establishments.

Most recently, data provided by the Massachusetts Cannabis Control Commission reported that over 70 percent of consumers purchase their cannabis at a store. “Residents turn away from the illicit market when safe, well-regulated options are available,” the Commission’s Executive Director Travis Ahern said.

Full text of the study, “Cannabis legalization and law enforcement drug seizures: A state-level analysis of cannabis policy effects on cannabis seizures in the United States,” appears in International Journal of Drug Policy.

Analysis: Cannabis Use Associated With Significant Reductions in Patients’ Daily Anxiety

Fort Myers, FL: The consumption of state-authorized medical cannabis products is associated with significant decreases in daily anxiety levels, according to longitudinal data published in the journal Nature: Scientific Reports.

Investigators affiliated with Florida Gulf Coast University assessed cannabis’ efficacy in a cohort of 416 patients with a history of anxiety. Participants’ anxiety levels were initially assessed at baseline. Daily shifts in anxiety levels were assessed for the following 45 days. On some days, subjects consumed state-licensed medical cannabis products. At other times, subjects engaged in meditation and other activities to moderate their anxiety.

Patients reported the greatest mitigation in their anxiety on the days they consumed cannabis.

The study’s authors concluded: “Results showed that across all 45 days and participants, MC [medical cannabis] use was the biggest factor in alleviating anxiety. … Investigating how participants administered their MC revealed no effect of route of administration on anxiety relief. … Future work should help paint a clearer picture of how initiating and maintaining MC use helps individuals deal with daily anxiety levels.”

In a previous study of state-registered medical cannabis patients, over 90 percent of respondents said that cannabis helped to relieve their anxiety. Survey data consistently reports that consumers are most likely to use cannabis for purposes of mitigating pain and anxiety.

Full text of the study, “Associations of cannabis use, other substances, and lifestyle choices on anxiety in medical cannabis patients across 45 days,” appears in Nature: Scientific Reports.

Florida: Supreme Court Sides With DeSantis Administration in Legalization Ballot Measure Fight

Tallahassee, FL: The Supreme Court will not entertain arguments challenging the DeSantis administration’s decision to invalidate tens of thousands of signatures in support of a proposed 2026 adult-use marijuana legalization ballot measure.

Election officials in February determined that petitioners from the Smart & Safe Florida campaign failed to turn in the necessary number of valid signatures to qualify for the November ballot. The campaign filed a legal challenge to that decision, arguing that state officials improperly dismissed tens of thousands of signatures that should have been counted.

Last week, the Court announced that it would not consider the petitioners’ challenge – stating, “No motion for rehearing will be entertained by the Court.” No further explanation was provided.

Petitioners qualified a similar measure on the 2024 ballot. That proposal gained 56 percent of the vote, shy of the 60 percent threshold required to pass a constitutional amendment in Florida. (Florida is the only state that requires citizen-initiated measures to gain more than a simple majority.)

The DeSantis administration vigorously opposed both efforts. In May, Gov. DeSantis signed legislation making it harder for parties to qualify measures for the electoral ballot. Earlier this year, state election officials audited the work of several counties, which they alleged had not properly verified voters’ signatures. State officials also launched a criminal probe to investigate the actions of various petitioners involved with the Smart & Safe campaign. Separately, the Attorney General’s office had previously challenged the wording of the proposed measure in court, calling it “unconstitutional.”

Historically, Florida has been among the states with the highest number of annual marijuana-related arrests. Under state law, possession of 20 grams or less of marijuana is a criminal misdemeanor, punishable by up to one year in jail and a $1,000 fine. Possessing greater amounts is a felony offense, punishable by up to five years in prison.

Georgia: Lawmakers Advance Legislation Expanding Medical Cannabis Access To Qualified Patients

Atlanta, GA: Lawmakers have amended and approved legislation, Senate Bill 220, significantly expanding the state’s limited medical cannabis access law.

Under existing law, qualified patients are limited to infused “low THC oil” products containing no more than five percent THC. The proposed measure allows patients to obtain “medical cannabis” products “containing a cumulative total of 12,000 milligrams or less of THC.” It also permits products to be available in formulations that may be consumed via vaporization. It also expands the pool of patients eligible to receive medical cannabis authorizations to include those diagnosed with lupus, severe arthritis, and severe insomnia, among other conditions.

Senate members initially passed the bill on March 6th by a vote of 39 to 17. House members amended and passed the bill days later by a vote of 138 to 21. The Senate signed off on the changes this week.

Georgia lawmakers approved legislation in 2015 legalizing the possession of non-herbal, low-THC oils for authorized patients. However, regulators failed to license dispensaries to provide these products until 2023.

Over 33,000 patients are currently enrolled in Georgia’s medical cannabis access program.

Mississippi: Bill Providing Doctors With Greater Discretion To Recommend Medical Cannabis Advanced to Governor’s Desk

Jackson, MS: Legislation (House Bill 1152) providing physicians with greater discretion to recommend medical cannabis has passed both legislative chambers with veto-proof majorities. The measure now awaits action by Republican Gov. Tate Reeves.

Under current law, patients are only eligible for medical cannabis therapy if they suffer from one of a limited list of qualifying conditions. Under HB 1152: The Right to Try Medical Cannabis Act, healthcare practitioners may submit a petition to the Department of Health requesting authorization for patients who are suffering from a non-qualifying illness. State officials will then have 45 days to either approve or deny the request. All decisions are final and cannot be appealed.

Members of the Senate initially approved the bill by a vote of 102 to 14. House members amended and approved the bill 34 to 7. This week, Senators concurred with the House’s changes by a vote of 102 to 14.

The Act is scheduled to take effect on July 1, 2026.

Separate legislation (HB 895) extending the validity period of a practitioner’s medical cannabis recommendation was also sent to the Governor.

Mississippi lawmakers approved legislation in 2022 regulating medical cannabis access. Nearly 60,000 patients are currently enrolled in the program.

Study: Cannabis Consumption Associated With Opioid Cessation in Polydrug Users

Vancouver, British Columbia: Polydrug consumers are more likely to cease using non-prescription opioids if they consume cannabis, according to data published in the journal Drug and Alcohol Review.

Researchers affiliated with the University of British Columbia assessed the relationship between the use of cannabis and unregulated opioids among people who use drugs (PWUD) living with chronic pain.

They reported that the daily use of cannabis was positively associated with opioid cessation, particularly among males.

“Participants reporting daily cannabis use exhibited higher rates of cessation compared to less frequent users or non-users,” the study’s authors concluded. “Our findings add to the growing evidence supporting the potential benefits of cannabis use among PWUD, underlining the need for further research.”

