FDA Reports on Purity of Commercially Available CBD Products
Washington, DC: Fewer than half of the commercially available hemp/CBD products tested this year by the US Food and Drug Administration (FDA) contain percentages of cannabidiol that are consistent with the products' labelling, according to data provided by the agency in a recently released report to Congress.
According to the report, the FDA tested 147 CBD-specific products marketed for sale online, including tinctures, capsules, gummies, and beverages. One hundred and two of those products provided information on the label indicating the specific percentages of CBD present in them. However, lab analyses confirmed that only 45 percent of those products contained actual amounts of CBD that were consistent with the products' advertising.
The findings are consistent with those of numerous other analyses -- such as those here and here -- which similarly report that the amount of cannabidiol available in commercially distributed CBD/hemp products typically differs significantly from what is advertised.
The FDA has been directed by Congress to conduct a sampling study of commercially available CBD products "to determine the extent to which products are mislabeled or adulterated." Such products are currently not regulated by the FDA, despite much of the public presuming otherwise.
The agency cautioned that its findings are "preliminary" and acknowledged that it will report to Congress once again "when complete data sets are available."
In March, the agency informed Congressional members that it "is actively evaluating what and how much data would be sufficient to support a conclusion that CBD can be safely allowed in dietary supplements under certain conditions." At that time, the agency reiterated its longstanding position that the majority of commercially available CBD-infused products are marketed in a manner that is inconsistent with the Food, Drug & Cosmetics Act.
Study: Cumulative Use of Cannabis Not Associated with Heart Abnormalities at Middle Age
San Francisco, CA: Neither the current nor the cumulative lifetime use of cannabis is associated with heart abnormalities at middle age, according to clinical data published in the journal Addiction.
An international team of researchers from Switzerland and the United States assessed the relationship between cumulative marijuana use and the prevalence of electrocardiogram (ECG) abnormalities in a group of 2,585 middle age subjects. Researchers controlled for several potential confounders, including subjects' use of alcohol and tobacco, as well as blood pressure and cholesterol levels.
Investigators reported: "We found no evidence that current or lifetime cumulative use of marijuana was associated with a higher prevalence or incidence of major or minor ECG abnormalities in this cohort, ... although major ECG abnormalities seemed to be less frequent in current marijuana users. ... Whether participants used marijuana daily, in the last 30 days or intermittently over a lifetime, marijuana use was not associated with an increase in prevalent or incident specific ECG abnormalities by middle-age."
They concluded, "Our finding that occasional marijuana was not associated with ECG abnormalities adds to the growing body of evidence that this level of marijuana use and CVD [cardiovascular disease] events and markers of subclinical atherosclerosis are not associated."
Subjects in the study are participants in an ongoing longitudinal trial known as the CARDIA (Coronary Artery Risk Development in Young Adults) study. Data derived from this cohort has previously reported that the cumulative use of marijuana is not independently associated with an increased risk of either atherosclerosis (hardening of the arteries) or other adverse cardiovascular events by middle age.
Full text of the study, "Association between marijuana use and electrocardiographic abnormalities by middle age," appears in Addiction.
Study: Cannabis-Based Products May Ease Symptoms in Autistic Patients
Boston, MA: The oral administration of cannabis-based products is associated with improvements in autistic patients with self-injurious behaviors and co-morbid epilepsy, according to data published in the journal Seminars in Pediatric Neurology.
A pair of investigators affiliated with the Tufts University School of Medicine described their clinical experience working with children and young adults with ASD (autism spectrum disorder) who had consumed either cannabis or hemp-based products. Among subjects with ASD-associated aggression, 60 percent reported improvements following treatment. Among subjects diagnosed with both ASD and epilepsy, 91 percent reported some improvement in seizure control.
Authors concluded: "Based on our experience, cannabis-based products appear to hold promise for use in patients with ASD. The primary reasons for use in our patient population was treatment of aggressive (including self-injurious behaviors) and epilepsy. Patients were not using these products for core symptoms of ASD such as language and social development, so the response to therapy for core symptoms was not assessed in our patient population."
Several small clinical trials -- such as those reported here, here, here, and here -- have similarly reported that plant-derived cannabis extracts are effective and well-tolerated in mitigating various symptoms in patients with ASD, including hyperactivity, seizures, anxiety, and rage attacks.
Full text of the study, "Autism Spectrum Disorder and medical cannabis: Review & clinical experience," appears in Seminars in Pediatric Neurology.
Data Mixed with Respect to Cannabis and Preterm Birth Risk, Other Neonatal Outcomes
Columbus, OH: Newly published data exploring the relationship between maternal cannabis exposure and the risk of preterm birth (births prior to 37 weeks) shows inconsistent results.
In one recent study, published in the American Journal of Perinatology, investigators affiliated with the Ohio State University College of Medicine assessed the impact of self-reported cannabis use during pregnancy in 363 women at high risk of having a preterm birth. Authors determined, "Marijuana use was not associated with total preterm birth in this cohort, suggesting that among women already at high risk of preterm birth, marijuana does not increase risk further."
Those findings are inconsistent with those of a separate paper published recently in the journal Pediatric and Perinatal Epidemiology. Researchers with John Hopkins University and the Boston University School of Medicine evaluated whether maternal cannabis use was independently associated with preterm birth and/or shorter gestational age in a cohort of 8,261 subjects. They reported that the concurrent use of cannabis and tobacco was associated with an increased risk of preterm birth, as was the use of marijuana alone if it was consumed in the final weeks of pregnancy. Maternal cannabis exposure was also associated with decreases in gestational age at birth. Authors acknowledged that prior studies on the subject have yielded mixed results and concluded, "Future studies need to confirm [these] findings before conclusions can be made regarding the risks of marijuana use a preterm birth."
