Despite prohibitionists’ often-expressed fears that legalization would lead more young people to use marijuana, new federal data released on Tuesday shows no such trend.
Reports of past-month cannabis use among those 12-17 remained stable from 2017 to 2018—and they’re significantly lower than in the years prior to when the first states began legalizing for adult use.
That’s according to the 2018 National Survey on Drug Use and Health (NSDUH), an annual report produced by the Substance Abuse and Mental Health Services Administration (SAMHSA).
“The percentage of adolescents in 2018 who used marijuana in the past year was lower than the percentages in 2002 to 2004 and in 2009 to 2013, but it was similar to the percentages in 2005 to 2008 and in 2014 to 2017,” SAMHSA said.
Recent studies that have used NSDUH data and other sources also demonstrate that youth marijuana use is not increasing post-legalization. In fact, research published in JAMA Pediatrics in July found that states with recreational cannabis experience a decline in underage marijuana use, with the study authors stating that regulated markets appear to deter illicit use.
Indeed, on a national scale, the percentage of adolescents who reported using marijuana began declining at a greater rate in the years after states started implementing legal cannabis systems. In 2018, 12.5 percent of those 12-17 said they used cannabis in the last month, compared to 13.5 percent in 2012, according to the NSDUH results.
Colorado and Washington State became the first U.S. states to vote to legalize marijuana for recreational use in late 2012, with legal sales commencing in 2014.
Between 2002 and 2018, the highest rate of adolescent marijuana use took place in 2002, when 15.8 percent reported past-month consumption.
“The survey results suggest that marijuana use among youth has remained stable and low in recent years, even as more states legalize medical and adult use,” Sheila Vakharia, PhD, deputy director of the Drug Policy Alliance’s Department of Research and Academic Engagement, told Marijuana Moment. “Rather than encouraging increased use, it is possible that legalization has limited access and deterred youth use. We find that these results strengthen the case for legalization in the interest of public health and protecting our nation’s young people.”
What’s more, the report found that cases of cannabis use disorder declined again for the 12-17 group in 2018, marking the seventh year in a row that fewer young people seem to be misusing the substance.
Interestingly, these trends are developing even as people’s perceptions of the risks of casual marijuana consumption are dropping. That seems to contradict an argument from reform opponents who claimed that legalizing cannabis would normalize it in such a way that underage individuals would feel more emboldened to experiment with marijuana.
Overall, marijuana consumption increased across age groups by about one percentage point over the past year, the survey found, with the bulk of that rise being attributable to those over 26. Past-month cannabis use for that demographic increased from 12.2 percent in 2017 to 13.3 percent in 2018.
This story was updated to include comment from the Drug Policy Alliance.
Photo courtesy of Philip Steffan.
Hemp-Derived CBD Helps Chronic Pain Patients Reduce Opioid Use, Study Finds
Chronic pain patients consuming hemp-derived cannabidiol, or CBD, on a daily basis for eight weeks reported a decrease in the opioid medications they needed, a new study reports.
“This is a prospective, single-arm cohort study for the potential role of cannabinoids as an alternative for opioids,” the paper states. “The results indicate that using the CBD-rich extract enabled our patients to reduce or eliminate opioids with significant improvement in their quality of life indices.”
The study, published this month in Postgraduate Medicine, sheds new light on the potential benefits of CBD extracted from hemp, a crop that became federally legal under the 2018 Farm Bill, although the Food and Drug Administration has yet to issue finalized guidelines that would allow CBD to be sold in dietary supplements and food products.
Researchers recruited 131 patients who obtain their care from the same pain clinic; 97 completed the eight-week follow-up period. All had been diagnosed with chronic pain and were taking opioid medications for relief.
For the study, participants were given a 60-count bottle of hemp-derived, CBD-rich soft gels. Each gel, according to the study, contained 15.7 mg CBD, 0.5 mg THC, 0.3 mg cannabidivarin, 0.9 mg cannabidiolic acid, 0.8 mg cannabichrome, and less than 1 percent of a botanical terpene blend. Nearly all (91) took two gel caps a day, totaling 30 mg of CBD; three participants opted not to use the hemp extract at all.
