More than nine in ten pediatric oncology providers with opinions favor patients’ access to cannabis therapy, according to survey data provided this week at the 2016 annual meeting of the American Society of Clinical Oncology.
Investigators from various US cancer treatment centers surveyed 654 pediatric oncology providers, including physicians and nurses, at three National Cancer Institute-designated cancer centers in Illinois, Massachusetts, and Washington. Over 300 providers (46 percent) completed the survey.
Of those, 92 percent said that they were “willing to help pediatric cancer patients access medical marijuana,” and just over one-third (34 percent) acknowledged that cannabis therapy “is appropriate in the early stages of cancer treatment.”
Thirty percent of respondents reported receiving requests from patients or their families to access medical marijuana therapy at least once per month.
Overall, pediatric oncology providers hold “predominantly favorable attitudes toward medical marijuana use in pediatric cancer patients,” authors concluded.
Previous surveys of physicians and health care providers report similar attitudes. Survey results published in 2013 in the New England Journal of Medicine reported that 76 percent of respondents supported the use of cannabis therapy in the treatment of metastatic breast cancer. A 2014 poll of over 1,500 physicians commissioned by Web MD similarly reported that 82 percent of oncologists believed that marijuana treatment provides legitimate therapeutic benefits.
An abstract of the survey data, “Pediatric oncology providers and use of medical marijuana in children with cancer,” appears online here.
Fewer adolescents are consuming cannabis; among those who do, fewer are engaging in problematic use of the plant, according to newly published data in the Journal of the American Academy of Child & Adolescent Psychiatry.
Investigators at Washington University School of Medicine in St. Louis evaluated government survey data on adolescents’ self-reported drug use during the years 2002 to 2013. Over 216,000 adolescents ages 12 to 17 participated in the federally commissioned surveys.
Researchers reported that the percentage of respondents who said that they had used cannabis over the past year fell by ten percent during the study period. The number of adolescents reporting problems related to marijuana, such as engaging in habitual use of the plant, declined by 24 percent from 2002 to 2013.
The study’s lead author acknowledged that the declines in marijuana use and abuse were “substantial.”
The study’s findings are consistent with previous evaluations reporting decreased marijuana use and abuse by young people over the past decade and a half — a period of time during which numerous states have liberalized their marijuana policies.
An abstract of the new study, “Declining prevalence of marijuana use disorders among adolescents in the United States, 2002 to 2013,” appears online here.
Per se driving limits for the presence of THC are arbitrary and may improperly classify motorists who are not behaviorally impaired, according to the findings of a study published today by the American Automobile Association (AAA) Foundation for Traffic Safety.
Per se driving limits criminalize the act of operating a motor vehicle if the driver possesses detectable amounts of specific drugs or drug metabolites above a set threshold. Under these laws, drivers are guilty per se of violating the traffic safety laws even absent evidence of demonstrable behavioral impairment.
Five states – Montana, Nevada, Ohio, Pennsylvania, and Washington – presently impose per se limits for the detection of specific amounts of THC in blood while eleven states (Arizona, Delaware, Georgia, Illinois, Indiana, Iowa, Michigan, Oklahoma, Rhode Island, Utah, and Wisconsin) impose zero tolerant per se standards. In Colorado, the presence of THC in blood above 5ng/ml “gives rise to permissible inference that the defendant was under the influence.” Legislation similar to Colorado’s law is presently pending in California.
However, the AAA report concludes, “[A] quantitative threshold for per se laws for THC following cannabis use cannot be scientifically reported.” This is because the body metabolizes THC in a manner that is significantly distinct from alcohol. In particular, acute effects of cannabinoids lag well behind the presence of maximum THC/blood levels. Additionally, residual levels of THC may be present in blood for extended periods of time, long after any psychomotor-related effects have ceased.
The Automobile Association’s finding is similar to that of the US National Highway Traffic Safety Administration, which acknowledges: “It is difficult to establish a relationship between a person’s THC blood or plasma concentration and performance impairing effects. … It is inadvisable to try and predict effects based on blood THC concentrations alone.”
NORML has long articulated a similar opposition to the imposition of per se driving thresholds for THC and/or its metabolites, stating, “[R]ecently adopted statewide per se limits and zero tolerant per se thresholds in the United States criminally prohibiting the operation of a motor vehicle by persons with the trace presence of cannabinoids or cannabinoid metabolites in their blood or urine are not based upon scientific evidence or consensus. … [T]he enforcement of these strict liability standards risks inappropriately convicting unimpaired subjects of traffic safety violations, including those persons who are consuming cannabis legally in accordance with other state statutes.”
Rates of prescription opioid abuse are significantly lower in jurisdictions that permit medical marijuana access, according to data reported by Castlight Health, an employee health benefits platform provider.
Investigators assessed anonymous prescription reporting data from over one million employees between the years 2011 and 2015.
In states that did not permit medical marijuana access, 5.4 percent of individuals with an opioid prescription qualified as abusers of the drug. (The study’s authors defined “abuse” as opioid use by an individual who was not receiving palliative care, who received greater than a 90-day cumulative supply of opioids, and received an opioid prescription from four or more providers.) By contrast, only 2.8 percent of individuals with an opioid prescription living in medical marijuana states met the criteria.
The findings are similar to those reported by the RAND Corporation in 2015, which determined, “[S]tates permitting medical marijuana dispensaries experience a relative decrease in both opioid addictions and opioid overdose deaths compared to states that do not.”
Data published in 2014 in the Journal of the American Medical Association (JAMA) Internal Medicine also reported that the enactment of statewide medicinal marijuana laws is associated with significantly lower state-level opioid overdose mortality rates, finding, “States with medical cannabis laws had a 24.8 percent lower mean annual opioid overdose mortality rate compared with states without medical cannabis laws.”
Full text of the new study, “The opioid crisis in America’s workforce,” appears online here.
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.