Tag: Tuesday

Clinical Trials: Cannabis Formulations Dominant in THC and CBN, but Not CBD, Associated With Improved Sleep Quality

Recife, Brazil: Cannabis formulations containing THC and CBN (cannabinol) are associated with improved sleep quality, according to the findings of a meta-analysis published in the journal Sleep Medicine Reviews.

Brazilian researchers reviewed data from six randomized controlled trials involving 1,077 participants.

Investigators reported that cannabinoid-based interventions “are associated with improvements in sleep quality in individuals with or without insomnia.” But they cautioned that the inclusion of either THC or CBN largely drove their efficacy.

“Our findings indicate that only treatments incorporating THC and/or CBN were associated with a significant improvement in subjective sleep assessments compared with placebo, whereas interventions with CBD alone did not demonstrate a statistically significant effect,” researchers reported. “These results support the hypothesis that different cannabinoids may exert distinct roles in modulating sleep-related therapeutic benefits.”

The study’s authors concluded, “The results are encouraging and provide support for further investigation of cannabinoid therapies for the treatment of poor sleep.”

One in six US adults say that they use cannabis as a sleep aid, according to survey data compiled earlier this year by Harris Polling. Data published in the journal Complementary Therapies in Medicine reports that the enactment of adult-use marijuana legalization laws is associated with significant reductions in the sales of over-the-counter sleep aids.

Full text of the study, “Effectiveness of cannabinoids on subjective sleep quality in people with and without insomnia and poor sleep: A systematic review and meta-analysis of randomized studies,” appears in Sleep Medicine Reviews.

Florida: Appellate Court Rules That Odor of Marijuana No Longer Constitutes Probable Cause for a Motor Vehicle Search

Tampa, FL: Police may no longer initiate motor vehicle searches solely based on smelling cannabis, according to a ruling issued by judges on Florida’s 2nd District Court of Appeal.

In the Court’s majority opinion, judges acknowledged that the use of cannabis in certain circumstances is legally regulated statewide. Therefore, state and local police can no longer presume that the odor of marijuana is, by definition, probable cause of a crime.

The majority opined, “By defining and legalizing discrete forms of cannabis on bases that are manifestly not discernable by smell, … the mere odor of cannabis standing alone no longer can make it clearly or immediately apparent that the substance is contraband without conducting some further search.” The ruling is anticipated to be appealed to the state Supreme Court.

Their decision is consistent with a recent ruling by Florida’s 5th District Court of Appeal, finding that police officers may not initiate a warrantless search of a motor vehicle based solely on an alert from a specially trained police dog.

Courts in several states where cannabis is legal for either medical or adult-use purposes – including Delaware, Maryland, Minnesota, Pennsylvania, and Vermont – have also determined that the odor of marijuana emanating from a motor vehicle is not by itself sufficient grounds to justify a warrantless search.

In a separate ruling earlier this year, judges on Florida’s 2nd District Court of Appeal determined that police cannot solely rely on the “appearance” of cannabis as evidence of a crime because “legal hemp and illegal cannabis are indistinguishable by appearance, texture, and odor.”

The case is Williams v. Florida.

Missouri: Supreme Court Ruling Narrows Pool of Marijuana Offenses Eligible for Expungements Under State’s Voter-Approved Law

Columbia, MO: A recent state Supreme Court decision restricts which marijuana-related offenses are eligible for expungement under Missouri’s voter-approved law.

Voters in 2022 passed a ballot initiative legalizing the adult-use marijuana market and mandating courts to review and expunge a broad range of cannabis-related convictions, including felony convictions. Since then, courts have expunged over 140,000 marijuana-related convictions.

However, a recently issued Supreme Court opinion (C.S. v. Missouri State Highway Patrol, et al., SC 100944) finds that only those with convictions involving three ounces of cannabis or less are eligible for expungement relief under the law.

Missouri NORML Coordinator Dan Viets, who helped draft the initiative’s expungement provisions, said that the Court’s new, narrow interpretation violates the intent of the voter-approved law.

“The Missouri Supreme Court majority is clearly substituting its personal preferences for the will of the voters as expressed in the plain language of the initiative,” Viets stated in a press release. “This decision is an example of the Court engaging in an extreme form of judicial activism. It is clearly abusing its authority by ignoring the expressed intent of the voters.”

Viets added, however, that many marijuana-related felony convictions have already been expunged and that he does not believe “those are going to be undone” by this decision.

“The effect is primarily going to be those cases from the 20th century, from before 2000, when most records were on paper,” Viets said. “And those cases still need to be examined, and those cases which are eligible under this new definition still need to be expunged.”

Twenty-five states and the District of Columbia have enacted laws providing explicit pathways to either expunge (or otherwise set aside) the records of those with low-level marijuana convictions. According to publicly available data compiled by NORML, state and local officials have issued over 100,000 pardons and more than 2.3 million marijuana-related expungements since 2018.

Survey: THC Beverage Consumers Acknowledge Reducing Their Alcohol Intake

New Orleans, LA: Consumers of hemp-derived cannabinoid-infused beverages frequently report reducing their alcohol intake, according to survey data compiled by the beverage manufacturer Crescent Canna.

Pollsters surveyed 1,066 respondents ages 21 and older. Survey participants were culled from Crescent Canna’s consumer database. Survey results were provided to the cannabis news site Marijuana Moment.

Over 56 percent of respondents acknowledged consuming either “slightly less” or “much less” alcohol after trying cannabis-infused beverages. Another 21 percent of respondents said that they quit drinking alcohol altogether.

According to separate survey data published last year, 60 percent of cannabis consumers say that their marijuana use results in less frequent alcohol consumption. The results of a clinical trial published in September in the journal Drug and Alcohol Dependence find that adults drink less alcohol and experience fewer alcohol cravings immediately following their use of cannabis.

Additional information from the Crescent Canna survey is available from Marijuana Moment.

Clinical Trial: Cannabis Extract Provides Sustained Relief for Patients With Chronic Low Back Pain

Hannover, Germany: Plant-derived cannabis extracts provide sustained improvements in patients with chronic lower back pain, according to randomized placebo-controlled data published in the journal Nature Medicine.

German investigators evaluated the efficacy of a proprietary cannabis extract containing 2.5 mg of THC and standardized percentages of CBD and CBG (cannabigerol) in a cohort of 820 patients. Study participants consumed either the extract or a placebo for 12 weeks, with a portion of subjects continuing enrollment in the trial for several additional months.

Compared to those receiving the placebo, patients receiving cannabis extracts demonstrated significant improvements in pain intensity, sleep quality, physical function, and overall quality of life. Participants who suffered from neuropathy and who consumed cannabis extracts for extended lengths of time experienced the greatest improvement. Adverse events associated with cannabis therapy were categorized as “mild to moderate.”

Researchers reported: “The results of the [clinical] trial demonstrate that VER-01 [plant-derived cannabis extracts] provides meaningful pain reduction compared to the placebo, accompanied by distinct improvements in physical function and sleep quality. … Importantly, prolonged treatment with VER-01 was associated with further reductions in pain intensity, as well as continued improvements in physical function, sleep quality and health-related quality of life. Notably, the treatment effect was even more pronounced in participants with a neuropathic pain component and those with severe pain at baseline.”

The study’s authors concluded: “This phase 3 study provides robust evidence supporting the efficacy and safety of VER-01 in the treatment of CLBP [chronic lower back pain]. These findings highlight the importance of further research with VER-01 in other chronic pain conditions and suggest that VER-01 could play an important role in modern pain management.”

