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Opioids

  • by Paul Armentano, NORML Deputy Director May 26, 2020

    Marijuana researchThe delivery of precise doses of THC via an inhaler is associated with pain mitigation in patients with neuropathy and other complex pain conditions, according to clinical trial data published in the European Journal of Pain.

    A team of Israeli researchers conducted a randomized placebo-controlled clinical trial to assess the safety and efficacy of a novel, metered-dose cannabis inhaler in 27 patients with chronic pain. Participants inhaled a precise dose containing either THC (at doses of either 0.5mg or 1mg) or placebo.

    They reported: “Both doses, but not the placebo, demonstrated a significant reduction in pain intensity compared with baseline and remained stable for 150-minutes. The 1mg dose showed a significant pain decrease compared to the placebo. Adverse events were mostly mild and resolved spontaneously. There was no evidence of consistent impairments in cognitive performance.”

    Authors concluded: “This feasibility trial demonstrated that a metered-dose cannabis inhaler delivered precise and low THC doses [that] produced a dose-dependent and safe analgesic effect in patients with neuropathic pain/complex-regional pain syndrome (CRPS). Thus, it enables individualization of medical cannabis regimens that can be evaluated pharmacokinetically and pharmacodynamically by accepted pharmaceutical models.”

    Prior clinical trials, such as those here and here, have similarly reported that a metered-dose inhaler can deliver precise therapeutic doses of cannabis to pain patients absent any significant adverse effects.

    Chronic pain is the most commonly reported qualifying condition among medical cannabis patients enrolled in state-specific access programs. A 2017 literature review by the National Academy of Sciences, Engineering, and Medicine concluded, “There is conclusive or substantial evidence that cannabis or cannabinoids are effective for the treatment of chronic pain in adults.”

    An abstract of the study, “Pharmacokinetics, efficacy, and safety of a novel selective-dose cannabis inhaler in patients with chronic pain: A randomized, double-blinded, placebo-controlled trial,” is online here. Additional information regarding cannabinoids and pain appears online here.

  • by Paul Armentano, NORML Deputy Director February 25, 2020

    Trauma patients administered oral THC consume fewer opioids than do similarly matched controls, according to clinical trial data published in the journal Trauma Surgery & Acute Care.

    Investigators affiliated with the Saint Anthony Hospital and Medical Campus in Colorado assessed the impact of the off-label use of dronabinol (FDA-approved synthetic oral THC) on opioid consumption patterns in trauma patients with acute pain. Sixty-six patients participated in the study. Half of the participants received dronabinol and the other half did not.

    Authors reported that patients administered oral THC experienced a “nine-fold greater reduction in opioid consumption” compared to controls. These opioid-sparing effects were most pronounced among participants who had prior experience with cannabis.

    They concluded: “The addition of dronabinol resulted in reduced opioid consumption, … suggesting a beneficial opioid-sparing effect of dronabinol in acutely painful conditions. … Because our study showed that the opioid-sparing effect of dronabinol may be greatest in patients who use marijuana, use of dronabinol adjunctively may benefit nearly half of [Colorado’s] population.”

    The study’s findings are consistent with those of numerous other papers reporting that patients typically mitigate their use of opioids following the initiation of cannabis/cannabinoid therapy.

    An abstract of the study, “Matched pilot study examining cannabis-based dronabinol for acute pain following traumatic injury,” is online here. Additional information on the relationship between cannabis and opioids is available in the NORML fact-sheet here.

  • by Paul Armentano, NORML Deputy Director November 25, 2019

    Patients suffering from persistent pain conditions who frequently use cannabis are far less likely to use non-prescription opioids, according to longitudinal data published in the journal PLOS One.

    A team of investigators from Canada and the United States assessed drug use trends in chronic pain patients over a multi-year period (June 1, 2014 to December 1, 2017).

    Authors reported “an independent negative association between frequent cannabis use and frequent illicit opioid use.” Specifically, subjects who consumed cannabis daily “had about 50 percent lower odds of using illicit opioids every day [as] compared to cannabis non-users.”

    Investigators did not identify a similarly significant association between occasional cannabis use and daily non-prescription opioid use.

    They concluded, “These findings provide longitudinal observational evidence that cannabis may serve as an adjunct to or substitute for illicit opioid use among PWUD (people who use drugs) with chronic pain.”

    The findings are consistent with those of prior studies — such as those here, here, and here — which report that pain patients reduce their use of opioids following access to medical cannabis therapy.

    Late last week, federal officials affirmed that no funding from the Substance Abuse and Mental Health Services Administration could be spent toward programs that propose the use of medical cannabis for those suffering with opioid dependence issues.

    Full text of the study, “Frequency of cannabis and illicit opioid use among people who use drugs and report chronic pain: A longitudinal analysis,” is online here. Additional information is available from the NORML fact-sheet, ‘Relationship Between Marijuana and Opioids.’

