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Clinical Trial: CBD Safe and Effective for Young People with Treatment-Resistant Anxiety Disorders
Melbourne, Australia: The adjunctive use of CBD safely and effectively reduces severe anxiety in young people, according to clinical data published in The Journal of Clinical Psychiatry.
Australian researchers assessed the daily administration of CBD in a cohort of 31 young people (ages 12 to 25) with refractory anxiety. Participants self-titrated their daily doses of CBD (between 400 mgs and 800 mgs) over a 12-week period.
CBD dosing was associated with a "statistically significant reduction in anxiety severity," as measured on the Overall Anxiety Severity and Impairment Scale (OASIS). CBD dosing also "demonstrated an acceptable safety profile, with no serious adverse events reported and no clinically significant deviations to blood cell counts."
Investigators reported, "Approximately 40 percent of all participants experienced a 50 percent reduction in OASIS score, and two-thirds experienced a 33 percent reduction." They added, "By the end of treatment, the number of participants rated as markedly or severely ill had decreased from 17 (56.7 percent) to 5 (16.7 percent)."
Authors acknowledged that CBD’s greatest efficacy was observed during the final four weeks of treatment, indicating that a longer treatment regimen may potentially lead "to even greater improvements."
They concluded: "Given that the patients included in our trial were some of the most severe and treatment resistant and had significant functional impairment and multiple failed treatment attempts, the reduction in anxiety severity observed here suggests that CBD has clinically meaningful anxiolytic effects. ... The findings of this trial suggest that further investigation of CBD for anxiety in conjunction with usual care is warranted."
Other human trials evaluating the use of CBD for anxiety have yielded inconsistent results. A 2019 placebo-controlled trial reported that daily CBD intake reduces symptoms of social anxiety disorder in teens, whereas a 2022 study determined oral doses of CBD to be ineffective at reducing symptoms of moderate-to-severe testing anxiety in college students. A 2018 Brazilian study reported that the consumption of 300mg of CBD significantly reduced anxiety due to public speaking, but that higher (600mg) and lower (150mg) had no effect.
Full text of the study, "Cannabidiol for treatment-resistant anxiety disorders in young people: An open-label trial," appears in The Journal of Clinical Psychiatry.
Study: Medical Cannabis Use Not Associated with Elevated Risk of Hospitalizations Due to Mental Health Disorders
Quebec, Canada: Authorized medical cannabis patients are at low risk for psychiatric hospitalizations resulting from their marijuana use, according to data published in the journal Substance Use & Misuse.
Canadian researchers assessed marijuana-related hospitalizations among a cohort of over 23,000 authorized medical cannabis patients. (Canada has legalized the use of cannabis products for both medical purposes and for adult use.) Specifically, investigators tracked incidences of hospitalizations attributable to either "cannabis poisoning" or because of "mental or behavioral disorders due to the use of cannabis." Patients in the study were tracked for a median of 240 days.
During the course of the trial, investigators reported that a total of 14 patients were hospitalized for issues related to cannabis toxicity and 26 were admitted for either mental or behavioral disorders. The findings push back against high-profile claims from some cannabis reform opponents that frequent marijuana exposure is a trigger for psychosis and other mental health disorders.
"The results suggest that the incidence of cannabis poisoning or cannabis-related mental or behavioral disorders was low among patients who were authorized to use cannabis for medical care," authors concluded. "Our observation of small rates of ED visits and hospitalization for cannabis poisoning and CUDs [cannabis use disorders] among this large cohort of medical cannabis users helps address concerns regarding increasing use of medical cannabis."
Full text of the study, "Incidence and predictors of cannabis-related poisonings and mental and behavioral disorders among patients with a medical cannabis authorization: A cohort study," appears in Substance Use & Misuse.
Analysis: Cannabis Use Not Associated with Increased COVID Severity
Los Angeles, CA: Current cannabis use is associated with deceased disease severity in patients hospitalized for COVID 19, according to data published in the Journal of Cannabis Research.
Researchers affiliated with the David Geffen School of Medicine at the University of California, Los Angeles conducted a retrospective analysis of 1,831 COVID patients admitted to two medical centers in California. They reported, "Active cannabis users hospitalized with COVID 19 had better clinical outcomes compared with non-users, including decreased need for ICU admission or mechanical ventilation." However, investigators reported no association between cannabis use and better overall survival rates.
Authors reported that the association between cannabis use and decreased symptom severity remained consistent even after researchers adjusted for potential confounders, such as age and comorbid conditions.
"To our knowledge, this study is one of the first evaluations of the effect of cannabis use on outcomes in patients hospitalized with COVID-19," they concluded. "While previous data have determined the detrimental relationship of tobacco smoking with COVID-19, this study suggests that cannabis may actually lead to reduced disease severity and better outcomes despite a five-fold greater concomitant use of tobacco amongst cannabis users compared to non-users in our study population."
