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Study: Cannabis Mitigates Pain in Patients with Refractory Gastroparesis, Is Associated with Improvements in In-Hospital Mortality

Valhalla, NY: The use of marijuana significantly reduces abdominal pain in patients with refractory gastroparesis, according to data published in The American Journal of Gastroenterology. (Gastroparesis involves the partial paralysis of the stomach; symptoms include abdominal pain, nausea and vomiting, heartburn, and weight loss.)

Researchers affiliated with New York Medical College and with Westchester Medical Center University Hospital assessed the effects of either plant cannabis or dronabinol (FDA-approved oral THC) on pain in a cohort of 24 patients with treatment-resistant gastroparesis.

While both the administration of oral THC and cannabis was associated with reductions in patients' self-reported pain, whole-plant cannabis was associated with greater improvements.

"Our study shows that cannabinoids may play an important role in the management of gastroparesis-related abdominal pain," authors concluded. "There are currently no treatments shown to be effective for gastroparetic pain in clinical trials, and cannabinoids may serve a niche for this under-treated symptom."

Separate data assessing the relationship between cannabis use and gastroparesis, published in the Journal of Clinical Gastroenterology, further reports that patients who consume cannabis possess "better hospitalization outcomes, including decreased length of stay and improved in-hospital mortality" as compared to those with no history of recent use.

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

Full text of the study, "Cannabinoids lead to significant improvement in gastroparesis-related abdominal pain," appears in The American Journal of Gastroenterology. Full text of the study, "Trends and socioeconomic health outcomes of cannabis use among patients with gastroparesis: A United States nationwide inpatient sample analysis," appears in the Journal of Clinical Gastroenterology.

Survey: Arthritis Patients Likely to Report Improvements Following CBD Therapy

Great Neck, NY: Arthritis patients frequently report symptom improvements and reductions in their use of prescription medications following the use of CBD products, according to data published in the Journal of Cannabis Research.

A team of investigators affiliated with the Zucker School of Medicine at Hofstra University in New York and with the Banner University Medical Center in Arizona surveyed a convenience sample of patients with either osteoarthritis or rheumatoid arthritis (RA). Most of the participants (70 percent) acknowledged having used CBD products for symptomatic relief.

"The overall cohort reported significant reductions in pain after CBD use, with a 44 percent reduction in numerical pain score and 2.58-point reduction [on a zero-to-ten numerical pain score]," authors reported. "Pairwise comparisons demonstrated that the osteoarthritis group had greater percentage reduction and point reduction compared to RA and other autoimmune arthritis."

Consistent with other studies, authors reported that many patients either reduced or eliminated their use of medications following their use of CBD products. They acknowledged, "Most respondents using CBD for joint pain reported a reduction or cessation of other medications due to CBD use (60.5 percent), including a reduction in anti-inflammatories (31.1 percent), discontinuation of anti-inflammatories (17.8 percent), reduction in acetaminophen (18.2 percent), discontinuation of acetaminophen (17.8 percent), reduction in opioids (8.6 percent), and discontinuation of opioids (18.9 percent)."

Most participants taking CBD products acknowledged experiencing either mild or no adverse effects.

Authors concluded: "In terms of the perceived effects of CBD on pain, physical function, and sleep quality, many patients using CBD reported symptomatic improvements. ... These findings suggest that CBD could be an alternative to opioids for the treatment of arthritic pain. ... Clinicians and patients should be aware of the various alternative therapeutic options available to treat their symptoms of arthritis, especially in light of the increased accessibility to cannabidiol products."

The administration of a topical form of CBD has been previously shown to be effective in patients with thumb basal joint arthritis, according to placebo-controlled trial data. Arthritis patients who consume medical cannabis have similarly reported reductions in their opioid intake and improvements in their quality of life.

Full text of the study, "Cannabidiol as a treatment for arthritis and joint pain: An exploratory cross-sectional study," appears in the Journal of Cannabis Research.

Analysis: Medical Cannabis Access Not Associated with Increases in Problematic Use by Young People

New York, NY: The implementation of state laws legalizing the medical use of cannabis is not associated with increases in rates of problematic marijuana use by either adolescents or by young adults, according to data published in the Community Mental Health Journal.

A pair of researchers affiliated with the Weill Medical College at Cornell University assessed rates of so-called ‘cannabis use disorder' among those ages 15 to 24 in states with and without medical cannabis access laws.