Studies have previously shown that patients with lower back pain reduce their use of opioids following the initiation of medical cannabis therapy.

Full text of the study, “Full-spectrum extract from cannabis sativa. DKJ127 for chronic low back pain: A Phase 3 randomized placebo-controlled trial,” appears in Nature Medicine.

Survey: Older Adults Say That Cannabis Is “Helpful” for Treating Anxiety, Insomnia, and Depression

Vancouver, Canada: More than two-thirds of older adults who consume cannabis for mental health conditions say that it helps manage their symptoms, according to survey data published in the journal Aging.

Canadian investigators reviewed anonymous survey responses from 1,615 older (age 50+) adults, 20 percent of whom acknowledged using cannabis to treat mental health symptoms. (Cannabis has been legally available in Canada for those 18 and older since 2018.)

Respondents were most likely to report consuming cannabis products to mitigate symptoms of anxiety, insomnia, and depression.

Most respondents (71 percent) said that cannabis was “somewhat or extremely helpful” for treating their symptoms and over half (57 percent) perceived cannabis to be “more or somewhat more effective” than traditional pharmaceuticals.

“Approximately one in five older Canadians reported using cannabis, at least in part, to manage mental health symptoms, the majority of whom have a positive view of its effectiveness and safety profile,” the study’s authors concluded. “Additional research in older populations is required to determine the effectiveness of cannabis for mental health conditions and cannabis safety in the aging body and with concomitant medications commonly used by this population. As there is a growing number of older adults using cannabis, healthcare providers must inquire about cannabis use, particularly for those with mental health conditions or experiencing symptoms that may be attributable to or impacted by cannabis, such as impaired cognition or balance.”

Prior surveys conducted in the United States and Canada indicate that an increasing percentage of adults are consuming cannabis products, with most saying that it improves their overall quality of life.

Full text of the study, “Characterization of the use and perceptions of cannabis for mental health in older Canadians: A cross-sectional analysis,” appears in Aging.

Analysis: Pupil Size Not Predictive of Acute Cannabis Exposure

Aurora, CO: Pupil size is not predictive of acute cannabis exposure and should not be relied upon as a determinant of marijuana-induced impairment, according to data published in the journal Clinical Toxicology.

Investigators affiliated with the University of Colorado performed pupillometer assessments on 126 participants. Ninety-five participants were assessed at baseline and then again following ad libitum cannabis inhalation. Thirty-five subjects completed the same assessments but did not use cannabis.

Following cannabis inhalation, subjects “did not exhibit a substantial and consistent difference in static pupil diameter relative to controls,” researchers reported.

As a result, the study’s authors cautioned against relying on ocular measures as evidence of cannabis-induced impairment, stating that the tests lacked the accuracy and specificity necessary to be a valid evidentiary tool.

Drug Recognition Evaluators typically perform a variety of ocular measurements, including assessments of pupil size, on drivers they suspect to be under the influence of cannabis.

Full text of the study, “Pupillary dynamics as a marker of acute. Cannabis inhalation,” appears in Clinical Toxicology.

Review: Cannabinoids Support “Healthy Aging” and “Enhanced Quality of Life” in Older Populations

Cambridge, United Kingdom: Cannabinoids hold promise for improving health and promoting longevity of older populations, according to the findings of a systematic review published in the Journal of Cannabis Research.

British researchers reviewed findings from 11 preclinical studies and seven human trials assessing the impact of cannabinoids, particularly CBD and THC, on older populations.

“THC enhances memory, reduces inflammation, and offers neuroprotection, while CBD extends lifespan, improves motility, and promotes autophagy in preclinical models,” investigators reported. “Both cannabinoids highlight potential for longevity and cognitive resilience, though careful dosing is crucial to minimize risks. Additionally, their combined antioxidant and anti-inflammatory properties might offer synergistic benefits for healthy aging. … Clinical studies also suggest potential therapeutic applications for cannabinoids in aging populations, although further research is needed to understand their mechanisms of action and long-term effects fully.”

The study’s authors concluded: “Cannabinoids hold promise for supporting healthy aging and enhancing the quality of life in older populations. While preliminary research suggests intriguing possibilities, more studies are needed to solidify the link between cannabis use, the ECS [endocannabinoid system], and healthy aging in humans.”

Survey data indicates that as many as one in five older adults consume cannabis products, with most saying that it improves their overall quality of life.

Full text of the study, “The impact of cannabis use on aging and longevity: A systematic review of research insights,” appears in the Journal of Cannabis Research.

Survey: Epidermolysis Bullosa Patients Frequently Use Cannabis for Symptom Management Among EB patients who consume cannabis, 28 percent report that cannabinoids provide greater pain relief than traditional medications.

Study: Cannabis Use Not Independently Associated With Increased Risk of Head and Neck Cancers

Gainesville, FL: Marijuana use is not independently associated with an elevated risk of head and neck cancers, according to data published in the Journal of Oral Pathology & Medicine.

Researchers affiliated with the University of Florida at Gainesville assessed the risk of head and neck cancers in a cohort of patients with a history of cannabis use. Investigators found no association once they adjusted for participants’ use of alcohol and tobacco. By contrast, subjects’ use of alcohol and cigarettes was associated with an elevated risk of cancer even after researchers adjusted for covariates.

They reported: “The odds ratio for oral cancer among cannabis users … became insignificant after adjustment for alcohol and cigarette smoking (OR=0.7 | OR=0.62). … Furthermore, after adjusting for cannabis use, the OR [odds ratios] for OPC [oropharyngeal cancer] in the alcohol users was 7.95 and 7.39 for smokers. The OR for OC [oral cancer] after adjusting for cannabis in the alcohol users was 9.67 and 7.52 in the cigarette smokers.”

The study’s authors concluded: “Alcohol and cigarette smoking rather than the use of cannabis may play a major role in establishing an association between cannabis use and both types of head and neck cancers. … Further large-scale studies are required to elucidate the risk of head and neck cancer in cannabis users.”

A 2020 review of 34 studies concluded that cannabis use is not associated with an increased risk of cancer, including those typically associated with tobacco. A 2025 study reported that cannabis use is associated with a decreased risk of pancreatic cancer.

Full text of the study, “Use of cannabis and odds ratio for oropharyngeal and oral cancer: A cohort study,” appears in the Journal of Oral Pathology & Medicine.

Feds: Few Banks Provide Services To State-Licensed Cannabis Businesses

Washington, DC: Just over 800 financial institutions have filed paperwork with the federal government to provide services to state-licensed cannabis businesses, according to the latest quarterly data available from the US Department of the Treasury.

This total remains nearly unchanged since the fourth quarter of 2019, when 789 banks and credit unions filed paperwork with the agency.

In total, fewer than ten percent of all financial institutions nationwide provide services to state-licensed cannabis businesses.

Federal law discourages banks and other financial institutions from facilitating relationships with cannabis-related businesses because marijuana remains classified as a Schedule I controlled substance. On seven occasions, members of the US House of Representatives have passed legislation (aka SAFE Banking) to explicitly permit banks and other institutions to engage in relationships with marijuana businesses. However, Senate leadership has never advanced this language to the floor for consideration.

Last fall, President Donald Trump indicated in a Truth Social post that, if elected, he would work with Congress to enact reforms at the federal level, including the passage of SAFE Banking. Federal lawmakers have yet to reintroduce the legislation this session.

According to survey data compiled by Whitney Economics, over 70 percent of participating cannabis businesses say that the “lack of access to banking or investment capital” is their top challenge.

