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Marijuana Reform Advocates in Multiple States Turn in Signatures for 2022 Initiative Campaigns

Tulsa, OK: Cannabis reform advocates in four states - Arkansas, Nebraska, Oklahoma, and North Dakota - have recently submitted signatures to election officials to place legalization proposals on the 2022 ballot.

Last Wednesday, representatives with the group Oklahomans for Sensible Marijuana Laws announced that they had turned in over 164,000 signatures to the Secretary of State's office in an effort to place a binding, statewide marijuana legalization initiative (State Question 820) on the November ballot. That total is well above the number of signatures necessary (94,911) to qualify for the 2022 ballot.

The proposed measure seeks to permit adults to legally possess and home-cultivate personal use qualities of cannabis while also establishing a licensed, retail marketplace. Those with past marijuana convictions, or those who are currently incarcerated for certain cannabis-related crimes, would be able to petition the courts for either record expungement or re-sentencing consideration.

On Friday, the group Responsible Growth Arkansas submitted just over 190,000 signatures to the Secretary of State's office to place the Arkansas Adult Use Cannabis Amendment on the November ballot. The constitutional amendment seeks to establish a state-licensed retail cannabis market for those age 21 and older. It also seeks to expand the state's existing medical cannabis access program by increasing the total number of licensed dispensaries and by eliminating certain taxes. Advocates need just over 89,000 valid signatures to qualify the measure for the ballot.

Also on Friday, the group Nebraskans for Medical Marijuana turned in over 90,000 signatures each for a pair of medical cannabis legalization measures - just above the roughly 87,000 necessary to qualify them for the November ballot.

Finally, on Monday, representatives with the group New Approach ND announced that they had turned in 25,762 signatures to Secretary of State's office. That total is roughly 10,000 signatures above the number of signatures necessary (15,582) to qualify it for the 2022 ballot. The proposed measure permits adults to legally possess and home-cultivate personal use qualities of cannabis while also establishing a licensed retail marketplace.

Legalization measures in South Dakota and Maryland have already been confirmed for ballot placement in their respective states. In May, the group Legal Missouri 2022 turned in more than 385,000 signatures to state officials - more than double the total (171,592) necessary to place a constitutional amendment on the ballot legalizing marijuana.

Survey: Cannabis Effective at Mitigating Musculoskeletal Pain

San Juan, Puerto Rico: Patients suffering from musculoskeletal pain disorders report obtaining significant relief following their use of medical cannabis products, according to data published in the Journal of the American Academy of Orthopedic Surgeons.

A team of Puerto Rican investigators surveyed 184 patients with chronic pain conditions regarding their use of medical cannabis. (Lawmakers legalized patient access to certain cannabis preparations in 2015.)

Respondents suffering specifically from musculoskeletal conditions reported an average reduction of 4.47 points on the Numeric Rating Scale following cannabis administration. Eighty-nine percent of survey participants said that cannabis was "more effective" than opioids for pain management - a finding that is consistent with other studies.

Authors concluded: "This study showed that the use of medical cannabis among patients with musculoskeletal conditions effectively reduced pain levels based on their NRS reported scores. In addition, most patients using medical cannabis considered that this drug represents a better option than narcotics (e.g., opioids) for adequate pain management. Additional studies on medical cannabis should evaluate whether the experience and perspective presented through this study could translate into satisfactory and consistent clinical outcomes."

Survey data from 2020 estimated that one in five Canadian patients battling musculoskeletal disorders used cannabis to ease their pain. Among pain patients enrolled in medical cannabis access programs, most subjects report decreasing or even eliminating their use of opiates.

Full text of the study, "Patient experience and perspective on medical cannabis as an alternative for musculoskeletal pain management," appears in the Journal of the American Academy of Orthopedic Surgeons.

Study: Subjects Perceive Decreased Fatigue Following Cannabis Smoking

Albuquerque, NM: The inhalation of cannabis is associated with perceived decreases in fatigue, according to data published in the journal Medical Cannabis and Cannabinoids.

A team of researchers affiliated with the University of New Mexico assessed the effects of smoked cannabis on fatigue intensity levels in 3,922 subjects over a 3+ year period. Study participants self-administered cannabis at home and reported symptom changes in real time on a mobile software application.

"On average, 91.94 percent of people experienced decreased fatigue following consumption with an average symptom intensity reduction of 3.48 points on a zero-to-10 visual analog scale," investigators reported. They added: "While labeled plant phenotypes (‘C. indica,' ‘C. sativa,' or ‘hybrid') did not differ in symptom relief, people that used joints to combust the flower reported greater symptom relief than pipe or vaporizer users. Across cannabinoid levels, tetrahydrocannabinol, and cannabidiol levels were generally not associated with changes in symptom intensity levels."

