Loading

opioids

  • by Paul Armentano, NORML Deputy Director June 18, 2019

    Marijuana and OpioidsThe administration of herbal cannabis is safe and effective in patients diagnosed with fibromyalgia, according to clinical data published this month in the Journal of Clinical Medicine.

    Israeli investigators assessed the use of cannabis over a six-month period in 211 patients with the disease. Eight-one percent of subjects reported “at least moderate improvement in their condition … without experiencing serious adverse events.” Patients were most likely to report overall reductions in pain and overall improvements in their quality of life following cannabis therapy.

    Twenty-two percent of subjects “stopped or reduced their dosage of opioids,” and 20 percent reduced their use of benzodiazepines – findings that are consistent with those of other studies.

    “In the present study, we demonstrated that medical cannabis is an effective and safe option for the treatment of fibromyalgia patients’ symptoms,” authors concluded. “Considering the low rates of addiction and serious adverse effects (especially compared to opioids), cannabis therapy should be considered to ease the symptom burden among those fibromyalgia patients who are not responding to standard care. … Future studies should aim to compare medical cannabis to the standard therapy of fibromyalgia, to establish the proper place of cannabis in fibromyalgia therapeutic arsenal.”

    An abstract of the study, “Safety and efficacy of medical cannabis in fibromyalgia,” is online here. Additional information on cannabis and fibromyalgia appears in the NORML publication here.

  • by Paul Armentano, NORML Deputy Director June 11, 2019

    Patients diagnosed with chronic pain and other debilitating conditions typically reduce, or in some cases, eliminate their use of opioids following their enrollment in state-sanctioned medical cannabis access programs.

    Several peer-reviewed studies now document this trend. In contrast to observational, population-based studies — which only seek to identify whether an association exists between the passage of medical cannabis laws and opioid use trends in the general population — these papers explicitly assess individual patients’ relationship with opioids following their registration in state-sponsored access programs.

    For example, researchers writing in the May edition of the journal Annals of Pharmacotherapy evaluated the use of opioids in 77 intractable pain patients newly enrolled in the Minnesota Medical Cannabis Program. Researchers reported “a statistically significant decrease in MME (milligram morphine equivalents) from baseline to both three and six months.”

    A 2018 study assessing prescription drug use trends among patients enrolled in New York state’s medical cannabis program yielded similar results. On average, subjects’ monthly analgesic prescription costs declined by 32 percent following enrollment, primarily due to a reduction in the use of opioid pills and fentanyl patches. “After three months treatment, medical cannabis improved [subjects’] quality of life, reduced pain and opioid use, and lead to cost savings,” authors concluded.

    These conclusions are hardly unique. A study of 244 state-registered chronic pain patients enrolled in Michigan’s medical cannabis program reported: “[M]edical cannabis use was associated with a 64 percent decrease in opioid use, decreased number and side effects of medications, and an improved quality of life. This study suggests that many CP [chronic pain] patients are essentially substituting medical cannabis for opioids and other medications for CP treatment.”

    A separate review of over 2,000 chronic pain patients in Minnesota reported that 63 percent of those who used opioids at the time of admission into the program “were able to reduce or eliminate their opioid use after six months.”

    Yet another study, this time evaluating the prescription drug use patterns of patients enrolled in Illinois’ medical access program, similarly revealed: “[O]ur results indicate that MC (medical cannabis) may be used intentionally to taper off prescription medications. These findings align with previous research that has reported substitution or alternative use of cannabis for prescription pain medications due to concerns regarding addiction and better side-effect and symptom management, as well as complementary use to help manage side-effects of prescription medication.”

    Perhaps most notably, a 2017 study published in the journal PLoS ONE compared prescription drug use patterns among pain patients enrolled in the New Mexico medical access program versus similarly matched control patents who were not. Compared to non-users, over a 21-month period medical cannabis enrollees “were more likely either to reduce daily opioid prescription dosages between the beginning and end of the sample period (83.8 percent versus 44.8 percent) or to cease filling opioid prescriptions altogether (40.5 percent versus 3.4 percent).” Enrollees were also more likely to report an improved quality of life.

    Authors concluded, “The clinically and statistically significant evidence of an association between MCP (medical cannabis program) enrollment and opioid prescription cessation and reductions and improved quality of life warrants further investigations on cannabis as a potential alternative to prescription opioids for treating chronic pain.”

