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IACM-Bulletin of 19 November 2023
Ohio voters approved a ballot proposal on November 7 legalizing recreational cannabis. This makes Ohio the 24th state in the United States to permit cannabis use for non-medical purposes. While this change brings new freedoms for adults, employers in Ohio are provided broad rights and responsibilities under the new law.
As approved by Ohio voters, the law permits adults to possess up to 2.5 ounces (about 70 g) of cannabis or 15 grams of cannabis extract. Individuals can purchase cannabis from retail locations or grow up to 12 plants in a private residence where at least two adults reside. Retail cannabis products will be subject to a 10% tax.
Science/Human: Cannabis may be as effective as opioids in the treatment of pain, and in addition improves emotion
According to an internet survey with 201 chronic pain patients from Finland cannabis may be as effective in reducing pain as opioids, but in addition may be associated with positive emotional effects. The study with 40 cannabis using patients and 161 opioid using patients was conducted by investigators of the Department of Psychology at Åbo Akademi University in Turku, Finland. The two groups were propensity score matched to control for possible confounding factors, resulting in 2 groups consisting of 39 patients each.
The cannabis group received higher scores than the opioid group in Positive Emotional Effects with large effect size, and in Holistic Positive Effects with medium effect size, with no difference in Negative Side Effects. Cannabis and opioids were perceived as equally efficacious in reducing pain intensity. Authors concluded that cannabis and opiates “were perceived to be equally efficacious in reducing pain intensity,” but cannabis “additionally positively affected broader pain-related factors such as emotion, functionality, and overall sense of wellbeing. “
Jylkkä J, Hupli A, Nikolaeva A, Alanen S, Back AE, Lindqvist S, Krabbe A, Lavie-Ajayi M, Kantonen O. The holistic effects of medical cannabis compared to opioids on pain experience in Finnish patients with chronic pain. J Cannabis Res. 2023;5(1):38.
A new study by investigators of the Universidad Nacional Autónoma de México suggests regular cannabis users may have a heightened ability to understand others’ emotions. Psychological assessments coupled with brain imaging revealed that users show stronger connectivity in brain regions associated with empathy. The study included 85 regular cannabis users and 51 non-consumers who completed psychometric tests and a subset of 46 users and 34 nonusers who underwent functional magnetic resonance imaging exams.
The major findings were: (1) Regular cannabis users may have a greater empathetic understanding of others compared to non-users. (2) Brain imaging indicates enhanced connectivity in the anterior cingulate cortex, a region related to empathy, among cannabis users. “Although further research is needed, these results open an exciting new window for exploring the potential effects of cannabis in aiding treatments for conditions involving deficits in social interactions, such as sociopathy, social anxiety, and avoidant personality disorder, among others,” said co-author Dr Víctor Olalde-Mathieu.
According to an observational study with 374 participants both 1000 mg isolated CBD per day and a broad spectrum product with 1000 mg CBD reduced stress. In this investigation by investigators of the Department of Psychiatry and Behavioral Neurosciences at Wayne State University School of Medicine in Detroit, USA, the broad spectrum extract was rated to be more effective than the isolate. Participants completed either her 30- or 60-day regimen were instructed to use a 1,000 mg CBD isolate product at will, and then switch over to the 1,000 mg broad spectrum product for the remainder of the regimen.
Overall, both products were rated to be highly effective and able to assist with stress management. Participants reported that the broad spectrum product's effectiveness and ability to reduce stress as greater than the isolate product across both regimens. However, participants preferred the taste of the isolate product over that of the broad spectrum across regimens. For the 30-day regimen, participants reported a more positive overall impression of the isolate as compared to the broad spectrum. However, overall impression did not differ between the products in the 60-day regimen.
In a small study by investigators of the College of Public Health and Health Professions and College of Medicine at the University of Florida in Gainesville, USA, cannabis was shown to reduce symptoms of post-traumatic stress disorder. The 15 participants were assessed at baseline and 30 and 70 days after the initiation of medical cannabis.
Symptom severity improved significantly at 30- and 70-day follow-ups. Similarly, statistically significant reductions in nightmares were reported at 30- and 70-day follow-ups. Corresponding improvements in sleep were noticed with participants reporting increased duration of sleep hours, sleep quality and sleep efficiency. Likewise, negative affect and global mental health improved significantly at follow-up.
Vaddiparti K, Liu Y, Bottari S, Boullosa CC, Zhou Z, Wang Y, Williamson J, Cook RL. Improved Post-Traumatic Stress Disorder Symptoms and Related Sleep Disturbances after Initiation of Medical Marijuana Use: Evidence from a Prospective Single Arm Pilot Study. Med Cannabis Cannabinoids. 2023;6(1):160-169.
According to a survey by investigators of the Mayo Clinic in Rochester, USA, cancer survivors with chronic pain have a higher prevalence of cannabis use compared to those patients without pain. An electronic survey was developed in conjunction with the National Cancer Institute Comprehensive Cancer Centers in the USA. This survey was distributed to cancer survivors within a multi-site, single institution setting.
The survey response rate was 23.0% (2304/10,000), of whom 72.7% of these patients (1676/2304) did in fact have a confirmed cancer diagnosis. Among these cancer survivors, 16.5% had chronic pain, and 12.4% reported cannabis use since their cancer diagnosis.
Philpot LM, Ramar P, Jatoi A, Rosedahl J, Canning R, Ebbert JO. Cannabis in Cancer Survivors Who Report High Impact Chronic Pain: Findings from a 1500+ Patient Survey. Am J Hosp Palliat Care. 2023;40(11):1196-1204.
According to a review and meta-analysis cannabis use may be associated with reduced weight and body mass index. Authors concluded that these “findings suggest that cannabis and subproducts could be considered adjuncts in obesity treatment by helping to reduce relevant anthropometric measurements.”
Faculdade Ciências Médicas de Minas Gerais, Belo Horizonte, Brazil.
In a study with rats CBD reduced methotrexate-induced neuroinflammation by reducing mitochondrial stress and stress of the endoplasmatic reticulum. Methotrexate is a medicinal drug used in the treatment of autoimmune diseases.
Department of Neurology, Faculty of Medicine, Suleyman Demirel University, Isparta, Turkey.
THC was shown to show antiviral effects against flaviviruses, a group of viruses which comprise also the dengue and zika virus. Authors suggest THC to “be further investigated in-vitro as a cure against dengue and zika virus infections.”
Department of Biochemistry, Assam Royal Global University, Guwahati, India.
In a study with 26,399 participants over age 50 cannabis use was associated with subjective memory complaints. Authors wrote that cannabis use “represents a modifiable lifestyle factor that has potential for both risk and protective properties that may impact the trajectory of cognitive decline in older age.”
Department of Psychiatry, University of Michigan, 2101 Commonwealth Blvd, Ann Arbor, USA.
In a mouse model of migraine CBD was effective “in preventing episodic and chronic migraine-like states with reduced risk of causing medication overuse headache.”
Biomedical Science Department, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, United States.