Archive for the ‘SCIENCE’ category

Study: Marijuana Use Inversely Associated With Intimate Partner Violence

August 26th, 2014

Marijuana use by newly married couples is predictive of less frequent incidences of intimate partner violence perpetration, according to longitudinal data published online ahead of print in the journal Psychology of Addictive Behaviors.

Investigators at Yale University, Rutgers, and the University of Buffalo assessed over 600 couples to determine whether husbands’ and wives’ cannabis use was predictive of domestic abuse at any time during the first nine years of marriage. Researchers reported: “In this community sample of newly married couples, more frequent marijuana use generally predicted less frequent IPV perpetration, for both men and women, over the first 9 years of marriage. Moderation analyses provided evidence that couples in which both spouses used marijuana frequently were at the lowest risk for IPV perpetration, regardless of the perpetrator’s gender.”

Stated the study’s lead author in a press release: “Although this study supports the perspective that marijuana does not increase, and may decrease, aggressive conflict, we would like to see research replicating these findings, and research examining day-to-day marijuana and alcohol use and the likelihood to IPV on the same day before drawing stronger conclusions.”

According to a previous study, published in January in the journal Addictive Behaviors, alcohol consumption — but not cannabis use — is typically associated with increased odds of intimate partner violence. Authors reported: “On any alcohol use days, heavy alcohol use days (five or more standard drinks), and as the number of drinks increased on a given day, the odds of physical and sexual aggression perpetration increased. The odds of psychological aggression increased on heavy alcohol use days only.” By contrast, researchers concluded that “marijuana use days did not increase the odds of any type of aggression.”

The abstract of the study, “Couples’ marijuana use is inversely related to their intimate partner violence over the first 9 years of marriage,” is online here.

JAMA: Medical Cannabis States Possess Lower Rates Of Opiate-Induced Fatalities

August 25th, 2014

The enactment of medicinal marijuana laws is associated with significantly lower state-level opioid overdose mortality rates, according to data published online today in the Journal of the American Medical Association (JAMA) Internal Medicine.

A team of investigators from the University of Pennsylvania, the Albert Einstein College of Medicine in New York City, and the Johns Hopkins Bloomberg School of Public Health in Baltimore conducted a time-series analysis of medical cannabis laws and state-level death certificate data in the United States from 1999 to 2010 — a period during which 13 states instituted laws allowing for cannabis therapy.

Researchers reported, “States with medical cannabis laws had a 24.8% lower mean annual opioid overdose mortality rate compared with states without medical cannabis laws.” Specifically, overdose deaths from opioids decreased by an average of 20 percent one year after the law’s implementation, 25 percent by two years, and up to 33 percent by years five and six.

They concluded, “In an analysis of death certificate data from 1999 to 2010, we found that states with medical cannabis laws had lower mean opioid analgesic overdose mortality rates compared with states without such laws. This finding persisted when excluding intentional overdose deaths (ie, suicide), suggesting that medical cannabis laws are associated with lower opioid analgesic overdose mortality among individuals using opioid analgesics for medical indications. Similarly, the association between medical cannabis laws and lower opioid analgesic overdose mortality rates persisted when including all deaths related to heroin, even if no opioid analgesic was present, indicating that lower rates of opioid analgesic overdose mortality were not offset by higher rates of heroin overdose mortality. Although the exact mechanism is unclear, our results suggest a link between medical cannabis laws and lower opioid analgesic overdose mortality.”

In a written statement to Reuters Health, lead author Dr. Marcus Bachhuber said: “Most of the discussion on medical marijuana has been about its effect on individuals in terms of reducing pain or other symptoms. The unique contribution of our study is the finding that medical marijuana laws and policies may have a broader impact on public health.”

Added co-author Colleen L. Barry in USA Today: “[The study's findings] suggest the potential for many lives to be saved. … We can speculate … that people are completely switching or perhaps supplementing, which allows them to lower the dosage of their prescription opioid.”

Nationwide, overdose deaths involving opioid analgesics have increased dramatically over the past decade. While fewer than 4,100 opiate-induced fatalities were reported for the year 1999, by 2010 this figure rose to over 16,600 according to an analysis by the US Centers for Disease Control.

An abstract of the JAMA study, “Medical Cannabis Laws and Opioid Analgesic Overdose Mortality in the United States, 1999-2010,” appears online here.