NORML has repeatedly called upon Congress to amend federal banking legislation, opining: “No industry can operate safely, transparently or effectively without access to banks or other financial institutions, and it is self-evident that the players in this industry (smaller and minority-owned businesses in particular), and those consumers that are served by it, will remain severely hampered without better access to credit and financing.”

Additional information is available from the Department of the Treasury, Financial Crimes Enforcement Network.

Study: Use of State-Regulated Cannabis Products Associated With Decreased Stress

Boulder, CO: The use of state-regulated cannabis products, particularly those dominant in CBD, is associated with reduced stress and improved mood, according to observational data published in the journal Human Psychopharmacology: Human & Experimental.

Researchers affiliated with the University of Colorado at Boulder assessed the ad libitum use of cannabis products in subjects with elevated levels of anxiety. Participants were assigned to consume state-regulated cannabis products dominant in either THC or CBD for the duration of the trial. Patients’ symptoms (feelings of depression, stress, and anxiety) were assessed at baseline, at two weeks, and at four weeks.

Investigators acknowledged “significant changes” in participants’ DASS Scale (Depression Anxiety Stress) scores over the length of the trial. Participants who consumed CBD-dominant products experienced the greatest decrease in symptoms. Contrary to researchers’ expectations, participants did not decrease their alcohol intake during the study.

The study’s authors concluded: “Among a sample of individuals underrepresented in research, both CBD and THC were significantly related to improvement in mood but not to alcohol use, with participants using CBD demonstrating more improvement over the course of the entire study period. … These results suggest that CBD may be helpful in reducing negative mood in the short term without increasing risk for disordered alcohol use.”

Patients authorized to use medical cannabis products most frequently report doing so to mitigate symptoms of pain, anxiety, post-traumatic stress, sleep disturbances, and depression.

Full text of the study, “Effects of cannabinoid on emotional states and alcohol use among underrepresented groups: Moderation by perceived discrimination,” appears in Human Psychopharmacology: Human & Experimental.

Survey: Epidermolysis Bullosa Patients Frequently Use Cannabis for Symptom Management

Chicago, IL: Patients with epidermolysis bullosa (EB), a rare blistering skin condition, often report using cannabis to mitigate pain, itching, and other symptoms, according to survey data published in the Journal of the American Academy of Dermatology.

Investigators affiliated with Northwestern University’s Feinberg School of Medicine in Chicago surveyed 244 EB patients.

Forty-four percent acknowledged having used either cannabis or CBD to treat their condition. Among cannabis consumers, 28 percent reported that cannabinoids provide greater pain relief than traditional medications.

“Cannabinoids are used by nearly half of all EB patients with notable improvements in pain, itch, and overall wellbeing, suggesting that cannabinoids could be a promising new therapy for EB symptom management,” the study’s authors concluded.

Case reports have previously documented that the topical use of CBD by patients with EB is associated with a “reduction in pain and blistering,” “rapid wound healing,” and “the objective need for less analgesic [medicines].” The oral consumption of cannabis extracts has also been associated with pain mitigation in EB patients.

Full text of the study, “Cannabinoids for epidermolysis bullosa symptom management: A survey,” appears in the Journal of the American Academy of Dermatology.

Analysis: No Uptick in Suicidal Ideation Post-Legalization

Halifax, Canada: Rates of suicide in Canada remained stable following the adoption of adult-use cannabis legalization, according to data published in the journal BJPsych Open.

Canadian investigators assessed the number of hospitalizations related to suicide during the six months immediately following legalization and again two years later. Suicide rates remained stable during the study period. Researchers also acknowledged, “Individuals present to the emergency department with cannabis use less frequently than alcohol.”

The study’s authors concluded: “Post-cannabis legalization, there is not an ongoing increase in emergency department presentations for suicidal ideation and attempts. This is in line with other work in Canadian jurisdictions showing no increases in cannabis-related emergency department presentations overall post-legalization.”

Data from the United States previously reported a correlation between the enactment of state-specific medical cannabis access laws and declining suicide rates. A more recent study determined that suicide rates rose in some states following the adoption of adult-use legalization, but fell in other legal jurisdictions.

Full text of the study, “Understanding the role of cannabis in patients with suicidal ideation presenting to the emergency department: Systematic chart review,” appears in BJPsych Open.

Case Series: Patients With Complex Regional Pain Syndrome Report Improvements Following Cannabis Use

London, United Kingdom: Patients with complex regional pain syndrome (chronic neuropathic pain) report improvements in their health-related quality of life following their use of medical cannabis products, according to data published in the journal Brain and Behavior.

British researchers assessed the use of cannabis-based medicinal products (CBMPs) in 64 pain patients enrolled in the UK Medical Cannabis Registry. (British health care providers may prescribe cannabis-based medicinal products to patients who are unresponsive to conventional medications.) Patients’ outcomes were assessed at baseline and six months later. Study participants consumed either herbal cannabis or oil extracts containing both THC and CBD.

Investigators reported “clinically important” improvements in patients’ pain severity, anxiety, sleep quality, and overall quality of life following cannabis treatment. Participants with prior experience using cannabis “were more likely to experience clinically significant improvements” in their pain scores than were cannabis-naïve subjects.

The study’s authors concluded: “These findings are consistent with existing literature which similarly demonstrates an association between CBMP treatment and consistent improvements in pain severity in chronic or neuropathic pain conditions. … Importantly, the observed changes in pain-specific PROMs in this study may confer opioid-sparing effects in complex regional pain syndrome patients. … This supports further research through high-quality randomized controlled trials to ascertain the efficacy of cannabis-based medicinal products in improving complex regional pain syndrome symptoms.”

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

Study: Cannabis Use Promotes Improvements in Patients With Chemotherapy-Induced Peripheral Neuropathy

Tel Aviv, Israel: Patients experience reductions in chemotherapy-induced neuropathic pain (CIPN) following the sustained daily use of medical cannabis products, according to data published in the journal Biomedicines.

Israeli investigators assessed outcomes in 751 patients with CIPN. Study participants consumed prescribed medical cannabis products (either herbal cannabis or oral extracts), dominant in either THC or CBD. (Approximately 150,000 Israeli patients receive prescription cannabis from the Ministry of Health.) Patients consumed cannabis daily for six months.

Researchers reported that patients in both cannabis treatment groups experienced significant symptomatic improvements, with those consuming higher doses of THC-dominant products reporting the greatest degree of improvement.

“The significant improvement in CIPN symptoms, ADL (activities in daily living), and QOL (quality of life), particularly in the THC-high cluster, supports the clinical use of medical cannabis as a complementary therapeutic option for patients with chemotherapy-induced neuropathy who experience limited relief from standard therapies,” the study’s authors concluded. “Moreover, the observed improvement in functionality (ADL) underscores the potential of cannabis to improve daily living and overall patient well-being, aspects often overlooked in traditional CIPN management.”

Numerous other studies have similarly reported that cannabis use provides sustained improvements in patients suffering from neuropathy.

Data published in the Journal of the American Medical Association reports that nearly one in three patients with chronic pain use cannabis as an analgesic agent and that many of them substitute it in place of opioids.

Full text of the study, “Comparative effects of THC and CBD on chemotherapy-induced peripheral neuropathy: Insights from a large real-world self-reported dataset,” appears in Biomedicines.

Maryland: Appellate Court Upholds Ban on Sale of Hemp-Derived Intoxicants

Annapolis, MD: Judges for the Maryland Appellate Court have ruled in favor of a state-imposed prohibition on the retail sale of hemp-derived intoxicants containing delta-8-THC, delta-10-THC, and other synthetically produced cannabinoids.

