• by Paul Armentano, NORML Deputy Director March 5, 2018

    Pain reliefCannabis therapy mitigates symptoms of the chronic pain condition fibromyalgia and is associated with a reduction in the use of other prescription drugs, according to clinical data published online ahead of print in the Journal of Clinical Rheumatology. An estimated 3 to 6 million Americans are afflicted by fibromyalgia, which is often poorly controlled by standard pain medications.

    Israeli investigators assessed the safety and efficacy of inhaled cannabis in a cohort of 26 patients with fibromyalgia. They reported that medical cannabis treatment “was associated with significant favorable outcomes in every item evaluated,” such as reductions in pain and increases in energy.

    Most patients also reduced their use of conventional prescription drugs, such as opiates and benzodiazepines, during the trial period. Nearly half of the participants (46 percent) reduced their prescription drug intake by more than 50 percent during the study. Several patients were also able to return to work following the initiation of cannabis therapy.

    Researchers concluded, “Medical cannabis treatment had a significant favorable effect on patients with fibromyalgia, with few adverse effects.”

    Prior trials evaluating the use of either whole-plant cannabis or synthetic cannabinoids have similarly shown efficacy in patients with the disease. A summary of these prior studies is available here.

    The abstract of the study, “Medical cannabis for the treatment of fibromyalgia,” is online here.

  • by Paul Armentano, NORML Deputy Director March 1, 2018

    Patients routinely reduce or eliminate their use of prescription opiates following the use of medical cannabis; two recently published studies reaffirm this relationship.

    In the first study, published by the Minnesota Department of Health, investigators assessed the prescription drug use patterns of 2,245 intractable pain patients participating in the state’s medical cannabis access program. Among those patients known to be taking opiates for pain upon enrollment in the program, 63 percent “were able to reduce or eliminate opioid usage after six months.” The findings are similar to those of registered patients in other states’ medical cannabis programs, including Illinois, Michigan, and New Mexico, among others.

    In the second study, Israeli researchers assessed the safety and efficacy of cannabis in a cohort of over 1,200 cancer patients over a period of six months. Ninety-six percent of patients “reported an improvement in their condition.” Nearly half of respondents reported either decreasing or eliminating their use of opioids during the treatment period.

    A third recently published clinical trial provides insight into explaining this relationship. Investigators from the United States and Australia and assessed the efficacy of inhaled cannabis and sub-therapeutic doses of oxycodone on experimentally-induced pain in a double-blind, placebo-controlled model. Researchers assessed subjects’ pain tolerance after receiving both substances separately or in concert with one another. While neither the administration of cannabis nor oxycodone alone significantly mitigated subjects’ pain, the combined administration of both drugs did so effectively.

    Authors determined, “Both active cannabis and a low dose of oxycodone (2.5 mg) were sub-therapeutic, failing to elicit analgesia on their own; however, when administered together, pain responses … were significantly reduced, pointing to the opioid-sparing effects of cannabis.” They concluded, “Smoked cannabis combined with an ineffective analgesic dose of oxycodone produced analgesia comparable to an effective opioid analgesic dose without significantly increasing cannabis’s abuse liability.”

    The new studies add to the growing body of research finding that cannabis access is associated with reduced rates of opioid use and abuse, opioid-related hospitalizations, opioid-related traffic fatalities, opioid-related drug treatment admissions, and opioid-related overdose deaths.

    Additional information regarding the association between cannabis and opioids is available from NORML’s fact-sheet here.

  • by Paul Armentano, NORML Deputy Director February 7, 2018

    Medical marijuanaCannabis therapy is safe and effective among elderly patients diagnosed with chronic pain, according to clinical data published online ahead of print in the European Journal of Internal Medicine.

    Researchers from Hebrew University and the Ben Gurion University of Negrev in Israel assessed the use of therapeutic cannabis over a period of six months in a cohort of 1,186 patients above 65 years of age. The majority of patients enrolled in the trial suffered from pain or cancer. Under an Israeli federal program, over 32,000 citizens are licensed to utilize cannabis therapy.

    “After six months of treatment, 93.7 percent of the respondents reported improvement in their condition, and the reported pain level was reduced from a median of 8 on a scale of 0-10 to a median of 4,” researchers reported. The majority of respondents also reported “a significant improvement in [their] overall quality of life.”