Study: Cannabis Inhaler Delivers Effective Relief To Neuropathy Patients

August 18th, 2014

The administration of a single dose of whole-plant cannabis via a thermal-metered inhaler is effective and well tolerated among patients suffering from neuropathy (nerve pain), according to clinical trial data published online ahead of print in the Journal of Pain and Palliative Care Pharmacotherapy.  

Israeli investigators assessed the efficacy of a novel, portable metered-dose cannabis inhaler in eight subjects diagnosed with chronic neuropathic pain. Researchers reported that the device administered an efficient, consistent, and therapeutically effective dosage of cannabinoids to all participants.

They concluded, “This trial suggests the potential use of the Syqe Inhaler device as a smokeless delivery system of medicinal cannabis, producing a delta-9-THC pharmacokinetic profile with low inter-individual variation of (maximum drug/plasma concentrations), achieving pharmaceutical standards for inhaled drugs.”

A series of clinical trials conducted by investigators affiliated with the Center for Medicinal Cannabis Research at the University of California, San Diego previously determined that the inhalation of whole-plant cannabis is efficacious in the treatment of neuropathic pain.

Full text of the study, “The pharmacokinetics, efficacy, safety, and ease of use of a novel portable metered-dose cannabis inhaler in patients with chronic neuropathic pain: A phase 1a study,” will appear in the Journal of Pain and Palliative Care Pharmacotherapy.

Does Medical Cannabis Legalization Impact Police Safety?

August 11th, 2014

Does Medical Cannabis Legalization Impact Police Officer Safety?While the US government effectively bans scientific research regarding cannabis and any potential therapeutic uses, you can help University of Texas at Dallas associate professor of Criminology Dr. Robert Morris, II conduct another in a series of cannabis policy research-related questions.

Dr. Morris and associates have already published an interesting research article earlier this year at PLoS One, answering the question: Does Legalizing Medical Cannabis Reduce Violent Crimes?*

This time around Dr. Morris and his colleagues are asking the sensible question public policy question: ‘Does Medical Cannabis Legalization Impact Police Officer Safety?’

NORML’s curious, aren’t you too?

Let’s help fund the research via crowdsourcing and find out the important answer to the above question after the data is gathered, crunched, analyzed and published.

Thanks for advancing science and public policy making in America regarding cannabis!

*The answer from the paper on medical cannabis’ impact on violent crime rates: ‘no’, violent crime rates do not rise because of the presence of medical cannabis retail stores.

Study: Habitual Marijuana Smoking Not Associated With Increased Risk Of Lung Cancer

June 23rd, 2014

Subjects who regularly inhale cannabis smoke possess no greater risk of contracting lung cancer than do those who consume it occasionally or not at all, according to data published online ahead of print in the International Journal of Cancer.

An international team of investigators from Canada, New Zealand, the United Kingdom, and the United States analyzed data from six case-control studies involving over 5,000 subjects (2,159 cases and 2,985 controls) from around the world.

Authors concluded, “Results from our pooled analyses provide little evidence for an increased risk of lung cancer among habitual or long-term cannabis smokers.”

Investigators had previously presented their data at the 2013 annual meeting of the American Academy for Cancer Research.

Their findings are similar to those of a 2013 review published in the journal Annals of the American Thoracic Society, which concluded: “[H]abitual use of marijuana alone does not appear to lead to significant abnormalities in lung function. … Overall, the risks of pulmonary complications of regular use of marijuana appear to be relatively small and far lower than those of tobacco smoking.”

An accompanying commentary in the same journal affirmed, “[C]annabis smoking does not seem to increase risk of chronic obstructive pulmonary disease (COPD) or airway cancers. In fact, there is even a suggestion that at low doses cannabis may be protective for both conditions.”

Preclinical studies have documented that cannabinoids possess potent anti-cancer properties, including the inhibition of lung cancer cell growth. To date, however, scientists have yet to conduct controlled clinical trials replicating these results in human subjects.

The abstract of the study, “Cannabis smoking and lung cancer risk: Pooled analysis in the International Lung Cancer Consortium,” appears online here.

The Fear of Pleasure: Why CBD-Only Legislation is Not a Real Solution

June 17th, 2014

Most of us were caught off-guard by the rush of states this year that approved the limited use of CBD-only marijuana extracts because these traditionally conservative states had heretofore rejected the medical use of marijuana. So it seems worth a moment to consider how this occurred, and what it means on a grander scale.

But first, a little recent history.