The decision reverses a lower court’s preliminary injunction halting state officials from taking legal actions against intoxicating hemp providers.

The Court determined that no “common right” exists for retailers to sell hemp-derived psychoactive products because they “are now and have always been illegal in Maryland.” The Court added, “That their prohibition has been the subject of lax enforcement does not make [them] legal.”

Judges further opined that the hemp sales ban is reasonable because it “protect[s] public health and [serves] the public interest.”

Courts have recently upheld similar state-imposed bans in Alabama, Alaska, Arkansas, and Virginia.

Consumers’ use of hemp-derived products containing delta-8-THC and other synthetically produced cannabinoids has increased in recent years, particularly in jurisdictions where cannabis remains illegal. The synthetic conversion process typically involves the use of potentially dangerous household products. Third-party laboratory testing of these unregulated products often finds that they contain percentages of cannabinoids that differ from what is advertised on the products’ labels. Some products also possess heavy metal contaminants and unlabeled cutting agents. Other novel compounds, like THC-O, have not been tested for safety in human trials.

Nearly half of all US states impose restrictions on the retail sale of delta-8-THC and similar products, according to reporting provided by Courthouse News Service.

The case is Moore v. Maryland Hemp Coalition.

Study: No Evidence of Residual Cannabis Effects on Driving Performance

San Diego, CA: Consumers who abstain from cannabis for 48 hours drive no differently than abstainers, according to driving simulator data published in the journal Psychopharmacology.

Researchers affiliated with the University of California at San Diego evaluated driving performance in a cohort of 191 cannabis consumers. Participants completed a 25-minute simulated drive following 48 hours of cannabis abstinence. In phase II of the study, a subset of near-daily consumers was matched against non-using controls.

“The current study showed no evidence of a dose-effect relationship between simulated driving performance following a brief abstinence period,” investigators reported. “The current study also shows no evidence of short-term residual effects on simulated driving performance when comparing frequent cannabis users to a healthy non-using comparison group.”

Despite subjects’ lack of psychomotor impairment, researchers acknowledged that some participants tested positive for THC at levels that would classify them as “under the influence” in states with either zero-tolerant or per se THC blood limits. That’s because THC and its metabolites remain present in bodily fluids for extended periods of time following cannabis abstinence, whereas the acute effects of cannabis on psychomotor skills largely dissipate within a few hours. Accordingly, NORML opposes the imposition of per se THC limits for motorists and has alternatively called for the expanded use of mobile performance technology like DRUID.

The study’s authors concluded: “In regular cannabis users who abstained for ≥ 48 hours, we found no evidence of residual cannabis effects on simulated driving performance. This included no relationship between driving simulator performance and cannabis use intensity, days of abstinence, or cannabinoid concentrations, nor differences on these measures when comparing the most frequent cannabis users to a non-using comparison group. … Results of this study have implications for how future policy might weigh different pieces of evidence in the absence of objective confirmation of acute cannabis intoxication, such as one’s cannabis use history or residual blood THC, in everyday determinations of impaired driving.”

Numerous studies have previously reported no correlation between the detection of either THC or its metabolites in blood, urine, saliva, and breath and impaired driving performance. Nevertheless, several states have enacted laws criminalizing drivers who operate a motor vehicle with trace levels of THC or THC metabolites, regardless of whether the driver is impaired.

Full text of the study, “Short-term residual effects of smoked cannabis on simulated driving performance,” appears in Psychopharmacology.

Study: Patients With Generalized Anxiety Experience Clinical, Cognitive Improvements Following Use of Plant-Derived CBD Extracts

Belmont, MA: Patients diagnosed with generalized anxiety disorder (GAD) exhibit symptomatic and cognitive improvements following the daily use of full-spectrum CBD-dominant extracts, according to clinical trial data published in the journal Biomedicines.

Investigators affiliated with Harvard Medical School and McLean Hospital in Boston assessed the daily use of 30mg of plant-derived CBD in 12 patients with GAD. Researchers evaluated changes in participants’ clinical and cognitive performance over six weeks of treatment.

Patients experienced “dramatic reductions” in anxiety during the first week of the trial, and they exhibited “significant improvements” on assessments of mood, sleep, and quality of life throughout the duration of the study. Participants also “demonstrated significantly improved performance on measures of executive function relative to baseline, evidenced by faster response time[s] … as well as higher accuracy” on neurocognitive assessments.

No participants experienced any serious adverse events during the trial.

“Results from this open-label clinical trial provide evidence that a hemp-derived, full-spectrum, high-CBD product similar to those currently available in the marketplace may be both safe and efficacious for the treatment of anxiety,” the study’s authors concluded. “Given the potential benefits observed in this trial, double-blind, placebo-controlled studies of hemp-derived high-CBD products are warranted to obtain robust data regarding the safety and efficacy of CBD-containing products for anxiety.”

Clinical data published in July in the Journal of Affective Disorders reported that the consumption of THC-dominant cannabis products is also associated with sustained reductions in anxiety.

Data published last year in the Journal of the American Medical Association reported that the adoption of statewide marijuana legalization laws is associated with significant declines in the dispensing of prescription anxiolytic drugs like benzodiazepines.

Full text of the study, “Clinical and cognitive improvement following treatment with a hemp-derived, full-spectrum, high-cannabidiol product in patients with anxiety: An open-label pilot study,” appears in Biomedicines.

Study: Adjunctive Use of FDA-Approved CBD Formulation Reduces Seizures in Pediatric Patients With Rett Syndrome

Milan, Italy: Children and teens diagnosed with Rett Syndrome (RTT) who take Epidiolex experience reductions in seizure frequency, according to data published in the Open Access Journal of the International League Against Epilepsy (aka Epilepsia).

Italian researchers assessed the efficacy of the use of FDA-approved, plant-derived CBD (Epidiolex) in 27 RTT patients with drug-resistant seizures. Participants consumed Epidiolex in conjunction with other medications. The median treatment duration was 14 months.

Following treatment, two-thirds of the cohort exhibited a greater than 50 percent reduction in seizure frequency, with 26 percent of participants experiencing a greater than 75 percent reduction. Many of the patients’ caregivers also observed positive changes beyond seizure control, including better attention, improved sleep, and enhanced motor function. Side effects related to CBD treatment were mild.

“Our findings suggest a strong trend toward the efficacy of CBD in reducing seizure frequency,” the study’s authors concluded. “The consistency of the response, combined with the absence of seizure aggravation and a favorable safety profile, highlights purified cannabidiol (Epidiolex) CBD as a promising therapeutic option for individuals with RTT. Moreover, beyond seizure control, a substantial proportion of patients also showed improvements in behavior, attention, and reactivity – especially among those who responded to treatment – further supporting the potential benefits of CBD in this population.”

A prior study concluded that RTT patients show improvements in alertness, communication skills, anxiety, and other symptoms following the twice-daily use of cannabis extracts containing standardized amounts of CBD and THC.

In 2018, Food and Drug Administration officials granted market approval to Epidiolex, a prescription medicine containing a standardized formulation of plant-derived cannabidiol for the treatment of Dravet Syndrome and Lennox-Gastaut Syndrome – two rare forms of childhood epilepsy.

Full text of the study, “Is purified cannabidiol a treatment opportunity for drug-resistant epilepsy in subjects with typical Rett syndrome and CDKL5 deficiency disorder,” appears in Epilepsia.

Analysis: Vaporizers’ Components May Expose Consumers to Heavy Metals

Karnataka, India: Components within certain cannabis vape cartridges may leach metals such as nickel and cadmium when exposed to high temperatures, according to a literature review published in the journal Scientific World.

