Chronic pain patients with legal access to medicinal cannabis significantly decrease their use of opioids, according to data published online ahead of print in The Journal of Pain.
Investigators at the University of Michigan, Ann Arbor conducted a retrospective survey of 244 chronic pain patients. All of the subjects in the survey were qualified under Michigan law to consume medicinal cannabis and frequented an area dispensary to obtain it.
Authors reported that respondents often substituted cannabis for opiates and that many rated marijuana to be more effective.
“Among study participants, medical cannabis use was associated with a 64% decrease in opioid use, decreased number and side effects of medications, and an improved quality of life,” they concluded. “This study suggests that many chronic pain patients are essentially substituting medical cannabis for opioids and other medications for chronic pain treatment, and finding the benefit and side effect profile of cannabis to be greater than these other classes of medications.”
About 40 people die daily from opioid overdoses, according to the US Centers for Disease Control.
Clinical trial data published last month in The Clinical Journal of Pain reported that daily, long-term herbal cannabis treatment is associated with improved pain relief, sleep and quality of life outcomes, as well as reduced opioid use, in patients unresponsive to conventional analgesic therapies.
The results of a 2015 Canadian trial similarly concluded that chronic pain patients who consumed herbal cannabis daily for one-year experienced reduced discomfort and increased quality of life compared to controls, and did not possess an increased risk of serious side effects.
Separate data published in 2014 in The Journal of the American Medical Association determined that states with medical marijuana laws experience far fewer opiate-related deaths than do states that prohibit the plant. Investigators from the RAND Corporation reported similar findings in 2015, concluding, “States permitting medical marijuana dispensaries experience a relative decrease in both opioid addictions and opioid overdose deaths compared to states that do not.” Clinical data published in 2011 in the journal Clinical Pharmacology & Therapeutics previously reported that the administration of vaporized cannabis “safely augments the analgesic effect of opioids.”
An abstract of the University of Michigan study, “Medical cannabis associated with decreased opiate medication use in retrospective cross-sectional survey of chronic pain patients,” appears online here.
Cannabis-influenced driving performance is significantly different from alcohol-induced driving behavior, according to driving simulator data published in the Journal of Applied Toxicology.
Investigators with the National Institute on Drug Abuse and the University of Iowa evaluated simulated driving performance in subjects following their consumption of vaporized cannabis, alcohol, or placebo.
Researchers reported that cannabis administration was associated compensatory driving behavior, such as decreased mean speed and increased mean following distance, whereas alcohol administration was associated with faster driving. Their findings are similar to those of other driving studies, like those here and here.
Investigators also reported that cannabis dosing in combination with low quantities of alcohol “mitigated drivers’ tendency to drive faster with alcohol” – a finding that contrasts with prior data acknowledging that the two substances combined typically possess an additive adverse effect on psychomotor performance.
“THC concentration-dependent associations with decreased speed, increased time below the speed limit and increased following distance suggest possible awareness by drivers of potential impairment and attempts to compensate,” authors concluded. “The compensatory behavior exhibited by cannabis-influenced drivers distinctly contrasts with an alcohol-induced higher risk behavior, evidenced by greater percent speed.”
According to the findings of a recently published literature review of crash culpability studies, “[A]cute cannabis intoxication is related to a statistically significant risk increase of low to moderate magnitude [odds ratio between 1.2 and 1.4].” By contrast, a 2015 case-control study by the US National Highway Traffic Safety Administration reported that driving with legal amounts of booze in one’s system is associated with a nearly four-fold increased crash risk (odds ratio = 3.93).
An abstract of the study, “Cannabis effects on driving longitudinal control with and without alcohol,” appears online here.
The enactment of statewide laws permitting the physician-authorized use of cannabis therapy has not stimulated increases in marijuana use by young people, according to findings published in The International Journal on Drug Policy.
A team of researchers from Columbia University in New York City reviewed federal data regarding rates of self-reported, monthly marijuana use among 12 to 17-year-olds between the years 2002 and 2011.