Throughout this year’s state legislative season, a total of 10 states enacted laws seeking to provide limited access to medical marijuana products that contain high levels of CBD and virtually no THC for qualified, typically pediatric patients suffering from severe and disabling seizures: Alabama, Florida, Iowa, Kentucky, Mississippi, Missouri, South Carolina, Tennessee, Utah and Wisconsin.

On one level, this unexpected embrace of the medicinal qualities of marijuana by states that previously rejected the concept must be seen as a favorable development. These serendipitous adoptions reflect a degree of compassion not obvious in the previous legislative debates in those states.

But it is far from certain that these laws will actually help the young patients they are intended to help.

First, such products are primarily only available in a handful of states like California and Colorado and none of these new state laws create a viable in-state supply source for such products. Further, even if a patient from out-of-state could find these products in California or Colorado, it would be a violation of federal law (and also likely state law) to take the medicine back to their home state.

And while some of these laws attempt to establish CBD research projects at their major universities or research hospitals, recent experience demonstrates that few universities or research hospitals are willing to enter this confusing field while marijuana remains a federal crime, and those that may be willing to take the bait will face a steep and long learning curve before the first patient will have high-CBD extracts available.

This legislative rush to CBD-only extracts also suggests (1) the degree to which elected officials are influenced by popular media, (2) their willingness to pick and choose the science they like (while ignoring the science they do not), and (3) the strong puritanical impulse that remains a factor with many elected officials.

And it all relates to the “Gupta Effect”. When CNN’s Dr. Sanjay Gupta’s report highlighting how high-CBD marijuana products control debilitating seizures among children suffering from Dravet’s syndrome (the most severe form of childhood epilepsy) went public, few Americans had even heard of cannabidiol. Most people were familiar with THC (tetrahydrocannabinol), the primary psychoactive ingredient in marijuana that principally accounts for the “high” that marijuana smokers enjoy, but had zero idea that CBD even existed.

Dr. Gupta, who had previously uncritically accepted the federal government’s consistent claim that marijuana had no legitimate medical use, when confronted with actual children whose lives had been transformed following their use of high-CBD marijuana extracts, understandably felt misled by the government’s anti-marijuana propaganda, and went public with two special programs introducing the importance of high-CBD extracts in reducing or eliminating seizures in these children.

In the second program Dr. Gupta made it clear that while CBD appeared to be the primary therapeutic ingredient for this class of patients, he also made the point that some level of THC was also required, because of what he termed the “entourage effect.” Without the THC, the CBD would either be less effective, or in some instances ineffective.

It’s embarrassing that so many of our elected officials would get their scientific understanding of the medical properties of marijuana from a popular television doctor, instead of conducting their own research into the available science, before moving legislation forward. But better they be motivated by a celebrity doctor than continue to ignore the benefits of medical marijuana altogether.

Of which there are a myriad.

The marijuana plant is one of the most studied biologically active substances of modern times. A search on PubMed, the repository for all peer-reviewed scientific papers, using the term “marijuana” yields nearly 20,000 scientific papers referencing the plant and/or its constituents, nearly half of which have been published just within the past decade. In addition, more than 100 controlled trials, involving thousands of subjects, have evaluated the safety and efficacy of cannabis and/or individual cannabinoids.

Most recently, a review of FDA-approved marijuana plant trials conducted by various California universities concluded, “Based on evidence currently available the Schedule I classification (for cannabis) is not tenable; it is not accurate that cannabis has no medical value, or that information on safety is lacking.” The best summary of this research can be found in the publication Emerging Clinical Applications for Cannabis and Cannabinoids, available on the NORML website. So the basic research is available for all who care to learn.

But few elected officials appear to be aware of this considerable body of science. Rather, the common refrain is to claim they cannot support the medical use of marijuana because the only evidence is “anecdotal”. These officials prefer to remain ignorant because it reinforces their preconceived notion that medical marijuana is a hoax perpetuated by those who simply wish to get “high”.

So what this latest rush to approve CBD-only marijuana products demonstrates, more than anything else, is the degree to which our public policy can frequently be influenced by a strong strain of puritanism that remains alive among our elected officials. If it feels good, it must be bad!

These many state legislators were willing to show some compassion by allowing the medical use of marijuana by these poor children suffering from multiple, disabling seizures, so long as the marijuana did not make them feel “high” (i.e., feel better!). These legislators are against pleasure, and if the use medical marijuana includes the feeling of pleasure, then it cannot be approved.

Excuse me, but is that not the purpose of using medicine when one is ill – to feel better?