A third study, published by a team of British and Australian researchers in the Medical Journal of Australia, assessed the impact of cannabis use patterns on birth outcomes in 314 women. Investigators reported that the continued use of cannabis after 15 weeks of pregnancy was independently associated with "significant reductions in infant gestational age at birth," as well as other adverse neonatal outcomes.
A fourth study, published in Nature: Journal of Perinatology, similarly identified an elevated risk of both preterm birth and shorter gestational age among marijuana-exposed newborns as compared to non-exposed controls. "[These] effects could not be attributed to other comorbidities, including other drug exposure and sociodemographic risks," because the study "involved rigorous matching" of marijuana-using subjects and controls, authors wrote. Their findings, however, are inconsistent with those of another, similarly designed case-control study, recently published in The Journal of Maternal-Fetal & Neonatal Medicine. That study reported no significant differences in either birth weight or rates of pre-term delivery among mothers who used cannabis during their pregnancy as compared to those who did not.
Yet another study, published this month in the Journal of Maternal-Fetal & Neonatal Medicine, assessed both maternal and neonatal outcomes among women with hypertension in pregnancy. Researchers identified no differences in outcomes that could be attributable to cannabis exposure between users and non-users. They concluded, "Marijuana use in pregnancy was not associated with maternal or neonatal outcomes or worsened hypertensive disease among women with hypertension in pregnancy after adjusting for maternal characteristics."
In May, a team of Columbia University researchers published a systematic review in the journal Frontiers in Psychology of 40 longitudinal studies assessing cognitive and developmental skills in marijuana-exposed offspring. That study concluded, "The [available] evidence [to date] does not support an association between prenatal cannabis exposure and clinically relevant cognitive deficits" later in life.
Missouri: Governor Signs Legislation Limiting Sales of Cannabis Edibles, Requiring Criminal Background Checks for Dispensary Employees
Columbia, MO: Republican Gov, Mike Parson on Monday signed legislation into law amending various aspects of the state's nascent medical cannabis access program.
The new law mandates criminal background checks for those either working in or affiliated with the medical cannabis industry. It "require all officers, managers, contractors, employees, and other support staff of licensed or certified medical marijuana facilities, and all owners of such medical marijuana facilities who will have access to the facilities or to the facilities' medical marijuana, to submit fingerprints to the Missouri state highway patrol for the purpose of conducting a state and federal fingerprint-based criminal background check."
Separate provisions of the law impose limits on the types of edible products that may be dispensed. No products shaped in a manner that resembles "a human, animal, or fruit" will be permitted. Edible products in the form of "geometric shapes" are allowed. The language further stipulates that the packaging of edible products containing ten or more milligrams of THC be stamped with the letter "M" and a diamond containing the letters "THC."
Other provisions in the law provide rules for physicians to authorize medical cannabis recommendations via telemedicine appointments.
Voters in 2018 approved a statewide ballot measure establishing the state's medical cannabis access program. Over 22,000 Missourians are registered with the state to participate in the program, but state-licensed dispensaries are not yet operational.
California: Nevada County District Attorney to Dismiss Decades' Worth of Marijuana Convictions
Truckee, CA: The Office of the District Attorney for Nevada County (population: 99,000) has filed a motion to dismiss hundreds of low-level marijuana convictions dating back to the 1970s. Several other felony marijuana convictions will be reduced to misdemeanors.
Nevada County joins Alameda, Los Angeles, Sacramento, Santa Clara, Santa Cruz, and several other counties in the state that have recently reviewed and expunged tens of thousands of past cannabis convictions.
A state law signed in 2018 requires officials to review and identify past marijuana convictions that may be eligible for dismissal. To date, officials have identified nearly 200,000 Californians eligible to have their convictions either dismissed or resentenced.
Missouri: Kansas City Council Votes to Eliminate Local Penalties for Marijuana Possession Offenses
Kansas City, MO: Members of the Kansas City council approved a municipal ordinance late last week repealing all local penalties specific to activities involving the personal possession of marijuana.
The measure, approved by the council in a 9 to 4 vote, amends the municipal code so that marijuana possession is no longer a violation within the city limits.
Local lawmakers acknowledged that, historically, marijuana law enforcement activities were disproportionately targeted toward people of color. They resolved, "Future [city] resources should be focused on prevention, investigation, and prosecution of violent crime."
The change in local law enforcement policy does not alter state law, nor does it prohibit county prosecutors from pursuing criminal charges for certain offenders.
"Councilman Brandon Ellington verbalized for the record that this [local policy change] does not prevent anyone in Kansas City, Missouri from being charged under state law, which defines the possession of marijuana of up to 10 grams for a first-time offender as a misdemeanor drug charge punishable by a $500 fine, with much steeper penalties for subsequent offenses," representatives of NORML KC posted in a statement on Facebook.
Kansas City voters approved a municipal initiative in 2017 decriminalizing offenses involving the possession of up to 35 grams of marijuana. This new legislation repeals that ordinance.
In 2018, the Jackson County prosecutor's office announced that they would cease prosecuting minor marijuana possession cases.
