Tag: Tuesday

Analysis: Cannabis Use Linked To Lower Risk of Cirrhosis, Other Alcohol-Associated Liver Diseases

Richmond, VA: Alcohol-dependent subjects who consume cannabis possess a significantly lower risk of being diagnosed with liver injuries such as cirrhosis, according to data published in the scientific journal Liver International.

An international team of investigators from the United States, Canada, and Chile assessed the impact of cannabis use on alcohol-associated liver disease (ALD) in a group of 33,114 alcohol-dependent adults. (ALD comprises a spectrum of progressive liver injuries, including steatosis, steatohepatitis, and cirrhosis.) Study participants were segregated into separate cohorts of heavy cannabis consumers, moderate consumers, and non-cannabis consumers.

“Cannabis use was associated with a 40 percent hazard reduction in the composite ALD, including alcohol-associated steatosis, hepatitis, fibrosis, and cirrhosis, as well as a 17 percent reduction in hepatic decompensation, and a 14 percent reduction in all-cause mortality,” researchers reported.

Those participants who consumed cannabis most frequently experienced the greatest risk reduction, suggesting “a dose-response relationship [and] … a potential protective association between cannabis use and ALD.”

The study’s authors concluded: “Cannabis use was linked to lower risks of ALD, liver-related complications and death compared to non-cannabis users. These findings suggest the cannabinoid system may represent a promising therapeutic target for ALD.”

Other studies have previously concluded that adults who consume cannabis are less likely to develop either liver cancer or liver steatosis (aka fatty liver disease).

Full text of the study, “The cannabinoid system as a potential novel target for alcohol-associated liver disease: A propensity-matched cohort study,” appears in Liver International.

Study: Cannabis Treatment Associated With Prolonged Survival in Patients With Aggressive Form of Cancer

Mahasarakham, Thailand: Patients diagnosed with cholangiocarcinoma (biliary tract cancer) who integrate cannabis into their palliative medical treatment experience prolonged survival compared to those who do not, according to the findings of a retrospective cohort study published in the scientific journal F1000 Research.

Thai investigators compared survival trends among 491 patients diagnosed with advanced CCA (cholangiocarcinoma). Of these, 404 patients received palliative care only. Eight-seven patients integrated the use of medicinal cannabis products into their treatment plan. (Medical cannabis products are regulated in Thailand and they are available by prescription for the treatment of specific conditions.) Baseline characteristics were similar between the two groups.

For those receiving standard care only, the median survival time after registration at a palliative clinic was 0.83 months. For those receiving cannabis, median survival time was 5.66 months.

“Medical cannabis increased overall survival rates among CCA patients,” the study’s authors concluded. “Our findings support the integration of medicinal cannabis into palliative care.”

Preclinical studies have consistently determined that cannabinoids possess anti-cancer activities, including the ability to induce apoptosis in cholangiocarcinoma cells. A prior observational study concluded that CCA patients who consumed cannabis experienced lower rates of in-patient mortality compared to similarly matched controls.

Full text of the study, “Survival rates of patients with combined hepatocellular cholangiocarcinoma receiving medical cannabis treatment: A retrospective, cohort comparative study,” appears in F1000 Research.

West Virginia: State Officials Refuse To Allocate Millions in Medical Cannabis Related Revenue, Despite Law Earmarking Funds for Research, Other Priorities

Charleston, WV: State officials have collected millions in taxes and regulatory fees specific to the administration of the state’s medical cannabis access program but are refusing to spend it.

According to reporting by the news service Mountain State Spotlight, officials have collected an estimated $34 million dollars in revenue from the program – which became operational in late 2021. However, state officials have failed to allocate any of the money to fund research or other public health priorities, as stipulated by law. Rather, the money is being held in a credit union under the control of the state Treasurer’s office.

A spokesperson for the Treasurer’s office said that the funds “will remain unallocated until federal law changes.”

No other state that similarly collects marijuana-related taxes and fees withholds using those funds to pay for state-specific programs or projects.

