Small doses of CBD appear to have no significant impact on driving, according to first-of-its-kind research published Tuesday in the Journal of the American Medical Association.
Similar doses of THC, meanwhile, were associated with short-term impairment “modest in magnitude and similar to that seen in drivers with a 0.05%” blood alcohol concentration, the study found. After about four hours, signs of marijuana impairment faded.
The University of Sydney-led experiment is the latest to study the effects of cannabis consumption on drivers, an issue of growing public concern as more jurisdictions around the world remove laws against the plant and its chemical components.
“The results should reassure people using CBD-only products that they are most likely safe to drive, while helping patients using THC-dominant products to understand the duration of impairment,” said Iain McGregor, academic director of the university’s Lambert Initiative for Cannabinoid Therapeutics.
The new research was funded by the Lambert Initiative, which studies the health effects of cannabis, and conducted at Maastricht University, in the Netherlands. Marijuana Moment reviewed a draft of the paper prior to its publication on Tuesday.
To measure the effects of the cannabinoids on drivers, researchers first had participants vaporize one of four cannabis blends: mainly THC, mainly CBD, a combination of the two cannabinoids or a placebo containing less than 0.2 percent total cannabinoids. The target dose for each cannabinoid other than the placebo was 13.75 milligrams.
Subjects then got into cars and took to the road. Accompanied by a licensed driving instructor, each completed a 100-kilometer circuit on a stretch of Dutch highway twice: first 40 minutes after consuming the cannabis blend and again four hours after consumption.
Researchers measured driving impairment by tracking how much drivers’ vehicles drifted in the lanes—a common metric known as standard deviation of lateral position (SDLP)—as well as fluctuations in vehicle speed. Participants were also tested in a laboratory setting for cognitive and psychomotor performance, blood cannabinoid concentrations and cardiovascular indicators such as heart rate and blood pressure.
Consuming CBD alone seemed to have little impact on performance.
“There were no significant differences between CBD-dominant cannabis and placebo,” the study says. “SDLP in the placebo and CBD conditions did not differ, indicating that CBD…did not impair driving.”
“These findings indicate for the first time that CBD, when given without THC, does not affect a subject’s ability to drive,” said Thomas Arkell, the study’s lead author.
Participants who consumed THC or a blend of cannabinoids, meanwhile, showed moderate but statistically significant impairment behind the wheel during their first test drive, posting SDLP numbers similar to drivers with blood alcohol concentrations of 0.05 percent. The study’s authors note the degree of impairment “is thought to indicate the lower limit of clinically relevant driving impairment.”
Unlike many drunk drivers, however, subjects who consumed THC or the THC–CBD blend seemed distinctly aware of their risk behind the wheel. That was true even as observable signs of their impairment faded.
Subjects described themselves as “significantly more impaired” after consuming THC or both cannabinoids, with a top complaint being decreased confidence. After the tests were completed, however, most subjects were able to correctly observe that their quality of driving itself was worse only during the first test.
“Participants considered their driving at 240-300 min to be significantly more impaired in the THC and THC/CBD conditions than in the placebo condition despite there being no difference across conditions in SDLP at that point in time,” the authors write.
The second test began four hours after consumption, which researchers say is about the time it seems to take for THC’s effects on driving to fade.
“Previous on-road and simulator studies have described increased SDLP for up to 3 hours following inhaled cannabis,” the study says. “Consistent with this, the present study failed to detect SDLP at 4-5 hours.”
That doesn’t mean consumers should necessarily assume they’re good to drive after just four hours. Higher inhaled doses or edible products, authors note, could extend the duration of impairment “and so these results should not be considered definitive.”
Similar limitations could apply to the study’s CBD findings. Authors note the 13.75 mg target dose in the study is considerably lower than what’s typically given in certain treatments, such as for pediatric epilepsy. “Driving outcomes may differ with higher CBD and THC doses and different CBD:THC ratios,” they write.
More fundamentally, the researchers acknowledge, the experiment could be failing to detect extremely minimal impairment caused by CBD. Confidence limits used in analyzing data from the 26-person experiment “suggested the possibility of subclinical impairment” too small to be measured in the study.
Nevertheless, the authors said, the findings offer valuable real-world data about how cannabis affects drivers—or, in some cases, apparently doesn’t.
“While some previous studies have looked at the effects of cannabis on driving, most have focused on smoked cannabis containing only THC (not CBD) and have not precisely quantified the duration of impairment,” said McGregor at the University of Sydney’s Lambert Initiative. “This is the first study to illustrate the lack of CBD effects on driving and to also provide a clear indication of the duration of THC impairment.”
