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Analysis: Cannabis Use Not Associated With Elevated Risk of Carotid Artery Calcification

La Jolla, CA: People with a history of cannabis use do not possess higher rates of carotid artery calcification (CAC) in either middle age or older adulthood, according to data published in the journal Vascular Medicine. Carotid artery calcification is an established marker of atherosclerosis (hardening of the arteries), which is linked to an elevated risk of heart attack and stroke.

Researchers at the University of California, San Diego, assessed the relationship between cannabis smoking and CAC in a representative cohort of 2,152 subjects between 45 and 84 years old.

Consistent with other studies, investigators determined, “In [this] racially and ethnically diverse cohort of older adults with a moderately high prevalence of carotid artery calcification, there were no statistically significant associations between a history of regular cannabis smoking, duration, or recency of cannabis smoking, and the prevalence of carotid calcified plaque.”

The study’s authors concluded: “The null findings reported herein are consistent with our previous research. … If smoking cannabis increases the risk of atherosclerotic disease, one would anticipate finding consistent evidence of adverse cardiac outcomes in human research. This is not the case.”

According to data published earlier this year in the Journal of the American Heart Association, the use of either alcohol or opioids is implicated in nearly 80 percent of all cardiovascular deaths related to substance use. By comparison, a history of cannabis use is associated with fewer than one percent of all substance use-related cardiovascular deaths.

Full text of the study, “Regular cannabis smoking and carotid artery calcification in the Multi-Ethnic Study of Atherosclerosis (MESA),” appears in Vascular Medicine.

Study: Patients Report Reduced Pain, Improved Mental Health Following Medical Cannabis Treatment

Melbourne, Australia: Chronic pain patients report physical and mental health improvements following their use of medical cannabis preparations, according to observational data published in the Journal of Pain & Palliative Care Pharmacotherapy.

Australian researchers assessed the use of medical cannabis preparations in 96 chronic pain patients. (Under Australian law, physicians may only authorize cannabis products to patients unresponsive to conventional prescription treatments.) Study participants consumed cannabis formulations either high in CBD, high in THC, or containing equal ratios of both cannabinoids. Patients’ symptoms were assessed at three, six, and 12 months.

Investigators reported: “We identified clear associations between patient commencement of a prescribed medicinal cannabis product and improvements in pain, mental health and sleep difficulties, with the most pronounced therapeutic effects visible within the first six months of treatment. Furthermore, significant improvements were noted across diverse domains of symptom interference on daily functions, suggesting an improved quality of life for patients. In relation to pain management, the majority of patients exhibited a notable decline in their use of both prescription and over-the-counter pain medications. This reduction in the use of other medications is consistent with the substantial improvements in pain severity reported by most patients.”

The most frequently reported adverse events were dry mouth and sleepiness.

The study’s authors concluded: “Overall, we found that the use of medicinal cannabis was associated with reduced pain during the first six months and improved mental well-being over 12 months. … Further longitudinal and controlled studies are necessary to better understand the sustained effects of cannabis-based medications on pain and mental health.”

Similarly designed studies of patients enrolled in the United Kingdom’s medical cannabis access program have reported that medical cannabis treatment is safe and effective for those suffering from chronic pain, anxiety, post-traumatic stress, fibromyalgia, depression, migraine, multiple sclerosis, osteoarthritis, inflammatory arthritis, inflammatory bowel disease, and other afflictions.

Full text of the study, “Changes in mental health symptoms associated with prescribed medicinal cannabis use: A one-year longitudinal study,” appears in the Journal of Pain & Palliative Care Pharmacotherapy.

Study: Those With a History of Cannabis Use Are Less Likely To Use Opioids Following Lower Back Surgery

Chicago, IL: Patients with a history of cannabis use consume fewer opioids following lower back surgery as compared to matched controls, according to data published in the Asian Spine Journal.