They concluded: "Using the largest database of real-time effects of cannabis usage in the USA, we found that combusting whole, dried cannabis flower has a generally fast-acting and energetic effect for the majority of people that have symptoms of fatigue. While some user sessions resulted in increased fatigue or fatigue-related side-effect experiences, the vast majority of people reported an overall decrease in their perceived fatigue intensity levels. … Future research would benefit from investigating real-time effects of cannabis usage on behavioral and mental fatigue under altered bodily states and how different phytochemicals in the cannabis plant aggregate and/or interact in its mental and physical effects in healthy people and clinical populations."

Using similar methods, UNM researchers have previously reported that cannabis exposure is associated with real-time reductions in migraine symptoms, pain intensity, stress, depressive symptoms, and nausea, among other symptoms.

Full text of the study, "The effect of consuming cannabis flower for treatment of fatigue," appears in Medical Cannabis and Cannabinoids.

Case Report: Low Doses of THC-Rich Cannabis Extracts Show "Encouraging" Results in Patient with Alzheimer's

Foz do Iguaçu, Brazil: Cannabis microdosing is associated with cognitive and behavioral improvements in a patient with mnemonic and non-mnemonic Alzheimer's disease (AD) symptoms, according to a case report published in the Journal of Medical Case Reports.

An international team of investigators affiliated with The Federal University for Latin American Integration in Brazil and with John Hopkins University in Baltimore reported on the experimental treatment of THC-rich extracts in a 75-year-old male patient with mild-stage Alzheimer's disease. The patient had been diagnosed with AD two-years prior to his use of cannabis.

Extracts used in the trial contained an 8-to-1 ratio of THC to CBD. The patient receiving the intervention used the extracts daily for 22 months. The subject's daily dosage never exceeded 1 mg of THC per day.

Investigators reported that the patient exhibited "rapid" and "robust" symptom amelioration following his use of low doses of THC-rich extracts. Specifically, they reported, "[C]ognitive and memory enhancement lasted for more than one year following the start of treatment and remained stable while we progressively evaluate/follow up with the patient, for more than one year after the official report ended." Authors also reported improvements in the subject's quality of life and in behavioral issues, including a reduction in mood swings and aggressiveness. Follow up evaluations identified no evidence of cannabis-related toxicity or significant side effects.

They concluded: "Our results are unprecedented and very encouraging. … In summary, data presented in this case report suggest that cannabinoid microdosing is a potential therapeutic for AD, with no significant side effects, although placebo-controlled clinical trials are needed to confirm and extend these data."

Prior studies and case reports assessing the use of THC in Alzheimer's disease patients have similarly reported improvements in AD symptoms, such as reduced agitation and improved sleep, following cannabinoid dosing.

Full text of the study, "Cannabinoid extract in microdoses ameliorates mnemonic and non-mnemonic Alzheimer's disease symptoms: A case report," appears in the Journal of Medical Case Reports.

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Study: Cannabis Use Not Predictive of Lack of Motivation

Corvallis, OR: Frequent cannabis use is not associated with motivation loss in adults, according to data published in the Journal of Clinical and Experimental Neuropsychology.

A team of researchers affiliated with Oregon State University assessed motivation and self-reported apathy in a cohort of regular (three times per week or more) cannabis users and controls (non-users).

Investigators identified no significant group differences in self-reported apathy after controlling for covariates (recent alcohol consumption and depressive symptoms).

Authors did report that cannabis consumers were more likely than non-users to "exert more [effort] for reward, suggesting enhanced motivation relative to healthy controls." Specifically, as reward magnitude increased, frequent cannabis users were more likely to select harder trials to complete than were controls.

Consistent with prior studies, they concluded: "The current findings do not support [the theory of] a-motivational syndrome in cannabis users; rather cannabis users displayed higher-effort decision-making in comparison to controls. ... Given the limited number of studies within the field, future research should continue using both self-report and task-based methodologies to assess motivation in cannabis users, while controlling for potential covariates, such as depression, substance use, and personality factors."

Full text of the study, "Effort-based decision making and self-reported apathy in frequent cannabis users and healthy controls: A replication and extension," appears in theJournal of Clinical and Experimental Neuropsychology.

Survey: Patients with Parkinson's Disease Report Symptomatic Relief from Cannabis

Bergen, Norway: Patients with Parkinson's disease (PD) often report symptomatic benefits from the use of cannabis, according to survey data published in the journal Acta Neurologica Scandinavica.

Norwegian investigators surveyed cannabis use patterns and related attitudes among PD patients. Consistent with prior surveys, they reported that a significant minority of PD patients consume cannabis for symptom relief. Respondents were most likely to report improvements in motor function, sleep, and pain as a result of their marijuana use.