The findings are consistent with prior data suggesting that cannabis use can mitigate opioid-related cravings and manage withdrawal symptoms.

Full text of the study, “Cannabis use and illicit opioid cessation among people who use drugs living with chronic pain,” appears in Drug and Alcohol Review.

Clinical Trial: Hemp-Derived Cannabinoids Improve Sleep Quality

Jacksonville, FL: The oral administration of a hemp-derived supplement containing precise percentages of THC, CBN, and CBD is associated with improved sleep quality, according to placebo-controlled trial data published in Health Science Reports.

Researchers affiliated with the University of North Florida and Jacksonville University assessed the impact of an orally administered cannabinoid supplement versus a placebo in 20 subjects with subthreshold insomnia symptoms.

Compared to the placebo, cannabinoid administration was associated with “significant improvements [from] baseline for sleep latency, sleep duration, and global sleep quality.” Participants also experienced “significant improvements in ‘mental health,’ [and] ‘feeling healthy and full of energy’” after using the cannabinoid supplement for ten days.

“The purpose [of this trial] was to examine the effectiveness of a hemp‐based supplement with CBD, CBN, THC, and a standardized terpene blend on sleep quality/quantity, anxiety, perceived stress, mood, pain, and HRQoL (health-related quality of life) in adults with subthreshold insomnia symptoms using a randomized double‐blind placebo‐controlled crossover pilot trial. We found the CS (cannabinoid supplement) was well‐tolerated and resulted in significant improvements in several sleep quality and health outcomes compared to both baseline and placebo,” the study’s authors concluded. “Improvements in daytime fatigue, pain affected sleep, mood, and anxiety were also associated with CS, though these were nonsignificant condition differences. In conclusion, [hemp-derived cannabinoid] supplementation may be a simple, effective, and well‐tolerated alternative to improve sleep quality and related health outcomes in adults with subthreshold insomnia symptoms.”

The trial’s results are consistent with those of several observational studies finding that patients with insomnia and other sleep disorders experience improvements following their use of cannabis. Studies have also identified a correlation between the adoption of statewide marijuana legalization laws and declining sales of over-the-counter (OTC) sleep aid medications.

Full text of the study, “Effectiveness of a cannabinoid supplement on sleep and mood in adults with subthreshold insomnia: A randomized double-blind placebo-controlled crossover pilot trial,” appears in Health Science Reports.

Texas: Judge Denies Effort To Enjoin Dallas’ Voter-Approved Marijuana Depenalization Ordinance

Dallas, TX: A Texas judge has denied a request from the state’s Republican Attorney General to enjoin Dallas’ voter-approved marijuana depenalization ordinance.

On Election Day, voters in Dallas (population 1.3 million) and two other cities (Bastrop and Lockhart) decided in favor of municipal ballot initiatives limiting the ability of local law enforcement to make misdemeanor marijuana possession arrests. Following the election, state Attorney General Ken Paxton filed litigation to prevent Dallas officials from implementing the law. (City officials in Bastrop and Lockhart declined to adopt their ordinances out of fear of litigation.)

In recent months, Paxton has filed lawsuits against multiple cities that have moved to end low-level marijuana arrests. To date, none of his lawsuits have been successful.

State law defines marijuana possession of 2 ounces or less as a criminal misdemeanor, punishable by up to 180 days in jail, a $2,000 fine, and a criminal record. According to data compiled by Texas NORML, police made an estimated 219,000 marijuana-related arrests between 2017 and 2021. Ninety-seven percent of those arrested were charged with possession only. Fifty-six percent of those arrested were under 25 years of age.

Additional information is available from Ground Game Texas.

Montana: Opponents of THC Limit Bill Outnumber Proponents by More Than 2 to 1 During Legislative Hearing

Helena, MT: Opponents of legislation imposing a 15 percent THC potency cap on adult-use marijuana products made their voices heard at a legislative hearing last week before members of the Senate Business, Labor and Economic Affairs committee.

Opponents of the bill, Senate Bill 443, outnumbered proponents by a margin of more than two to one. Many witnesses represented state-licensed cannabis businesses, who argued that passage of the measure would recriminalize most of their products. Others argued that the bill sought to unreasonably undermine the state’s marijuana legalization law, which was approved by 57 percent of voters.

NORML’s Deputy Director Paul Armentano provided testimony against the bill, stating: “Prohibiting adults from accessing products with more than 15 percent THC from state-licensed retailers will not eliminate consumers’ demand for them. Rather, it will encourage consumers to seek out these products in the unregulated market. It will also move the production of these products exclusively underground – thereby undermining the primary goal of legalization, which is to provide adults with safe, affordable, above-ground access to lab-tested products of known purity, potency, and quality.”

Some witnesses also pushed back against language in the bill equating the availability of higher-THC products with slavery.

In 2021, lawmakers approved legislation imposing a 35 percent THC potency limit on botanical products. They also capped the amount of THC permissible in edible products and concentrates. Montana is one of the only states in the nation to impose limits on the THC content of legally regulated cannabis products.

Following the hearing, committee members moved to table the bill – thereby suspending it from further consideration. A motion to reconsider the bill also failed.

Separate legislation, Senate Bill 255, establishing a mandatory registry for cannabis consumers and tracking their purchases was also scheduled to be debated last week, but it was never brought before the committee.

Analysis: Most ‘Hemp-Derived’ Intoxicating Products Sold Online Contain Synthetically Produced Cannabinoids

San Diego, CA: Most commercially available hemp-derived intoxicating products are infused with synthetic cannabinoids, including novel cannabinoids like THCP and HHC, according to an analysis of 104 products by the San Diego/Imperial Counties Joint Labor Management Cannabis Committee.

Investigators assessed the composition and potency of 104 distinct products from 68 brands. All the products were available online and delivered to California by the US Postal Service. (Hemp-derived intoxicating products are not currently subject to federal regulations or oversight.) No age verification was required when purchasing any of the products. Most of the products were categorized as either vape products or gummies.

Researchers determined that 95 percent of the products sampled, including 97 percent of vape products, contained cannabinoids produced through a chemical synthesis rather than naturally extracted from the plant. While delta-8-THC and delta-9-THC were the most frequently identified synthetically derived cannabinoids, investigators also identified highly potent novel cannabinoids such as THCP and HHC in nearly one-third to one-half of products. Some products also tested positive for the presence of kratom, hallucinogenic mushrooms, or similar psychoactive substances.

The study’s authors cautioned that exposure to either synthetic cannabinoids or byproducts produced during the chemical conversion process can pose potential risks to consumers’ health.