A pair of researchers reviewed data from nine previously published studies. Studies identified the presence of heavy metals like nickel, chromium, lead, cobalt, cadmium, and copper in cannabis vape (CV) e-liquids and aerosols. Investigators suggested that “long-term contact between the metal parts of the CV and the acidic liquid may cause metal dissolution.”

They reported: “Metals like Pb [lead], Co [cobalt], Cr [chromium], Ni [nickel], and Cu [copper] are released from the structural components of CVs when operated at high temperatures. Factors like device age and storage, vape liquid composition and pH, operating temperature, and design characteristics of CVs influence metal dissolution. … However, these results cannot be generalized to all CVs, as the studies were primarily experimental.”

The study’s authors concluded: “Regulatory guidelines are needed to prevent CV liquid contamination from accessories or packaging. … Future research is warranted into the adverse health implications of heavy metals released from CVs through animal and human studies.”

NORML has previously cautioned that various components in portable vape cartridges – including heating coils, wicks, metal cores, and mouthpieces – can be sources of elemental emissions.

Separate analyses of the aerosol produced by nicotine-filled e-cigarette devices have similarly detected metal emissions. Metal exposure over time has been linked to a variety of serious health concerns, including lung disease, brain damage, and cardiovascular disease.

Full text of the study, “Heavy metals in cannabis vape and their health implications — A scoping review,” appears in The Scientific World Journal.

Study: Using Cannabis Prior To Drinking Results in Significantly Less Alcohol Consumption

Fort Collins, CO: Subjects drink less alcohol and experience fewer alcohol cravings after consuming cannabis, according to data published in the journal Drug and Alcohol Dependence.

Researchers affiliated with Colorado State University assessed adults’ willingness to consume alcohol in a laboratory setting. Participants were offered drinks every fifteen minutes during a one-hour session. During visits where participants were permitted to consume cannabis before the session, subjects reduced their intake of alcoholic beverages by 25 percent.

Investigators reported: “We tested whether cannabis serves as a substitute for alcohol in a sample of community adults who drink heavily and use cannabis regularly. Consistent with our hypothesis, … self-administering cannabis before alcohol significantly reduced alcohol consumption compared to when alcohol was offered without cannabis. Furthermore, we found a trend toward an acute reduction in alcohol craving following cannabis and alcohol co-administration compared to alcohol administration alone, … suggesting that craving reduction may be a plausible mechanism through which cannabis substitution for alcohol could occur in some individuals.”

The study’s authors concluded, “[These findings] provide … support for the idea that legal-market cannabis can serve as substitute for alcohol among some individuals who engage in heavy drinking.”

According to survey data published in 2024 in The Harm Reduction Journal, 60 percent of cannabis consumers say that their cannabis use results in less frequent alcohol consumption.

Full text of the study, “Cannabis administration is associated with reduced alcohol consumption: Evidence from a novel laboratory co-administration paradigm,” appears in Drug and Alcohol Dependence.

Case Series: Insomnia Patients Report Improved Sleep Quality Following Cannabis Use

London, United Kingdom: Patients with insomnia report improvements in their sleep quality and reduced anxiety following their use of medical cannabis products, according to data published in the journal PLOS Mental Health.

British researchers assessed the use of cannabis-based medicinal products (CBMPs) in 124 insomnia patients enrolled in the UK Medical Cannabis Registry. (British health care providers may prescribe cannabis-based medicinal products to patients unresponsive to conventional medications.) Patients’ outcomes were assessed at baseline, 1, 3, 6, 12, and 18 months. Study participants primarily consumed THC-dominant herbal cannabis.

Investigators reported that cannabis use was associated with improved outcomes “across multiple metrics,” including better sleep quality, reduced anxiety, and improved health-related quality of life. Fewer than one in ten participants reported any adverse events from cannabis. The most frequently reported side effects were dry mouth and fatigue.

The study’s authors concluded: “This case series study investigated the outcomes of insomnia patients prescribed cannabis-based medicinal products over an 18-month period. The 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. … These findings can be used to inform future RCTs [randomized controlled trials].”

Placebo-controlled clinical trial data have previously affirmed the efficacy of plant-derived cannabis extracts in patients with chronic insomnia. Separate data reports that nearly 40 percent of insomnia patients either reduce or eliminate their use of prescription sleep aids following their use of cannabis.

Other observational studies assessing the use of cannabis products among those enrolled in the UK Medical Cannabis Registry have reported them to be effective for patients diagnosed with treatment-resistant epilepsy, cancer-related pain, anxiety, fibromyalgia, inflammatory bowel disease, hypermobility disorders, depression, 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.

Texas: Medical Cannabis Expansion Bill Takes Effect

Austin, TX: Legislation took effect Monday, expanding patients’ access to state-qualified medical cannabis products.

Under the law, patients diagnosed with chronic pain, Crohn’s disease, traumatic brain injury, and other newly eligible conditions may enroll in the Texas Compassionate Use Program and obtain state-licensed medical cannabis products.

The new law also expands the pool of cannabis products available for patients, including vaporizers, and it increases the total number of licensed dispensaries that can operate in the state from three to a total of fifteen.

According to data provided by the Texas Department of Safety, over 116,000 patients participate in the Compassionate Use Program.

Delaware: Governor Vetoes Measure That Sought To Relax Cannabis Zoning Restrictions

Dover, DE: Democratic Gov. Matt Meyer vetoed legislation last week (Senate Bill 75) that sought to loosen local zoning restrictions limiting where licensed adult-use cannabis retailers can operate.

The bill would have imposed statewide rules explicitly permitting retailers to operate within 500 feet “of a place of worship, school, licensed child-care, residential treatment facility, park, or library,” and/or “within a one-half mile of another retail marijuana store.” The bill was introduced in response to some municipal lawmakers enacting more restrictive zoning laws, effectively imposing local bans on marijuana retailers.

In his veto message, Gov. Meyer said, “While I fully support the goals of implementing a safe, equitable, and accessible adult-use cannabis market in Delaware, displacing local land use authority without offering any corresponding partnership or support is not how we build durable, effective policy or trust.”

State lawmakers approved legislation legalizing the adult-use marijuana market in April 2023, but retail sales did not begin until last month. Currently, consumers are only able to purchase cannabis at approximately a dozen retail locations — all of which are existing medical cannabis dispensaries that received ‘conversion licenses’ to sell to patients and adults. Proponents of SB 75 say that the Governor’s veto will further delay consumers from gaining access to state-licensed marijuana products.

Review: CBD Dosing Reduces Systolic Blood Pressure

São Paulo, Brazil: CBD administration reduces blood pressure levels, according to a meta-analysis of randomized placebo-controlled trials published in the Brazilian Journal of Pharmacognosy.

Brazilian researchers reviewed data from four clinical trials involving 104 participants. Study results “demonstrated a significant reduction in systolic blood pressure after acute cannabidiol.” CBD dosing also resulted in reductions in diastolic blood pressure, although these changes were not statistically significant.

“These findings suggest that cannabidiol may benefit blood pressure control, specifically with prolonged use in hypertensive patients,” the study’s authors concluded. “But further high-quality randomized controlled trials are required to approve its efficacy, safety, and clinical applicability in cardiovascular care.”

Longitudinal data published earlier this month concluded that the cumulative lifetime cannabis use is not associated with an elevated risk of high blood pressure.

A prior analysis of over 91,000 French adults, published in the journal Nature: Scientific Reports, reported that both current and lifetime cannabis use is associated with lower blood pressure. Another study, published in the European Journal of Internal Medicine, noted that the use of medical cannabis products is associated with decreases in hypertension among elderly subjects.