According to the Spotlight, “If West Virginia distributed the entire fund today, roughly $19 million would go back to the Bureau for Public Health within the Department of Health, nearly $8 million to the Fight Substance Abuse Fund overseen by the Department of Health, $6 million to the Division of Justice and Community Services and $1.5 million to a special revenue account for law enforcement professional training and professional development programs.”

Several lawmakers who were involved in writing the state’s medical cannabis law told the Spotlight that they were unaware that officials were refusing to allocate the funds.

Read the full reporting from Mountain State Spotlight.

Virginia: Judge Enjoins County Officials From Disciplining Firefighter for Off-Duty Use of Medical Cannabis

Hanover, VA: Local government officials cannot take disciplinary action against a Hanover County (population: 110,000) firefighter who uses state-authorized medical cannabis products while off-duty, according to a preliminary injunction issued earlier this month by a judge for the 15th Judicial Circuit in Virginia.

The injunction finds that it is in the public interest to protect the rights of Virginians to use lawfully authorized medical cannabis products without fear of retaliation or termination by their employers. It further finds that local officials are not at risk of losing federal funding by allowing public employees to consume medical cannabis while they are away from their jobs.

The injunction specifically restricts the County’s enforcement actions, stating that the firefighter’s lawful off-duty use – limited to cannabis oil as defined by statute – does not impair his performance or safety and must be accommodated consistent with Virginia law.

Virginia legalized physician-authorized medical cannabis access in 2020. The law states that “No employer shall discharge, discipline, or discriminate against an employee for such employee’s lawful use of cannabis oil under the laws of the Commonwealth pursuant to a valid written certification issued by a practitioner for the treatment or to eliminate the symptoms of the employee’s diagnosed condition or disease.” Over 104,000 Virginians are registered in the state’s medical access program.

“This case reinforces that Virginia law means something in Virginia, even when local governments try to hide behind outdated federal policies,” said Eric Postow, Managing Partner at Holon Law Partners in Fairfax, which handled the case. “Our client earned this protection through his service and his integrity. No firefighter or public servant should have to choose between their health and their career.”

In a press release, he added: “This injunction marks one of the first major Virginia rulings affirming that local governments must comply with state medical cannabis protections. It underscores that public employees lawfully certified under Virginia’s medical cannabis program cannot be disciplined for off-duty use, provided it does not impair work performance or endanger others.”

Most states that regulate medical cannabis products provide explicit employment protections for patients’ off-the-job use, while approximately a third adult-use states do provide similar protections for those age 21 and older.

“Virginia law is clear and explicit in protecting the employment rights of medical cannabis patients, including those who are public employees,” said NORML’s development director, JM Pedini. “NORML worked closely with firefighters across the Commonwealth for three years to ensure that state law protects the jobs of the heroes who risk their lives to keep Virginians safe,” added Pedini, who also serves as the executive director of the state chapter, Virginia NORML.

NORML has also advocated for the enactment of similar protections for firefighters in Maryland, but lawmakers have yet to advance the issue.

The complete press release is available from Holon Law Partners.

Study: Opioid Prescribing Rates Fall Following Cannabis Legalization

Athens, GA: Cancer patients decrease their reliance on prescription opioids following the opening of cannabis retailers, according to data published in the Journal of the American Medical Association (JAMA) Health Forum.

Researchers affiliated with the University of Georgia, Indiana University, and the University of Chicago assessed the relationship between state-licensed cannabis establishments and prescription opioid usage among commercially insured patients diagnosed with cancer.

Consistent with prior studies, researchers identified “significant reductions … in the rate of [cancer] patients with opioid prescriptions, the mean daily supply [of opioid medications], and the mean number of [opioid] prescriptions per patient after medical and recreational cannabis dispensary openings.”

The study’s authors concluded, “These findings indicate that medical or recreational cannabis laws may be significantly associated with reduced opioid use among patients diagnosed with cancer … [and that] cannabis may be a substitute for opioids in the management of cancer-related pain.”

Several studies have previously identified an association between cannabis legalization and reductions in opioid-related mortality.