Admittedly, for some of these puritans, the association of the word “high” with the use of marijuana may lie at the heart of the problem for them. Marijuana has long been demonized by conservatives, law enforcement, and many in the medical community, and that has spilled-over to the marijuana “high”.

If they understood that the marijuana “high” makes the user feel better, and that seriously ill patients almost always want (and need) to feel better, perhaps they could overcome their fear of medical marijuana. But for now at least, it is clear that in their view the marijuana “high”, like marijuana itself, is something to be avoided by responsible Americans, even if that precludes the use of medical marijuana by seriously ill patients.

It is time we moved beyond the notion that pleasure is bad, and stopped treating the marijuana “high” as something to be avoided, when it makes patient feel better. For them, feeling better and feeling high is often the same.

Federal Government To Increase Its Supply Of Marijuana For Clinical Research

May 6th, 2014

Federal agencies are moving forward with plans to increase the US government’s production of research-grade cannabis.

Last week, the US Drug Enforcement Administration (DEA) publicly announced in the Federal Register that it is increasing its marijuana production quota from 21 kilograms to 650 kilograms (about 1,443 pounds) in order to meet increasing demand for the plant from clinical investigators.

Federal regulations permit a farm at the University of Mississippi to cultivate set quantities of cannabis for use in federally approved clinical trials. Regulators at the DEA, the US Food and Drug Administration, PHS (Public Health Service), and the US National Institute on Drug Abuse must approve any clinical protocol seeking to study the plant’s effects in human subjects.

On various occasions, marijuana reform advocates and researchers have publicly criticized NIDA for failing to approve proposed trials seeking to assess the therapeutic benefits of cannabis. However, in March, federal regulators finally signed off on a long-delayed clinical protocol from researchers at the University of Arizona College of Medicine to evaluate the use of cannabis its in war veterans suffering from post-traumatic stress. Also this spring, lawmakers in several states, including Alabama, Kentucky, and Wisconsin, passed legislation encouraging state-sponsored clinical trials to assess the therapeutic potential of cannabidiol – a nonpsychotropic organic component of cannabis – in the treatment of intractable epilepsy.

“The additional supply [of cannabis] to be manufactured in 2014 is designed to meet the current and anticipated research efforts involving marijuana,” A NIDA spokesperson told TheHill.com. “[T]his projection of increased demand is due in part to the recent increased interest in the possible therapeutic uses of marijuana.”

According to a keyword search using the terms ‘smoked marijuana’ on the clinicaltrials.gov website, eight trials are presently ongoing to evaluate the plant’s effects in humans. Two of these trials are assessing the plant’s potential therapeutic efficacy.

New Study Tells Nothing About Marijuana’s Role in Heart Disease

April 24th, 2014

A new study on marijuana appeared in Journal of the American Heart Association. These are interesting data, but we have to interpret them very carefully.

Sure, we know cannabis can raise heart rate briefly, but most users develop tolerance to the effect. We’ve also seen (in a much larger sample) that it doesn’t increase mortality rates even among survivors of heart attacks.

But the new study made the news anyway. Investigators specifically searched a French database where physicians are legally bound to report any drug-related case that they view as “leading to temporary or permanent functional incapacity or disability, to inpatient hospitalization or prolongation of existing hospitalization, to congenital anomalies, or to an immediate vital risk or death.”

They then looked for cannabis users and found a shade less than 2,000 in the past 5 years. It’s impossible to know what that number means without knowing the number of people these physicians saw or how many patients used cannabis and did not end up reported to this database.

They then found a whopping 35 of these who had cardiac complications. It is impossible to know what to make of this number without knowing the number of cannabis users in France, which the authors report is 1.2 million. If you divide 35 by 1.2 million you get roughly .00003. I’m guessing that not all these cannabis users went to the doctor and not every person who used cannabis and had cardiac complications fessed up to the doctor, so let’s say that we’re off by two orders of magnitude. Let’s give the prohibitionists the benefit of the doubt and multiply by 100. That’d put the rate of problems up to .003.

If those are the chances of having cardiac complications as a French cannabis user, my first thought is that using cannabis protects people from cardiac problems. We need a comparison group of people who don’t use cannabis to know their rate of cardiac problems, but, as the authors point out, we simply don’t have those data. The closest estimates were 57 per 10,000 people, based on another study, which is .0057, or almost twice as bad as the rate among the cannabis users (after our generous overestimation). I’m not going to hold my breath for the the headline, “Cut your heart disease in half with cannabis.”

