Study: Majority Of Medical Cannabis Patients Are Seeking Pain Relief

MICHIGAN: Most US patients registered to access medical cannabis cite chronic pain as their primary qualifying condition, according to data published in the journal Health Affairs.

Investigators from the University of Michigan, Ann Arbor reviewed patient registration data from the majority of states that provide medical cannabis access. (Some states, notably California and Maine, possess voluntary registries and therefore do not compile patient profile data.)

They reported that in 2016, chronic pain was the most common qualifying condition reported by patients (65 percent). They added, “Of all patient-reported qualifying conditions, 85 percent had either substantial or conclusive evidence of therapeutic efficacy,” as defined by the 2017 report published by the National Academy of Sciences, Engineering, and Medicine. The authors of that report concluded that there exists conclusive or substantial evidence for the effectiveness of cannabis in the treatment of chronic pain, nausea and vomiting, and spasticity.

Separate studies indicate that legal cannabis access is typically associated with reduced rates of opioid use and abuse. Studies have also identified a reduction in the prevalence of opioid-related mortality following statewide marijuana access.

Authors concluded: “[O]ur data show that the number of medical cannabis patients has risen dramatically over time as more states have legalized medical cannabis. … [W]e believe not only that it is inappropriate for cannabis to remain a Schedule I substance, but also that state and federal policy makers should begin evaluating evidence-based ways for safely integrating cannabis research and products into the health care system.”


For more information, contact Paul Armentano, NORML Deputy Director, at: paul@norml.org. Full text of the study, “Qualifying conditions of medical cannabis license holders in the United States,” appears in Health Affairs. Additional information is available in NORML’s fact-sheet, “Relationship Between Marijuana and Opioids.”

New Study: Children With Autism See Improvement After Treatment With Tikun Olam High-CBD, Low-THC Medical Cannabis

NEW YORK: Children with Autism Spectrum Disorder (ASD) see a “significant” improvement in symptoms and less reliance on other medications after treatment with Tikun Olam’s Avidekel™ medical cannabis, as confirmed by a new study published in Scientific Reports.

The two-year study, “Real Life Experience Of Medical Cannabis Treatment In Autism: Analysis Of Safety And Efficacy,” followed 188 children (average age: 13) diagnosed with ASD. The patients were treated with Tikun Olam’s high-CBD, low-THC medical cannabis strains, which have been specifically cultivated and shown to provide symptom relief for ASD and related conditions with minimal psychoactive effect.

At the study’s outset, the most common patient symptoms were restlessness (90.4%), rage attacks (79.8%), and agitation (78.7%). After six months of daily cannabis treatment at Tikun Olam clinics in Israel, 80.1% of patients reported improvement of their symptoms, with 30.1% reporting “significant” improvement. Other key findings include:

  • Of 27 patients who had epilepsy, 24 reported improved or disappearance of symptoms;
  • 34% of patients decreased other medications; and
  • 20% of patients stopped using antipsychotic medication.

“Autism is a leading condition of concern worldwide, so this study couldn’t have come at a better time,” says Dr. Annabelle Manalo, PhD, Tikun Olam’s Science Director. “The data shows that autism patients can improve their overall quality of life utilizing a high CBD strain, and most importantly, that young users can safely and effectively benefit from medical cannabis.”

“With this study, cannabis is shown to be an effective choice for parents looking for the safest and most neuroprotective treatment.”

Side effects to cannabis treatment were minimal, with the most common at six months reported as restlessness (6.6%), sleepiness (3.2%), psychoactive effect (3.2%).

Case Report: Daily CBD Administration Associated With Remission Of Schizophrenic Symptoms

GERMANY: The adjunctive use of cannabidiol is associated with a remission in schizophrenic symptoms in a patient previously unresponsive to conventional treatment, according to a case report published in the Australian & New Zealand Journal of Psychiatry.

Investigators from the University of Leipzig in Germany assessed the use of twice-daily dosing of 750mg of CBD in conjunction with clozapine in a patient with treatment-resistant schizophrenia. Cannabidiol dosing was associated with remission criteria and improvements remained consistent over eight months.

“Our case report contradicts the assumption that CBD is not likely to be any superior than existing antipsychotics,” authors concluded. “In fact, CBD might be particularly suitable for those patients [who are] resistant to antipsychotics due to its different mode of action.”


For more information, contact Paul Armentano, NORML Deputy Director, at: paul@norml.org. Full text of the study, “Remission of severe, treatment-resistant schizophrenia following adjunctive cannabidiol,” appears in the Australian & New Zealand Journal of Psychiatry.

