Studies: Marijuana Legalization Laws Correlated With Reduced Opioid Prescribing Trends
Lexington, KY: The enactment of statewide marijuana legalization laws is associated with a reduction in the number of opioids prescribed and filled, according to a pair of studies published online Monday in the journal JAMA Internal Medicine.
In the first study, investigators from the University of Kentucky and Emory University assessed the relationship between medical and adult-use marijuana laws and opioid prescribing patterns among Medicaid enrollees nationwide. Enrollees included all Medicaid fee-for-service and managed care enrollees - a high-risk population for chronic pain, opioid use disorder, and opioid overdose.
Researchers reported that the enactment of both medicalization and adult-use laws were both associated with reductions in opioid prescribing rates, with broader legalization policies associated with the greatest rates of decline.
"State implementation of medical marijuana laws was associated with a 5.88 percent lower rate of opioid prescribing. Moreover, the implementation of adult-use marijuana laws, which all occurred in states with existing medical marijuana laws, was associated with a 6.38 percent lower rate of opioid prescribing," they concluded. "[T]he further reductions in opioid prescribing associated with the newly implemented adult-use marijuana laws suggest that there were individuals beyond the reach of medical marijuana laws who may also benefit from using marijuana in lieu of opioids. Our finding that the lower opioid prescribing rates associated with adult-use marijuana laws were pronounced in Schedule II opioids further suggest that reaching these individuals may have greater potential to reduce the adverse consequences, such as opioid use disorder and overdose."
In the second study, University of Georgia researchers evaluated the association between the enactment of medical cannabis access laws and opioid prescribing trends among those eligible for Medicare Part D prescription drug coverage. Researchers reported that medicalization, and specifically the establishment of brick-and-mortar cannabis dispensing facilities, correlated with significantly reduced opioid prescription drug use.
"This longitudinal analysis of Medicare Part D found that prescriptions filled for all opioids decreased by 2.11 million daily doses per year from an average of 23.08 million daily doses per year when a state instituted any medical cannabis law. Prescriptions for all opioids decreased by 3.742 million daily doses per year when medical cannabis dispensaries opened," they concluded. "Combined with previously published studies suggesting cannabis laws are associated with lower opioid mortality, these findings further strengthen arguments in favor of considering medical applications of cannabis as one tool in the policy arsenal that can be used to diminish the harm of prescription opioids."
The studies' findings are consistent with those of numerous prior papers concluding that legal cannabis access is associated with decreases in opioid use, abuse, hospitalizations, and mortality.
Full text of the studies, "Association of medical and adult-use marijuana laws with opioid prescribing for Medicaid enrollees" and "Association between US state medical cannabis laws and opioid prescribing in the Medicare Part D population," appear in JAMA Internal Medicine.
Senate Leader Plans To Spearhead Federal Hemp Reform
Washington, DC: Senator Mitch McConnell (R-KY), Majority Leader of the United States Senate, has publicly announced his intention to sponsor federal legislation to legalize and fund the licensed production of industrial hemp.
According to a press release issued by the Senator, the forthcoming legislation - entitled the Hemp Farming Act of 2018 - "will allow states to be the primary regulators of hemp" and will allocate grant funding to federally subsidize industrial hemp cultivation.
The Senator previously shepherded federal reforms in 2014 permitting states to legally authorize hemp cultivation as part of academic research pilot programs. Over two-dozen states have established regulations permitting limited hemp cultivation under this provision. In 2017, state-licensed producers grew over 39,000 acres of hemp, up from roughly 16,000 acres in 2016.
Legislation, HR 3530, is currently pending in the US House of Representatives to exclude low-THC strains of cannabis grown for industrial purposes from the federal definition of marijuana. That measure has 43 co-sponsors.
According to a Congressional Research Service report, the United States is the only developed nation in which industrial hemp is not an established crop.
Study: Cannabinoid Therapy Improves Dystonia In HD Patients
Bochum, Germany: Cannabinoid treatment is associated with improvements in dystonia in patients with early-onset Huntington's disease, according to observational data published online ahead of print in the Journal of Huntington's Disease.
A team of investigators from Germany and Austria assessed the treatment of various synthetic or organic cannabinoid preparations - including Sativex, dronabinol, and nabilone - in seven HD patients who had been unresponsive to conventional therapies.
"Treatment with cannabinoids in all cases lead to an improvement of motor symptoms, mainly driven by improvement of dystonia," authors concluded. Patients generally reported "no relevant side effects."
Huntington's disease is a degenerative brain disorder that often goes unresponsive to conventional treatments.
Full text of the study, "Cannabinoids for treatment of dystonia in Huntington's Disease," appears in the Journal of Huntington's Disease.
Utah: Governor Signs Series Of Marijuana-Related Bills
Salt Lake City, UT: Republican Gov. Gary Herbert has signed a series of bills to facilitate access and research to cannabis and cannabis-related products.
House Bill 195 provides patients with no more than six-months to live the legal option to access cannabis-infused products. Under the law, patients with a physician's recommendation may legally possess up to a one-month supply of products. All cannabis products must be obtained from a state-approved provider. Access to herbal formulations of cannabis is not permitted under the law.
House Bill 197 permits the Department of Agriculture and Food to contract with a third party to cultivate cannabis for the purpose of manufacturing marijuana-infused oils and other related products. These products would be provided to terminally ill patients and also used in state-sponsored research trials. The new program is required to be operational by January 1, 2019.
Finally, Senate Bill 130, the Cannabidiol Product Act, establishes rules for the licensed cultivation of industrial hemp for the purpose of manufacturing CBD-infused products. These products must contain a 10 to 1 ratio of CBD to THC. These products are intended to be sold at "cannabidiol-qualified pharmacies" to patients with a written recommendation from a physician.
Utah lawmakers signed legislation into law in 2014 permitting patients with intractable epilepsy the option of possessing certain CBD-infused products. However, that law provided no legal in-state supply source for the products.
Activists have collected over 160,000 signatures from registered voters in support of a 2018 statewide ballot initiative, the Utah Medical Cannabis Act, to permit qualified patients to obtain either herbal cannabis or cannabis-infused products from a limited number of state licensed dispensaries. Last week, a representative from the Lt. Governor's Office confirmed that state officials had validated 117,000 of those signatures - more than the 113,000 needed to qualify for the state ballot.
Indianapolis, IN: Republican Gov. Eric Holcomb has signed legislation, Senate Bill 52, authorizing for the retail sale of certain hemp extract products.
Under the measure, retailers may legally sell "low THC hemp extract" products that possess a "certificate of analysis prepared by an independent drug testing laboratory." The testing must confirm that the products contain no more than 0.3 percent THC. Additional packaging and labeling requirements take effect on July 1, 2018.
Hemp extract products may be "derived from or contain any part of the plant cannabis sativa L. that meets the definition of industrial hemp" and that "contains no other controlled substances."
In 2017, lawmakers approved legislation permitting for the use of products containing at least ten percent CBD and no more than 0.3 percent THC for patients with treatment-resistant epilepsy. However, the law provided no legal supply source for these products and state police have consistently cited the law's lack of clarity as a justification for raiding dozens of CBD retailers.
In February, justices for the Ninth Circuit US Court of Appeals heard oral arguments challenging the federal government's contention that hemp-derived CBD products are illegal in the United States. The judges have yet to render an opinion in the matter.