Investigators affiliated with the Chicago Medical School and Yale University assessed opioid utilization trends in a cohort of 1,216 patients who had undergone lumbar fusion surgery. Half of the cohort had a history of cannabis consumption and half did not. Participants were tracked for six months.

“Cannabis users had lower rates of opioid utilization compared to non-cannabis users as early as two months after fusion [surgery],” researchers determined. “[This] relationship … persisted at six months.”

The study’s authors concluded: “We found that cannabis users tended to wean off opioid analgesics earlier than non-cannabis users postoperatively, offering support for the opioid-sparing effect of cannabis theory. … Knowledge of cannabis use patterns may potentially allow physicians to cater to individual needs and provide appropriate dose titration over time. This may help reduce opioid dependence and improve patient outcomes.”

Separate studies have reported that postoperative patients who self-report consuming cannabis are less likely than non-users to engage in the long-term use of prescription opioids.

Full text of the study, “Effects of cannabis use surgery on post-operative opioid utilization in lumbar fusion patients: An American retrospective study,” appears in the Asian Spine Journal.

Survey: Six Years After Legalization, Nearly Two-Thirds of Canadians Approve of the Policy Change

Ottawa, Canada: Sixty-two percent of Canadians approve of Parliament’s 2018 decision to legalize cannabis use and retail sales nationwide, according to nationally representative polling data.

The percentage of Canadians expressing support for legalization has held steady for the past four years. Fewer than 20 percent of Canadians favor legalizing and regulating the use of other controlled substances.

Pollsters also reported that the majority of Canadians purchase “all” of their cannabis products from legal retailers. Separate polling data has previously reported that the percentage of Canadian consumers transitioning to the legal cannabis market has grown year over year.

Additional polling information is available from Research Co.

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Study: Cannabis Provides Sustained Benefits for Fibromyalgia Patients

London, United Kingdom: Patients with fibromyalgia (FM) report symptom improvements following their use of medical cannabis preparations, according to observational data published in the Journal of Pain & Palliative Care Pharmacotherapy.

British researchers assessed the use of cannabis-based medicinal products (CBMPs) consisting of either flower or oil extracts in 148 patients enrolled in the UK Medical Cannabis Registry. (Since 2018, British specialists have been permitted to prescribe cannabis-based medicinal products to patients unresponsive to conventional medications.) Researchers assessed changes in patient-reported outcomes at one, three, six, and twelve months.

“Improvements in the generalized anxiety disorder-7 questionnaire, single-item sleep quality scale, fibromyalgia symptom severity score and EQ-5D-5L Index values [a descriptive scale assessing mobility, self-care, usual activities, pain/discomfort and anxiety/depression] were observed at each follow up period compared to baseline,” investigators reported.

Study participants also significantly reduced their use of prescription opioids during the trial. The most frequently reported adverse events were fatigue, headache, and dry mouth.

The study’s authors concluded: “Positive associations between initiation of CBMP therapy and decreased fibromyalgia severity were observed at all time points. … These findings are complemented by the wider literature.”

Other observational studies assessing the use of cannabis products in patients enrolled in the UK Cannabis Registry have reported them to be effective for those suffering from chronic pain, anxiety, post-traumatic stress, depression, migraine, multiple sclerosis, osteoarthritis, inflammatory arthritis, and inflammatory bowel disease.

Full text of the study, “Comparison of cannabis-based medicinal product formulations for fibromyalgia: A cohort study,” appears in the Journal of Pain & Palliative Care Pharmacotherapy.

Study: Prenatal Cannabis Exposure Not Associated With Elevated Rates of ADHD, Behavior Disorders in Early Adolescence

San Francisco, CA: Infants who test positive for prenatal cannabis exposure are not at higher risk of being diagnosed with ADHD (Attention Deficit Hyperactivity Disorder) or DBD (Disruptive Behavior Disorder) in early adolescence, according to data published in the Journal of Developmental and Behavioral Pediatrics.