Full text of the study, “Systematic review and meta-analysis to investigate the effects of cannabidiol on blood pressure: Examination of randomized double-blind and triple-blind placebo trials,” appears in the Brazilian Journal of Pharmacognosy.

Case Report: Vaporized Cannabis Reduces Severity of Opioid Withdrawal Symptoms

New York, NY: Cannabis use is associated with less severe symptoms in a patient undergoing naloxone-precipitated withdrawal, according to a case report published in the journal Experimental and Clinical Psychopharmacology.

Researchers affiliated with Columbia University in New York and Johns Hopkins University in Baltimore assessed the effects of vaporized cannabis pre-treatment on naloxone-precipitated opioid withdrawal in a 52-year-old patient. The patient had a history of heroin and fentanyl use. Investigators assessed the patient’s withdrawal symptoms following the use of naloxone, with and without using cannabis.

They reported that vaporized cannabis reduced the severity and onset of opioid withdrawal symptoms in a dose-dependent manner. Specifically, the patient required “three rescue doses of morphine” when naloxone was administered alone, but he needed only “a single rescue dose” when cannabis use preceded naloxone treatment.

“These results support the continued investigation into combined naloxone + cannabinoid formulations as overdose reversal agents for improved tolerability,” the study’s authors concluded.

Their conclusion is consistent with survey data reporting that opioid-dependent subjects frequently acknowledge consuming cannabis to mitigate drug cravings and reduce withdrawal symptoms.

Full text of the study, “The effects of vaporized cannabis on the severity of naloxone-precipitated opioid withdrawal,” appears in Experimental and Clinical Psychopharmacology.

Clinical Trial: CBD-Infused Gel Improves Sleep Quality, Reduces Migraine-Related Disability in Patients With Bruxism-Associated Pain

Katowice, Poland: Patients with bruxism (teeth grinding or clenching) and other temporomandibular disorders experience improved sleep and fewer migraines following the topical application of CBD, according to data from a placebo-controlled clinical trial published in the journal Pharmaceuticals.

Polish investigators assessed the topical application of CBD-infused gel versus placebo in 60 patients with bruxism-associated muscle pain. Twenty patients received a placebo, 20 patients received a gel containing five percent CBD, and 20 patients received a gel containing 10 percent CBD. Participants administered the gels daily for 30 days.

Both CBD treatment groups “demonstrated statistically significant improvements in PSQI [Pittsburgh Sleep Quality Index] and MIDAS [the Migraine Disability Assessment Scale] scores compared to the control group.” Both treatment groups experienced similar improvements, regardless of CBD concentration. No serious adverse events or treatment-related complications were reported during the study period.

“This study demonstrates that topical application of cannabidiol (CBD) gel, at both five percent and 10 percent concentrations, significantly improves sleep quality and reduces migraine-related disability in patients with bruxism-associated muscular pain. These effects were observed alongside reductions in muscle tension and pain, suggesting a broader therapeutic impact of CBD beyond localized symptom relief,” the study’s authors concluded. “The findings support the use of topical CBD as a well-tolerated, non-invasive adjunct in the multimodal management of temporomandibular disorders (TMD), especially in patients experiencing comorbid sleep and headache disturbances.”

The transdermal delivery of CBD has previously been associated with reduced levels of lower back and leg pain in patients with spinal stenosis, as well as with improved outcomes in patients with hand osteoarthritis.

Full text of the study, “Expanding the therapeutic profile of topical cannabidiol in temporomandibular disorders: Effects of sleep quality and migraine disability in patients with bruxism-associated muscle pain,” appears in Pharmaceuticals.

Analysis: Alcohol Use, but Not Cannabis, Associated With Elevated Risk of Unwanted Pregnancies

San Francisco, CA: Alcohol use, but not cannabis use, is linked to significantly higher rates of unwanted pregnancies, according to data published in the journal Addiction.

Researchers affiliated with the University of California, San Francisco tracked outcomes in a cohort of 936 women who expressed a strong desire not to become pregnant.

Those who acknowledged drinking heavily were 50 percent more likely to become pregnant over the course of the study (13.5 months) as compared to those who drank little or no alcohol. By contrast, those participants who used cannabis did not possess an elevated pregnancy risk compared to non-consumers.

“Heavy drinking, but not cannabis use or other drug use, appears to be associated with elevated pregnancy risk among those who most desire to avoid pregnancy,” the study’s authors concluded. “This study is continuing to follow participants through pregnancy, which will enable further examination of whether people with less desired pregnancies are more likely than those with more desired pregnancies to continue alcohol and/or drug use during pregnancy.”

Full text of the study, “Alcohol and drug use and attainment of pregnancy preferences in the southwestern United States: A longitudinal cohort study,” appears in Addiction.

Analysis: No Rise in Teen Cannabis Use Following Legalization

New York, NY: The adoption of state-specific cannabis legalization laws is not associated with rising rates of marijuana use by adolescents, nor is it associated with increases in problematic cannabis use among adults, according to data published in the International Journal of Mental Health and Addiction.

Researchers affiliated with Columbia University Mailman School of Public Health assessed changes in cannabis consumption patterns following the enactment of adult-use legalization laws.

Consistent with other studies, they found no increase in marijuana use among young people (those ages 12 to 20) following legalization. Investigators also failed to identify any increases in either daily use or problematic use “among men and women who used cannabis in any age group.”

Rates of past-year cannabis use did increase among those ages 21 and older, with greater increases reported among women.

The study’s authors concluded: “No increases in past-month daily cannabis use and past-year DSM-5 CUD [cannabis use disorder] among those using cannabis were observed after RCL [recreational cannabis laws] enactment. There were no increases in any cannabis outcomes after RCL enactment among those 12–20 years old. RCL enactment may contribute to narrowing of the cannabis gender gap. Ongoing surveillance is essential to ensure that the social justice aims of legalization are achieved without negative public health consequences.”

Full text of the study, “Gender differences in cannabis outcomes after recreational legalization: A United States repeated cross-sectional study, 2008-2017,” appears in the International Journal of Mental Health and Addiction.

Study: Lifetime Cannabis Use Not Associated with Increased Risk of Hypertension

San Diego, CA: Cumulative lifetime cannabis use is not associated with an elevated risk of high blood pressure, according to longitudinal data published in the journal Hypertension.

Investigators affiliated with the University of California at San Diego assessed the relationship between cannabis use and hypertension in a cohort (the CARDIA study) of over 2,800 participants. Subjects were assessed at baseline and repeatedly over the following 35 years.

Consistent with other studies, researchers identified “no association … between cumulative lifetime use of cannabis … and incidents [of] hypertension.”

Other assessments of CARDIA study participants have failed to identify links between long-term cannabis use and increased risks of heart abnormalities, hardening of the arteries, or other cardiovascular diseases.

A prior analysis of over 91,000 French adults, published in the journal Nature: Scientific Reports, reported that both current and lifetime cannabis use is associated with lower blood pressure. Another study , published in the European Journal of Internal Medicine, reported that the use of medical cannabis products is associated with decreases in hypertension among elderly subjects.

Full text of the study, “Lifetime cannabis use and incident hypertension: The Coronary Artery Risk Development in Young Adults (CARDIA) study,” appears in Hypertension.

Study: Pain Patients Reduce Their Opioid Use Following Adjunctive Use of Medical Cannabis

Perth, Australia: Chronic pain patients receiving prescribed cannabis extracts significantly reduce their opioid consumption, according to longitudinal data published in the journal Pain Management.

