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SCIENCE

  • by Paul Armentano, NORML Deputy Director February 24, 2016

    flag_of_canadaA 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.

  • by Paul Armentano, NORML Deputy Director February 22, 2016

    for_painThe long-term, daily use of cannabis is associated with improved analgesia and reduced opioid use in patients with treatment-resistant chronic pain conditions, according to clinical trial data reported online ahead of print in The Clinical Journal of Pain.

    Investigators with Hebrew University in Israel evaluated the use of cannabis on pain in a cohort of 176 patients, each of whom had been previously unresponsive to all conventional pain medications. Subjects inhaled THC-dominant cannabis daily (up to 20 grams per month) for a period of at least six months.

    A majority of participants (66 percent) experienced improvement in their pain symptom scores after cannabis therapy, and most reported “robust” improvements in their quality of life. Subjects’ overall consumption of opioid drugs declined 44 percent by the end of the trial, and a significant percentage of participants discontinued opioid therapy altogether over the course of the study.

    Authors concluded, “In summary, this long-term prospective cohort suggests that cannabis treatment in a mixed group of patients with treatment-resistant chronic pain may result in improved pain, sleep and quality of life outcomes, as well as reduced opioid use.”

    The Israeli results are similar to those reported in a 2015 Canadian trial which concluded that chronic pain patients who use 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.

    According to data published in 2014 in The Journal of the American Medical Association, US states with medical marijuana laws experience far fewer opiate-related deaths than do states that prohibit the plant. Investigators from the RAND Corporation and the University of California, Irvine 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.”

    A review published earlier this year in the Canadian Journal of Anesthesia assessing the clinical use of cannabinoids for pain in over 1,300 subjects concludes, “Overall, the recent literature supports the idea that currently available cannabinoids are modestly effective analgesics that provide a safe, reasonable therapeutic option for managing chronic non-cancer-related pain and possibly cancer-related pain.”

    An abstract of the study, “The effect of medicinal cannabis on pain and quality of life outcomes in chronic pain: A prospective open-label study,” appears online here.

  • by Paul Armentano, NORML Deputy Director February 16, 2016

    joint_budA report published last fall claiming that an estimated three in ten consumers of cannabis suffer from a ‘use disorder’ has been dismissed in a new study published in JAMA Psychiatry.

    Investigators at the Washington School of Medicine in St. Louis assessed trends in marijuana use and the prevalence of marijuana use disorders during the years 2002 to 2013. Researchers determined that the self-reported use of cannabis by adults increased an estimated 19 percent, but that reports of cannabis-related problems actually declined during this same period.

    “We’re certainly seeing some increases in marijuana use,” the lead researcher of the new study said. “But our survey didn’t notice any increase in marijuana-related problems. Certainly, some people are having problems so we should remain vigilant, but the sky is not falling.”

    Separate evaluations of self-reported marijuana use by young people have determined that rates of cannabis use by high-school students is significantly lower today than it was 15 years ago.

    Full text of the study, “Recent Trends in the Prevalence of Marijuana Use and Associated Disorders in the United States,” appears online in JAMA Psychiatry here.

  • by Paul Armentano, NORML Deputy Director February 9, 2016

    cannabis_pillsCannabinoids are safe and effective in the treatment of chronic pain conditions, according to a review of recent clinical trials published online ahead of print in the Canadian Journal of Anesthesia.

    Investigators at the University of Montreal, Department of Anesthesiology evaluated the results of 26 clinical trials “of good or excellent quality” involving 1,364 subjects. Trials assessed the use of various types of cannabinoid preparations, including herbal cannabis, liquid and oral cannabis extracts, and synthetic cannabinoid agents in pain treatment.

    Authors reported that cannabinoids were efficacious in alleviating various types of pain, including pain due to neuropathy, musculoskeletal disorders, fibromyalgia, HIV, and other chronic pain conditions.

    They concluded, “Overall, the recent literature supports the idea that currently available cannabinoids are modestly effective analgesics that provide a safe, reasonable therapeutic option for managing chronic non-cancer-related pain and possibly cancer-related pain.”

    Their conclusion mimics that of a 2015 systematic review published in the Journal of Neuroimmune Pharmacology that reported, “[C]annabinoids are safe, demonstrate a modest analgesic effect, and provide a reasonable treatment option for treatment of chronic non-cancer pain.”

    An abstract of the study, “Medical cannabis: considerations for the anesthesiologist and pain physician,” appears online here.

  • by Paul Armentano, NORML Deputy Director January 27, 2016

    cbdThe administration of cannabis oil extracts high in cannabidiol reduces seizure frequency in children with intractable epilepsy, according to clinical data published online ahead of print in the journal Seizure.

    Israeli researchers retrospectively evaluated the effects of CBD oil in a multicenter cohort of 74 patients with intractable epilepsy. Participants in the trial were resistant to conventional epilepsy treatment and were treated with CBD extracts for a period of at least three months. Extracts in the study were provided by a pair of Israeli-licensed growers and were standardized to possess a CBD to THC ratio of 20 to 1.

    Investigators reported: “CBD treatment yielded a significant positive effect on seizure load. Most of the children (89 percent) reported reduction in seizure frequency. … In addition, we observed improvement in behavior and alertness, language, communication, motor skills and sleep.”

    They concluded, “The results of this multicenter study on CBD treatment for intractable epilepsy in a population of children and adolescents are highly promising. Further prospective, well-designed clinical trials using enriched CBD medical cannabis are warranted.”

    Previously published retrospective studies and surveys, such as those here and here and here, have also reported CBD administration to be efficacious in reducing seizure frequency.

    In 2013, the United States Food and Drug Administration granted orphan drug status to imported, pharmaceutically standardized CBD (aka Epidiolex) extracts for use in experimental pediatric treatment. Open-label safety trial data published online in December 2015 in the journal Lancet Neurology reported a median reduction in seizures in adolescent patient treated with Epidiolex that approached 40 percent. Authors concluded, “Our findings suggest that cannabidiol might reduce seizure frequency and might have an adequate safety profile in children and young adults with highly treatment-resistant epilepsy.”

    An abstract of the study, “CBD-enriched medical cannabis for intractable pediatric epilepsy: The current Israeli experience,” appears online here.

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