Tag: Weed Connection

Analysis: Medical Cannabis Products Provide Sustained Improvements in Patients With Chronic Pain, Anxiety, and Depression

Toronto, Canada: Patients authorized to use medical cannabis products experience sustained improvements in their pain, anxiety, depression, and quality of life, according to observational data published in the Canadian Journal of Pain.

Researchers assessed the real-world effectiveness of cannabis products in a cohort of 139 Canadian patients authorized to use medical cannabis. (Nearly 200,000 Canadians are currently registered in Canada’s medical cannabis access program.) Patients’ symptoms were assessed at baseline, 6, 12, and 24 weeks.

Consistent with other long-term observational studies, patients experienced notable improvements in their pain, anxiety, depression, sleep duration, and quality of life. These improvements were maintained throughout the duration of the study. Few, if any, significant adverse events were associated with cannabis treatment.

The study’s authors concluded: “Patients in the study had improved scores with respect to a reduction in pain and pain-related disability, anxiety, depression, sleep, and overall quality of life. Often, the benefits of MC [medical cannabis] were maintained long-term into Week 24. Further data from the … study may offer additional insights into the usage of medical cannabis products and their potential benefits in the general population and inform dosing for future clinical trials focused on cohorts with specific medical conditions or indications.”

According to a recently published meta-analysis of 64 studies, most patients consuming medical cannabis products experience sustained improvements in their health-related quality of life. “Improvements [are] observed across multiple health conditions over short-, medium- and long-term follow-up,” researchers determined.

Full text of the study, “Canadian real-world evidence: Observational 24-week outcomes for health care practitioner authorized cannabis,” appears in the Canadian Journal of Pain.

Study: Retail Cannabis Access Associated With Decline in Suicides Among Older Adults

Atlanta, GA: The opening of state-licensed adult-use cannabis retailers is associated with fewer suicides among mid-life and older adults, according to data published by the National Bureau of Economic Research.

Researchers affiliated with Emory University assessed the relationship between adult-use marijuana legalization and suicide rates. They determined: “Suicide rates among adults aged 45 and older decline following the opening of recreational marijuana dispensaries, while there is no effect among those ages 25-44. … These results hold when controlling for other state-level factors such as beer and cigarette taxes, opioid policies, unemployment rates, poverty, and income, none of which show significant impacts on suicide rates in this demographic. … These findings are important because of the implication that access to recreational marijuana has palliative effects among older populations which manifest in lower suicide rates.”

The study’s authors concluded: “These findings contribute to the growing body of literature on the public health impacts of marijuana legalization, offering evidence that recreational dispensary openings may play a role in reducing suicides among older adults, particularly in vulnerable subgroups. Although further research is needed to explore the underlying mechanisms driving these effects, these results point to one potential benefit of legalized recreational marijuana.”

Full text of the study, “Marijuana legalization and suicides among older adults,” is available from the National Bureau of Economic Research.

Ohio: Attorney General Certifies Proposed Referendum Challenging Marijuana Recriminalization Law

Columbus, OH: The state’s Attorney General has authorized petitioners to begin collecting signatures in favor of a proposed referendum challenging a GOP-backed law recriminalizing certain marijuana-related activities.

In December, Republican Gov. Mike DeWine signed SB 56 into law. The law amends and repeals various provisions of Ohio’s voter-approved adult-use legalization law. Among the more significant changes, it criminalizes possessing marijuana products obtained from out-of-state, including products legally purchased at licensed dispensaries in neighboring jurisdictions. It also repeals provisions 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 (such as the denial of parental rights or certain hospital procedures, such as organ transplants).

Other provisions in the law impose new criminal sanctions upon those who either possess or transport certain cannabis products if they are not in their original, unopened packaging and restrict the retail sale of hemp-derived products, including beverages, solely to state-licensed dispensaries.

Following the passage of SB 56, business owners and other advocates formed the group Ohioans for Cannabis Choice, which is pushing back against the new restrictions. The AG’s office rejected a prior petition submitted by the group due to potentially “misleading” language. By contrast, other statewide cannabis interest groups have expressed opposition to the referendum.

