#NORML #News Source: @norml @WeedConnection Posted By: norml@weedconnection.com media :: news - Tue, 09 Feb 2021 04:20:21 PST
Adult-Use Marijuana Legalization Not Associated with Any Rise in Substance Abuse Treatment Admissions
Philadelphia, PA: The enactment of statewide laws in Colorado and Washington legalizing retail sales of cannabis for adults is not associated with any increase in the number of teens or young adults seeking drug abuse treatment for the use of either opioids, cocaine, or methamphetamine, according to data published in the Journal of Substance Abuse Treatment.
Researchers from Temple University in Philadelphia and the University of Tennessee in Knoxville compared pre- and post-legalization trajectories of substance abuse treatment admissions rates in Colorado and Washington to a set of other US states that did not legalize recreational marijuana use. Specifically, investigators assessed treatment admissions for opioids, cocaine, and methamphetamine among those between 12 and 24 years of age.
Authors failed to identify any uptick in drug treatment admissions in either Colorado or Washington post-legalization, nor did the treatment trajectories in those states significantly differ from the trajectories in comparable states that did not liberalize their cannabis laws.
They reported: "To the best of our knowledge, this is the first study to investigate whether RML [recreational marijuana legalization] in the U.S. led to an increase in SUD [substance use disorder] treatment admissions [for] illicit drugs other than marijuana. We found that the legalization of recreational marijuana use in Colorado and Washington did not result in an increase in SUD treatment admissions for cocaine, opioids, or methamphetamines among adolescents or emerging adults."
Commenting on the study's findings, NORML's Deputy Director Paul Armentano said: "This data further undermines longstanding claims that marijuana acts as any sort of a ‘gateway' to the abuse of other controlled substances - an allegation that has, historically, largely guided prohibitionist-based marijuana policies in the United States despite a lack of hard evidence."
Separate data released late last year by the US Centers for Disease Control similarly reported that the number of adolescents admitted to drug treatment programs for marijuana-related issues has fallen precipitously in states that have legalized and regulated its adult-use. Data published in 2019 in the journal JAMA Pediatrics also reported that the enactment of laws regulating the use of cannabis by adults is associated with declines in self-reported marijuana use by young people.
Full text of the study, "Treatment admissions for opioids, cocaine, and methamphetamines among adolescents and emerging adults after legalization of recreational marijuana," appears in the Journal of Substance Abuse Treatment. Additional information is provided in the NORML fact sheet, "Marijuana Regulation and Teen Use Rates."
Rising Volume of Storefront Dispensaries Associated with Declines in Opioid-Related Fatalities
Davis, CA: The greater availability of cannabis access via storefront dispensaries and retailers is associated with declines in opioid-related deaths, according to an analysis of county-level data published in the British Medical Journal (BMJ).
A pair of researchers affiliated with the University of California at Davis and Yale University in Connecticut assessed the relationship between the volume of storefront dispensaries and opioid-related mortality rates in legal marijuana states over a four year period (2014-2018).
Consistent with prior ecological studies, such as those here, here, and here, investigators "found that increased medical and recreational storefront dispensary counts are associated with reduced opioid related mortality rates during the study period. These associations appear particularly strong for deaths related to synthetic opioids such as fentanyl. Given the alarming rise in the fentanyl-based market in the US, and the increase in deaths involving fentanyl and its analogs in recent years, the question of how legal cannabis availability relates to opioid related deaths is particularly pressing. Overall, our study contributes to understanding the supply side of related drug markets and how it shapes opioid use and misuse."
The study is one of several published in recent weeks reporting reductions in opioid usage following marijuana liberalization. Writing in the journal Applied Health Economics and Health Policy, Canadian investigators similarly reported that retail marijuana legalization in that country preceded a "marked decline" in the volume of opioids prescribed to patients enrolled in both public and private health care plans.
Two just-published longitudinal studies separately reported that patients provided medical cannabis for chronic pain significantly reduce or eliminate their use of opioids over time. In the first study, participants' mean opioid dosage fell by 78 percent within six-months of initiating cannabis therapy. In the second study, subjects accessing medical cannabis exhibited "opioid-sparing effects" over a twelve-month period.
Full text of the study, "Association between county level cannabis dispensary counts and opioid related mortality rates in the United States: panel data study," appears in BMJ.
Opioid Prescriptions Decline in Canada Following Enactment of Adult-Use Marijuana Legalization
Toronto, Canada: The enactment of marijuana legalization in Canada preceded a "marked decline" in the volume of opioids prescribed to patients enrolled in both public and private health care plans, according to data published in the journal Applied Health Economics and Health Policy.
A team of investigators affiliated with the University of Toronto assessed the volume of opioids prescribed, and the amount of money spent on opioids, in the months immediately preceding and immediately following the legalization of adult-use marijuana sales. Researchers obtained claims data for more than 80 percent of all of the opioids prescribed in Canada during the study period (January 2016 to June 2019).
Consistent with the findings of other ecological studies, researchers determined, "The legalization of cannabis coincided with a marked drop in opioid volumes prescribed in Canada."