    Additional information on the relationship between cannabis and opioids is available from the NORML fact-sheet here.

  • by NORML May 21, 2019

    The administration of oral CBD reduces cue-induced cravings and anxiety in subjects with a history of heroin use, according to clinical data published in The American Journal of Psychiatry.

    Investigators at The Mount Sinai Health System in New York City assessed the effect of CBD versus placebo in 42 drug-abstinent participants with a history of heroin use. In contrast to placebo, CBD dosing of either 400mg or 800mg “significantly reduced both the craving and anxiety induced by drug cues … in the acute term. CBD also showed significant protracted effects on these measures seven days after the final short-term exposure.”

    Researchers concluded, “CBD’s potential to reduce cue-induced craving and anxiety provides a strong basis for further investigation of this phytocannabinoid as a treatment option for opioid use disorder.”

    In observational models, patients with legal access to cannabis typically reduce or eliminate their use of opioids. In clinical models, CBD administration has been shown to reduce cravings for tobacco. CBD dosing has also been associated with reduced cravings for methamphetamine in preclinical models.

    Commenting on the study’s findings, NORML Deputy Director Paul Armentano said, “These conclusions add to the growing body of evidence that cannabis and its constituents represent an exit away from the use or abuse of other controlled substances rather than a supposed ‘gateway.'”

    The abstract of the study, “Cannabidiol for the reduction of cue-induced craving and anxiety in drug-abstinent individuals with heroin use disorder: A double-blind randomized placebo controlled trial,” appears online here. Additional information is available in NORML’s fact-sheet, “Relationship between marijuana and opioids.”

  • by Paul Armentano, NORML Deputy Director February 1, 2019

    Patients authorized to legally use medical cannabis frequently substitute it in place of benzodiazepines, according to a pair of new studies published this week. Benzodiazepines are class of drugs primarily used for treating anxiety. According to data compiled by the US Centers for Disease Control, the drug was attributed to over 11,500 overdose deaths in 2017.

    In the first study, Canadian researchers assessed the relationship between cannabis and benzodiazepines in a cohort of 146 patients enrolled in the nation’s medical marijuana access program. They reported that 30 percent of participants discontinued their use of anti-anxiety medications within two-months of initiating cannabis therapy, and that 45 percent did so by six-months. “Patients initiated on medical cannabis therapy showed significant benzodiazepine discontinuation rates after their first follow-up visit to their medical cannabis prescriber, and continued to show significant discontinuation rates thereafter,” authors concluded.

    In the second study, investigators at the University of Michigan surveyed over 1,300 state-registered medical cannabis patients with regard to their use of opioids and benzodiazepines. They reported that 53 percent of respondents acknowledged substituting marijuana for opioids, and 22 percent did so for benzodiazepines.

    These findings are consistent with numerous other papers — such as those here, here, here, and here — documenting patients’ use of cannabis in place of a variety of prescription drugs, particularly opioids and anti-anxiety medications.

    Full text of the study, “Reduction of benzodiazepine use in patients prescribed medical cannabis,” appears in the journal Cannabis and Cannabinoid Research here.

    An abstract of the study, “Pills to pot: Observational analyses of cannabis substitution among medical cannabis users with chronic pain,” appears in The Journal of Pain here.

    Additional information is available in NORML’s fact-sheet, “Relationship between marijuana and opioids,” here.

  • by NORML December 27, 2018

    2018 NORML's Top TenRead the ten biggest stories that shaped marijuana policy in 2018.

    #1: Public Support in Favor of Adult Use Legalization at Historic Highs
    More adults than ever before believe that marijuana use by adults ought to be legal. An October poll conducted by Gallup reported that 66 percent of adults – including majorities of Democrats, Independents, Republicans, and those over the age of 55 – back legalization. The percentage is the highest level of support ever reported by the polling firm. A 2018 Pew poll similarly reported greater public support for legalization than ever before, while a June poll by the Center for American Progress reported that 68 percent of voters nationwide endorse legalization – the highest level of national support ever recorded in a scientific survey.

    #2: Marijuana Initiatives Win at the Ballot Box
    Voters in four states – Michigan, Missouri, Oklahoma, and Utah – passed voter initiated measures in 2018 regulating the use of marijuana. Missouri, Oklahoma, and Utah became the 31st, 32nd, and 33rd states to enact medical cannabis access laws, while Michigan became the tenth state to permit adult marijuana use. In January, Vermont legislatively enacted provisions permitting adults to grow and possess marijuana for their own personal use.