“CBD could significantly reduce opioid use and improve chronic pain and sleep quality among patients who are currently using opioids for pain management.”
Researchers asked participants to complete a series of questionnaires to access various factors at the onset of the study, at the four-week mark and at the eight-week point. Among them: their pain intensity level, how much their pain disrupted their lives, the quality of their sleep and how willing they were to cut back on opioids.
Of the total 94 participants who took CBD regularly, 50 reported they were able to reduce opioid medications at week 8. The authors also note: “Additional reductions in polypharmacy on the medication receipt were noted; six participants reported reducing or eliminating their anxiety medications, and four participants reported reducing or eliminating their sleep medication.”
Overall, 89 participants reported their quality of life had improved over the study period. Two measures changed significantly: patients’ self-rating of sleep quality and pain intensity and interference.
At baseline, the study’s authors calculated respondents’ scores regarding sleep quality to an average of 12.09—the higher the score, the poorer the quality of sleep. At the four-week and eight-week check-in points, the score decreased to 10.7 and 10.3, respectively. Similarly, another scale the authors used to measure pain and how it interferes with the enjoyment of life found the mean score value change from 6.5 at baseline to 5.9 at week 4 and 5.7 at week 8.
“The results of this study suggest that using CBD-rich hemp extract oil may help reduce opioid use and improve quality of life, specifically in regards to pain and sleep, among chronic pain patients,” the study concludes. “This is consistent with emerging literature on the topic, which has concluded that CBD is an effective analgesic, and one that helps reduce barriers to opioid reduction, such as physiological withdrawal symptoms.”
In an interview with Appalachian News Express, the study’s lead author Alex Capano said that outside of survey studies, her research is “the largest study on the use of CBD to reduce the use of opioids in the treatment of chronic pain.”
“It’s also the first study on CBD and opioid reduction to identify key data points, such as hemp extract doses, delivery method, and specific cannabinoid content,” she continued. “Most participants used a relatively low dose of 30mg of CBD per day, whereas other studies on CBD have tested very large doses, 10x or 20x that amount. Lower doses of CBD mean reduced risk of side effects and improved outcomes.”
Problematic Marijuana Use Is Declining Among People Who Consume Every Day, Study Finds
Contrary to the expectations of public health experts, the rate of frequent marijuana consumers who are diagnosed with cannabis use disorder (CUD) is not increasing, a new study reports. In fact, it’s actually decreasing, and that may be due to the growing number of states that have legalized access to marijuana.
According to the paper, “CUD prevalence decreased significantly across all ages reporting daily/almost daily cannabis use between 2002-2016. Cannabis dependence prevalence decreased for adolescents and young adults and was stable only among adults ages 26+ reporting daily/almost daily cannabis use.”
Recent studies have had mixed results on the prevalence of CUD—a diagnosis that includes either misuse and/or dependence—in the last two decades. Because people who consume marijuana every day or almost every day are the most at risk for problematic use, researchers at Columbia University’s Mailman School of Public Health set out to get a better understanding of this group’s general health.
Their findings were published last month in the journal Drug and Alcohol Dependence.
The study’s authors used data from the National Surveys on Drug Use and Health for the years 2002-2016. The final sample, totaling 22,651 people, included participants who were 12 and older and reported using marijuana at least 300 days in the past year.
To measure problematic marijuana use, the authors used criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, for cannabis dependence and cannabis abuse, such as:
- Spent a great deal of time over a period of a month obtaining, using, or getting over the effects of marijuana
- Unable to keep set limits
- Unable to cut down cannabis use
- Recurrent use resulting in failure to fulfill major role obligations
- Continued use despite persistent or recurrent social or interpersonal problems
Other factors considered in the research asked whether participants had a perceived need for mental health treatment, whether a doctor had indicated they had other health issues and whether or not they’d driven under the influence of illegal drugs with and without alcohol.
Over the study period, the authors found that the prevalence of CUD decreased among their sample in all age groups: For adolescents ages 12 to 17, the rate fell by 26.8 percent; for 18- to 25-year-olds, by 29.7 percent; and for adults 26 and older, by 37.5 percent.