While the study’s authors acknowledged that many medical marijuana states possess greater overall rates of youth cannabis use compared to non-medical states, they affirmed that these jurisdictions already possessed elevated use rates prior to changes in law, and that the laws’ enactment did not play a role in influencing youth use patterns.
“While states with MML (medical marijuana laws) feature higher rates of adolescent marijuana use, to date, no major U.S. national data set, including the NSDUH (US National Survey on Drug Use in Households), supports that MML are a cause of these higher use levels,” investigators concluded. “[W]hen within-state changes are properly considered and pre-MML prevalence is properly controlled, there is no evidence of a differential increase in past-month marijuana use in youth that can be attributed to state medical marijuana laws.”
Their findings are similar to those of a separate 2015 study assessing the relationship between state medical marijuana laws and rates of self-reported adolescent marijuana use over a 24-year period in a sampling of over one million adolescents in 48 states. Researchers in that study reported no increase in teens’ overall cannabis use that could be attributable to changes in law, and acknowledged a “robust” decrease in consumption among 8th graders. They concluded “[T]he results of this study showed no evidence for an increase in adolescent marijuana use after the passage of state laws permitting use of marijuana for medical purposes. … [C]oncerns that increased marijuana use is an unintended effect of state marijuana laws seem unfounded.”
The abstract of the study, “Prevalence of marijuana use does not differentially increase among youth after states pass medical marijuana laws: Commentary on and reanalysis of US National Survey on Drug Use in Households data 2002-2011,” appears online here.
Members of Australia’s House and Senate approved legislation this week to amend federal law to permit for the licensed production and distribution of cannabis to qualified patients.
The measure amends the Narcotic Drugs Act of 1967 to allow “for the cultivation and production of cannabis and cannabis resin for medicinal and scientific purposes,” and to authorize “a state or territory government agency to undertake [in the] cultivation and production of cannabis and [in the] manufacture of medicinal cannabis products.”
The move by Parliament follows recent efforts by several Australian territories to provide patients participating in clinical trials with access to the plant.
“This is an historic day for Australia and the many advocates who have fought long and hard to challenge the stigma around medicinal cannabis products so genuine patients are no longer treated as criminals,” Minister for Health Sussan Ley said in a statement. “This is the missing piece in a patient’s treatment journey and will now see seamless access to locally-produced medicinal cannabis products from farm to pharmacy.”
Government officials will still need to develop and approve regulations for the new program before any production licenses can be issued.
Canada, Israel, and the Netherlands are among the handful of nations that presently provide federal licenses to private growers to supply medical marijuana to qualified patients. Colombia, Jamaica, and Puerto Rico are also expected to begin licensing medical marijuana manufacturing in the near future.
In 2013, Uruguay officials approved legislation authorizing the retail production and sale of cannabis to those age 18 and older. Consumers in that country are anticipated to be able to begin purchasing cannabis at state-licensed pharmacies by mid-2016.
A federal court in Canada ruled today that government officials cannot prohibit physician-authorized patients from growing their own supply of medical cannabis.
The decision strikes down regulations enacted in 2013 that sought to take away patients’ longstanding authority to grow personal use quantities of cannabis. The court opined that the regulations unduly infringed upon patients’ liberties and that they were “not in accordance with the principles of fundamental justice.”
The judge’s ruling provides Parliament with six months to create new rules governing the regulation and distribution of medical cannabis in a manner that no longer requires patients to obtain medicine solely from federally-licensed, private third party providers.
NORML Canada‘s John Conroy served as lead counsel for the plaintiffs in the case, while NORML Deputy Director Paul Armentano served as an expert witness and filed an affidavit in the case.
Canadian officials first legalized the physician authorized use, possession, and home cultivation of medical marijuana in 2001. Those regulations were significantly amended in 2013 in a manner that sought to prohibit qualified patients from continuing to receive cannabis from Health Canada or from growing it themselves.
Last year, newly elected Prime Minister Justin Trudeau promised to amend Canada’s marijuana laws in a manner that regulates the plant’s use and sale for all adults.
Text of the decision, Allard et al. v Canada, is online here.