    Furthermore, over 18 percent of the study’s participants “stopped using opioid analgesics or reduced their dose” – a result that led investigators to conclude, “Cannabis can decrease the use of other prescription medicines, including opioids.” Numerous prior studies, such as those compiled here, similarly show that pain patients typically mitigate or eliminate their opioid use during cannabis therapy.

    The adverse effects most commonly reported by participants were dizziness and dry-mouth.

    Authors concluded: “The older population is a large and growing part of medical cannabis users. Our study finds that the therapeutic use of cannabis is safe and efficacious in this population.”

    Read the abstract of the study, “Epidemiological characteristics, safety and efficacy of medical cannabis in the elderly,” here.

  • by Paul Armentano, NORML Deputy Director February 5, 2018

    The legalization and regulation of marijuana for adults is associated with a drastic reduction in overall arrests, increased tax revenue, and is not adversely impacting public health or safety, according to a comprehensive report issued by the Drug Policy Alliance.

    Among the report’s highlights:

    Marijuana arrests are down. Arrests for marijuana in all legal marijuana states and Washington, D.C. have plummeted, saving states hundreds of millions of dollars and sparing thousands of people from being branded with lifelong criminal records.

    Youth marijuana use is stable. Youth marijuana use rates have remained stable in states that have legalized marijuana for adults age 21 and older.

    Marijuana legalization is linked to lower rates of opioid-related harm. Increased access to legal marijuana has been associated with reductions in some of the most troubling harms associated with opioids, including opioid overdose deaths and untreated opioid use disorders.

    Calls to poison control centers and visits to emergency departments for marijuana exposure remain relatively uncommon.

    Legalization has not made the roads less safe. DUI arrests are down in Colorado and Washington. The total number of arrests for driving under the influence, of alcohol and other drugs, has declined in Colorado and Washington, the first two states to regulate marijuana for adult use. There is no correlation between marijuana legalization and crash rates. The crash rates in both states are statistically similar to comparable states without legal marijuana laws.

    Marijuana tax revenues are exceeding initial estimates.

    The marijuana industry is creating jobs. Preliminary estimates suggest that the legal marijuana industry employs between 165,000 to 230,000 full and part-time workers across the country.

    The full DPA report is available online here. Their findings are similar to prior reviews of the impact of adult use regulatory schemes on health and safety, such as this 2016 CATO Institute report.

    NORML has similarly compiled fact-sheets of the most relevant peer-reviewed data addressing the impact of legalization on health, safety, and the economy here.

  • by Paul Armentano, NORML Deputy Director January 30, 2018

    Long-term exposure to cannabis smoke is not associated with adverse effects on pulmonary function, according to clinical data published in the journal Chronic Obstructive Pulmonary Diseases.

    A team of investigators led by researchers at the Colorado School of Public Health assessed the relationship between marijuana use and respiratory function and symptoms in a cohort of 2,300 subjects ages 40 to 80, many of whom also smoked tobacco.

    Authors reported, “Neither current nor former marijuana use was associated with increased risk of cough, wheeze, or chronic bronchitis when compared to never marijuana users after adjusting for covariates. … Current and former marijuana smokers had significantly higher FEV1 (forced expiratory volume) … when compared to never users. … Both current and former marijuana use was associated with significantly less quantitative emphysema … when compared to never users, even after adjusting for age, … current tobacco smoking pack years, and BMI. … In agreement with other published studies, we also did not find that marijuana use was associated with more obstructive lung disease.”

    The long-term combined use of tobacco and cannabis also was not found to be associated with any additive adverse effects on the lungs. Authors concluded, “Among older adults with a history of tobacco use, marijuana use does not appear to increase risk for adverse lung function. … There may be no to little increased risk of marijuana use for a further increase in respiratory symptoms or adverse effects on lung function among those with a history of concomitant tobacco use.”

    Prior longitudinal studies assessing the effects of long-term cannabis smoke exposure on lung function have similarly reported that subjects’ marijuana use history is not positively associated with increased incidences of chronic obstructive pulmonary disease (COPD), lung cancer, or with other significant detrimental effects on pulmonary function.

    Full text of the study, “Marijuana use associations with pulmonary symptoms and function in tobacco smokers enrolled in the subpopulations and intermediate outcome measures in COPD Study (SPIROMICS),” appears online here.

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