  • by Jeff Riedy, Executive Director, Lehigh Valley NORML November 12, 2019

    Medical marijuanaLehigh Valley NORML, and medical cannabis patients from across Pennsylvania, will hold the second in a series of monthly protests at the Department of Health (PaDOH) headquarters on Forster St. “Patients First: Fixing Medical Marijuana in PA” will commence on Wednesday November 13, 2019 from 08:30 AM-5:00 PM.

    These events offer a voice to the large number of registered medical marijuana patients who are deeply dissatisfied with the current program. Key concerns: Expensive prices, product shortages and quality, few legal protections and the daily threat of a DUI charge.

    Their first rally, on October 23, saw a groundswell of support from the patient community, and  garnered significant media attention. The Nov. 13th protest again focuses on the struggles within Pennsylvania’s very restrictive medical marijuana program.

    While boasting an enrollment of around 200,000 patients, those registered continue to suffer under the extended growing pains of a stunted program. Employers and law enforcement are also playing catch up to the new laws. Patients have faced lost jobs and needless DUI charges.

    Meanwhile, those who hold the lucrative cultivation, processing, and dispensary licenses are finding new ways to profit, primarily by selling to out of state investors. Patients are stuck paying some of the most expensive cannabis product prices in the country: Average out-of-pocket expenses of over $1000 per month, with no relief from insurance.

    These protests will highlight the program’s shortcomings, and offer sensible solutions directly from the patient community. A Patients’ Bill of Rights for Medical Cannabis will be offered to legislators as a proposed Resolution.

    Lehigh Valley NORML Executive Director Jeff Riedy said, ”These protests were organized in response to the ongoing cries from registered patients. We fought to win this Medical Cannabis program in Pennsylvania, and we continue to support it. Now, we believe that the needs of our patients are being overlooked in favor of business enterprises. It’s time for our regulators and legislators to listen to our seriously ill residents once again.”

    According to longtime NORML organizer Chris Goldstein, “It’s time for the Department of Health to begin actively evolving this program. Prices need to come down significantly for working patients, and those living on a fixed income. Healthcare only works when people can afford it.”

    The next event will be on December 18, and will include a protest at the Capitol, along with a rally and brief press conference inside the Capitol Rotunda. Patients will engage in citizen lobbying efforts throughout the day.

  • by Josh Kasoff, Nevada NORML November 5, 2019

    To honor both those who have bravely served and those who still suffer due to federal cannabis laws, Nevada NORML will be hosting a unique event on Veteran’s Day. The virtual lobby day, a lobbying event done entirely through electronic means, will raise awareness of the many federal pieces of legislation that could benefit veterans such as Hawaii Senator Brian Schatz and California Congresswoman Barbara Lee-sponsored The Veterans Medical Marijuana Safe Harbor Act, which would allow veterans in states or Indian tribal lands with current medicinal laws to both possess medical cannabis and discuss medical cannabis options with a Veterans Affairs-affiliated doctor – without fear of repercussions.

    Another crucial benefit of The Veterans Medical Marijuana Safe Harbor Act is that its passage will enact a series of studies conducted by the Secretary of Veterans Affairs two years after it’s passing, one on the “effects of medical marijuana on veterans in pain” and another pertaining to “the relationship between treatment programs involving medical marijuana that are approved by states, the access of veterans to such programs, and a reduction in opioid abuse among veterans.”

    Six months following the completion of these studies, the Secretary will compile the findings into a detailed report that will then be submitted to Congress, hopefully providing undeniable evidence to the prohibitionist members of the Legislative Branch who refuse to believe in medical freedom.

    With Nevada NORML’s Virtual Lobby Day, volunteers will be utilizing a variety of communication mediums, from letter writing campaigns to phone banking and social media, to contact their representatives to demonstrate support for these federal bills. Through registering to vote from The Nevada Secretary of State’s Office, volunteers will then be directed to a script containing valuable speaking points depending on which bill they’ll be calling the representative about along with their contact information.

    “We have set a goal of 1,000 calls to our representatives’ offices in DC on November 12th.” said Nevada NORML Director Madisen Saglibene. “We know that with our statewide efforts, we can show our leaders the constituent support that exists to urge their support for the Veterans Medical Marijuana Safe Harbor Act.”

    To stand in solidarity through social media, shareable graphics will be produced by NORML with accompanying hashtags such as “#freedomisNORML” and #homemeansNevada.

    The time we’re living in is among the most crucial for cannabis reform, and continued demonstrations of support for reform and medical expansion for our nation’s heroes will hopefully lead to quicker results than waiting idly for change.

    Rep. Barbara Lee with Nevada NORML’s leadership

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