Despite widespread concerns that relaxing cannabis laws could lead to more dangerous roadways, data on the subject has been largely inconclusive, allowing speculation to run rampant.
After evaluating available evidence last year, experts tasked by U.S. congressional lawmakers to look into the issue concluded that fundamental questions about THC’s impact on driving remain unanswered.
“Although laboratory studies have shown that marijuana consumption can affect a person’s response times and motor performance,” wrote the Congressional Research Service, “studies of the impact of marijuana consumption on a driver’s risk of being involved in a crash have produced conflicting results, with some studies finding little or no increased risk of a crash from marijuana use.”
The lack of clear evidence has frustrated both legalization opponents, who worry about increased highway dangers, but also medical marijuana patients who are at risk of arrest and conviction for THC-impaired driving even days after their medicine’s effects wear off.
In Pennsylvania, the House of Representatives approved a measure in October that would protect registered medical marijuana patients from being penalized under the state’s DUI laws.
“You can ask any veteran or anybody that’s using medical cannabis right now, if they took the prescription on Monday, [on] Wednesday, they’re not high,” Rep. Ed Gainey (D) said in a floor speech before the vote. “And if they got pulled over, they darned shouldn’t be charged for being intoxicated or under the influence of medical marijuana.”
Photo courtesy of the Lambert Initiative for Cannabinoid Therapeutics at the University of Sydney
Areas With More Marijuana Dispensaries Have Fewer Opioid Deaths, New Study Finds
Increasing access to marijuana dispensaries is associated with a significant reduction in opioid-related deaths, according to a new study.
“Higher medical and recreational storefront dispensary counts are associated with reduced opioid related death rates, particularly deaths associated with synthetic opioids such as fentanyl,” the paper, published on Wednesday in the British Medical Association journal’s BMJ, concluded.
It’s a finding that “holds for both medical and recreational dispensaries,” the study says.
Researchers looked at opioid mortality and cannabis dispensary prevalence in 23 U.S.states from 2014 to 2018 and found that, overall, counties where the number of legal marijuana shops increased from one to two experienced a 17 percent reduction in opioid-related fatalities.
Increasing the dispensary count from two to three was linked to an additional 8.5 percent decrease in opioid deaths.
Further, the study found that this trend “appeared particularly strong for deaths associated with synthetic opioids other than methadone, with an estimated 21 percent reduction in mortality rates associated with an increase from one to two dispensaries.”
“If consumers use cannabis and opioids for pain management, increasing the supply of legal cannabis might have implications for fentanyl demand and opioid related mortality rates overall.”
“While the associations documented cannot be assumed to be causal, they suggest a potential association between increased prevalence of medical and recreational cannabis dispensaries and reduced opioid related mortality rates,” the researchers wrote. “This study highlights the importance of considering the complex supply side of related drug markets and how this shapes opioid use and misuse.”
This is far from the first piece of research to draw a connection between legal cannabis access and reduced harms from opioids. Multiple studies have found that marijuana effectively treats conditions like chronic pain for which opioids are regularly prescribed, and surveys show that many patients have substituted addictive painkillers with cannabis.
“Cannabis is generally thought to be a less addictive substance than opioids,” the new study says. “Cannabis can potentially be used medically for pain management and has considerable public support.”
“Given the alarming rise in the fentanyl based market in the US, and the increase in deaths involving fentanyl and its analogs in recent years, the question of how legal cannabis availability relates to opioid related deaths is particularly pressing.”
“Our findings suggest that increasing availability of legal cannabis (modeled through the presence of medical and recreational dispensary operations) is associated with a decrease in deaths associated with the T40.4 class of opioids, which include the highly potent synthetic opioid fentanyl,” it continues. “This finding is especially important because fentanyl related deaths have become the most common opioid related cause of death.”
Earlier this month, a separate study determined that medical cannabis use is associated with significant reductions in dependence on opioids and other prescription drugs, as well as an increase in quality of life.
These studies could also provide valuable context to a federal health agency in the U.S. that is conducting a review of studies to learn if marijuana and kratom could potentially treat chronic pain with fewer side effects than opioids.
Photo courtesy of WeedPornDaily.
Feds To Send Marijuana And Hemp Samples To Labs As Part Of Large-Scale Testing Accuracy Study
A federal science agency is inviting labs to participate in a large-scale study to assess their ability to accurately analyze marijuana and hemp samples for their cannabinoid profile and possible contaminants.