Authors concluded: "The findings of this 42-month time-series analysis revealed a steady and significantly consistent decline in the mean and median MED [morphine equivalent dose] per claim for public payer drug plans. However, when comparing the pre- versus post-legalization time periods, the decline in the mean MED per claim was approximately 5.4 times greater in the period following legalization (22.3 vs. 4.1 mg per claim). In addition, total public payer monthly opioid spending reductions averaged $Can95,000 per month before October 2018 [when adult-use sales were legalized] compared to $Can267,000 per month following the legalization of cannabis. Similar findings were also observed within private drug plans. ... The findings of this study add to the growing body of evidence that easier access to cannabis for patients with pain may reduce opioid use and partially offset expenditures for both public and private drug plans."
Full text of the study, "Opioid prescribing in Canada following the legalization of cannabis: A clinical and economic time-series analysis," appears in Applied Health Economics and Health Policy.
Study: Cannabis Inhalation Associated with Reduction in Distress-Related Symptoms
Albuquerque, NM: Subjects report significant reductions in distress-related symptoms following the inhalation of herbal cannabis, according to data published in the Journal of Cannabis Research.
A team of researchers affiliated with the University of New Mexico assessed the effects of cannabis inhalation on feelings of irritability, anxiety, and stress in 670 subjects over a nine-month period. Study participants self-administered cannabis at home and reported symptom changes in real time on a mobile software application.
A decrease in distress-related symptoms was reported by subjects over 95 percent of the time following their use of herbal cannabis. Researchers reported, "On average, respondents recorded a maximum symptom intensity reduction of 4.33 points for agitation/irritability, 3.47 points for anxiety, and 3.98 for stress on an 11-point visual analog scale."
Authors reported that higher THC levels were most closely associated with reductions in distress-related symptoms. By contrast, "CBD levels were generally not associated with changes in symptom intensity levels."
They concluded: "The findings suggest the majority of patients in our sample experienced relief from distress-related symptoms following consumption of Cannabis flower, and that among product characteristics, higher THC levels were the strongest predictors of relief."
Using similar methods, UNM researchers have previously reported that cannabis exposure is associated with real-time reductions in migraine symptoms, pain intensity, depressive symptoms, as well as improvements in sleep.
Full text of the study, "The effectiveness of inhaled cannabis flower for the treatment of agitation/irritability, anxiety, and common stress," appears in the Journal of Cannabis Research.
Review: Safety Profile of Oral THC Medications in Older Patients
London, United Kingdom: The administration of oral preparations of synthetic THC is associated with increased incidents of dizziness or lightheadedness in patients over the age of 50, according to a review of randomized controlled trial data published in JAMA Network Open.
A team of researchers affiliated with Kings College in London reviewed safety data from 30 randomized controlled trials involving over 1,400 total subjects. Participants in the trials all consumed oral preparations of THC, primarily synthetic THC (e.g., dronabinol, nabilone, namisol).
Authors reported a dose-specific relationship between higher amounts of THC and dizziness. Subjects were also more likely to self-report feelings of "thinking or perception disorder" following the consumption of higher doses of oral THC. Authors cautioned, however, that these latter symptoms were "not diagnosed using standard assessments," and that the association was largely due to the findings of only two of the 30 trials evaluated.
No other neuropsychiatric adverse events were identified in the trials.
A prior literature review, published last year, assessing the safety profile of oral THC in older patients reported, "The risks of cannabinoids in older persons are modest, but not insignificant." Authors concluded that the most commonly reported side effects in older subjects were sedation, dizziness, and dry mouth. They also cautioned that cannabinoids may potentially be contraindicated with certain blood thinning medications like warfarin.
By contrast, longitudinal data from Israel reported that the use of whole-plant cannabis by elderly patients (ages 65 and older) for a period of six-months was "safe and efficacious." Researchers reported that patients who used cannabis were less likely to fall and were more likely to report an improvement in their medical conditions. Following six-months of cannabis therapy, "the vast majority of the patients" either reduced their use of certain prescription medications or ceased using them altogether - a finding that is consistent with numerous other studies.
Full text of the study, "Evaluation of THC-related neuropsychiatric symptoms among adults aged 50 years and older," appears in JAMA Open Network.
West Virginia: Regulators Begin Issuing Permits for Medical Cannabis Dispensary Operators, Qualifying Patients
Charleston, WV: Regulators affiliated with the West Virginia Office of Medical Cannabis began issuing permits this week to dispensary operators and medical cannabis patients - nearly four years after the state's medicinal cannabis program was initially signed into law.
Regulators so far have granted approval to over 30 providers to operate dispensaries in over 80 locations throughout the state. A list of providers and locations is available online here.
Registration for eligible patients began on Wednesday. Under the law, qualifying patients can only receive cannabis recommendations from physicians who are authorized to participate in the state's access program. An estimated 30 physicians in the state are currently participating in the program. A directory of participating physicians is available online here.
Lawmakers initially approved limited medical marijuana access in April of 2017. Legislators expanded the program in 2019 and in 2020 they amended the law again to allow operators to provide herbal cannabis in addition to infused pills, liquids oils, cream, and dermal patches.
For more information, visit the West Virginia Office of Medical Cannabis.