"We found that states that have implemented MML [medical marijuana laws] for more than five years are not significantly associated with smaller or greater 2019 DALYs [disability adjusted life years] for cannabis use disorders in an adolescent and young adult population aged 15 to 19, and 20 to 24 years-old, as compared to states that have not," they concluded. "Our findings suggest that MML may have a negligible effect (if any) on cannabis use disorders in this population group."

Their findings are consistent with those of several other studies that have failed to identify any link between medical cannabis legalization and increased marijuana use among young people.

Full text of the study, "Long-term impact of medical marijuana laws on the burden of cannabis use disorders in US male and female adolescents and young adults," appears in Community Mental Health Journal.

Study: Cannabis Use Associated with Lower BMI Among Those with HIV/HCV

Marseille, France: People co-infected with HIV and hepatitis C who consume cannabis are at a lower risk of being overweight, according to data published in the journal AIDS Education and Prevention.

French investigators assessed the relationship between cannabis use and body mass index (BMI) in a cohort of 992 HIV/HCV patients. Consistent with prior research, they reported that a history of marijuana use was "inversely associated with BMI."

Prior studies involving HIV/HCV subjects have also identified a link between cannabis use and a lower risk of diabetes, fatty liver disease, and early mortality.

Other case control studies have consistently reported that those with a history of marijuana use are less likely than abstainers to be obese or to suffer from type 2 diabetes.

Full text of the study, "Cannabis use as a protective factor against overweight in HIV-hepatitis C virus co-infected people," appears in AIDS Education and Prevention.

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Federal Court Strikes Down Residency Requirement for Those Seeking State Marijuana Licensure

Augusta, ME: Federal court judges have ruled that a Maine law requiring licensed medical cannabis providers to be in-state residents is unconstitutional.

Judges for the US Court of Appeals for the First Circuit ruled 2 to 1 that the law was “facially protectionist” and thereby in violation of the Constitution’s dormant commerce clause – which seeks to discourage states from taking steps that excessively burden interstate commerce. The majority further determined that the medical cannabis industry is subject to the dormant commerce clause, even despite the federal prohibition of marijuana, because commercial activity in the marijuana market is routinely taking place absent any intervention from federal law enforcement.

They opined, “Congress’s enactment of the Rohrabacher-Farr Amendment in the wake of the CSA’s [Controlled Substances Act] passage … undermines the notion that no such interstate market exists. … [Further,] the prohibition that Maine’s Medical Marijuana Act seeks to impose on out-of-state actors entering that very market reflects the reality that the market continues to operate. That prohibition even indicates that the market is so robust that, absent the Medical Marijuana Act’s residency requirement, it would be likely to attract entrants far and wide.”

The majority concluded, “Why, then, would it be improper for us to apply the dormant Commerce Clause here? There is an interstate market, and a state is trying to protect its advantageous position with respect to it.”

The dissenting judge argued that the commerce clause’s protections ought to be applicable only to national markets involving goods or services that Congress has deemed legal.

Maine regulators had already dropped a similar residency requirement for those seeking licensure to participate in the adult-use market.

The case is Northeast Patients Group v. Maine Department of Administrative and Financial Services.

Analysis: Heavy Metals Frequently Identified in Unregulated CBD Products

Miami, FL: CBD-infused products commercially available in retail stores and online often contain heavy metals, such as lead, arsenic, and mercury, and typically contain less-than-advertised quantities of cannabidiol, according to data published in the journal The Science of the Total Environment.

Investigators affiliated with the University of Miami School of Medicine and with the Ellipse Analytics Testing Lab in Denver assessed 516 CBD products for cannabidiol content as well as for the presence of heavy metal contaminants. Of these products, 121 products were intended for oral consumption.

Consistent with prior analyses of unregulated CBD products, many contained impurities and inaccurate labeling.

Of the CBD-infused edible products analyzed, 42 percent tested positive for the presence of lead, 37 percent tested positive for mercury, 28 percent tested positive for arsenic, and eight percent tested positive for cadmium.

Over 40 percent of all of the products tested contained significant lower percentages of CBD than advertised on the products’ labeling. Among edible products only, 29 percent contained lower quantities of CBD than advertised.

“Low-level contamination of edible CBD products with heavy metals and phthalates is pervasive,” authors concluded. “There is substantial discrepancy between the product label claims for CBD potency and the amount measured in both edible and topical products, underscoring the need for tight regulations for CBD product label integrity to protect consumers.”