Investigators affiliated with the University of California at San Francisco and Kaiser Permanente assessed the relationship between in-utero cannabis exposure and behavioral outcomes in a cohort of over 141,000 children born between 2011 and 2018. Children were followed up to a maximum age of 11.

“Maternal prenatal cannabis use was not associated with ADHD, and there was an inverse association with DBD,” researchers determined.

They added: “The data reflect offspring population-level outcomes and do not predict the outcome for any individual. Additional research is needed to tease apart the mechanisms underlying the inverse association between prenatal cannabis use and the risk of ADHD and DBD.”

The lack of association between prenatal cannabis exposure and ADHD is consistent with previous findings.

Several members of the same research team published separate studies in the Journal of the American Medical Association, finding that prenatal cannabis exposure is not positively associated with elevated rates of either childhood autism or an increased risk of early childhood developmental delays.

Studies assessing the relationship between in-utero cannabis exposure and various neonatal outcomes, such as birth weight, have historically yielded inconsistent results. However, longitudinal data suggests that cannabis exposure is not typically associated with adverse neurodevelopmental consequences in late adolescence, finding, “Although there is a theoretical potential for cannabis to interfere with neurodevelopment, human data drawn from four prospective cohorts have not identified any long-term or long-lasting meaningful differences between children exposed in utero to cannabis and those not.”

Full text of the study, “Prenatal cannabis use and offspring Attention Hyperactivity Disorder and Disruptive Behavior Disorders: A retrospective cohort study,” appears in the Journal of Developmental and Behavioral Pediatrics.

Survey: Cannabis as Effective as Prescription Medicines for Treatment of Hand Pain

Chicago, IL: Patients with hand pain-related pathologies frequently turn to cannabis for pain relief, according to data published in the journal Hand.

Researchers affiliated with the University of Chicago surveyed 122 patients suffering from hand-related pain. Fifteen percent of respondents acknowledged using cannabis to manage their symptoms.

Investigators reported: “Compared with pre-usage pain scores, both cannabinoids and Rx/OTC medications induced significant reductions in pain associated with patients’ hand pathologies. … Subjectively, … cannabinoids were preferred over Rx/OTC medications by 64 percent of the cannabinoid cohort, and no respondents preferred traditional medications over cannabinoids.”

The study’s authors concluded: “Although this is a small-scale study, these findings support the idea that cannabinoids are used regularly and are effective for pain control in orthopedic hand patients. Given the variety of cannabinoids among patients surveyed, future directions include examining the formulations, ingestion methods, and potencies that most improve pain from hand pathologies. Orthopedic surgeons should continue working with their patients to find successful, safe, and personalized ways to achieve adequate pain control.”

Full text of the study, “Prevalence and effect of cannabinoids in pain management and hand pathologies,” appears in Hand. Additional information on cannabis and chronic pain is available from NORML’s publication, Clinical Applications for Cannabis & Cannabinoids.

Delaware: Governor Signs Legislation Providing State-Level Protections for Businesses Providing Financial Services To Licensed Cannabis Retailers

Dover, DE: Democrat Gov. John Carney has signed legislation (HB 355) into law providing state-level legal protections for financial institutions and other entities that provide financial or accounting services to licensed cannabis-related businesses.

The law stipulates that “banks, credit unions, armored car services, and providers of accounting services are not subject to prosecution under Delaware law merely by providing lawful services to licensed businesses engaged in the production, distribution and sale of cannabis.”

Lawmakers passed legislation in 2023 regulating adult-use cannabis sales. However, regulators have yet to award licenses to cannabis business applicants.

The new law does not protect banks and other institutions from potential federal litigation. Federal law currently discourages financial institutions from partnering with state-licensed cannabis businesses because of their involvement with a Schedule I controlled substance.

Federal legislation seeking to amend the law currently has 36 co-sponsors in the US Senate and 130 co-sponsors in the House, but has yet to receive a floor vote in either chamber during the current session.

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