They wrote: “The presence of synthetic cannabinoids in these products doesn’t just challenge their classification as ‘hemp’ – it also fundamentally distorts consumer expectations around potency. Many of the lab-made cannabinoids found in our analysis are far more potent than natural delta-9 THC, meaning a product’s psychoactive effects may be dramatically understated if potency is assessed solely by delta-9 THC content. … Novel and unknown isomers associated with chemically synthesized cannabinoids, like delta-8 THC, may present significant risks due to their unpredictable chemical and physical properties.”

They concluded: “To restore order to the market and bring clarity and certainty to consumers, all THC-containing products should be regulated as cannabis within California’s established framework. This will protect consumer safety, ensure tax compliance, and uphold the intent of the state’s cannabis laws.”

NORML and other groups have urged the FDA to establish regulatory guidelines governing the production, testing, labeling, and marketing of hemp-derived cannabinoid products. In 2021, NORML issued a report on delta-8-THC and other novel synthetically derived cannabinoids that cautioned consumers to avoid these unregulated products because they are often mislabeled and may contain impurities.

Full text of the white paper, ‘The Great Hemp Hoax,’ is available from the San Diego/Imperial Counties Joint Labor Management Cannabis Committee.

Survey: Nearly Half of Military Veterans Use Cannabis for Pain Relief

San Francisco, CA: An estimated 40 percent of veterans suffering from chronic pain consume cannabis products to mitigate their symptoms, according to survey data published in the journal Global Advances in Integrative Medicine and Health.

A team of investigators affiliated with the University of California at San Francisco and Yale University surveyed pain patients enrolled in the Veterans Health Administration primary care services program.

Forty percent of respondents acknowledged using cannabis products to manage their symptoms. However, the study’s authors suggested that this percentage may reflect under-reporting because cannabis use is discouraged within the Veterans Administration. Respondents were most likely to report using cannabis to manage pain or mobility (81 percent), sleep (62 percent), PTSD or anxiety (43 percent), stress (43 percent), and depression (29 percent).

Prior surveys indicate that veterans frequently consume cannabis to improve their health-related quality of life and to reduce their reliance on prescription medications.

Full text of the study, “Natural product use for chronic pain: A new survey of patterns of use, beliefs, concerns, and disclosures to providers,” appears in Global Advances in Integrative Medicine and Health.

Idaho: Voters May No Longer Be Able To Amend State’s Marijuana Policies

Boise, Idaho: State lawmakers have approved a resolution asking voters to provide legislators with the exclusive authority to amend state laws specific to the legalization or decriminalization of marijuana and other controlled substances.

Lawmakers in both chambers passed House Joint Resolution 4 along party lines. It asks voters to decide next year on the following ballot question: “Shall Section 26, Article III of the Constitution of the State of Idaho be amended to provide that only the Idaho Legislature shall have power and authority to legalize the growing, producing, manufacturing, transporting, selling, delivering, dispensing, administering, prescribing, distributing, possessing, or using of marijuana, narcotics, or other psychoactive substances?”

If enacted by voters, no future initiatives pertaining to how marijuana or other controlled substances are regulated will be permitted to appear on the Idaho ballot.

While the majority of Idahoans have expressed support for various drug policy reforms, such as the legalization of medical cannabis, GOP lawmakers who dominate the legislature remain steadfastly opposed to liberalizing the state’s marijuana laws. In February, Republican Gov. Brad Little signed legislation into law, making Idaho the only state to impose mandatory minimum penalties for low-level marijuana possession. That law takes effect in July.

North Dakota: Lawmakers Advance Competing Bills Permitting Edible Forms of Medical Cannabis

Bismarck, ND: Members of the House and Senate have passed competing bills through their respective chambers providing for the use of “cannabinoid edible products” by qualified medical cannabis patients. Under current law, state-registered patients may possess either herbal cannabis or infused tinctures, capsules, or topical patches.

Both measures – House Bill 1203 and Senate Bill 2294 – define “cannabinoid edible products” as “soft or hard lozenges in a geometric square shape into which a cannabinoid concentrate or the dried leaves or flowers of the plant of the genus cannabis is incorporated.” The Senate version of the bill limits edible products to no more than 5 mg per serving, while the House version imposes a 10 mg limit.

Edible cannabis products possess a longer duration of effect compared to inhaled or vaporized herbal cannabis.

Voters approved the state’s medical cannabis law nearly a decade ago. Nearly 10,000 North Dakotans are currently registered to access medical cannabis.

Separate legislation (HB 1596) fully decriminalizing low-level marijuana possession by adults was passed by the House in February and awaits further action by the Senate.

Study: Patients With Hypermobility Disorders Report Sustained Improvements Following Cannabis Treatment

London, United Kingdom: Patients suffering from hypermobility disorders report sustained symptomatic improvements following their use of cannabis-based medicinal products (CBMPs), according to observational data published in the journal of the American College of Rheumatology, ACR Open Rheumatology.

British researchers assessed the use of botanical cannabis or oil extracts in 161 patients with Ehlers-Danlos syndrome or similar hypermobility disorders enrolled in the UK Medical Cannabis Registry. (British specialists may prescribe cannabis-based medicinal products to patients unresponsive to conventional medications.) Researchers assessed changes from baseline in patient-reported outcomes at one, three, six, 12, and 18 months.

Patients reported sustained improvements in pain-specific metrics, as well as improvements in sleep and anxiety following cannabis therapy. The most reported adverse effects associated with cannabis treatment were headache and lethargy.

“This case series found improvements in perceived pain severity and interference, general HRQoL [health-related quality of life], sleep quality, and anxiety in patients with HSD [hypermobility spectrum disorder] or hEDS [hypermobile Ehlers-Danlos syndrome] after CBMP prescription,” the study’s authors concluded. “At 18 months, between 18.01 percent and 25.47 percent of individuals reported a clinically significant improvement in their pain depending on the assessment measure used. … [T]hese findings may help guide current clinical practice and shared decision‐making between patients and physicians.”

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

Full text of the study, “UK Medical Cannabis registry: An analysis of outcomes of medical cannabis therapy for hypermobility-associated chronic pain,” appears in ACR Open Rheumatology.

Longitudinal Study: Childhood Depression, Suicidal Ideation Precede Cannabis Use

Los Angeles, CA: Emotional problems in early childhood are predictive of teen marijuana use – particularly among females, according to longitudinal data published in the Open Journal of Medical Sciences.