They added: “Given that the consumer demographic purchasing CBD products includes those afflicted with pain, insomnia, anxiety, and other health conditions, these findings could give consumers and medical practitioners hesitation about the benefits and potential harm of CBD use. If left unaddressed, these findings could lead to decline in consumer trust and public health concerns. CBD mistrust could lead to consumers and retailers abandoning this category of potentially efficacious medical therapies. … It is incumbent upon manufacturers to recognize the prevalence of misleading claims on labels, identify the sources of the discrepancies between label claims and measured CBD content, and improve label accuracy through a commitment to frequent and thorough independent testing procedures.”

Heavy metal contamination has also been identified in unregulated delta-8 THC vapor products.

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

Full text of the study, “Heavy metal and phthalate contamination and leveling integrity in a large sample of US commercially available cannabinoid (CBD) products,” appears in The Science of the Total Environment.

Survey: Cannabis Reportedly More Effective Than Prescription Anti-Emetics for Hyperemesis Gravidarum

Los Angeles, CA: Survey respondents who acknowledge having consumed cannabis to address symptoms of Hyperemesis Gravidarum (HG) frequently report that it is more effective than prescription medications at reducing severe nausea and vomiting.

A team of researchers affiliated with the University of California, Los Angeles and with the Hyperemesis Education and Research Foundation in Oregon surveyed 550 respondents who suffered from HG during their pregnancy. Among respondents, 96 percent acknowledged having used prescription anti-emetics; 14 percent reported having used cannabis. Most (71 percent) of those who acknowledged having consumed cannabis said that they did so because prescription medications inadequately managed their symptoms.

Of those who consumed cannabis, 82 percent reported HG symptom relief – a finding that is consistent with prior case reports and surveys. By comparison, only 60 percent reported obtaining relief from prescription anti-emetics. Moreover, among patients who reported experiencing weight loss during pregnancy, 56 percent of those who used cannabis reported gaining some or all of it back within two weeks of treatment, compared to 25 percent of prescription drug users.

Authors concluded: “This study adds to growing literature supporting antiemetic properties of cannabis and cannabinoid compounds while also suggesting their potential to treat HG. … A minority of respondents in this survey reported using cannabis for HG; however, those who used cannabis or CBPs [cannabis-based products] reported more frequent relief from HG symptoms compared to those who used prescription antiemetics. Furthermore, those cannabis users were more likely to report weight gain within two weeks of treatment than those who used ondansetron, reportedly the most effective prescription antiemetic for survey respondents.

“Cannabis products may be perceived as a more effective alternative, but more research is required to understand its mechanism and safety… In the meantime, providers must weigh unknown risks of recommending cannabis… with the well-established risk of adverse maternal and fetal outcomes for refractory HG.”

Full text of the study, “Patterns of use and self-reported effectiveness of cannabis for Hyperemesis Gravidarum,” appears in the journal of the German Society of Gynecology and Obstetrics.

Study: CBG Administration Lowers Blood Pressure in Preclinical Model

Hershey, PA: Mice injected with the cannabinoid CBG (cannabigerol) experience a significant decrease in mean blood pressure, according to preclinical data published in the journal Frontiers in Physiology.

A team of researchers with Penn State College of Medicine assessed the cardiovascular impact of CBG compared to placebo in healthy mice. Animals in the study were injected in the abdomen with either CBG or a saline solution.

Authors reported, “[A]cute CBG administration elicits a significant decrease in blood pressure in phenotypically normal male mice, without altering heart rate or locomotor activity.”

They concluded: “The present study provides new mechanistic insight into the cardiovascular effects of CBG in the context of normal blood pressure. … Overall, these findings add to the growing literature regarding the role of cannabinoids in blood pressure regulation. Additional research on CBG is needed to define the precise molecular mechanisms and sites of action, effects of more chronic administration, and potential for therapeutic use to lower blood pressure in models of hypertension.”

A 2017 clinical trial previously documented the ability of oral doses of CBD to lower blood pressure in healthy volunteers, while a 2021 observational trial identified a link between long-term cannabis use and a reduction in systolic and diastolic blood pressure in elderly subjects.

Cannabinoids have long been known to influence cardiovascular function, though data regarding their effects has been conflicting. According to the results of a 2021 literature review of 67 studies published in the American Journal of Medicine, “[M]arijuana itself does not appear to be independently associated with excessive cardiovascular risk factors,” although authors did caution that “it can be associated with other unhealthy behaviors such as alcohol use and tobacco smoking that can be detrimental” to cardiovascular health.

Data assessing neonatal outcomes among children with in utero exposure to cannabinoids is inconsistent, with some studies highlighting potential links with pre-term birth and lower birth weight and other studies finding no such associations.

Full text of the study, “Acute cannabigerol administration lowers blood pressure in mice,” appears in Frontiers in Physiology.

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