NIH: Teen Marijuana Use Not Increasing Despite Legalization

MARYLAND: Self-reported marijuana use by adolescents has failed to increase in recent years despite the majority of states legalizing it for either medical or adult use, according to the latest data compiled by the University of Michigan’s Monitoring the Future survey, which is commissioned by the US National Institutes on Drug Abuse. NIDA is a part of the US National Institutes of Health.

Summarizing the findings in a press release, the agency acknowledged: “Rates of marijuana use by teens have been of great interest to researchers over the past decade, given major social and legislative shifts around the drug; it is now legal for adult recreational use in 10 states plus the District of Columbia, and it is available medicinally in many more. Fortunately, even as teens’ attitudes toward marijuana’s harms continue to relax, they are not showing corresponding increases in marijuana use.”

Marijuana use prevalence by young people did not change significantly between 2017 and 2018, the survey reported. Between the years 2012 and 2018, both rates of lifetime marijuana use and rates of annual marijuana use by 8th, 10th, and 12th graders have declined. Ten states have enacted laws regulating adult marijuana use during this same period of time, and several others have legalized medical cannabis access.


For more information, contact Paul Armentano, NORML Deputy Director, at: paul@norml.org. Further data is available from NORML’s fact-sheet, “Marijuana Regulation and Teen Use Rates.”

 

Study: Majority Of Chronic Pain Patients Replace Opioids With Cannabis

OHIO: More than two-thirds of chronic pain patients registered to legally access medical cannabis products substitute marijuana for prescription opioids, according to data published in The Journal of Headache and Pain.

Investigators from the United States and Canada assessed the use of medical cannabis and prescription drugs in a cohort of over 2,000 Canadian patients licensed to access marijuana products. Among those patients with a primary diagnosis of chronic pain, 73 percent reported substituting cannabis in place of opioids. Among those patients diagnosed specifically with headache/migraine, cannabis was frequently reported as a substitute for other medications – including opiates (43 percent), anti-depressants (39 percent), NSAIDS (21 percent), triptans (8 percent), and anti-convulsants (8 percent).

“Most patients in the pain groups reported replacing prescription medications with medicinal cannabis, the most common of which were opiates/opioids across all patient groups,” authors concluded. “This is notable given the well-described ‘opioid-sparing effect’ of cannabinoids and growing abundance of literature suggesting that cannabis may help in weaning from these medications and perhaps providing a means of combating the opioid epidemic.”


For more information, contact Paul Armentano, NORML Deputy Director, at: paul@norml.org. Full text of the study, “Patterns of medicinal cannabis use, strain analysis, and substitution effect among patients with migraine, headache, arthritis, and chronic pain in a medicinal cannabis cohort,” appears in The Journal of Headache and Pain. NORML’s fact-sheet highlighting the relevant, peer-reviewed research specific to the relationship between cannabis and opioids is available online.

Patients Use Fewer Opioids Following Enrollment In Medical Cannabis Program

NEW YORK:  Patients enrolled in New York state’s medical cannabis program reduce their use of opioids and spend less money on prescription medications, according to data published online in the journal Mental Health Clinician.

Investigators from GPI Clinical Research labs in Rochester and the University of Buffalo assessed trends in patients’ medical cannabis and prescription drug use following their enrollment in the state’s marijuana access program.

On average, subjects’ monthly analgesic prescription costs declined by 32 percent following enrollment, primarily due to a reduction in the use of opioid pills and fentanyl patches. “After three months treatment, medical cannabis improved [subjects’] quality of life, reduced pain and opioid use, and lead to cost savings,” authors concluded.

The study’s findings are similar to those reported among enrollees in other states’ medical cannabis programs, including the experiences of patients in IllinoisMichiganMinnesotaNew Mexico, and elsewhere.


For more information, contact Paul Armentano, NORML Deputy Director, at: paul@norml.org. Full text of the study, “Preliminary evaluation of the efficacy, safety, and costs associated with the treatment of chronic pain with medical cannabis,” appears in The Mental Health Clinician. NORML’s fact-sheet highlighting the relevant, peer-reviewed research specific to the relationship between cannabis and opioids is available online.

Study: Cannabis Exposure Not Associated With Residual Adverse Impact On Cognition

PENNSYLVANIA:  Cannabis exposure in adolescents and young adults is not associated with any significant long-term detrimental effects on cognitive performance, according to a systematic literature review  published Wednesday in the journal JAMA Psychiatry.

Investigators affiliated with the University of Pennsylvania, Perelman School of Medicine and with the Children’s Hospital of Pennsylvania reviewed data from 69 separate studies published between 1973 and 2017 involving 8,727 subjects (2,152 frequent or heavy users and 6,575 controls). Researchers reported no significant long-term deficits in memory, attention, or other aspects of cognitive functioning that could be independently attributed to cannabis use, regardless of subjects’ age of initiation. These findings are in contrast to similar studies assessing the impact of alcohol use and other controlled substances on cognitive performance, which “have shown medium to large effect sizes.”