Investigators affiliated with the Charles R. Drew University of Medicine and Science in Los Angeles assessed the relationship between early childhood depression and marijuana use by mid-adolescence. Participants’ baseline emotional problems, including feelings of hopelessness, depression, and suicide attempts, were assessed at ages 9-10. Substance outcomes (marijuana and tobacco initiation) were tracked from baseline to follow-up at ages 14-15.

Researchers reported that childhood depression and other psychological factors significantly predicted future initiation of tobacco and cannabis. This relationship was especially significant among women.

“This study underscores the significant role of childhood depression, hopelessness, and suicidality in predicting the initiation of tobacco and marijuana use during adolescence,” researchers concluded. “Childhood depression, hopelessness, and suicidality may contribute to substance use through interconnected psychological, neurobiological, and social mechanisms. … The findings [of this study] emphasize the urgent need for policies that prioritize early mental health screening and intervention. … Investing in early mental health interventions, equitable policies, and multi-level approaches is critical for breaking the cycle of mental health challenges and substance use.”

The findings are consistent with those published in the Journal of Affective Disorders, which reported that adolescents who suffered from depression are more likely to use cannabis later in life, not vice-versa.

Full text of the study, “Childhood depression, hopelessness, and suicidal attempts predict earlier tobacco and marijuana use initiation during adolescence,” appears in the Open Journal of Medical Sciences.

Analysis: Historic Drop in Alcohol Sales as Legal Cannabis Sales Spike

Ottawa, Ontario: Sales of alcohol and cannabis in Canada are on opposite trajectories, according to data provided by Statistics Canada, the national statistical agency of the Canadian government.

For the fiscal year ending March 31, 2024, sales of alcoholic beverages experienced historic declines, with beer sales experiencing the largest overall decrease. In comparison, “Sales of recreational cannabis by provincial cannabis authorities and other retail outlets increased 11.6 percent or $0.5 billion from one fiscal year earlier, reaching $5.2 billion in 2023/2024.” Sales of cannabis products had previously grown nearly 16 percent in 2022/2023.

Canada legalized the adult-use marijuana market in 2018.

Separate data published in February in the American Journal of Preventive Medicine reported that fewer young adults in the US acknowledge consuming alcohol following the opening of licensed marijuana retailers.

While survey data finds that many consumers acknowledge substituting marijuana for alcohol, observational data gathered from jurisdictions that have legalized cannabis is mixed – with some studies reporting dips in alcohol sales post-legalization and others reporting no significant changes at the population level.

Complete data sets are available from Statistics Canada.

Study: Plant-Derived THC Extracts Reduce Fibromyalgia-Related Pain

Novara, Italy: Fibromyalgia (FM) patients suffering from treatment-resistant pain experience therapeutic benefits following the daily use of plant-derived cannabis extracts, according to observational data published in the Journal of Anesthesia, Analgesia, and Critical Care.

Italian investigators assessed the safety and efficacy of THC-dominant cannabis extracts in a cohort of 65 FM patients. Study participants, on average, had lived with the disease for seven years and were generally unresponsive to conventional pharmacological therapies. Patients in the study administered THC extracts three times daily for six months.

On average, participants experienced a 2.6-point reduction in pain on a ten-point numerical rating scale. Improvements were most pronounced in younger patients. Six patients elected to discontinue the study because of self-reported side effects, including dry mouth, headache, drowsiness, and impaired thinking.

In December, British researchers published longitudinal data finding that the adjunctive use of cannabis preparations provided sustained improvements in fibromyalgia patients’ pain, anxiety, sleep, and overall quality of life. Numerous other studies have reported similar results.

Full text of the study, “Real-world use of cannabis oil for pain management in fibromyalgia,” appears in the Journal of Anesthesia, Analgesia, and Critical Care.

Study: Medical Cannabis Products Provide Improved Sleep Outcomes for Patients With Insomnia

London, United Kingdom: Patients diagnosed with insomnia experience sleep-related improvements following their use of medical cannabis preparations, according to long-term observational data published in the journal PLoS Mental Health.

British investigators assessed the adjunctive use of cannabis-based medicinal products (CBMPs) in a cohort of 124 patients enrolled in the UK Medical Cannabis Registry. (British healthcare providers may prescribe cannabis-based medicinal products to patients unresponsive to conventional medications.) Patients’ outcomes were assessed at baseline and at 1, 3, 6, 12, and 18 months. Study participants consumed either herbal cannabis or oil extracts containing standardized concentrations of THC and CBD.

Consistent with other studies, participants reported improvements in their sleep quality, anxiety, depression, and health-related quality of life. Fewer than 1 in 10 participants reported an adverse event, most of which were categorized as mild or moderate (e.g., fatigue, dry mouth).

“These findings indicate a promising association between cannabis-based medicinal product treatment and improvements in sleep-specific outcomes and general HRQoL [health-related quality of life] measures,” the study’s authors concluded. They cautioned, however, that the magnitude of participants’ improvements declined over time – suggesting that some patients may become tolerant to the sleep-inducing effects of cannabis. Therefore, there remains “a need for high quality RCTs [randomized clinical trials] to assess the long-term efficacy and safety of cannabis-based medicinal products for primary insomnia.”

Placebo-controlled clinical trial data have previously documented the short-term efficacy of plant-derived cannabis extracts in patients suffering from chronic insomnia. A 2025 observational study reported sustained improvements in subjective sleep scores among state-registered medical cannabis patients over one year.

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

Full text of the study, “UK Medical Cannabis Registry: A clinical outcomes analysis for insomnia,” appears in PLoS Mental Health.

Analysis: Over One-Third of US Adults Acknowledge Having Consumed CBD Products

Palo Alto, CA: A growing percentage of those ages 18 and older have consumed CBD products, according to nationwide survey data published in The Journal of Cannabis Research.

Investigators at Stanford University and the University of California at San Diego surveyed a nationally representative sample of adults regarding their use of CBD, as well as other plant-derived or synthetic cannabinoids.

More than 35 percent of those surveyed acknowledged having consumed CBD, with respondents indicating that they primarily used it to mitigate pain, relieve anxiety, or improve sleep. Fewer than five percent of respondents acknowledged having consumed products containing the plant cannabinoids CBN (cannabinol) or CBG (cannabigerol).

Nearly eight percent of respondents acknowledged having used delta-8-THC products. Most respondents said they did so primarily for recreational purposes. (Elevated quantities of delta-8 THC in commercially available products are typically the result of a chemical synthesis during which manufacturers convert hemp-derived CBD to delta-8 THC.) Fewer than two percent of respondents said that they had ever tried the synthetic novel cannabinoid HHC (hexahydrocannabinol). Both products are mood-altering.