Organizers need to collect approximately 250,000 signatures from Ohio voters to place the referendum before voters in November.

A summary of SB 56’s revisions to Ohio’s adult-use marijuana legalization and hemp laws is available from Ohio State University.

Review: THC Concentrations Are “Unreliable” Indicators of Driving Impairment

Providence, RI: The detection of THC in biological fluids is not predictive of psychomotor impairment, according to a literature review published in the journal Current Addiction Reports.

Researchers at Brown University affirmed: “There are no reliable or practical biochemical or behavioral methods used in real-time with drivers on the road to determine cannabis-induced impairment. … Many studies have found weak or non-existent correlations between THC concentrations in blood, oral fluid, or breath and actual driving performance or impairment.”

That finding is consistent with the opinions of numerous scientists and traffic safety groups, including the National Highway Traffic Safety Administration and the American Automobile Association.

The study’s authors concluded: “These findings collectively underscore that THC concentrations in common biofluids (e.g., blood and saliva) and exhaled breath are unreliable as sole indicators of current driving impairment. … There are no empirically supported thresholds for blood or oral fluids that reliably indicate cannabis impairment.”

Nonetheless, several states impose per se limits for motorists who are determined to have trace levels of THC in their blood or other bodily fluids. (These laws criminalize operating a motor vehicle with detectable quantities of THC or its metabolites, even absent evidence of driving impairment.) Several studies have determined that subjects may continue to test positive for traces of THC in their blood and oral fluids for days post-abstinence.

NORML has long opposed the imposition of per se THC limits for motorists and has alternatively called for the expanded use of mobile performance technology like DRUID. In a peer-reviewed paper published by the Humboldt Journal of Social Relations, NORML’s Deputy Director Paul Armentano wrote: “The sole presence of THC and/or its metabolites in blood, particularly at low levels, is an inconsistent and largely inappropriate indicator of psychomotor impairment in cannabis consuming subjects. … Lawmakers would be advised to consider alternative legislative approaches to address concerns over DUI cannabis behavior that do not rely solely on the presence of THC or its metabolites in blood or urine as determinants of guilt in a court of law. Otherwise, the imposition of traffic safety laws may inadvertently become a criminal mechanism for law enforcement and prosecutors to punish those who have engaged in legally protected behavior and who have not posed any actionable traffic safety threat.”

Full text of the study, “Recent advances in the science of cannabis-impaired driving,” appears in Current Addiction Reports.

Analysis: In Utero Cannabis Exposure Not Associated With Later Developmental Delays

Chapel Hill, NC: Infants exposed to cannabis in utero are no more likely to require emergency department care or suffer from developmental delays than non-exposed children, according to data published in the journal Academic Pediatrics.

Investigators affiliated with the University of North Carolina at Chapel Hill examined the relationship between in utero cannabis exposure and infants’ health care utilization and developmental outcomes.

“Compared to those unexposed, … children who were exposed to cannabis in utero have similar WCC [well child care] attendance and ED [emergency department] use over the first 2 years and similar developmental outcomes at 3 years,” researchers reported.

The authors acknowledged that their results were consistent with those of other studies, finding no differences in ED visits or developmental delays among cannabis-exposed and cannabis-unexposed children.

Although many studies have associated in utero cannabis exposure with low birth weight, longitudinal studies following in utero-exposed infants to adulthood have generally failed to identify “any long-term or long lasting meaningful differences” in their neurodevelopment.

Full text of the study, “Health care utilization and developmental delay among infants exposed to cannabis in utero,” appears in Academic Pediatrics.

California: Supreme Court Rules Police Can’t Search Vehicles Based on “Weed Crumbs”

Sacramento, CA: Police may neither charge a motorist with violating California’s “open container law” nor search a person’s vehicle solely upon the identification of a small quantity of marijuana “crumbs” on the floorboards, according to a ruling handed down by the state’s Supreme Court.

In a unanimous opinion, the Justices determined that the state’s “open container” law should not be applied so broadly as to pertain to situations where police find “any loose marijuana” in a motor vehicle. Rather, the court decided that the marijuana “must be of a usable quantity, in imminently usable condition, and readily accessible to an occupant” to constitute a violation of the state’s “open container” law.

