Tag: Weed Connection

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.

Study: Cannabis Provides Sustained Relief for Patients With Treatment-Resistant Depression

London, United Kingdom: Patients suffering from treatment-resistant depression report sustained improvements in their health-related quality of life following the use of medical cannabis preparations, according to longitudinal data published in the Journal of Affective Disorders.

British investigators assessed the adjunctive use of cannabis-based medicinal products (CBMPs) in a cohort of 698 patients enrolled in the UK Medical Cannabis Registry. (British healthcare providers may prescribe cannabis-based medicinal products to patients unresponsive to conventional medications.) Patients’ outcomes were assessed at baseline and at 1, 3, 6, 12, 18 and 24 months. Study participants consumed either herbal cannabis or oil extracts containing standardized concentrations of THC and CBD.

Consistent with prior observational studies, participants reported “improvement[s] in mood, anxiety, general health-related quality of life, and sleep” over the duration of the study, with subjects reporting the most dramatic changes during the first three months. Few participants reported any serious adverse events. Patients who presented with the most severe depressive symptoms at baseline exhibited the greatest overall improvement in their symptoms.

The study’s authors concluded: “This UK Medical Cannabis Registry study of patients with treatment-resistant depression prescribed CBMPs demonstrated sustained and clinically meaningful improvements in depression, anxiety, health-related quality of life, and sleep quality over 24 months. Improvements were most pronounced within the first three months and were sustained thereafter. Adverse events were infrequent and predominantly mild to moderate. … Further randomized controlled trials, stratified by comorbidity profiles and product composition, are required to confirm efficacy, optimize treatment regimens, and clarify long-term safety.”

Other observational studies assessing the use of cannabis products among patients enrolled in the UK Medical Cannabis Registry have reported them to be beneficial for those diagnosed with treatment-resistant epilepsy, cancer-related pain, anxiety, endometriosis, inflammatory bowel disease, hypermobility disorders, migraine, multiple sclerosis, osteoarthritis, substance use disorders, insomnia, and inflammatory arthritis, among other conditions.

Full text of the study, “UK Medical Cannabis Registry: A two-year case series of clinical outcomes in depression,” appears in the Journal of Affective Disorders.

CBD-Rich Cannabis Extracts Reduce ADHD Symptoms in Children With Autism

Tel Aviv, Israel: The administration of CBD-rich oil extracts in children with autism is associated with reduced impulsivity and improvements in other ADHD-related symptoms, according to data published in the journal Current Neuropharmacology.

Israeli researchers assessed the efficacy of CBD-dominant extracts in a cohort of children diagnosed with ASD (autism spectrum disorder) and ADHD (attention deficit hyperactivity disorder) over three-to-six months. Study participants were assessed at baseline and at the completion of the study by their schoolteachers utilizing a standardized rating scale (the Conners’ Teaching Rating Scale questionnaire).

Assessments revealed “significant improvements … in the following categories: anxious-shyness, perfectionism, ADHD index, emotional liability, and hyperactive-impulsivity.” Participants also demonstrated reduced hyperactivity and improvements in their ability to maintain attention, though these changes did not reach statistical significance.

The study’s authors concluded: “This is the first prospective study to evaluate the effects of CBD-rich cannabis on ADHD symptoms in children with ASD using standardized teacher-based Assessments (CTRS). The findings indicate improvements in core behavioral domains. While previous studies have focused primarily on parent-reported outcomes or small-scale trials, our results support emerging evidence on the role of cannabinoids in modulating attention and emotional regulation. … These findings support the need for future clinical trials to validate efficacy and determine optimal dosing.”

Placebo-controlled clinical trials have previously demonstrated that CBD-rich cannabis extracts are safe and effective in mitigating symptoms in children with ASD, while observational studies indicate that cannabis inhalation reduces ASD symptoms in adults.

Full text of the study, “CBD-Rich cannabis therapy in children with autism spectrum disorder may improve symptoms of hyperactivity and attention deficit: An open-label study, appears in Current Neuropharmacology.

Survey: Medical Cannabis Use Common Among Cystic Fibrosis Patients

Vancouver, Canada: Patients with cystic fibrosis frequently acknowledge consuming cannabis products to ease their symptoms, according to survey data published in the journal BMJ Open Respiratory Research.

Canadian researchers surveyed 110 patients with either cystic fibrosis (CF) or cystic fibrosis-related disorders (CFTR). (Cannabis products are legal in Canada for both medical purposes and for adult use.)

Nearly half of those surveyed acknowledged being current cannabis consumers. Most (85 percent) consumers said that they used cannabis products explicitly for therapeutic relief, primarily for the treatment of insomnia, stress, anxiety, joint pain, low appetite, depression, and/or abdominal pain. Most respondents described cannabis as medically efficacious and said that it improved their health-related quality of life. Respondents frequently acknowledged cannabis to be “just as or more effective” than traditional prescription medications.

“Use of cannabis was common in this sample of adults with CF and CFTR-related disorder,” the study’s authors concluded. “Cannabis use and vaping should be routinely and openly discussed during CF clinic visits so that healthcare providers can ensure patients receive education about evidence for potential risks versus benefits and ultimately support patients in making informed decisions about cannabis use and vaping.”

Full text of the study, “Evaluating the use and perceptions of cannabis and vaping post-cannabis legalization in people with cystic fibrosis and CFTR-related disorders: Survey results from a large Canadian adult cystic fibrosis clinic,” appears in BMJ Open Respiratory Research.

Ohio: Attorney General Rejects Bid To Challenge Marijuana Recriminalization Law

Columbus, OH: The state’s Attorney General has rejected a petition that sought to repeal certain provisions of Senate Bill 56, arguing that the proposal’s summary language was misleading.