Separate data published by JAMA Network Open 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.
v Full text of the study, “Cannabis laws and opioid use among commercially insured patients with cancer diagnoses,” appears in JAMA Health Forum.

Ohio: House Lawmakers Approve Legislation Repealing Key Provisions of Voter-Approved Marijuana Legalization Law

Columbus, OH: House lawmakers decided on Wednesday in favor of a substitute version of Senate Bill 56, which makes numerous changes to the state’s voter-approved adult-use marijuana legalization law.

The Republican-spearheaded bill amends existing law in several ways. It stipulates that consumers cannot legally possess cannabis products sourced from out of state, including products legally purchased at licensed dispensaries in neighboring jurisdictions. No other legalization state imposes such restrictions.

It also repeals provisions currently 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. It restricts consumers who home-cultivate cannabis from harvesting more than 2.5 ounces of total flower, and it imposes felony penalties for those who grow more than six plants at one time. It imposes new arbitrary limits on the percentages of THC permitted in adult-use and medical cannabis products and it caps the total number of retail licenses permitted statewide.

Other provisions in the legislation create an expedited pathway for those seeking to expunge past marijuana-related convictions, regulate the sale of certain hemp-derived products, and redirect a portion of tax revenues from marijuana sales to individual municipalities that license cannabis retailers.

NORML has vociferously lobbied against proposed changes to Ohio’s adult-use marijuana law, which was approved in 2023 by 57 percent of voters. NORML’s action alert opposing SB 56 has been shared with lawmakers over 18,000 times. It states: “This bill is a slap in the face to the millions of Ohioans who voted in favor of Issue 2. Once again, politicians are arrogantly trying to claim that the public didn’t know what they were voting for.”

A commentary authored by NORML Deputy Director Paul Armentano and Political Director Morgan Fox, published in The Columbus Dispatch, opined: “Lawmakers had years to craft legislation regulating Ohio’s adult-use marijuana market. They chose not to do so, instead leaving the decision up to the electorate. Legislators do not have the right to play Monday morning quarterback now simply because most Ohioans voted in a way they disapprove of.”

The legislation now returns to the Senate, which initially proposed even more comprehensive changes to the law. If Senators fail to approve the House’s amended version of the bill, it will be advanced to a conference committee for further debate.

“NORML is asking all Ohioans who care about personal freedom and the rights of voters to urge the legislature to reject SB 56 in its current form,” said Fox. “This isn’t what Ohioans voted for, and the fact that this bill is being rushed through the legislature, with almost no opportunity for public comment, indicates that lawmakers know they are undermining the will of the voters. Regardless of where one stands on cannabis issues, everyone should be outraged at this.”

NORML’s legislative alert opposing Ohio’s Senate Bill 56 is available from NORML’s Take Action Center.

Analysis: Consumers Self-Titrate When They Encounter More Potent Cannabis Products

Hanover, NH: Consumers regulate their cannabis intake based upon the potency of the product they are consuming, according to data published in the Journal of Psychiatric Research.

Researchers affiliated with Dartmouth Medical School in New Hampshire and Columbia University in New York assessed consumers’ self-reported use of lower-potency cannabis flower and higher-potency cannabis concentrates.

Consistent with prior research, investigators reported, “[T]hose who use both flower (i.e., lower potency product) and dab concentrates (i.e., higher potency product) tend to use greater amounts of flower than concentrates, and the median amount of flower used among flower-only consumers is consistently larger than the median amount of concentrates used among concentrate-only consumers.”

Researchers also reported that more experienced consumers are more likely to gravitate toward more potent products, arguably due to “their higher tolerance.”

The study’s authors concluded: “Results suggest that cannabis consumers self-titrate when switching between flower and concentrate product types. … Understanding self-titration is critical for developing evidence-based regulatory strategies.”

The study’s findings come at a time when some state lawmakers are calling for the imposition of arbitrary caps on the percentage of THC permissible in certain retail cannabis products. NORML has pushed back against the imposition of THC caps – opining that cannabis products, regardless of THC potency, cannot cause lethal overdose or organ toxicity, that consumers regulate their ingestion of more potent products accordingly, and that re-criminalizing select cannabis products relegates their production and sale exclusively to the unregulated marketplace.