The Court further determined that a police officer’s identification of “weed crumbs” does not provide probable cause for a warrantless vehicle search. They ruled, “The marijuana-related conduct here – possession of the rolling tray on the backseat and the crumbs on the floor [totaling 0.36 grams] – was lawful and alone was insufficient to find probable cause of a violation of California’s controlled substances law.”

The Supreme Court’s ruling reverses the decision of the California Court of Appeals, which had previously granted police the authority to search the defendant’s vehicle based upon a finding of probable cause.

The case is Sellers v. The Superior Court of Sacramento County.

Oklahoma: Governor Says State’s Medical Marijuana Program a “Pandora’s Box,” Calls for It To Be “Shut Down”

Oklahoma City, OK: Republican Gov. Kevin Stitt says that the state’s voter-approved medical cannabis access law “opened a Pandora’s Box” and should be repealed.

Speaking Monday during his State of the State address, the Governor said: “This industry is plagued by foreign criminal interests and bad actors, making it nearly impossible to rein in. We can’t put a Band-aid on a broken bone. Knowing what we know, it’s time to let Oklahomans bring safety and sanity back to their neighborhoods. Send the marijuana issue back to the vote of the people and shut it down.”

On Tuesday, the state’s Attorney General similarly said that he would like to see the medical cannabis industry “gone.”

Fifty-seven percent of Oklahomans approved a ballot initiative in 2018 legalizing the production and dispensing of cannabis for authorized patients. Approximately 320,000 Oklahomans are currently registered with the state to access medical cannabis products.

Despite the Governor’s claims of foreign involvement in the state’s medical cannabis industry, DEA statistics published last year reported interdicting only 15 Chinese-affiliated illegal marijuana grow operations nationwide.

Since 2022, Oklahoma lawmakers have imposed a moratorium prohibiting regulators from issuing licenses for any new medical cannabis dispensaries, processors, or commercial growers. Approximately 1,450 dispensaries are currently licensed in the state.

Earlier this year, representatives from the Oklahoma Bureau of Narcotics publicly alleged that nearly half of the marijuana sold illegally in the United States originates from the state. However, other state agencies said that they had no data to substantiate those claims.

Florida: DeSantis Administration Says Marijuana Legalization Won’t Appear on November’s Ballot, Petitioners Say Otherwise

Tallahassee, FL: Election officials and the state’s Attorney General announced this week that petitioners behind a proposed ballot initiative legalizing adult-use retail marijuana sales had failed to gather the requisite number of signatures to qualify it for the November ballot. But representatives with the campaign are challenging the state’s count and have called the administration’s declaration “premature.”

According to a campaign spokesperson, representatives from the Smart & Safe Florida campaign submitted over 1.4 million signatures from Florida voters – far more than the 880,062 signatures necessary. To date, however, election officials have verified fewer than 784,000 total signatures.

Specifically, the campaign is challenging the state’s dismissal of at least 98,000 signatures, which, if determined valid, would be sufficient to qualify it for this year’s ballot.

Petitioners qualified a similar measure on the 2024 ballot. That proposal gained 56 percent of the vote, just shy of the 60 percent threshold required to pass a constitutional amendment in Florida. (Florida is the only state that requires citizen-initiated measures to gain more than a simple majority.)

The DeSantis administration has vigorously opposed both efforts. In May, Gov. DeSantis signed legislation making it harder for parties to qualify measures for the electoral ballot. Last month, state election officials audited the work of several counties, which they alleged had not properly verified voters’ signatures. Most recently, the state launched a criminal probe to investigate the actions of various petitioners involved with the Smart & Safer campaign. Separately, the Attorney General’s office had previously challenged the wording of the proposed measure in court, calling it “unconstitutional.”

Historically, Florida has been among the states with the highest number of annual marijuana-related arrests. Under state law, possession of 20 grams or less of marijuana is a criminal misdemeanor, punishable by up to one year in jail and a $1,000 fine. Possessing greater amounts is a felony offense, punishable by up to five years in prison.