Observational trial data has determined that cannabis inhalation is associated with improvements in tremor, rigidity, pain, sleep, and bradykinesia (slowness of movement) in patients with PD. Placebo-controlled trial data has also determined that acute CBD administration (300mg) is associated with a statistically significant reduction in experimentally-induced anxiety and tremor in PD patients.

Full text of the study, "Cannabis use in Parkinson's disease: A nationwide online survey," appears inActa Neurologica Scandinavica.

Clinical Trial: CBD Administration Ineffective for Restless Legs Syndrome

Manaus, Brazil: The administration of oral doses of CBD is ineffective at reducing the severity of restless legs syndrome (RLS) in patients with Parkinson's disease (PD) and REM sleep behavior disorder (RBD), according to clinical trial data published in the journal Cannabis and Cannabinoid Research.

Brazilian researchers compared the use of CBD versus a placebo over a 14-week period. Patients in the CBD arm of the trial received up to 300mgs of cannabidiol.

Patients who were administered CBD demonstrated no improvements compared to those receiving placebo.

"CBD showed no reduction in the severity of RLS manifestations in patients with PD and RBD," authors concluded.

By contrast, a series of case reports pub lished in 2020 and in 2017 reported that cannabis inhalation is associated with perceived efficacy in patients with refractory restless legs syndrome.

Full text of the study, "Cannabidiol for restless legs syndrome/Willis-Ekbom disease in Parkinson's disease patients with REM sleep behavior disorder: A post hoc exploratory analysis of a phase 2/3 clinical trial," appears in Cannabis and Cannabinoid Research.

California: Governor Signs Legislation Reducing Cannabis Tax Burden

Sacramento, CA: Democratic Gov. Gavin Newsom signed budget legislation late last week that reduces various marijuana-specific taxes.

Specifically, the legislation eliminates the cultivation tax on licensed growers and caps any further increase in the excise tax for three years, among other changes.

According to an economic analysis published this spring by The Reason Foundation, regulatory costs, high taxes, and municipal bans on cannabis retailers have significantly inhibited the growth of the licensed marijuana marketplace in California. The analysis estimated that California imposes an effective tax rate of as much as $92 per ounce. This amount is higher than the tax burden imposed on retail cannabis transactions in other states.

California NORML Director Dale Gieringer, who authored the study's forward, recommended at that time that lawmakers impose "substantive tax cuts" in order to "reduce demand for the illicit market, while still retaining reasonable revenues" for state-licensed retailers. Following last week's bill signing, he added, "The budget bill is a helpful start, but much more needs to be done to make legal cannabis more readily accessible to consumers who now rely on the unregulated market."

District of Columbia: Mayor Signs Legislation Allowing Adults Access to Medical Cannabis Dispensaries Following 'Self-Certification' Process

Washington, DC: Mayor Muriel Bowser has signed legislation legislation removing the requirement that adults seeking to purchase cannabis products from licensed DC medical cannabis dispensaries must obtain a recommendation from a licensed physician. Members of the DC City Council had previously voted unanimously in favor of legislation, known as the Medical Marijuana Self-Certification Emergency Amendment Act of 2022.

The measure permits individuals age 21 or older to "self-certify ... that they are utilizing cannabis for medical purposes" when they register with local regulators for a medical cannabis identification card. Once registered, self-certified adults may access any of the District's seven licensed medical cannabis dispensaries.

Councilmembers Mary Cheh and Kenyan McDuffie, who sponsored the measured, said that the legislation is needed to dissuade residents from patronizing the unregulated marketplace. "Due to the lower barriers to access in the gray market, a significant number of medical marijuana patients have shifted from purchasing their medical marijuana from legal medical dispensaries to the illicit gray market, creating a significant risk to the long-term viability of the District's legal medical marijuana industry," they said. "If this trend continues, it is possible that gray market sales could wipe out the District's legal marijuana dispensaries. Given the... benefits that regulated and safe legal dispensaries provide to medical marijuana users in the District, it is vital that the industry survive until the District can stand up a regulated recreational market and transition toward full regulation of recreational marijuana products."

Under District law, adults may possess and home-cultivate limited amounts of cannabis for their own personal use. However, Congressional action has prohibited the City Council from passing municipal legislation to provide adults with retail cannabis access.

Because the self-certification bill was enacted as "emergency legislation," it is not subject to Congressional review.

In June, DC Councilmembers passed separate legislation, the Cannabis Employment Protections Amendment Act of 2022, protecting those who use cannabis from facing discrimination in the workplace. That bill currently awaits action by the mayor.

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