The National Institute of Standards and Technology (NIST) said in a notice on Thursday that it will provide samples of cannabis that it’s already analyzed to labs and then ask them to run their own tests. Once that’s complete, NIST will reveal the actual data and compare the numbers to identify any disparities.
The point of the study isn’t to expose labs that fail to provide accurate analyses; rather, it’s intended to help forensic analysts and the cannabis industry develop best practices. NIST, which is part of the U.S. Department of Commerce, said it’s especially important given that hemp was federally legalized under the 2018 Farm Bill, while its higher THC cannabis cousin marijuana remains federally illegal.
“If you’re going to confiscate a farmer’s crop, or subject a person to prosecution, you want to be sure that measurement is accurate,” NIST research chemist Brent Wilson said in a press release.
Is it hemp or is it marijuana? Legally, there's a big difference. Now, NIST is helping labs increase the accuracy of the measurements they make to answer that question. Find out how: https://t.co/3tQZzzcleL pic.twitter.com/ntsmZuuGUb
— National Institute of Standards and Technology (@NIST) January 14, 2021
The agency has previously led research on analyzing hemp oil, but this one involving both hemp and marijuana will target flower, which is more challenging for labs. To get the samples for this new study, NIST ground down various cannabis buds and sorted them—”like a baker sifting flour”—to separate the material by particle size.
Wilson then “blended the powders into batches and carefully measured how much of each compound and contaminant was present in each batch.”
“NIST will send samples from those batches to participating labs,” the agency said. “All labs will receive legal hemp samples. Labs that are licensed to handle controlled substances can also request marijuana samples.”
Labs interested in participating in the study have until February 5 to enroll. Samples will be distributed in April.
While determining THC content is a central concern, the research will also look at CBD and other cannabinoids so that cannabis companies are able to ensure that their products meet legal standards and are properly labeled for consumers.
After a lab has analyzed the samples, it will report back to NIST with the results as well as information about the testing method it used. The results will be published, but they will be anonymized. The public will “be able to see the amount of variation across labs but not how any specific lab performed.”
“Our goal is to provide a learning opportunity for labs, not to publicize their performance,” NIST research chemist Melissa Phillips said.
Following the study’s completion, the agency will investigate which testing methods produce the most accurate results to inform the industry. Then it will re-run the test, which is expected to show “less variability in the lab measurements, as labs overall improve their methods.”
A description of the study exercise states that participating labs “may also elect to report only selected analytes (e.g., only reporting total THC, but not all cannabinoids).”
“Participants will be asked to report triplicate results for each sample provided using measurement procedures and calculations normally performed in their laboratories,” it says. “In addition, participants will also be asked to identify the type of sample preparation and analytical methods employed in their testing to facilitate conclusions about potential method bias.”
There are currently 46 labs that are listed as participants in NIST’s cannabis research program. That includes multiple private labs as well as one police department and a division of the U.S. Department of Agriculture. There are also facilities from Canada and the Netherlands enrolled.
In December, the Department of Justice announced that it was awarding NIST a grant to help to develop a method of differentiating hemp and marijuana.
The previous year, the Drug Enforcement Administration similarly announced that it was seeking a device to “provide specificity to distinguish between hemp and marijuana” since the former crop was legalized.
The complications resulting from hemp legalization is especially apparent in Texas, where marijuana possession arrests fell almost 30 percent from 2018 to 2019 following the state-level legalization of the non-intoxicating cannabis crop.
Prosecutors in the state have dismissed hundreds of low-level cannabis cases since hemp was legalized. And officials announced last year that labs wouldn’t be performing testing in misdemeanor cases, with the Department of Public Safety saying it “will not have the capacity to accept those.”
Photo courtesy of National Institute of Standards and Technology.
Best Music Playlists For Psychedelic Therapy Are Explored In New Johns Hopkins Study
Psychedelic therapy sessions often incorporate music—and typically that music is of the classical genre. But new research out of the Johns Hopkins University School of Medicine suggests there may in fact be no special value in playing a Mozart concerto or Chopin étude for tripping patients.
Gongs could work just as well, if not better, the study found.
“Western classical music has long been assumed to be the standard in psychedelic therapy,” researchers wrote in the study, published Tuesday in the American Chemical Society (ACS) journal Pharmacology and Translational Science. “The present data challenge this notion that Western classical music, or for that matter any specific genre of music, is an intrinsically superior form of music to support psychedelic therapy, at least for all people at all times.”