Additional information is available from Smart & Safe Florida.

Analysis: Marijuana Access Associated With “Striking” Decline in Daily Opioid Use by IV Drug Consumers

Boston, MA: Adult-use marijuana legalization markets are associated with significant declines in non-medical opioid use among people who inject drugs (PWID), according to data published in the journal Drug and Alcohol Dependence.

Researchers affiliated with Boston University’s School of Public Health and Emory University evaluated trends in non-prescription opioid use among PWIDs in 13 states following marijuana legalization.

Investigators identified “striking” declines in the prevalence of daily opioid use post-legalization. “Notably, the magnitude of this decline was equivalent across all racial and ethnic groups and for males and females,” investigators reported.

The study’s authors concluded, “Our findings suggest that ongoing efforts to reduce regulatory barriers and legal and criminal consequences of cannabis use via RCL+MCLs [recreational cannabis legalization and medical cannabis legalization] may have the potential to help reduce overdoses and other opioid-related harms among PWID.”

Previous studies have reported that cannabis can reduce cravings and mitigate withdrawal symptoms in opioid-dependent subjects. Data from Canada finds that people who inject opioids are more likely to cease their behavior if they regularly consume cannabis.

Full text of the study, “Cannabis legalization and cannabis and opioid use in a large, multistate sample of people who inject drugs: A staggered adoption difference-in-differences analysis,” appears in Drug and Alcohol Dependence.

Study: Cannabis Formulations Associated With Reduced Pain, Improved Quality of Life in Endometriosis Patients

Wellington, New Zealand: Endometriosis patients experience decreased pain and improvements to their health-related quality of life following the medically authorized use of standardized cannabis formulations, according to observational data published in the journal BMJ Complementary Medicine and Therapies.

New Zealand investigators assessed the safety and efficacy of cannabis products in a cohort of 28 patients with endometriosis. (Medically authorized access to cannabis products is legal in New Zealand.) Study participants consumed either CBD-dominant oil extracts or CBD in combination with herbal cannabis for three months as an adjunct to their standard medications. Study subjects possessed no history of recent cannabis use before enrolling in the study.

Consistent with prior studies, cannabis therapy was associated with less pain and improved health-related quality of life.

“There was a difference between pain scores for week 1 compared to week 12 with a decrease in ‘overall’ pain from 5.46 to 3.77 and ‘worst’ pain from 7.62 to 5.38,” researchers reported. “Across the whole cohort, there was a substantial decrease in mean total EHP-30 [the Endometriosis Health Profile 30 standardized questionnaire] score from 68.77 at baseline to 37.40 after 3 months which indicates improved quality of life.”

The study’s authors concluded, “Our findings suggest that usage of medicinal cannabis had limited adverse events and resulted in a decrease in pain and improved quality of life over a 12-week period.”

Endometriosis patients enrolled in the United Kingdom’s Medical Cannabis Registry similarly report that the long-term use of cannabis preparations provides sustained symptomatic relief. In surveys, patients with endometriosis frequently acknowledge cannabis to be more effective at treating their symptoms than traditional pharmaceuticals.

Full text of the study, “Perceived impact of medicinal cannabis on pelvic pain and endometriosis related symptoms in Aotearoa New Zealand: An observational cohort study,” appears in BMJ Complementary Medicine and Therapies.

Analysis: Aggregate Harms Associated With Use of Alcohol, Tobacco Far Outweigh Cannabis-Related Risks

Toronto, Canada: The use of alcohol and tobacco causes far greater overall harms to both individual consumers and to society than does cannabis, according to a scientific analysis published in the Journal of Psychopharmacology.

An international working group of experts assessed the aggregate harms associated with the use of sixteen psychoactive substances, including alcohol, tobacco, cannabis, opioids, benzodiazepines, and methamphetamine. Substances were scored based upon the likelihood that their use causes specific harms to the user (e.g., mortality risk, physical or mental health damage, dependence, etc.) and/or to others (e.g., environmental damage, economic loss, motor vehicle injuries, etc.).