“Among those with past-year daily/almost daily cannabis use, there were reductions in the prevalence of DSM-IV cannabis abuse across all age groups, with reductions observed for all individual abuse items in adolescents and young adults,” the study states. “There were also reductions in the prevalence of DSM-IV cannabis dependence among adolescents and young adults, but not in adults ages 26+. Reductions in most DSM-IV dependence items were observed in young adults while reductions in only a few dependence items were found for adolescents and older adults.”
Researchers offer several possible explanations for the declining rates, many of which point to the influence of legalization. “First, the new national cannabis policy environment, with 33 states legalizing medical use and 10 states allowing recreational use of cannabis may have played a role in reducing stigma and perceptions of risk associated with cannabis use,” Silvia Martins, one of the study’s authors, said in a statement. “Secondly, increasing legalization may also be associated with changes in social attitudes resulting in fewer conflicts with relatives and friends around cannabis use.”
As a result, according to the paper, “[t]his could explain reductions in the abuse item ‘Continued use despite persistent or recurrent social or interpersonal problems,’ which reflects difficulties in interactions with others due to cannabis use.”
It’s also possible that “a sector of the population that is healthier overall” is starting to use marijuana more because of legal access, which “may have diluted the prevalence of cannabis abuse/dependence over time.” They may use “less potent” cannabis or in lower daily amounts, researchers note. Additionally, more people may feel less afraid to admit on a federal survey that they use marijuana frequently.
Ultimately, Martins said, the study’s results “contradict the predominating hypothesis that the prevalence of DSM-IV CUD would be stable, or increase, among those using with this regularity.”
Photo courtesy of Sharon McCutcheon on Unsplash
Marijuana Use Tied To Lower Rates Of Depression And Suicidal Ideation Among PTSD Patients
People suffering from post-traumatic stress disorder (PTSD) who consume marijuana experience significantly fewer depressive episodes and lower rates of suicidal ideation compared to non-users, according to a new study.
The research, published in the Journal of Psychopharmacology on Tuesday, analyzed nationally representative health data from Statistics Canada’s 2012 Community Health Survey and found that people with PTSD who have not reported past-year marijuana use are much more likely to have suicidal thoughts and go through depressive phases.
“This study provides preliminary epidemiological evidence that cannabis use may contribute to reducing the association between post-traumatic stress disorder and severe depressive and suicidal states.”
Among the more than 24,000 people who were eligible for the study, with was conducted by researchers at the the British Columbia Centre on Substance Use and University of British Columbia, 420 were clinically diagnosed with PTSD. Of those, 106 individuals with PTSD (28.2 percent) said they used cannabis in the past year. That’s markedly higher than the average of those who don’t have PTSD (11.2 percent).
“We know that with limited treatment options for PTSD, many patients have taken to medicating with cannabis to alleviate their symptoms,” Stephanie Lake, lead author of the study, said in a press release. “However, this is the first time that results from a nationally representative survey have shown the potential benefits of treating the disorder with cannabis.”
Those suffering from PTSD who didn’t report past-year cannabis use were about seven times as likely to have experienced a recent major depressive episode, the study found. They were also 4.3 times as likely to have contemplated suicide.
“Among cannabis-using respondents, PTSD was not associated with a recent depressive episode or suicide ideation.”
While the study only looked at Canadian respondents, the findings are relevant to U.S. patients as well, as members of the military stateside also experience higher rates of PTSD compared to the general population.
A former secretary of the U.S. Department of Veterans Affairs (VA), David Shulkin, has said recently that he’s in favor of having the department conduct clinical research into the therapeutic benefits of marijuana for veterans with PTSD, stating that the suicide rate among the population demonstrates that ignoring the treatment option comes at the “peril” of service members.
While VA declined to support research initiatives into cannabis for medical conditions that commonly afflict veterans under his leadership, Shulkin said this week that the department “should be involved and should be open to research for anything that will help veterans improve their lives, including medical cannabis.”
“We’re only just beginning to understand what the therapeutic potential of cannabis may be for a variety of health conditions,” M-J Milloy, senior author of the new study, said. “These findings are promising, and merit further study in order to fully understand the benefits of cannabis for people living with PTSD.”
Photo by davide ragusa on Unsplash.