    #3: Congress Amends CSA to Lift Ban on Commercial Hemp Production
    Hemp-specific provisions included in the 2018 Farm Bill (aka The Agriculture Improvement Act of 2018) for the first time amend the federal classification of marijuana to distinguish between cannabis and hemp. Under the new law, which takes effect on January 1, 2019, hemp plants containing no more than 0.3 percent THC are no longer classified as a schedule I controlled substance. The Act also broadens the definition of ‘hemp’ (Section 297A) to include “any part of the plant, including …. extracts [or] cannabinoids” that do not possess greater than 0.3 percent THC on a dry weight basis. The Act also for the first time in decades permits for the licensed commercial cultivation of hemp under a partnership of state and federal regulations.

    #4 Canada Legalizes Adult Marijuana Use and Retail Sales
    Canadian lawmakers this summer approved federal legislation permitting the use of marijuana by those ages 18 and older, and regulating adult use cannabis production and sales. Retailers began selling cannabis in compliance with the new law in October. In November, justices for Mexico’s Supreme Court also struck down the nation’s marijuana ban – finding that laws criminalizing the private use and cultivation of cannabis by adults are unconstitutional.

    #5: Governors Campaign, Win On Marijuana Legalization Platforms
    Candidates for Governor in numerous state races campaigned and won in 2018 on a pledge to legalize and regulate the adult use of cannabis. Specifically, incoming governors in Connecticut, Minnesota, and Illinois explicitly pledged to enact legalization. Re-elected Governor of New York Andrew Cuomo has also pledged to enact adult use legalization in early 2019, as has New Jersey Gov. Phil Murphy.

    #6: Incoming House Rules Chair to Allow Floor Votes on Marijuana-Related Measures
    Massachusetts Democratic Rep. Jim McGovern said in November that he will permit federal lawmakers to debate and vote on marijuana-related amendments when he assumes control of the House Rules Committee in 2019. Representative McGovern replaces outgoing Rules Chair Pete Sessions (R-TX), who lost his re-election bid. Representative Sessions used his position as Chairman of the House Rules Committee to block House floor members from voting on over three-dozen marijuana-related amendments during his leadership tenure. “Unlike my predecessor, I’m not going to block amendments for marijuana,” McGovern said. “Citizens are passing ballot initiatives, legislatures are passing laws, and we need to respect that. Federal laws and statutes are way behind.”

    #7: Legal Marijuana Access is Associated with Reduced Opioid Abuse
    Over a dozen peer-reviewed studies were published in 2018 finding that regulated marijuana access is associated with lower rates of opioid use, abuse, and mortality. Among patients enrolled in medical cannabis access programs, use of opioids frequently decreases or is eliminated altogether.

    #8: FBI: Marijuana Arrests Spike for Second Straight Year
    The total number of persons arrested in the United States for violating marijuana laws rose for the second consecutive year, according to data released in September by the US Federal Bureau of Investigation. According to the FBI’s Uniform Crime Report, police made 659,700 arrests for marijuana-related violations in 2017. As in previous years, marijuana possession arrests were least likely to occur in the western region of the United States, where possessing the plant has largely been either legalized or decriminalized. By contrast, in Midwestern states, marijuana-related arrests comprised over 53 percent of all drug arrests.

    #9: FDA Approves First Ever Plant-Derived Cannabis Medicine
    Regulators at the US Food and Drug Administration in June for the first time granted market approval to a plant-derived cannabis medicine, Epidiolex. The medicine contains a standardized formulation of plant-derived cannabidiol for the explicit treatment of two rare forms of severe epilepsy: Lennox-Gastaut syndrome and Dravet syndrome. In September, the US Drug Enforcement Administration classified Epidiolex to Schedule V — the lowest restriction categorization available under federal law.

    #10: States, Localities Move to Expunge Past Marijuana Convictions
    California became the first state to automatically review and expunge past marijuana-related convictions, under legislation enacted in October. Delaware enacted a similar law calling for the mandatory expungement of certain marijuana-related offenses, joining several other states that permit those with past records to petition to have those records sealed. Local officials in various cities in 2018, including Denver, Philadelphia, and Seattle, announced the facilitation of similar policies.

Page 1 of 812345...Last »