Experts ranked alcohol as the substance associated with the greatest overall harm, followed by tobacco, non-prescription opioids, cocaine, and methamphetamine.

The finding is consistent with those of other international expert panels, including those conducted in Australia, the European Union, New Zealand, and the United Kingdom, which all rank alcohol as the drug responsible for the greatest amount of overall harm. Similarly, a 2024 US study published in the Journal of Studies on Alcohol and Drugs determined that “secondhand harms from others’ alcohol use were substantially more prevalent than those from others’ use of any other drug.” A more recent evaluation in the United States ranked only fentanyl, methamphetamine, crack, and heroin above alcohol in terms of potential harm.

Full text of the study, “Drug harms in Canada: A multi-criteria decision analysis,” appears in the Journal of Psychopharmacology.

Massachusetts: Commissioners Reject Claims That Petitioners Fraudulently Obtained Signatures for Marijuana Repeal Effort

Boston, MA: Representatives of the State Ballot Law Commission are allowing an anti-marijuana initiative effort to move forward despite claims that signature gatherers misled some voters into signing the petition.

Last week, commissioners dismissed the complaint, finding that there was insufficient evidence to substantiate widespread fraud. To prevail in the case, proponents needed to establish that nearly 4,000 voters had been misled to sign the petition.

The initiative, entitled ‘An Act to Restore a Sensible Marijuana Policy,’ seeks to repeal Massachusetts laws permitting adults to home-cultivate marijuana and regulating the adult-use retail cannabis market. Those laws were enacted by voters in 2016. Prohibition groups are funding ballot efforts in three states – Arizona, Maine, and Massachusetts – to repeal voter-initiated adult-use legalization laws.

The commission’s decision came despite polling data indicating that a large percentage of Massachusetts’ voters say they would have refused to sign the initiative petition had they better understood its intentions. Voters in Maine have made similar allegations. However, state officials there have responded that canvassers’ misrepresentation of their efforts is First Amendment-protected speech.

Survey: Most Primary Care Physicians Say They Are “Not Comfortable” Counseling Patients About Medical Cannabis

La Jolla, CA: Most primary care physicians are unwilling to answer their patients’ questions about medical cannabis, according to survey data published in the Journal of the American Geriatrics Society.

Investigators affiliated with the University of California at San Diego surveyed a cohort of internal medicine and family medicine physicians from San Diego, California.

Respondents said that their patients frequently inquire about medical cannabis use, but most acknowledged “not feeling competent” discussing the issue – a finding that is consistent with other studies.

Researchers reported: “Primary care physicians are asked about cannabis for therapeutic purposes by patients of all ages, but few are prepared to provide advice. … Physicians were generally not comfortable counseling patients of any age about cannabis use due to limited training and an incomplete evidence base. Some shifted responsibility to the patient, urging them to use cannabis ‘at their own risk,’ or referring to experts in specialty clinics or cannabis dispensary workers.”

While over two-thirds of health care practitioners nationwide acknowledge that cannabis possesses medical utility, most refuse to speak to their patients about it, and many say that they do not receive adequate medical training on cannabis-related issues.

Full text of the study, “Exploring physicians’ perspectives on cannabis use for therapeutic purposes with a focus on older versus younger adults,” appears in the Journal of the American Geriatrics Society.

Clinical Trial: Short-Term CBD Dosing Not Associated With Liver Abnormalities

Brisbane, Australia: The use of CBD-dominant medical cannabis products by cancer patients is not associated with liver damage, including the elevated production of the alanine aminotransferase (ALT) enzyme, according to clinical trial data published in the journal BMJ Supportive & Palliative Care.

Australian researchers assessed the potential impact of daily CBD administration (up to 600 mg per day) on liver health in a cohort of 287 patients with advanced cancer. (Australian law permits physicians to authorize cannabis products to patients unresponsive to conventional prescription treatments.) Investigators measured patients’ ALT and aspartate aminotransferase (AST) levels at baseline, day 14, and day 28. (High levels of these enzymes in blood signals liver cell damage or disease.)

They reported no significant elevations in patients’ ALT and AST levels over the duration of the study. “Medicinal cannabis products did not have a significant adverse impact on ALT or AST levels,” the study’s authors concluded.