“Upon review of the summary, we identified omissions and misstatements that, as a whole, would mislead a potential signer as to the scope and effect of SB 56,” the AG determined.

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 sought to place a referendum on the November ballot asking voters to reject the law. Activists now have the option of revising and resubmitting their petition for reconsideration.

A spokesperson for the groups says that it intends to do so, stating, “Voters this November will have the opportunity to say no to SB 56, no to government overreach, no to closing 6,000 businesses and abandoning thousands of Ohio workers, and no to defying the will of Ohioans who overwhelmingly supported legalizing cannabis in 2023.”

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

Clinical Trial: Cannabis Topicals Mitigate Pain, Improve Physical Functioning in Breast Cancer Patients

Minneapolis, MN: Breast cancer patients prescribed aromatase inhibitors (estrogen-blocking drugs) experience reduced musculoskeletal pain following their use of topical balms containing plant-derived cannabinoids, according to clinical trial data published in the journal Cannabis and Cannabinoid Research.

Researchers with the University of Minnesota evaluated the efficacy of CBD-dominant and THC-dominant topicals in 21 patients suffering from aromatase inhibitor-induced pain. Study participants were randomly selected to apply either CBD-dominant or THC-dominant balms on their hands, wrists, and fingers three times daily for at least two weeks. Cannabis products were provided at no cost by a state-licensed medical cannabis manufacturer.

Eighty-six percent of participants experienced improvements in their baseline pain scores, with patients using THC-dominant topicals reporting the greatest degree of pain relief. Benefits were sustained throughout the length of the trial (up to four weeks).

“Women with breast cancer and AIMSS [aromatase inhibitor-induced musculoskeletal syndrome] affecting hands and wrists reported improved pain and physical functioning when using THC and CBD balms. Use of topical cannabis balms was well tolerated and did not impact estradiol levels or lead to systemic THC absorption,” the study’s authors concluded. “Cannabis balms appear safe and may lead to improvement in AIMSS in patients with breast cancer. Future placebo-controlled trials with longer duration of use are needed.”

Previous clinical trials have similarly demonstrated the efficacy of CBD-infused topicals in treating osteoarthritic hand pain.

Full text of the study, “A randomized, open-label trial to assess feasibility and tolerability of topical cannabis balms for the treatment of aromatase inhibitor-associated musculoskeletal syndrome (AIMSS),” appears in Cannabis and Cannabinoid Research.

Czech Republic: Legislation Takes Effect Legalizing Personal Marijuana Possession

Prague, Czechia: Legislation legalizing the personal possession of cannabis took effect in the Czech Republic on January 1st.

Under the law, which was passed last year, those 21 or older may home-cultivate (up to three plants) and possess (up to 100 grams) cannabis in private without penalty. Adults may also legally possess lower amounts of cannabis (up to 25 grams) outside their homes.

Possessing larger quantities of cannabis or engaging in cannabis sales remains subject to civil and/or criminal penalties.

The Czech Republic is one of several European countries that have recently taken action to eliminate marijuana possession penalties. Last year, German lawmakers approved legislation permitting those 18 or older to possess limited quantities of cannabis. Lawmakers in Luxembourg and Malta have also enacted similar policies.

Canada: No Increase in Youth Cannabis Use Post Legalization

Ottawa, Canada: Rates of teen marijuana use in Canada have remained largely unchanged in the years following the adoption of adult-use legalization, according to data published in the journal Drug and Alcohol Dependence Reports.

Health Canada officials reviewed youth use data for the years prior to legalization and afterward.

They reported, “Overall, there was no change in prevalence of past 12-month, past 30-day, or frequent cannabis use” among students in grades 7 to 12. Researchers also reported no changes in young people’s age of cannabis initiation or in the percentage of teens who acknowledge driving after consuming cannabis.

The study’s authors concluded: “The current study provides estimates of cannabis use among a large, population-based sample of youth in the Canadian provinces over a 10-year period. … [It] examined grade 7–12 students and found no change in past 12-month cannabis use overall. … Continued public education programs can help maintain and improve youth awareness of the potential harms of cannabis.”

Data from the United States reports nationwide declines in youth marijuana use over the past decade, during which time nearly half of all states have adopted adult-use legalization.

Full text of the study, “Changes in patterns of use. And perceptions of cannabis among students in Canada: A decade of data from the Canadian Student Alcohol and Drugs Survey,” appears inDrug and Alcohol Dependence Reports.

Maine: Cannabis Sales Tax Hike Takes Effect

Augusta, ME: Sales taxes on the purchase of adult-use cannabis products rose nearly 30 percent on January 1, as new legislation took effect.

Under the new tax law, which lawmakers approved last year, consumers must pay a 14 percent sales tax on adult-use marijuana products (up from 10 percent). Medical cannabis products are subject to lower taxes.

Democratic Gov. Janet Mills had initially proposed the sales tax hike to address the state’s budget deficit.

Separate provisions in the tax bill, however, reduce certain excise taxes imposed upon cannabis cultivators, which may result in lower retail prices for consumers.

Maine is one of several states, including Maryland, Michigan, and Minnesota, where lawmakers last year voted to increase cannabis-related sales taxes. (Michigan’s tax increase is being challenged in court.) By contrast, in October, a legislative effort led by California NORML successfully rolled back marijuana-related taxes in that state.

NORML opposes excessive taxes on retail cannabis goods because they escalate prices out of reach for some consumers. “Excessive taxes drive a growing percentage of consumers to the unregulated market, thereby undermining the primary goal of legalization, which is to provide adults with safe, affordable, above-ground access to lab-tested products of known purity, potency, and quality,” NORML’s Deputy Director Paul Armentano said. “Tax increases also hurt state-licensed businesses and their employees because they increase their costs and reduce their customer base.”