Full text of the study, “Self-titration of cannabis consumption: An epidemiological perspective,” appears in the Journal of Psychiatric Research.

Florida: Health Officials Move To Revoke Medical Cannabis Access for Those With Certain Drug Convictions

Tallahassee, FL: Health officials are actively identifying and revoking patients’ access to state-authorized medical cannabis products, as required by legislation signed into law earlier this year.

Republican Gov. Ron DeSantis signed legislation in July mandating state officials to “immediately suspend the registration” of any state-registered patient or caregiver convicted of “trafficking in the sale, manufacture, or delivery of, or possession with intent to sell, … of a controlled substance.” Some 925,000 Floridians are registered in the state’s medical cannabis access program.

Last week, a representative of the state’s Office of Medical Marijuana Use told lawmakers that the agency is complying with the law and that it intends to take action against patients “that meet the new requirement for revocation.”

NORML actively opposed the law change. NORML members generated hundreds of emails to lawmakers opposing the new restrictions, opining: “Patients do not lose their access to opioids and other traditional medications based on past convictions. They should not lose their access to medical cannabis either.”

Study: Cannabis Use Inversely Associated With Rhinitis

Houston, TX: Cannabis consumers are far less likely than non-users to develop chronic rhinitis and similar sinonasal diseases, according to case-control data published in the journal Laryngoscope Investigative Otolaryngology.

Researchers affiliated with Houston’s Methodist Hospital, Department of Otolaryngology, assessed rates of chronic rhinosinusitis (CRS), allergic rhinitis (AR), and chronic rhinitis (CR) in a nationally representative sample of 25,164 cannabis consumers and 113,418 matched controls.

Contrary to investigators’ expectations, subjects who consumed cannabis were less likely than non-users to suffer from symptoms of sinonasal diseases, with more frequent consumers possessing the lowest risk. This inverse relationship persisted regardless of whether subjects smoked cannabis or orally ingested marijuana products.

“Given the known detrimental impact of tobacco smoking use on sinonasal tissue and inflammation, it was expected that patients who more regularly used cannabis would also be more likely to have sinonasal inflammatory diseases, especially in those who smoked cannabis. However, the present study results do not support this hypothesis,” the study’s authors concluded. “Instead, … certain user cohorts were almost half as likely to develop CRS, AR, and CR as never users. … To our knowledge, this is the first study to demonstrate this finding.”

Sinonasal diseases are characterized by persistent inflammation of the nasal passages. They are estimated to adversely impact the health of approximately one-quarter of the global population.

Full text of the study, “The associative impact of recreational cannabis on sinonasal diseases,” appears in Laryngoscope Investigative Otolaryngology.

Michigan: Industry Association Files Legal Challenge To Halt Lawmakers’ Cannabis Tax Hike

Lansing, MI: Representatives of the state’s largest cannabis industry trade organization have filed a lawsuit to block the implementation of the state’s newly enacted marijuana tax.

Earlier this month, lawmakers passed a budget bill imposing a 24 percent wholesale tax on marijuana products sold in the state. The tax increase takes effect on January 1, 2026.

Last week, the Michigan Cannabis Industry Association filed litigation declaring the tax hike to be illegal because it improperly amends the state’s voter-initiated marijuana legalization law. They argue that any changes to marijuana-related taxes must be approved by a three-quarters supermajority in both chambers. (Another group has also filed a similar suit.)

Lawmakers narrowly passed the budget bill despite significant pushback from cannabis advocacy and industry groups.

“Raising taxes on adult-use cannabis products will escalate prices out of reach for many consumers,” stated NORML in an action alert that was shared with state lawmakers over 3,000 times. “This will drive a growing percentage of consumers to the unregulated market, 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. This proposed tax increase will also hurt state-licensed businesses and their employees because it will increase their costs and reduce their customer base.”

