#NORML #News Source: @norml @WeedConnection Posted By: norml@weedconnection.com media :: news - Tue, 18 May 2021 04:20:21 PST
Study: Medical Cannabis Authorizations Correlated with Reduced Use of Opioids
Alberta, Canada: Medical cannabis patients reduce their use of opioids at rates greater than matched controls, according to longitudinal data published in the journal BMC Public Health.
Researchers affiliated with the University of Alberta and the University of Toronto assessed the relationship between medical cannabis use and opioid intake in a cohort of 30,000 chronic opioid users. Over 5,300 of the study participants were authorized by their physicians to use medical cannabis while the remaining subjects served as controls. Investigators evaluated changes in the weekly average oral morphine equivalent (OME) of opioid drugs for medical cannabis patients relative to controls during the 26 weeks before and during the 52 weeks after patients received their authorizations.
They reported, "Among those prescribed high doses of opioids (OME>100), there were significant reductions in opioid consumption" relative to matched controls. By contrast, those subjects prescribed lower doses of opioids prior to receiving their medical cannabis authorizations failed to show a statistically significant reduction in their opioid intake relative to controls.
Authors concluded: "This short-term analysis on this population-based study of patients in Alberta, Canada showed that authorization for medical cannabis had intermediate effects on weekly OME in adults prescribed chronic opioids treatment, which was dependent on initial opioid dose. ... Greater observations of changes in OME appear to be in those patients who were on a high dosage of opioids (OME>100). ... Overall, our findings may contribute ongoing evidence for clinicians regarding the potential impact of medical cannabis to reduce the opioid burden among patients."
Full text of the study, "Opioid use in medical cannabis authorization for adult patients from 2013 to 2018: Alberta, Canada," appears in BMC Public Health. Additional information on the relationship between cannabis and opioid use patterns is available from the NORML fact sheet, "Relationship between Marijuana and Opioids."
Review: Use of Medical Cannabis Products Not Associated with Increased Risk of "Serious Cardiovascular Events"
Salt Lake City, UT: Patients' consumption of either purified or synthetic cannabinoids, including THC, is not associated with any increased risk of serious cardiovascular events, according to a review of clinical trial data published in the Journal of the American Pharmacists Association.
An international team of investigators from the United States and Thailand reviewed data from 46 randomized clinical trials involving 2,800 patients. Subjects in the trials typically consumed oral doses of either synthetic forms of THC (e.g., nabilone or dronabinol) or purified cannabis extracts.
The most common cardiovascular events reported by study subjects were non-serious in nature. These included increased risks of either hypotension (low blood pressure) or tachycardia (rapid heartbeat). By contrast, authors concluded, "None of the studies reported serious cardiovascular events."
They cautioned, however, that few participants in the studies smoked cannabis flower - which may expose subjects to other ingredients or contaminants that could potentially trigger more serious adverse cardiovascular events. They further acknowledged that just under half of the trials reviewed excluded subjects from participation if they possessed underlying cardiovascular diseases, and that most of the studies were relatively short-term in duration.
Investigators concluded: "Cannabis and cannabinoid use were associated with tachycardia, hypotension, and orthostatic hypotension. ... In general, there is a paucity of data for other cardiovascular events among medical cannabis users, particularly serious cardiovascular events. ... More trials with longer durations and in patients with existing cardio- vascular diseases or real-world evidence are needed to better determine the effects of cannabinoids on the cardio- vascular system."
Israeli data published earlier this year reported that elderly patients with hypertension responded favorably to medical cannabis treatment and that it "was associated with a reduction in systolic and diastolic blood pressure, as well as heart rate."
Analyses of nationally representative samples of recreational marijuana consumers have reported mixed results regarding the relationship between cannabis and adverse cardiovascular events. A 2021 study of 57,000 US adults concluded, "After controlling for several confounding variables, we found that there was a decrease in the prevalence of cardiovascular events with marijuana use (Odds Ratio: 0.74)." By contrast, a 2020 review of nearly 134,000 US adults reported, "Frequent marijuana smoking is associated with significantly higher odds of stroke and myocardial infarction or coronary artery disease, with a possible role in premature cardiovascular disease." Most recently, the results of a 2021 literature review of 67 studies published in The American Journal of Medicine concluded, "[M]arijuana itself does not appear to be independently associated with excessive cardiovascular risk factors." Authors did caution, however, that "it can be associated with other unhealthy behaviors such as alcohol use and tobacco smoking that can be detrimental" to cardiovascular health.