Australian investigators assessed opioid consumption patterns over 12 months in two similar cohorts of chronic pain patients. One group of patients was prescribed cannabis extracts containing standardized quantities of THC and CBD as an adjunctive treatment. (Australian physicians may prescribe cannabis products to patients unresponsive to conventional prescription treatments.) The other group did not receive cannabis therapy.

Patients who received cannabis decreased their average opioid intake to 2.7mg/day after one year of treatment. By contrast, patients who did not receive cannabis consumed an average of 42.3 mg/day of opioids at follow-up.

Patients who consumed cannabinoids were also more likely than controls to experience decreases in depression, anxiety, insomnia, and disability. However, those in the cannabis treatment group were more likely to drop out of the study prior to its completion, indicating that some patients were unable to tolerate the long-term use of cannabis extracts.

The study’s authors concluded: “These findings indicate that the introduction of cannabinoids can produce useful reductions in opioid consumption in real-world settings. … However, this treatment is tolerated by only a subgroup of patients.”

Similarly designed studies in the United States have also reported that cannabis products are associated with substantial reductions in patients’ daily consumption of opioids. Ecological studies from the U.S. and Canada also report significant overall declines in the volume of opioid prescriptions following cannabis legalization.

Full text of the study, “Opioid reduction in patients with chronic non-cancer pain undergoing treatment with medicinal cannabis,” appears in Pain Management.

Analysis: Marijuana Retailers Not Associated With Increased Prevalence of Motor Vehicle Accidents

New Haven, CT: The opening of marijuana retailers is not associated with any immediate increases in motor vehicle accidents, according to data published in the journal Cannabis and Cannabinoid Research.

Yale University researchers assessed motor vehicle crash data for the weeks prior to and after the adoption of adult-use marijuana legalization in Connecticut. They also compared motor vehicle crash data during the same period with that of a control state (Maryland).

Researchers reported “no significant changes” in the prevalence of either statewide accidents (compared to Maryland) or local (within proximity to dispensaries) accidents.

“Here we show that the introduction of recreational cannabis dispensaries in Connecticut did not lead to a significant rise in MVA [motor vehicle accident] rates statewide or at the local level near cannabis dispensaries,” the study’s authors concluded. “The lack of substantial differences in crash rates within the eight weeks before and after recreational dispensary openings suggests that dispensaries may not be a relevant determinant of traffic safety in the proximity of these outlets.”

The study’s findings are consistent with those of a three-year analysis of motor vehicle crash data from Washington state, which reported “no statistically significant impact of cannabis sales on serious injury/fatal crashes” following retail commercialization. By contrast, assessments from other states evaluating longer-term trends in traffic safety following legalization have yielded mixed results.

Full text of the study, “Changes in local community spatial trends of motor vehicle accidents near cannabis dispensaries after recreational cannabis legalization,” appears in Cannabis and Cannabinoid Research.

Trump Says Cannabis Rescheduling Decision Is Forthcoming

Washington, DC: President Donald Trump affirmed at a news conference Monday that his administration is “looking” at federally reclassifying cannabis and that it would “make a determination over the next few weeks.”

He said that the subject is “complicated.” While he acknowledged hearing “great things” about cannabis’ medical utility, he also said that he’s heard “bad things having to do with just about everything else [about marijuana].”

The President’s remarks were in response to a question from a news reporter. They are his first public statements about cannabis policy since winning the election.

The Biden Administration initiated the regulatory process to review cannabis’ federal classification in late 2022 — marking the fifth time that an administrative petition to remove cannabis from Schedule I had been filed, but the first time that the White House had ever led such an effort.

The following year, the US Department of Health and Human Services recommended that the Drug Enforcement Administration reclassify cannabis from Schedule I to Schedule III of the Controlled Substances Act. The DEA called for hearings on the matter, which were scheduled to begin earlier this year. Those hearings were stayed following allegations that the DEA had engaged in inappropriate and biased acts that warranted their disqualification from the proceedings.

There has been no further movement on the matter since January.

In a Truth Social post in September, Trump wrote, “As President, we will continue to focus on research to unlock the medical uses of marijuana to a Schedule 3 drug, and work with Congress to pass common sense laws, including SAFE banking for state authorized companies, and supporting states’ rights to pass marijuana laws.”

Analysis: Cannabis Dispensary Openings Associated With Fewer Opioid Deaths

Atlanta, GA: Counties with licensed cannabis dispensaries experience a reduction in opioid-related fatalities as compared to those without regulated marijuana access, according to an analysis of federal data published in The Washington Post.

The analysis measured county-level dispensary openings and trends in opioid-related deaths. The author reported: “When a county opens its first dispensary — giving residents easy access to marijuana – opioid death rates go down relative to counties that don’t yet have any dispensaries. The effects aren’t small, either. Ten years after that first dispensary opens, death rates in cannabis counties are, on average, about 30 percent lower than death rates in counties without a dispensary.”

He added, “The fact that the drop in deaths shows up right after the first dispensary opens – and not before – strongly suggests that opioid users do shift to marijuana, at least enough to stop overdosing.”

The findings are consistent with those of other studies reporting that increases in the volume of medical and recreational storefront dispensaries are associated with reduced opioid-related mortality rates.

Studies also report that opioid-dependent subjects acknowledge using cannabis to reduce drug cravings and mitigate withdrawal symptoms.

The analysis, “Data shows a new remedy for the opioid crisis,” is available from The Washington Post.

Canada: Nearly Eight in Ten Consumers Say They Obtain Cannabis Exclusively From Legal Markets

Waterloo, Canada: Most Canadian cannabis consumers have transitioned to the legal marketplace following nationwide legalization, according to survey data published in the journal Drug and Alcohol Review.

An international team of investigators from Canada, the United States, and the United Kingdom assessed trends in marijuana-related purchases among 2,686 current cannabis consumers.

Seventy-eight percent of respondents said that “all their cannabis came from legal sources in the past year.”

The data is consistent with prior studies finding that most Canadian consumers have transitioned from the unregulated market to the legal adult-use marketplace following legalization.

Researchers attribute consumers’ transition to falling prices. “Prices of legal cannabis products have decreased substantially over the first 5 years after federal legalization in Canada, with a narrowing differential between the cost of legal and illegal products,” they reported.

The study’s authors concluded: “These findings demonstrate a consistent and substantial transition to legal retail sources in Canada over the first 5 years of legalization, … reflecting considerable progress towards Canada’s objective of displacing illegal sources through the creation of a legal cannabis market.”

Data compiled in the United States similarly reports that a growing percentage of consumers are switching to the legal marketplace. According to a 2023 survey, 52 percent of consumers residing in legal states said that they primarily sourced their cannabis products from brick-and-mortar establishments.

A separate US economic study reports that consumers are most likely to transition to the legal marketplace in jurisdictions where state-licensed retailers are widely available. According to the study’s findings, “States with roughly 20 to 40 legal regulated stores per 100,000 residents, in general, have captured 80 percent to 90 percent of all cannabis sales in the legal market.”

Full text of the study, “Self-reported cannabis prices and expenditures from legal and illegal sources five years after legalization of non-medical cannabis in Canada,” appears in Drug and Alcohol Review.

Preclinical Study: CBD Dosing Mitigates Cravings for Alcohol

San Diego, CA: CBD administration reduces alcohol intake and alcohol-associated withdrawal symptoms in rodents, according to preclinical data published in the journal Nature: Neuropsychopharmacology.

Investigators affiliated with the University of California at San Diego assessed the effects of CBD dosing on alcohol-dependent rats. They reported that CBD mitigated alcohol intake, prevented alcohol-induced damage to the brain, and attenuated relapse-like behaviors.