Prior studies assessing the influence of CBD on liver health have yielded inconsistent results. While studies involving healthy volunteers have typically failed to demonstrate an association between short-term CBD dosing and elevated liver enzymes, other studies of certain higher-risk patient populations – such as those with kidney failure – have shown minor increases in liver enzyme production, though the clinical significance of these changes remains unclear.

Full text of the study, “Liver enzyme effects of medicinal cannabis in advanced cancer: A sub-study of two randomized trials,” appears in BMJ Supportive & Palliative Care.

Clinical Trial: Plant-Derived Cannabis Formulations Show Comparable Efficacy to Lorazepam in Insomnia Patients

Khlong Hok, Thailand: Plant-derived cannabis preparations provide comparable benefits to lorazepam in patients with chronic insomnia, according to randomized clinical trial data published in the journal Sleep Medicine.

Thai investigators compared the safety and efficacy of a pair of plant-derived cannabis preparations to the benzodiazepine lorazepam in 60 adults diagnosed with chronic insomnia. Subjects were randomly assigned to consume either lorazepam, cannabis oil extracts, or an oral pill containing cannabinoids and other traditional herbal compounds. Participants consumed the products before bedtime for four weeks.

All three interventions significantly improved subjective sleep quality as measured by the Pittsburgh Sleep Quality Index, researchers reported. However, cannabis preparations provided superior improvements in patients’ overall health-related quality of life.

“Our findings suggest that culturally rooted herbal remedies and regulated cannabis oil preparations may offer a holistic benefit profile by targeting both nocturnal symptoms and daytime well-being,” the study’s authors concluded. “Given the global push toward reducing benzodiazepine prescriptions due to safety concerns, the availability of validated herbal and cannabis-based alternatives is of high clinical value.”

Surveys find that consumers frequently report using cannabis as a sleep enhancer. In jurisdictions where cannabis products are legally available, sales of over-the-counter sleep medicines decline, as do prescription sales of opioids and benzodiazepines.

Full text of the study, “Integrative therapies for chronic insomnia: A randomized controlled trial of a traditional Thai herbal remedy and cannabis sativa oil,” appears in Sleep Medicine.

Case Studies: Cannabis Provides Sustained Improvements in Adolescents With Tourette Syndrome

Hannover, Germany: The use of plant-derived cannabis preparations is safe and clinically effective in adolescents suffering from Tourette syndrome (TS), according to the conclusions of a pair of case studies published in the journal Frontiers in Psychiatry.

German researchers reported on the long-term use of cannabis in two male adolescents with TS. Both subjects utilized cannabis formulations (either oil extracts or vaporized flower) daily for several years.

Investigators reported: “Long-term treatment with different THC-containing cannabinoids resulted not only in a constant improvement of tics, psychiatric comorbidities, and quality of life, but also did not cause severe adverse effects and in particular no psychological symptoms such as anxiety, psychosis, and substance abuse including CUD [cannabis use disorder]. Most importantly, neurocognitive test results during the course of therapy showed no evidence that the patients’ cognitive abilities had become below average. There was also no indication of behavioral abnormalities, social problems, neglection of social interests, or loss of interests, motivation, and drive. This is remarkable, since in both patients CBM [cannabis-based medicine] treatment was initiated before puberty and doses of THC were relatively high.”

The study’s authors concluded: “In both patients, CBM [cannabis-based medicine] treatment resulted in continued benefit with significant improvement of tics and psychiatric comorbidities without severe adverse effects. … Although generalizability from our case reports of two single patients is limited, we suggest [that health professionals] take treatment with THC-containing drugs into consideration in severely affected and otherwise treatment refractory children and adolescents before thinking of surgical treatment using deep brain stimulation.”

Placebo-controlled clinical trial data demonstrate that cannabinoid extracts reduce tic frequency and severity in TS, while observational studies have shown long-term benefits in TS patients who inhale cannabis flower.

Full text of the study, “Long-term use of cannabis-based medicines in two children with Tourette syndrome: A case report,” appears in Frontiers in Psychiatry.