Preclinical studies and reviews have suggested that the administration of certain cannabis compounds could potentially modulate COVID infections. However, to date, no controlled clinical trials have substantiated the theory that cannabinoids can assist in either preventing COVID infections or in mitigating symptoms of the virus. Clinical trial data published in November failed to demonstrate that the adjunctive use of CBD aided COVID patients in their recovery from the virus. A separate observational study published last year reported that COVID 19 patients with elevated rates of overall substance use were more likely to experience more adverse outcomes, including hospitalization and death.
Full text of the study, "Cannabis consumption is associated with lower COVID-19 severity among hospitalized patients: A retrospective cohort analysis," appears in the Journal of Cannabis Research.
Texas: Voters in Five Cities to Decide on Marijuana Depenalization Initiatives
Austin, Texas: Voters in five Texas cities will decide this November on local ballot measures to end low-level marijuana possession arrests.
Activists with the group Ground Game Texas successfully gathered signatures from voters in the cities of Denton (population: 140,000), Elgin (population: 10,000), Harker Heights (32,000), Killeen (149,000), and San Marcos (64,000) to place marijuana-related questions before local lawmakers. In each instance, councilmembers moved to defer the issue to the November ballot.
The measures seek to amend local laws so that police officers can no longer "issue citations or make arrests for Class A or Class B misdemeanor possession of marijuana offenses" absent defendants' alleged involvement in a "felony level narcotics" case. If voters approve the proposals, police will still be permitted to confiscate cannabis from those who possess it in small quantities.
In May, voters in Austin overwhelmingly approved a similar municipal measure depenalizing marijuana possession and prohibiting police from executing 'no knock' warrants.
Texas law does not allow for statewide, citizen-initiated measures.
Statewide polling finds that 67 percent of Texans, including majorities of Democrats, Independents, and Republicans, support legalizing the sale and use of marijuana.
Under state law, minor marijuana possession is classified as a criminal misdemeanor, punishable by up to 180 days incarceration and a $2,000 fine. Texas police made an estimated 219,000 marijuana-related arrests between 2017 and 2021. Ninety-seven percent of those arrested were charged with possession only.
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Study: Medical Cannabis May Present a "Useful Treatment Strategy" for Fibromyalgia Patients
Montreal, Canada: Cannabis products are associated with symptom relief among fibromyalgia (FM) patients, according to data published in the journal Arthritis Care & Research.
Canadian researchers assessed the efficacy of medical cannabis products (flower or extracts) over a one-year period in a cohort of patients with FM. Investigators assessed patients' levels of pain intensity, sleep quality, and depression/anxiety every three months. All of the subjects enrolled in the study were qualified to use medical cannabis products by their general practitioner.
Consistent with other studies, researchers reported an association between the consumption of medical cannabis and improvements in subjects' sleep, depression/anxiety, and pain - with the greatest reduction in pain intensity (a mean decrease of 1.7 points on a zero to 10 scale) occurring within the first six-months of treatment.
Authors reported: "Our current findings are consistent with observations of pain relief, improved sleep, and alleviation of symptoms of anxiety and depression in other studies among patients with chronic pain using medical cannabis. Although preliminary, our findings suggest that improvements in negative affect and sleep might represent potential mechanisms of action underlying pain reductions among FM patients who are using medical cannabis."
They concluded, "Medical cannabis may present a useful treatment strategy for patients with FM in light of an effect on the triad of symptoms of pain, negative affect, and sleep disturbances."
Survey data reports that fibromyalgia patients frequently consume cannabis for therapeutic purposes. A recent review of the relevant literature concluded, "[T]he use of cannabinoids and cannabis carries limited side effects in the treatment of FM, and they can also improve some common and debilitating symptoms associated with FM, thus making them an adequate potential treatment option, when other treatment lines have been exhausted."
Full text of the study, "Predictors of pain reduction among fibromyalgia patients using medical cannabis: A long-term prospective cohort trial," appears in Arthritis Care & Research.
Congress: Bipartisan Bill Introduced to Designate Funding for Clinical Trials on the Efficacy of State-Licensed Medical Cannabis Products
Washington, DC: Representatives Scott Peters (D-CA) and David Joyce (R-OH) have introduced legislation, the Developing and Nationalizing Key Cannabis Research Act of 2022, to provide designated funding for clinical research into the therapeutic benefits of cannabis.
The legislation authorizes the Director of the National Institutes of Health to designate "institutions of higher education as Centers for Excellence in Cannabis Research for the purpose of interdisciplinary research related to cannabis and other biomedical, behavioral, and social issues related to cannabis." This research will explicitly include clinical investigations assessing "the safety and efficacy of cannabis in providing therapeutic benefits for certain priority diseases or conditions" as well as studies evaluating "the relative risk of cannabis as compared to alcohol and tobacco," among other purposes.
To carry out this work, the measure appropriates $50,000,000 for each of fiscal years 2024 to 2028 to ten designated research centers. It also allows scientists affiliated with these designated centers to obtain state-legal cannabis products and to administer those products to subjects in clinical trials.