“The present study demonstrates that chronic administration of cannabidiol attenuates both behavioral and neurobiological manifestations of alcohol dependence in rodent models,” authors concluded. “Specifically, CBD reduced alcohol intake and withdrawal symptoms, lowered relapse-like behaviors, normalized neuronal excitability in the basolateral amygdala (BLA), and prevented alcohol-induced neurodegeneration in striatal regions associated with reward and habit formation. … These results underscore CBD’s potential therapeutic utility for alcohol use disorder (AUD) and provide mechanistic insights into its actions.”

Placebo-controlled clinical data published earlier this year concluded that the oral administration of 800 mg of synthetic CBD significantly reduces subjects’ cravings for alcohol. A 2021 observational study determined that the consumption of CBD-dominant cannabis is associated with reductions in subjects’ alcohol intake. The authors of that study reported that participants who ingested CBD-dominant cannabis during the trial period “drank fewer drinks per drinking day, had fewer alcohol use days, and fewer alcohol and cannabis co-use days” compared with those who did not.

According to 2024 survey data, 60 percent of cannabis consumers say that using cannabis leads to less alcohol consumption.

Full text of the study, “Cannabidiol mitigates alcohol dependence and withdrawal with neuroprotective effects in the basolateral amygdala and striatum,” appears in Nature:Neuropsychopharmacology.

Federal: Language Facilitating Medical Cannabis Access for Veterans Included in Senate, House Versions of Military Spending Bill

Washington, DC: Members of the US Senate and the House of Representatives have approved amendments allowing physicians affiliated with the Department of Veterans Affairs to recommend medical cannabis to qualified patients in jurisdictions that regulate its use.

Federal regulations currently preclude physicians associated with the Veterans Affairs Department from filling out the paperwork necessary to issue a state-authorized medical marijuana recommendation. The pending language amends these rules so that no federal funds may be used to prohibit physicians from engaging in the medical marijuana authorization process.

The new provisions are included in the House and Senate versions of a much broader legislative package, the Military Construction, Veterans Affairs, and Related Agencies Appropriations Act. However, because the two chambers have approved differing versions of the Act, members must still reconcile the language of the two bills. That process typically takes place in a conference committee.

In prior years, lawmakers have removed similar cannabis reform language from the Military Construction bill during the conference committee process.

Lawmakers are anticipated to take further action on the Act shortly after reconvening from their August recess.

Study: Medical Cannabis Associated With Health-Related Quality of Life Improvements, Reduced Opioid Use Among Patients With Substance Use Disorders

London, United Kingdom: Patients diagnosed with substance use disorders (SUD) report improved sleep quality, reduced anxiety, and decreased opioid use following the sustained use of medical cannabis products, according to observational data published in the journal European Addiction Research.

British investigators assessed the use of cannabis-based medicinal products (CBMPs) in SUD patients enrolled in the UK Medical Cannabis Registry. (British health care providers may prescribe cannabis-based medicinal products to patients unresponsive to conventional medications.) More than half (53 percent) of the participants suffered from an opioid use disorder. Patients’ outcomes were assessed at one, three, and six months.

“[T]herapy with CBMPs in patients with SUDs was associated with improvements in [patients’] anxiety, sleep quality and HRQoL [health-related quality of life] at 1, 3 and 6 months,” investigators reported. “Additionally, treatment with CBMPs was associated with a reduction in the median daily OME [oral morphine equivalent] from baseline to 6 months with no severe or life-threatening adverse events reported. These findings are in line with similar studies and broader data from the UK Medical Cannabis Registry for other conditions.”

The study’s authors concluded: “In the context of SUD, CBMPs may … play a role in the maintenance therapy of opiate-dependent individuals with co-morbid anxiety and sleep disorders or symptoms. … CBMPs may also play a role during tapering of opioid doses during maintenance therapy due to the prevalence of anxiety and sleep disruption in individuals experiencing withdrawal from medications. … Although capturing a 6-month follow-up is valuable, longitudinal data to see if PROMs [patient-reported outcome measures] would stay the same, improve further or instead decline would also prove useful in strengthening the evidence base for CBMPs in the treatment of substance use disorders.”

Survey data have previously reported that a significant percentage of patients undergoing opioid maintenance therapy acknowledge consuming cannabis to ease withdrawal symptoms and drug cravings.

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

Full text of the study, “UK Medical Cannabis Registry: A clinical analysis of patients with substance use disorder,” appears in the European Addiction Research.

Study: Patients Engage in Compensatory Driving Behaviors Following Ingestion of THC Extracts

Queensland, Australia: Patients who consume oral doses of THC drive at slower speeds and engage in other compensatory behaviors, according to driving simulator data published in the journal Psychopharmacology.

Australian researchers assessed subjects’ simulated driving performance prior to and 90 minutes after their ad libitum consumption of prescribed THC oil extracts. (Australian physicians may prescribe cannabis products to patients unresponsive to conventional prescription treatments.) On average, study subjects consumed 11 mg of THC prior to driving.

Similar to the results of prior studies, subjects engaged in compensatory driving behaviors – such as driving at slower speeds and increasing the distance between their vehicle and the vehicles in front of them – following THC dosing. Few other changes in participants’ baseline performance were identified, leading investigators to presume that patients likely become tolerant to THC’s potential effects on cognitive and psychomotor performance.

“Our results align with a growing body of evidence demonstrating that chronic THC use can mitigate the acute effects of the substance on driving performance and driving-related cognitive functions,” researchers reported.

The study’s authors concluded: “Taken together, our findings suggest that … medicinal cannabis users may … be more inclined to compensate for cannabis impairment through alterations in speed and following distance. … Future research is needed to further investigate the effects of THC on these driving-related skills and behaviors using a wider range of doses and administration methods, with populations of varying tolerance levels.”

The study’s findings are consistent with those of several others, determining that daily cannabis consumers, and patients especially, exhibit tolerance to many of cannabis’ psychomotor-influencing effects. According to the findings of a literature review published in the Journal of the German Medical Association, “Patients who take cannabinoids at a constant dosage over an extensive period of time often develop tolerance to the impairment of psychomotor performance, so that they can drive vehicles safely.”

Full text of the study, “The effects of orally ingested delta-9-tetrahydrocannabinol on drivers’ hazard perception and risk-taking behaviors: A within-subjects study of medicinal cannabis users,” appears in Psychopharmacology.

Analysis: Cannabis Use Not Associated with Elevated Risk of Kidney Disease

Baltimore, MD: Adults with a history of cannabis use do not possess an elevated risk of kidney disease at midlife, according to longitudinal data published in the journal Cannabis and Cannabinoid Research.

A team of investigators affiliated with Johns Hopkins University School of Medicine in Baltimore and Tulane University in New Orleans assessed the relationship between cannabis use and kidney function. Study participants included current cannabis consumers and non-users. Participants were assessed at baseline and again nearly a decade later.

“Compared with those with no history of cannabis use, participants with current regular cannabis use were not at higher risk of incident CKD [chronic kidney disease] (OR: 0.79), rapid kidney function decline (OR: 0.80) or incident albuminuria [the presence of albumin in urine, a symptom of kidney disease (OR: 0.84) after adjustment for [confounders],” researcher reported.

The study’s authors concluded, “[T]here was no independent association between cannabis use and adverse kidney outcomes over time.”

Full text of the study, “Evaluating the association of cannabis use and longitudinal kidney outcome,” appears in Cannabis and Cannabinoid Research.