“A considerable proportion of US adults have ever used cannabinoid products, especially CBD and delta-8 THC,” the study’s authors concluded. Pain, anxiety, insomnia and arthralgia [are] common medical reasons for use across the different cannabinoids assessed. These differences underscore the complexity of the derived cannabinoid product landscape and the diverse motivations driving their use.”

Consumers are more likely to use delta-8-THC products in jurisdictions where cannabis remains legally unavailable. Neither commercially available delta-8-THC nor HHC products are subject to regulatory testing for purity or potency.

Full text of the study, “Prevalence and reasons for using cannabidiol, delta-8-tetrahydrocannabinol, cannabinol, cannabigerol, and hexahydrocannabinol among US adults,” appears in The Journal of Cannabis Research.

Analysis: Medical Cannabis Products Provide Sustained Improvements in Patients With Chronic Pain, Anxiety, and Depression

Toronto, Canada: Patients authorized to use medical cannabis products experience sustained improvements in their pain, anxiety, depression, and quality of life, according to observational data published in the Canadian Journal of Pain.

Researchers assessed the real-world effectiveness of cannabis products in a cohort of 139 Canadian patients authorized to use medical cannabis. (Nearly 200,000 Canadians are currently registered in Canada’s medical cannabis access program.) Patients’ symptoms were assessed at baseline, 6, 12, and 24 weeks.

Consistent with other long-term observational studies, patients experienced notable improvements in their pain, anxiety, depression, sleep duration, and quality of life. These improvements were maintained throughout the duration of the study. Few, if any, significant adverse events were associated with cannabis treatment.

The study’s authors concluded: “Patients in the study had improved scores with respect to a reduction in pain and pain-related disability, anxiety, depression, sleep, and overall quality of life. Often, the benefits of MC [medical cannabis] were maintained long-term into Week 24. Further data from the … study may offer additional insights into the usage of medical cannabis products and their potential benefits in the general population and inform dosing for future clinical trials focused on cohorts with specific medical conditions or indications.”

According to a recently published meta-analysis of 64 studies, most patients consuming medical cannabis products experience sustained improvements in their health-related quality of life. “Improvements [are] observed across multiple health conditions over short-, medium- and long-term follow-up,” researchers determined.

Full text of the study, “Canadian real-world evidence: Observational 24-week outcomes for health care practitioner authorized cannabis,” appears in the Canadian Journal of Pain.

Analysis: Medical Cannabis Products Provide Sustained Improvements in Patients With Chronic Pain, Anxiety, and Depression

Toronto, Canada: Patients authorized to use medical cannabis products experience sustained improvements in their pain, anxiety, depression, and quality of life, according to observational data published in the Canadian Journal of Pain.

Researchers assessed the real-world effectiveness of cannabis products in a cohort of 139 Canadian patients authorized to use medical cannabis. (Nearly 200,000 Canadians are currently registered in Canada’s medical cannabis access program.) Patients’ symptoms were assessed at baseline, 6, 12, and 24 weeks.

Consistent with other long-term observational studies, patients experienced notable improvements in their pain, anxiety, depression, sleep duration, and quality of life. These improvements were maintained throughout the duration of the study. Few, if any, significant adverse events were associated with cannabis treatment.

The study’s authors concluded: “Patients in the study had improved scores with respect to a reduction in pain and pain-related disability, anxiety, depression, sleep, and overall quality of life. Often, the benefits of MC [medical cannabis] were maintained long-term into Week 24. Further data from the … study may offer additional insights into the usage of medical cannabis products and their potential benefits in the general population and inform dosing for future clinical trials focused on cohorts with specific medical conditions or indications.”

According to a recently published meta-analysis of 64 studies, most patients consuming medical cannabis products experience sustained improvements in their health-related quality of life. “Improvements [are] observed across multiple health conditions over short-, medium- and long-term follow-up,” researchers determined.

Full text of the study, “Canadian real-world evidence: Observational 24-week outcomes for health care practitioner authorized cannabis,” appears in the Canadian Journal of Pain.

Study: Retail Cannabis Access Associated With Decline in Suicides Among Older Adults

Atlanta, GA: The opening of state-licensed adult-use cannabis retailers is associated with fewer suicides among mid-life and older adults, according to data published by the National Bureau of Economic Research.

Researchers affiliated with Emory University assessed the relationship between adult-use marijuana legalization and suicide rates. They determined: “Suicide rates among adults aged 45 and older decline following the opening of recreational marijuana dispensaries, while there is no effect among those ages 25-44. … These results hold when controlling for other state-level factors such as beer and cigarette taxes, opioid policies, unemployment rates, poverty, and income, none of which show significant impacts on suicide rates in this demographic. … These findings are important because of the implication that access to recreational marijuana has palliative effects among older populations which manifest in lower suicide rates.”

The study’s authors concluded: “These findings contribute to the growing body of literature on the public health impacts of marijuana legalization, offering evidence that recreational dispensary openings may play a role in reducing suicides among older adults, particularly in vulnerable subgroups. Although further research is needed to explore the underlying mechanisms driving these effects, these results point to one potential benefit of legalized recreational marijuana.”

Full text of the study, “Marijuana legalization and suicides among older adults,” is available from the National Bureau of Economic Research.

Ohio: Attorney General Certifies Proposed Referendum Challenging Marijuana Recriminalization Law

Columbus, OH: The state’s Attorney General has authorized petitioners to begin collecting signatures in favor of a proposed referendum challenging a GOP-backed law recriminalizing certain marijuana-related activities.

In December, Republican Gov. Mike DeWine signed SB 56 into law. The law amends and repeals various provisions of Ohio’s voter-approved adult-use legalization law. Among the more significant changes, it criminalizes possessing marijuana products obtained from out-of-state, including products legally purchased at licensed dispensaries in neighboring jurisdictions. It also repeals provisions protecting adult-use consumers from facing either workplace or professional disciplinary action, as well as other forms of discrimination based solely upon their private marijuana use (such as the denial of parental rights or certain hospital procedures, such as organ transplants).

Other provisions in the law impose new criminal sanctions upon those who either possess or transport certain cannabis products if they are not in their original, unopened packaging and restrict the retail sale of hemp-derived products, including beverages, solely to state-licensed dispensaries.

Following the passage of SB 56, business owners and other advocates formed the group Ohioans for Cannabis Choice, which is pushing back against the new restrictions. The AG’s office rejected a prior petition submitted by the group due to potentially “misleading” language. By contrast, other statewide cannabis interest groups have expressed opposition to the referendum.