Under current federal law and regulations, researchers are prohibited from clinically evaluating any state-licensed products. Rather, scientists wishing to study cannabis in clinical settings must utilize cannabis provided by federally-licensed entities - of which there has been only one (the University of Mississippi) for more than 50+ years. (In May 2021, the agency announced that it had reached agreements with a handful of third-party applicants to allow them to grow cannabis for use in federally approved clinical trials. However, the US National Institute on Drug Abuse has yet to officially partner with any of these entities and there is no explicit timeline as to when they will do so.) Scientists have long complained that the quality of cannabis provided by the University of Mississippi's cultivation program is of inferior quality and that it is not representative of the products available in state-legal markets.
Last month, members of the US House of Representatives voted in favor of legislation, "The Medical Marijuana and Cannabidiol Research Expansion Act," to facilitate cannabis-specific scientific research and potential drug development. That language is anticipated to be fast-tracked to the President's desk. However, it does not authorize scientists to access cannabis flowers and other products manufactured in accordance with state-approved marijuana programs.
"This proposed legislation is long overdue," NORML's Deputy Director Paul Armentano said. "It seeks to address knowledge gaps by providing dedicated funding so that scientists can better understand the safety and efficacy of real-world products - products that are currently being consumed by patients and by others daily in the majority of states in America."
Despite federal hurdles, scientific interest and studies involving cannabis have increased significantly over the past two decades. Since 2010, scientists in the US and around the world have published an estimated 30,000 peer-reviewed papers referencing the cannabis plant or its constituents, with the annual number of total papers increasing every year. By comparison, researchers published fewer than 3,000 total papers about marijuana in the years between 1990 and 1999 and fewer than 2,000 total studies during the 1980s.
Study: Medical Cannabis Associated with Pain Mitigation, Reduced Reliance on Opioids in Patients with Advanced Cancer
Syracuse, NY: Patients with advanced cancer respond favorably to medical cannabis, according to data published in the journal Cureus.
Investigators affiliated with Upstate University Hospital in Syracuse, New York evaluated cancer patients' use of cannabis for palliative purposes. All of the participants in the trial were enrolled in the state's medical cannabis registry.
Consistent with prior data, the majority of subjects (85 percent) reported symptom improvements following their use of cannabis - with nearly half reporting reductions in their pain. Also consistent with prior studies, a significant percentage (45 percent) of subjects reported decreasing their use of opioid pain medications. Very few participants (less than four percent) experienced adverse effects from their use of medical cannabis products.
"Medical marijuana appears to have an important role in the palliation of symptoms in advanced cancers with few adverse effects," authors concluded. "Prospective studies examining this treatment modality should be prioritized."
Full text of the study, "Experience with medical marijuana for cancer patients in the palliative setting," appears in Cureus.
Survey: Middle-Aged Women Frequently Report Cannabis Use to Mitigate Menopause Symptoms
Belmont, MA: Many middle-aged women acknowledge consuming cannabis products to alleviate menopause-related symptoms, according to survey data published in the journal Menopause.
A team of researchers affiliated with McLean Hospital and with Harvard Medical School in Boston surveyed 258 women (median age: 51 years old) regarding their use of cannabis.
The majority of respondents (79 percent) said that cannabis effectively treats menopause-related symptoms. Women were most likely to report using cannabis to alleviate sleep disturbances and to regulate mood. Respondents were most likely to report consuming cannabis via smoking.
"The current study indicates that many individuals are currently using commercially available MC [medical cannabis] products as an adjunct treatment for menopause-related symptoms. ... The most commonly reported indications for MC use were menopause-related disturbance of sleep and mood/anxiety, indicating these symptoms may be salient targets for future clinical trials of cannabinoid-based therapies," authors concluded. "Future research should continue to examine MC use for menopause-related symptoms, including assessing how unique cannabinoid profiles, modes of use, and other MC use characteristics impact safety and efficacy."
Previous surveys, such as those here and here, have estimated that one-third of women consume cannabis for purposes of managing menopause-related symptoms.
Full text of the study, "A survey of medical cannabis use during peri-menopause and post-menopause," appears in Menopause.
Massachusetts: Lawmakers Advance Legislation Creating 'Social Equity Trust Fund,' Facilitating Licensing of On-Site Consumption Lounges
Boston, MA: House and Senate lawmakers have advanced legislation (S. 3096) which seeks to promote greater diversity among those participating in the state's licensed cannabis industry and that lays the groundwork for the establishment of on-site cannabis consumption facilities.
Specifically, the measure creates a "Cannabis Social Equity Trust Fund to encourage the full participation ... of entrepreneurs from communities that have been disproportionately harmed by marijuana prohibition and enforcement." Money in the fund "shall be used to make grants and loans, including no-interest loans and forgivable loans, to social equity program participants and economic empowerment priority applicants."
In addition, the bill provides guidance for the eventual licensing of on-site adult-use consumption facilities. It also calls on state officials to conduct a study and to make recommendations "to ensure that students have access to [the] medical use of marijuana" while they attend school.
To date, only a handful of states - including Alaska and Nevada - have allowances for social consumption facilities. By contrast, many states now provide allowances for qualified students to access cannabis products while on school grounds.
The bill now awaits action from Republican Gov. Charlie Baker, who reportedly favors the bill and is expected to sign it into law.