In short, this study tells us a lot about what kinds of cardiac complications appeared in people who were reported to the French government for cannabis-related problems, but tells us little about the link between cannabis use and cardiovascular disease.
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Study: Medical Cannabis Laws Not Associated With Increased Use By Adolescents

April 22nd, 2014

The enactment of state laws legalizing the physician-recommended use of cannabis therapy is not associated with increased levels of marijuana use by young people, according to data published online in the Journal of Adolescent Health.

Researchers at Rhode Island Hospital and Brown University assessed the impact of medical cannabis laws by examining trends in reported drug use by high-schoolers in a cohort of states before and after legalization. Researchers compared these trends to geographically matched states that had not adopted medical marijuana laws.

Authors reported overall “no statistically significant differences in marijuana use before and after policy change for any state pairing,” and acknowledged that some states that had adopted medical cannabis laws experienced a decrease in adolescent’s self-reported use of the plant. “In the regression analysis, we did not find an overall increased probability of marijuana use related to the policy change,” they stated.

Investigators concluded, “This study did not find increases in adolescent marijuana use related to legalization of medical marijuana. … This suggests that concerns about ‘sending the wrong message’ may have been overblown. … Our study … may provide some reassurance to policy makers who wish to balance compassion for individuals who have been unable to find relief from conventional medical therapies with the safety and well-being of youth.”

A 2013 study published in the American Journal of Public Health similarly concluded that the passage of medical marijuana laws in various states has had no “statistically significant … effect on the prevalence of either lifetime or 30-day marijuana use” by adolescents residing in those states.

A 2012 study by researchers at McGill University in Montreal reported: “[P]assing MMLs (medical marijuana laws) decreased past-month use among adolescents … and had no discernible effect on the perceived riskiness of monthly use. … [These] estimates suggest that reported adolescent marijuana use may actually decrease following the passing of medical marijuana laws.”

Read the abstract of this latest study, “The Impact of State Medical Marijuana Legislation on Adolescent Marijuana Use,” online here.

Minnesota: African Americans Six Times More Likely Than Whites To Be Arrested For Marijuana Possession

April 21st, 2014

African Americans are arrested for marijuana possession offenses in Minnesota at a rate that is more than six-times higher than that of Caucasians, according to an analysis of 2011 FBI arrest data released today by the nonpartisan think-tank Minnesota 2020 and commissioned in part by Minnesota NORML.

Although African Americans comprise less than six percent of the state’s population, they represented over 27 percent of those persons arrested for violating marijuana possession laws in 2011. By comparison, whites comprise some 87 percent of the state’s population and constituted 69 percent of those arrested for violating marijuana possession laws. “Thus, the black arrest rate for marijuana possession was 687 and the white arrest rate was 107, making blacks 6.4 times more likely to be arrested for marijuana possession than whites,” the study found.

In 2010, blacks in Minnesota were arrested for cannabis possession at 7.8 times the rate of whites. Both African Americans and Caucasians consume cannabis at approximately similar rates.

The racial disparity in Minnesota in marijuana possession arrests is significantly higher than the national average. According to a 2013 analysis of marijuana possession arrests by race in 945 counties nationwide, blacks are approximately four times as likely as whites to be arrested for marijuana possession.

“[This] kind of over-representation cannot be accounted for without racial bias,” Minnesota 2020 Executive Director Steve Fletcher said today at a press conference. “It means black Minnesotans are bearing a disproportionate share of the personal and collateral costs of our war on drugs.”

A variety of factors contribute to the disparity in arrest rates, the study found. These include “over-policing in communities of color, cultural differences in where or how marijuana is used and purchased, and [the prevalence] of grants and seizure policies that incentivize volume over quality in drug arrests,” the think-tank acknowledged in a press release.

The report estimated that the collateral costs of a low-level marijuana arrest may total as much as $76,000 over the course of a decade, including attorney fees, fines, costs associated with attending mandatory drug treatment, lost income and job prospects, and barriers to public assistance and federal aid.

“In light of these human and financial costs, Minnesota lawmakers and law enforcement officials have a responsibility to consider whether marijuana possession laws in their current conception are actually contributing to public safety, or if they are instead producing undue hardship for individuals and growing inequities within society,” the study concludes.

Full text of the study, entitled “Collateral Costs: Racial Disparities and Injustice in Minnesota’s Marijuana Laws,” is available online here.