Organizers need to collect approximately 250,000 signatures from Ohio voters to place the referendum before voters in November.

A summary of SB 56’s revisions to Ohio’s adult-use marijuana legalization and hemp laws is available from Ohio State University.

Review: THC Concentrations Are “Unreliable” Indicators of Driving Impairment

Providence, RI: The detection of THC in biological fluids is not predictive of psychomotor impairment, according to a literature review published in the journal Current Addiction Reports.

Researchers at Brown University affirmed: “There are no reliable or practical biochemical or behavioral methods used in real-time with drivers on the road to determine cannabis-induced impairment. … Many studies have found weak or non-existent correlations between THC concentrations in blood, oral fluid, or breath and actual driving performance or impairment.”

That finding is consistent with the opinions of numerous scientists and traffic safety groups, including the National Highway Traffic Safety Administration and the American Automobile Association.

The study’s authors concluded: “These findings collectively underscore that THC concentrations in common biofluids (e.g., blood and saliva) and exhaled breath are unreliable as sole indicators of current driving impairment. … There are no empirically supported thresholds for blood or oral fluids that reliably indicate cannabis impairment.”

Nonetheless, several states impose per se limits for motorists who are determined to have trace levels of THC in their blood or other bodily fluids. (These laws criminalize operating a motor vehicle with detectable quantities of THC or its metabolites, even absent evidence of driving impairment.) Several studies have determined that subjects may continue to test positive for traces of THC in their blood and oral fluids for days post-abstinence.

NORML has long opposed the imposition of per se THC limits for motorists and has alternatively called for the expanded use of mobile performance technology like DRUID. In a peer-reviewed paper published by the Humboldt Journal of Social Relations, NORML’s Deputy Director Paul Armentano wrote: “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.”

Full text of the study, “Recent advances in the science of cannabis-impaired driving,” appears in Current Addiction Reports.

Analysis: In Utero Cannabis Exposure Not Associated With Later Developmental Delays

Chapel Hill, NC: Infants exposed to cannabis in utero are no more likely to require emergency department care or suffer from developmental delays than non-exposed children, according to data published in the journal Academic Pediatrics.

Investigators affiliated with the University of North Carolina at Chapel Hill examined the relationship between in utero cannabis exposure and infants’ health care utilization and developmental outcomes.

“Compared to those unexposed, … children who were exposed to cannabis in utero have similar WCC [well child care] attendance and ED [emergency department] use over the first 2 years and similar developmental outcomes at 3 years,” researchers reported.

The authors acknowledged that their results were consistent with those of other studies, finding no differences in ED visits or developmental delays among cannabis-exposed and cannabis-unexposed children.

Although many studies have associated in utero cannabis exposure with low birth weight, longitudinal studies following in utero-exposed infants to adulthood have generally failed to identify “any long-term or long lasting meaningful differences” in their neurodevelopment.

Full text of the study, “Health care utilization and developmental delay among infants exposed to cannabis in utero,” appears in Academic Pediatrics.

California: Supreme Court Rules Police Can’t Search Vehicles Based on “Weed Crumbs”

Sacramento, CA: Police may neither charge a motorist with violating California’s “open container law” nor search a person’s vehicle solely upon the identification of a small quantity of marijuana “crumbs” on the floorboards, according to a ruling handed down by the state’s Supreme Court.

In a unanimous opinion, the Justices determined that the state’s “open container” law should not be applied so broadly as to pertain to situations where police find “any loose marijuana” in a motor vehicle. Rather, the court decided that the marijuana “must be of a usable quantity, in imminently usable condition, and readily accessible to an occupant” to constitute a violation of the state’s “open container” law.

The Court further determined that a police officer’s identification of “weed crumbs” does not provide probable cause for a warrantless vehicle search. They ruled, “The marijuana-related conduct here – possession of the rolling tray on the backseat and the crumbs on the floor [totaling 0.36 grams] – was lawful and alone was insufficient to find probable cause of a violation of California’s controlled substances law.”

The Supreme Court’s ruling reverses the decision of the California Court of Appeals, which had previously granted police the authority to search the defendant’s vehicle based upon a finding of probable cause.

The case is Sellers v. The Superior Court of Sacramento County.

Oklahoma: Governor Says State’s Medical Marijuana Program a “Pandora’s Box,” Calls for It To Be “Shut Down”

Oklahoma City, OK: Republican Gov. Kevin Stitt says that the state’s voter-approved medical cannabis access law “opened a Pandora’s Box” and should be repealed.

Speaking Monday during his State of the State address, the Governor said: “This industry is plagued by foreign criminal interests and bad actors, making it nearly impossible to rein in. We can’t put a Band-aid on a broken bone. Knowing what we know, it’s time to let Oklahomans bring safety and sanity back to their neighborhoods. Send the marijuana issue back to the vote of the people and shut it down.”

On Tuesday, the state’s Attorney General similarly said that he would like to see the medical cannabis industry “gone.”

Fifty-seven percent of Oklahomans approved a ballot initiative in 2018 legalizing the production and dispensing of cannabis for authorized patients. Approximately 320,000 Oklahomans are currently registered with the state to access medical cannabis products.

Despite the Governor’s claims of foreign involvement in the state’s medical cannabis industry, DEA statistics published last year reported interdicting only 15 Chinese-affiliated illegal marijuana grow operations nationwide.

Since 2022, Oklahoma lawmakers have imposed a moratorium prohibiting regulators from issuing licenses for any new medical cannabis dispensaries, processors, or commercial growers. Approximately 1,450 dispensaries are currently licensed in the state.

Earlier this year, representatives from the Oklahoma Bureau of Narcotics publicly alleged that nearly half of the marijuana sold illegally in the United States originates from the state. However, other state agencies said that they had no data to substantiate those claims.

Florida: DeSantis Administration Says Marijuana Legalization Won’t Appear on November’s Ballot, Petitioners Say Otherwise

Tallahassee, FL: Election officials and the state’s Attorney General announced this week that petitioners behind a proposed ballot initiative legalizing adult-use retail marijuana sales had failed to gather the requisite number of signatures to qualify it for the November ballot. But representatives with the campaign are challenging the state’s count and have called the administration’s declaration “premature.”

According to a campaign spokesperson, representatives from the Smart & Safe Florida campaign submitted over 1.4 million signatures from Florida voters – far more than the 880,062 signatures necessary. To date, however, election officials have verified fewer than 784,000 total signatures.

Specifically, the campaign is challenging the state’s dismissal of at least 98,000 signatures, which, if determined valid, would be sufficient to qualify it for this year’s ballot.