NORML has previously cautioned that those persons either predisposed to or at high risk of cardiovascular issues, such as heart attack or stroke, may be at elevated risks from cannabis inhalation.
Full text of the study, "A systematic review and meta-analysis of randomized controlled trials of cardiovascular toxicity of medical cannabinoids," appears in the Journal of the American Pharmacists Association.
Older Veterans Using Cannabis for Mental Health Conditions
Champaign, IL: Older veterans are turning to cannabis to treat certain mental health conditions, as well as to mitigate chronic pain and improve sleep, according to data published in The American Journal of Drug and Alcohol Abuse.
A team of investigators affiliated with the University of Illinois assessed marijuana use in a cohort of 514 older (ages 60+) veterans residing in a state (Illinois) where medical cannabis access is legal.
Compared to non-veterans of similar ages, veterans in the study were more likely to report using cannabis for the treatment of mental health conditions, such as post-traumatic stress, anxiety, and insomnia.
Veterans in the study typically reported "desirable health outcomes" as a result of their cannabis use. Most subjects said that cannabis reduced their chronic pain, improved their sleep, and led to improvements in their overall quality of life - a finding that is consistent with prior studies assessing the use of medical cannabis in older populations.
Authors concluded: "The present study contributes needed evidence about motives for and health outcomes of cannabis use by older veterans which may differ from younger veterans. ... Veterans reported positive effects of cannabis use for their pain, sleep quality, health conditions, and QOL (quality of life). ... Our results may help clinicians to consider [the] motives behind cannabis use by veterans and engage more with veterans about alternative ways to treat their conditions."
Full text of the study, "Biopsychosocial factors and health outcomes associated with cannabis, opioids and benzodiazepines use among older veterans," appears in The American Journal of Drug and Alcohol Abuse. Additional information on cannabis use among veterans is available from the NORML fact sheet, "Marijuana and Veterans Issues."
Nearly Ten Percent of US Adults Over Age 50 Have Used Cannabis in the Past Year
Austin, TX: Nearly ten percent of adults age 50 or older say that they have consumed cannabis in the past year, according to data published in The American Journal of Drug and Alcohol Abuse.
A pair of researchers affiliated with the University of Texas at Austin examined cannabis use patterns among a nationally representative cohort of 17,685 subjects aged 50+. Nine percent of respondents reported having used cannabis within the past year. Among them, nearly 20 percent (18.5 percent) defined their use as medical. Over 85 percent of older cannabis consumers said that it was either "fairly or very easy" for them to obtain cannabis, despite only a minority of respondents acknowledging having acquired marijuana products from state-regulated outlets. Most respondents said that they did not discuss their cannabis use with their primary health care providers.
The findings are consistent with several prior studies showing a dramatic uptick in the percentage of older adults acknowledging the use of cannabis for either medical or recreational purposes.
Full text of the study, "Comparing older nonmedical and medical cannabis users: Health-related characteristics, cannabis use patterns, and cannabis sources," appears in The American Journal of Drug and Alcohol Abuse.
Survey: Fibromyalgia Patients Frequently Report Using Medical Cannabis
Montreal, Canada: The use of cannabis for medical purposes is commonly reported among Canadian patients with fibromyalgia (FM), according to survey data published in the journal Clinical and Experimental Rheumatology.
A team of researchers affiliated with McGill University in Montreal surveyed a cohort of 1,000 rheumatology patients. Among the 117 patients with FM, 24 percent reported a history of cannabis use. (By contrast, only 11 percent of non-FM patients reported having used cannabis.) Of those FM patients with past cannabis experience, 61 percent classified themselves as current marijuana consumers, with many reporting experiencing "substantial" symptom relief from the substance.
The findings are consistent with those of other studies reporting that FM patients frequently use both whole-plant cannabis and CBD products to manage their disease symptoms.
Some dozen human studies, including this one and this one, indicate that cannabinoids provide relief to patients with fibromyalgia. Most recently, data published in February reported that the long-term use of various types of cannabis preparations was associated with significant improvements in pain and other symptoms in patients with refractory fibromyalgia.
Full text of the study, "Use of medical cannabis by patients with fibromyalgia in Canada after cannabis legalization: A cross-sectional study," appears in Clinical and Experimental Rheumatology.
