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  • 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 Paul Armentano, NORML Deputy Director June 10, 2019

    Marijuana and OpioidsMilitary veterans who participate in a state’s medical marijuana access program frequently report substituting cannabis for alcohol and other controlled substances, according to data published in The American Journal of Drug and Alcohol Abuse.

    A team of investigators from Palo Alto University in California, Harvard University, and the Perelman School of Medicine in Philadelphia surveyed marijuana use patterns in 93 US military veterans participating in a medical cannabis collective.

    Nearly 80 percent of respondents reported using cannabis “to treat both physical and mental health symptoms.” Respondents were most likely to report using cannabis therapeutically to mitigate symptoms of chronic pain (69 percent), anxiety (66 percent), post-traumatic stress (59 percent), and depression (56 percent).

    Over 60 percent of respondents said that they consumed cannabis as a substitute for other illicit or licit substances, particularly alcohol. Nearly half of all respondents said that they use medical cannabis in place of other prescription medications.

    Authors concluded, “The current study also confirms the findings of previous studies that have documented a trend in substitution behavior, where cannabis is substituted for other drugs, which, if associated with reduced harm, could be beneficial for overall health.”

    Under existing federal regulation, physicians affiliated with the Department of Veterans Affairs may not legally provide the paperwork necessary for veterans to obtain medical cannabis in states that regulate its access.

    The abstract of the study, “A cross-sectional examination of choice and behavior of veterans with access to free medicinal cannabis,” is online here. Additional information is available in the NORML fact-sheet “Marijuana and Veteran Issues.”

  • by NORML January 31, 2019

    Seventy-five percent of military veterans say that they would consider using either "cannabis or cannabinoid products as a treatment option," according to member survey data compiled by the group Iraq and Afghanistan Veterans of America (IAVA). The organization represents over 400,000 veterans nationwide.

    Under existing federal regulations, physicians affiliated with the Department of Veteran Affairs are forbidden from providing medical cannabis recommendations, even in jurisdictions that legally permit private practitioners to do so.

    “Federal lawmakers must stop discriminating against veterans with regard to matters of marijuana and health," said NORML Political Director Justin Strekal. "These men and women put on the uniform to defend this nation’s freedoms and it is the height of hypocrisy for the federal government to deny them rights afforded to the millions of other Americans who reside in states where access to medical cannabis is legally recognized.”

    Overall, 83 percent of respondents expressed support for legalizing medical cannabis access, and 68 percent believe that the Department of Veterans Affairs "should allow for research into cannabis as a treatment option." Proposed federal legislation to direct the agency to conduct clinical trials on the use of cannabis for PTSD and for other conditions is currently pending in the US House and Senate.

    Twenty percent of those surveyed acknowledged having previously used cannabis for medical purposes. Other studies have estimated that as many as 41 percent of veterans acknowledge having consumed cannabis for therapeutic purposes. Available data documents that cannabis is effective in the treatment of chronic pain and may potentially mitigate symptoms of post-traumatic stress, along with other conditions commonly facing veterans.

    Additional information is available from the NORML fact-sheet, "Marijuana and Veterans Issues," here.

  • by Paul Armentano, NORML Deputy Director May 8, 2018

    Medical marijuanaPatients enrolled in New York state’s medical cannabis program reduce their use of opioids and spend less money on prescription medications, according to data published online in the journal Mental Health Clinician.

    Investigators from the GPI Clinical Research in Rochester and the University of Buffalo assessed trends in patients’ medical cannabis and prescription drug use following their enrollment into the state’s marijuana access program.

    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.

    The study’s findings are similar to those reported among enrollees in other states medical cannabis programs, including the experiences of patients in Illinois, Michigan, Minnesota, New Mexico, and elsewhere.

    The full text of the study, “Preliminary evaluation of the efficacy, safety, and costs associated with the treatment of chronic pain with medical cannabis,” appears online here. NORML’s fact-sheet highlighting the relevant, peer-reviewed research specific to the relationship between cannabis and opioids is available online here.

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