Petitioners qualified a similar measure on the 2024 ballot. That proposal gained 56 percent of the vote, just shy of the 60 percent threshold required to pass a constitutional amendment in Florida. (Florida is the only state that requires citizen-initiated measures to gain more than a simple majority.)

The DeSantis administration has vigorously opposed both efforts. In May, Gov. DeSantis signed legislation making it harder for parties to qualify measures for the electoral ballot. Last month, state election officials audited the work of several counties, which they alleged had not properly verified voters’ signatures. Most recently, the state launched a criminal probe to investigate the actions of various petitioners involved with the Smart & Safer campaign. Separately, the Attorney General’s office had previously challenged the wording of the proposed measure in court, calling it “unconstitutional.”

Historically, Florida has been among the states with the highest number of annual marijuana-related arrests. Under state law, possession of 20 grams or less of marijuana is a criminal misdemeanor, punishable by up to one year in jail and a $1,000 fine. Possessing greater amounts is a felony offense, punishable by up to five years in prison.

Additional information is available from Smart & Safe Florida.

Analysis: Marijuana Access Associated With “Striking” Decline in Daily Opioid Use by IV Drug Consumers

Boston, MA: Adult-use marijuana legalization markets are associated with significant declines in non-medical opioid use among people who inject drugs (PWID), according to data published in the journal Drug and Alcohol Dependence.

Researchers affiliated with Boston University’s School of Public Health and Emory University evaluated trends in non-prescription opioid use among PWIDs in 13 states following marijuana legalization.

Investigators identified “striking” declines in the prevalence of daily opioid use post-legalization. “Notably, the magnitude of this decline was equivalent across all racial and ethnic groups and for males and females,” investigators reported.

The study’s authors concluded, “Our findings suggest that ongoing efforts to reduce regulatory barriers and legal and criminal consequences of cannabis use via RCL+MCLs [recreational cannabis legalization and medical cannabis legalization] may have the potential to help reduce overdoses and other opioid-related harms among PWID.”

Previous studies have reported that cannabis can reduce cravings and mitigate withdrawal symptoms in opioid-dependent subjects. Data from Canada finds that people who inject opioids are more likely to cease their behavior if they regularly consume cannabis.

Full text of the study, “Cannabis legalization and cannabis and opioid use in a large, multistate sample of people who inject drugs: A staggered adoption difference-in-differences analysis,” appears in Drug and Alcohol Dependence.

Study: Cannabis Formulations Associated With Reduced Pain, Improved Quality of Life in Endometriosis Patients

Wellington, New Zealand: Endometriosis patients experience decreased pain and improvements to their health-related quality of life following the medically authorized use of standardized cannabis formulations, according to observational data published in the journal BMJ Complementary Medicine and Therapies.

New Zealand investigators assessed the safety and efficacy of cannabis products in a cohort of 28 patients with endometriosis. (Medically authorized access to cannabis products is legal in New Zealand.) Study participants consumed either CBD-dominant oil extracts or CBD in combination with herbal cannabis for three months as an adjunct to their standard medications. Study subjects possessed no history of recent cannabis use before enrolling in the study.

Consistent with prior studies, cannabis therapy was associated with less pain and improved health-related quality of life.

“There was a difference between pain scores for week 1 compared to week 12 with a decrease in ‘overall’ pain from 5.46 to 3.77 and ‘worst’ pain from 7.62 to 5.38,” researchers reported. “Across the whole cohort, there was a substantial decrease in mean total EHP-30 [the Endometriosis Health Profile 30 standardized questionnaire] score from 68.77 at baseline to 37.40 after 3 months which indicates improved quality of life.”

The study’s authors concluded, “Our findings suggest that usage of medicinal cannabis had limited adverse events and resulted in a decrease in pain and improved quality of life over a 12-week period.”

Endometriosis patients enrolled in the United Kingdom’s Medical Cannabis Registry similarly report that the long-term use of cannabis preparations provides sustained symptomatic relief. In surveys, patients with endometriosis frequently acknowledge cannabis to be more effective at treating their symptoms than traditional pharmaceuticals.

Full text of the study, “Perceived impact of medicinal cannabis on pelvic pain and endometriosis related symptoms in Aotearoa New Zealand: An observational cohort study,” appears in BMJ Complementary Medicine and Therapies.

Analysis: Aggregate Harms Associated With Use of Alcohol, Tobacco Far Outweigh Cannabis-Related Risks

Toronto, Canada: The use of alcohol and tobacco causes far greater overall harms to both individual consumers and to society than does cannabis, according to a scientific analysis published in the Journal of Psychopharmacology.

An international working group of experts assessed the aggregate harms associated with the use of sixteen psychoactive substances, including alcohol, tobacco, cannabis, opioids, benzodiazepines, and methamphetamine. Substances were scored based upon the likelihood that their use causes specific harms to the user (e.g., mortality risk, physical or mental health damage, dependence, etc.) and/or to others (e.g., environmental damage, economic loss, motor vehicle injuries, etc.).

Experts ranked alcohol as the substance associated with the greatest overall harm, followed by tobacco, non-prescription opioids, cocaine, and methamphetamine.

The finding is consistent with those of other international expert panels, including those conducted in Australia, the European Union, New Zealand, and the United Kingdom, which all rank alcohol as the drug responsible for the greatest amount of overall harm. Similarly, a 2024 US study published in the Journal of Studies on Alcohol and Drugs determined that “secondhand harms from others’ alcohol use were substantially more prevalent than those from others’ use of any other drug.” A more recent evaluation in the United States ranked only fentanyl, methamphetamine, crack, and heroin above alcohol in terms of potential harm.

Full text of the study, “Drug harms in Canada: A multi-criteria decision analysis,” appears in the Journal of Psychopharmacology.

Massachusetts: Commissioners Reject Claims That Petitioners Fraudulently Obtained Signatures for Marijuana Repeal Effort

Boston, MA: Representatives of the State Ballot Law Commission are allowing an anti-marijuana initiative effort to move forward despite claims that signature gatherers misled some voters into signing the petition.

Last week, commissioners dismissed the complaint, finding that there was insufficient evidence to substantiate widespread fraud. To prevail in the case, proponents needed to establish that nearly 4,000 voters had been misled to sign the petition.

The initiative, entitled ‘An Act to Restore a Sensible Marijuana Policy,’ seeks to repeal Massachusetts laws permitting adults to home-cultivate marijuana and regulating the adult-use retail cannabis market. Those laws were enacted by voters in 2016. Prohibition groups are funding ballot efforts in three states – Arizona, Maine, and Massachusetts – to repeal voter-initiated adult-use legalization laws.