Analyzing a 10-person trial involving the use of psilocybin therapy to help people quit smoking tobacco, the Johns Hopkins team compared sessions featuring classical music with those involving overtone-based music, featuring instruments such as gongs, Tibetan singing bowls or the didgeridoo, among others.
“Although we found no significant differences between the two musical genres studied here,” the team wrote, “several trends suggested that the overtone-based playlist resulted in somewhat better outcomes and was preferred by a larger portion of this small sample of participants.”
Spoiler alert – they did about the same but a hint that the overtone playlist (gong etc.) did a bit better than Western classical. Apparently classical music is not such a sacred cow for psychedelic therapy. With @juststrickland and Albert Garcia-Romeu.
— Matthew W. Johnson (@Drug_Researcher) December 30, 2020
In other words, while the results don’t prove that overtone-based music yields better outcomes than classical, the findings nevertheless “call into question whether Western classical music typically played in psychedelic sessions holds unique benefit.”
As one of the study’s authors, Johns Hopkins researcher Matthew Johnson, put it in a recent tweet: “Apparently classical music is not such a sacred cow for psychedelic therapy.”
The researchers said the study “provides the first contemporary and within-subject experimental manipulation of session set and setting factors in psychedelic research” and is the “first fully randomized test of different musical genres supporting psychedelic therapy.”
Participants each had three therapy sessions, one featuring classical music, another featuring overtone music and a third session for which they could choose between the two genres. Psilocybin doses were between 20 milligrams and 30 milligrams per 70 kilograms of body weight.
Among the data researchers analyzed were participants’ evaluations of their own experiences, including “mystical experiences”—such as feelings of unity and transcendence of time and space—as well as “challenging experiences,” such as feelings of panic or losing sanity.
“Visual inspection of individual and average data indicated higher overall scores for overtone-based sessions compared to Western classical sessions,” the authors wrote. “This difference was of a medium effect size but was not statistically significant.”
As described in the paper there is about 25% overlap with the classic playlist we compared it to, link below. Most of that overlap was near onset and come down. A few tracks on the older classical playlist already fit the overtone-based genre.https://t.co/rKUsd6N005
— Matthew W. Johnson (@Drug_Researcher) December 31, 2020
Researchers also analyzed smoking abstinence outcomes based on the music genre participants selected for their third psychedelic therapy session, after sampling both genres. Participants who chose to listen to overtone music during the third session were more successful at quitting smoking—both immediately after treatment (83.3 percent) and over a period of about 30 months afterward (66 percent). By comparison, half of participants who chose Western classical music quit smoking immediately, and all of those people were still not smoking after 30 months.
Experts have long stressed the role of set and setting in a psychedelic experience, noting how both a person’s psychological state as well as their environment can affect the behavioral and clinical effects of entheogenic drugs. “Traditional laboratory contexts that contain overtly ‘sterile’ stimuli (e.g. white walls and medical equipment,” the authors note as one example, “have been suggested to increase the likelihood of negative reactions.”
While music is a standard feature of clinical psychedelic therapy, the new study says, the default by therapists to predominantly Western classical playlists is “likely due to recommendations present in early guidelines,” which specifically mentioned classical music.
But it may not be music at all, but instead a collection of sounds, that complements the psychedelic experience.
“The lack of superiority of the Western classical playlist is even more interesting considering that some of the overtone-based playlist tracts consisted of sounds without traditionally identifiable melody and/or rhythm and therefore might not be classified as songs or music by some,” the study says. “This suggests that the sounds capable of supporting psychedelic therapy sessions may go beyond the bounds of traditionally defined musical genres.”
The researchers concluded that the study lends support to the idea that “developing a process for generating patient-specific musical selections rather than providing standardized music may improve therapeutic outcomes.”
“For example, future work could evaluate how patient-selected music impacts therapeutic effects or identify individual factors predictive of response to varying musical genres or musical features other than genre to individualize session selections,” the wrote. “More broadly, these findings emphasize the need for the parametric study of psychedelic session components to either provide improved standardized conditions, or to individualize conditions to improve the therapeutic effects of psychedelic therapy across diverse and varied populations.”
Johns Hopkins University, where the study analysis was done, is widely regarded as a leading institution on psychedelic research. In 2000, it became the first U.S. institution to gain federal approval to reinstitute research into psychedelic drugs using subjects who didn’t already have a history of using the drug, and last year it launched the country’s first-ever psychedelic research center.
Photo courtesy of Wikimedia/Workman