Authors concluded: “Associations between cannabis use and cognitive functioning in cross-sectional studies of adolescents and young adults are small and may be of questionable clinical importance for most individuals. Furthermore, abstinence of longer than 72 hours diminishes cognitive deficits associated with cannabis use. [R]esults indicate that previous studies of cannabis youth may have overstated the magnitude and persistence of cognitive deficits associated with marijuana use.”


For more information, contact Paul Armentano, NORML Deputy Director, at (202) 483-5500. Full text of the new study, “Association of cannabis with cognitive functioning in adolescents and young adults: A systematic review and meta-analysis,” appears in JAMA Psychiatry.

Study: Maternal Cannabis Use Not Associated With Adverse Neurodevelopment

MARYLAND: Cannabis exposure in utero is not associated with any significant, long-lasting adverse outcomes in offspring, according to a scientific review published online ahead of print in the journal Preventive Medicine.

A pair of researchers from the University of Maryland, Department of Obstetrics, Gynecology and Reproductive Sciences and the Virginia Commonwealth University, Department of Obstetrics and Gynecology and Psychiatry reviewed four prospective cohort studies evaluating the long-term health outcomes of in utero cannabis exposure.

They concluded, “The evidence base for maternal-infant health outcomes of cannabis use in pregnancy is more robust than for many other substances. … 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.”

A 2016 literature review published in the journal Obstetrics & Gynecology similarly reported that the moderate use of cannabis during pregnancy is not an independent risk factor for adverse neonatal outcomes such as low birth weight.

A 2017 study reported that maternal marijuana use was not independently associated with adverse effects on their children’s educational attainment. By contrast, maternal alcohol use was associated with detrimental educational outcomes in the cohort.

Study: Cannabis Use Not An Independent Risk Factor For Increased Likelihood Of Psychotic Symptoms

PENNSYLVANIA: There exists “minimal evidence” in support of an association between cannabis use by itself and the onset of psychotic symptoms in young people, according to data published online ahead of print in the Journal of Adolescent Health.

Investigators from the University of Pennsylvania, Department of Psychiatry assessed the relationship between drug use and the onset of psychotic symptoms in a cohort of 4,171 young people ages 14 to 21. Authors reported that “neither frequent nor early cannabis use predicted increased odds of psychosis spectrum classification” after researchers adjusted for potential confounders (e.g., concurrent use of other substances, comorbid psychopathology, and trauma exposure).

They concluded, “Overall, we found minimal evidence for associations between cannabis use by itself and psychosis spectrum symptoms.”

The findings are similar to those of a 2015 longitudinal study reporting that early-onset cannabis use is not positively associated with a greater risk of psychosis or other mental health disorders in mid-life.

A 2016 literature review published in the journal Current Psychiatry Reports concluded that cannabis use likely does not cause the psychosis, but rather, that subjects susceptible to the disorder may be more likely to engage in habitual use of the substance.

Studies: Changes In Marijuana’s Legal Status Not Associated With Increased Use By Young People

NEW YORK: Changes in marijuana’s legal status under state law is not associated with increased cannabis use or access by young people, according to pair of recently published studies.

In the first study, published online in the journal Substance Use & Misuse, researchers at Columbia University in New York surveyed the marijuana use habits of a national sampling of 1,310 adolescents over a two-year period. Investigators assessed whether respondents from states with liberalized cannabis policies were more likely to acknowledge having consumed cannabis as compared to those residing in jurisdictions where the substance remains criminally prohibited.

Authors reported that the study’s findings “failed to show a relationship between adolescents’ use of marijuana and state laws regarding marijuana use. … [They] suggest that eased sanctions on adult marijuana use are not associated with higher prevalence rates of marijuana use among adolescents.”

In the second study, published in the journal Drug and Alcohol Dependence, a team of investigators from Columbia University, the University of California at Davis, and Boston University examined the relationship between medical cannabis laws and the prevalence of marijuana availability and use by adolescents and by those age 26 or older. Authors reported no changes over a nine-year period (2004 to 2013) with regard to the past-month prevalence of marijuana use by those ages 12 to 17 or those between the ages of 18 and 25. Those age 25 and younger also experienced no change in their perception of marijuana’s availability. By contrast, self-reported marijuana use and perceived availability increased among adults age 26 or older during this same time period.

The conclusions are similar to those of numerous separate studies reporting that changes in marijuana’s legal status are not associated with any uptick in teens’ use of the substance, such as those hereherehere, and here.