The commission’s decision came despite polling data indicating that a large percentage of Massachusetts’ voters say they would have refused to sign the initiative petition had they better understood its intentions. Voters in Maine have made similar allegations. However, state officials there have responded that canvassers’ misrepresentation of their efforts is First Amendment-protected speech.

Survey: Most Primary Care Physicians Say They Are “Not Comfortable” Counseling Patients About Medical Cannabis

La Jolla, CA: Most primary care physicians are unwilling to answer their patients’ questions about medical cannabis, according to survey data published in the Journal of the American Geriatrics Society.

Investigators affiliated with the University of California at San Diego surveyed a cohort of internal medicine and family medicine physicians from San Diego, California.

Respondents said that their patients frequently inquire about medical cannabis use, but most acknowledged “not feeling competent” discussing the issue – a finding that is consistent with other studies.

Researchers reported: “Primary care physicians are asked about cannabis for therapeutic purposes by patients of all ages, but few are prepared to provide advice. … Physicians were generally not comfortable counseling patients of any age about cannabis use due to limited training and an incomplete evidence base. Some shifted responsibility to the patient, urging them to use cannabis ‘at their own risk,’ or referring to experts in specialty clinics or cannabis dispensary workers.”

While over two-thirds of health care practitioners nationwide acknowledge that cannabis possesses medical utility, most refuse to speak to their patients about it, and many say that they do not receive adequate medical training on cannabis-related issues.

Full text of the study, “Exploring physicians’ perspectives on cannabis use for therapeutic purposes with a focus on older versus younger adults,” appears in the Journal of the American Geriatrics Society.

Clinical Trial: Short-Term CBD Dosing Not Associated With Liver Abnormalities

Brisbane, Australia: The use of CBD-dominant medical cannabis products by cancer patients is not associated with liver damage, including the elevated production of the alanine aminotransferase (ALT) enzyme, according to clinical trial data published in the journal BMJ Supportive & Palliative Care.

Australian researchers assessed the potential impact of daily CBD administration (up to 600 mg per day) on liver health in a cohort of 287 patients with advanced cancer. (Australian law permits physicians to authorize cannabis products to patients unresponsive to conventional prescription treatments.) Investigators measured patients’ ALT and aspartate aminotransferase (AST) levels at baseline, day 14, and day 28. (High levels of these enzymes in blood signals liver cell damage or disease.)

They reported no significant elevations in patients’ ALT and AST levels over the duration of the study. “Medicinal cannabis products did not have a significant adverse impact on ALT or AST levels,” the study’s authors concluded.

Prior studies assessing the influence of CBD on liver health have yielded inconsistent results. While studies involving healthy volunteers have typically failed to demonstrate an association between short-term CBD dosing and elevated liver enzymes, other studies of certain higher-risk patient populations – such as those with kidney failure – have shown minor increases in liver enzyme production, though the clinical significance of these changes remains unclear.

Full text of the study, “Liver enzyme effects of medicinal cannabis in advanced cancer: A sub-study of two randomized trials,” appears in BMJ Supportive & Palliative Care.

Clinical Trial: Plant-Derived Cannabis Formulations Show Comparable Efficacy to Lorazepam in Insomnia Patients

Khlong Hok, Thailand: Plant-derived cannabis preparations provide comparable benefits to lorazepam in patients with chronic insomnia, according to randomized clinical trial data published in the journal Sleep Medicine.

Thai investigators compared the safety and efficacy of a pair of plant-derived cannabis preparations to the benzodiazepine lorazepam in 60 adults diagnosed with chronic insomnia. Subjects were randomly assigned to consume either lorazepam, cannabis oil extracts, or an oral pill containing cannabinoids and other traditional herbal compounds. Participants consumed the products before bedtime for four weeks.

All three interventions significantly improved subjective sleep quality as measured by the Pittsburgh Sleep Quality Index, researchers reported. However, cannabis preparations provided superior improvements in patients’ overall health-related quality of life.

“Our findings suggest that culturally rooted herbal remedies and regulated cannabis oil preparations may offer a holistic benefit profile by targeting both nocturnal symptoms and daytime well-being,” the study’s authors concluded. “Given the global push toward reducing benzodiazepine prescriptions due to safety concerns, the availability of validated herbal and cannabis-based alternatives is of high clinical value.”

Surveys find that consumers frequently report using cannabis as a sleep enhancer. In jurisdictions where cannabis products are legally available, sales of over-the-counter sleep medicines decline, as do prescription sales of opioids and benzodiazepines.

Full text of the study, “Integrative therapies for chronic insomnia: A randomized controlled trial of a traditional Thai herbal remedy and cannabis sativa oil,” appears in Sleep Medicine.

Case Studies: Cannabis Provides Sustained Improvements in Adolescents With Tourette Syndrome

Hannover, Germany: The use of plant-derived cannabis preparations is safe and clinically effective in adolescents suffering from Tourette syndrome (TS), according to the conclusions of a pair of case studies published in the journal Frontiers in Psychiatry.

German researchers reported on the long-term use of cannabis in two male adolescents with TS. Both subjects utilized cannabis formulations (either oil extracts or vaporized flower) daily for several years.

Investigators reported: “Long-term treatment with different THC-containing cannabinoids resulted not only in a constant improvement of tics, psychiatric comorbidities, and quality of life, but also did not cause severe adverse effects and in particular no psychological symptoms such as anxiety, psychosis, and substance abuse including CUD [cannabis use disorder]. Most importantly, neurocognitive test results during the course of therapy showed no evidence that the patients’ cognitive abilities had become below average. There was also no indication of behavioral abnormalities, social problems, neglection of social interests, or loss of interests, motivation, and drive. This is remarkable, since in both patients CBM [cannabis-based medicine] treatment was initiated before puberty and doses of THC were relatively high.”

The study’s authors concluded: “In both patients, CBM [cannabis-based medicine] treatment resulted in continued benefit with significant improvement of tics and psychiatric comorbidities without severe adverse effects. … Although generalizability from our case reports of two single patients is limited, we suggest [that health professionals] take treatment with THC-containing drugs into consideration in severely affected and otherwise treatment refractory children and adolescents before thinking of surgical treatment using deep brain stimulation.”

Placebo-controlled clinical trial data demonstrate that cannabinoid extracts reduce tic frequency and severity in TS, while observational studies have shown long-term benefits in TS patients who inhale cannabis flower.

Full text of the study, “Long-term use of cannabis-based medicines in two children with Tourette syndrome: A case report,” appears in Frontiers in Psychiatry.