An estimated 40,000 Michiganders work in the state-regulated cannabis industry.

Last month, a legislative effort led by California NORML successfully rolled back marijuana-related taxes in that state. By contrast, lawmakers in Maryland and Minnesota both enacted cannabis-related tax hikes this year.

JAMA Commentary: Indefensible for Clinicians To Remain “Willfully Ignorant” About Medical Cannabis

Boston, MA: Clinicians must have a better understanding of cannabis and its effects so that they may competently and adequately serve their patients, according to a commentary published in the journal JAMA (Journal of the American Medical Association) Network Open.

“Clinicians are increasingly confronted by patients using cannabis, often unsupervised and poorly informed,” the commentary states. “It is no longer defensible for clinicians to remain willfully ignorant. … Medical cannabis is here. Will physicians catch up, or will we, through omission, continue to let patients navigate therapeutic uncertainty alone?”

The commentary demands that medical professionals receive formal training encompassing six core competencies: “endocannabinoid system physiology; pharmacokinetics of tetrahydrocannabinol, cannabidiol, and other cannabinoids; relevant indications (e.g., chronic pain, chemotherapy-induced nausea); risk profiles, dosing and administration methods; legal and regulatory frameworks; and strategies for patient-centered communication and shared decision-making.” An accompanying paper highlighting these topics also appears in the journal.

“Opponents may decry the Schedule I classification as a barrier to training or research. But clinicians routinely practice in ethically fraught and politically charged realms (e.g., abortion, addiction, reproductive health), navigating care even when laws lag. Cannabis demands the same professional responsibility,” the commentary concludes. “We need not wait for the US Drug Enforcement Administration reclassification to act. Education can and must advance based on patient needs, accumulated clinical evidence, and ethical obligations.”

Numerous surveys of medical professionals – including nurses, pharmacists, clinicians, and other health care practitioners – find that health practitioners believe that they are inadequately trained in matters specific to medical cannabis. Separate survey data also report that fewer than 1 in 5 patients think that their primary care providers are sufficiently knowledgeable about cannabis-specific health-related issues. Instead, patients typically acknowledge obtaining cannabis-related information from either “friends and family” or from non-governmental websites.

Full text of the commentary, “Cannabis education – A professional and moral obligation for physicians,” appears in JAMA Network Open.

Literature Review: Cannabis Formulations Reduce Dementia-Related Agitation and Aggression

Padova, Italy: Cannabinoids reduce dementia-induced agitation in older patients and “offer a promising therapeutic option for managing behavioral and psychological symptoms of dementia,” according to the findings of a systematic review published in the Journal of Psychopharmacology.

A team of Italian investigators reviewed data from ten published studies involving 278 participants. Study subjects were at least 60 years old and suffered from either Alzheimer’s, vascular, or mixed dementia.

“Most studies identified a positive effect of [cannabinoid] intervention in reducing behavioral disturbances,” researchers reported. “Agitation emerged as the symptom most consistently benefiting from cannabinoid use … Notably, the observed changes surpassed those reported in similar RCTs [randomly controlled trials] evaluating the effects of antipsychotics and antidepressants. In addition, improvements were reported in nocturnal disturbances, physical and verbal aggression, resistance to care, and vocalizations.”

The studies also reported that cannabinoids were “sufficiently safe and well-tolerated” in this older patient population.

“In conclusion, cannabinoids show promising potential in managing symptoms such as agitation and aggression in people with dementia, with an overall favorable safety and tolerability profile,” the study’s authors determined. “Among the various formulations studied, the available evidence indicates that CBD-rich, low-THC preparations deserve particular attention. These formulations are more widely available in many countries and are associated with a lower risk of side effects. … These findings, together with the need for safer and better-tolerated therapeutic strategies, support further investigation of CBD- rich formulations as a potential first-line option in future clinical research on BPSD [behavioral and psychological symptoms of dementia].”

Full text of the study, “Can cannabinoids alleviate behavioral symptoms in older adults with dementia? A systematic review,” appears in the Journal of Psychopharmacology.

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.