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Legal Medical Marijuana Associated With Lower Opioid Use Rates, Another Study Finds

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Legal access to medical marijuana is associated with lower rates of moderate and high-risk opioid use, according to a recent study—the latest in a string of research to come to the same conclusion.

Researchers analyzed prescription data on nearly 5 million people from 2006 to 2014, and they found that patients living in states that have legalized medical cannabis were less likely to take prescription painkillers, even after adjusting for various individual and state-level factors such as whether a state had a prescription monitoring system in place.

“Medical marijuana legalization was found to be associated with a lower odds of any opioid use,” the study found.

The results were published on Friday in the Journal of General Internal Medicine.

In general, patients were less likely to take opioids if they lived in a state with medical cannabis (19.3 percent) than those in non-legal state (19.9 percent). Chronic opioid use was also lower in legal states (1.8 percent) than non-legal states (1.9 percent).

“In states where marijuana is available through medical channels, a modestly lower rate of opioid and high-risk opioid prescribing was observed.”

The study considered different subgroups as well, looking at patients who didn’t have cancer and also pain patients who didn’t have cancer. The study revealed a similar trend: lower rates of opioid use in states with medical marijuana.

For that latter group, opioid use was generally lower in legal states (33.5 percent) compared to non-legal states (34.7 percent). This group was also less likely to use opioids long-term in legal states (4.5 percent) than non-legal states (4.8 percent), which is important because chronic use is more likely to result in patients building a tolerance to opioids that leads to misuse.

High-risk opioid use—defined as taking opioids and benzodiazepines at least once on the same day, taking painkillers that contain 120 morphine milligram equivalents or being diagnosed with a substance use disorder within the same year of being prescribed opioids—was also lower in legal states (5.1 percent) than non-legal states (5.6 percent).

“This study indicates that legalizing medical marijuana is associated with lower use of opioids and opioids used chronically across states, broadly, and in subgroups of cancer patients and cancer-free groups with chronic pain,” the researchers wrote.

There are multiple recent studies supporting this conclusion. For example, a research released in November demonstrated that it’s not just a question of whether a state enacted a medical cannabis system; lower opioid overdoses occurred specifically in counties where dispensaries were allowed to operate.

Marijuana Dispensaries Reduce Local Opioid Overdose Rates, Study Finds

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Marijuana Moment is made possible with support from readers. If you rely on our cannabis advocacy journalism to stay informed, please consider a monthly Patreon pledge.

Kyle Jaeger is Marijuana Moment's Sacramento-based senior editor. His work has also appeared in High Times, VICE and attn.

Politics

Top Federal Drug Official Says There’s ‘No Evidence’ That Occasional Marijuana Use Is Harmful For Adults

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The head of the nation’s top federal drug research agency says that she’s yet to see evidence that occasional marijuana use by adults is harmful.

National Institute on Drug Abuse (NIDA) Director Nora Volkow made the remarks in an interview with FiveThirtyEight that was published on Tuesday. It’s a notable admission given that the agency has historically gone to great lengths to highlight the potential risks of cannabis consumption.

“There’s no evidence to my knowledge that occasional [adult] marijuana use has harmful effects. I don’t know of any scientific evidence of that,” Volkow said. “I don’t think it has been evaluated. We need to test it.”

The quote stood out in an article that generally attempts to highlight possible risks of cannabis use while providing an overview of studies that run the gamut on marijuana health impacts. Volkow also said she found it “surprising” that research has indicated that cannabis consumers tend to have a lower body mass index (BMI).

“BMI is lower in marijuana users, and that was very surprising, and yet we know that high BMI, particularly the older you get, can have negative effects,” she said. “This is why we need to study it.”

This is certainly not to say that the NIDA director supports marijuana commercialization efforts. But to advocates, it’s encouraging to see a federal health official rely on the science and acknowledge that, as it stands, the evidence hasn’t pointed to serious harms for adults who occasionally use cannabis.

She did tell FiveThirtyEight that she is “absolutely” concerned about use by young people and said that daily consumption of high-THC products ““can have harmful effects even on the adult brain.”

But Volkow has taken a fairly level-headed approach to marijuana, pointing out potential dangers for adolescents and pregnant women, for example, while at the same time acknowledging that her expectations about the impact of state-level reforms haven’t always come to fruition.

For example, she recognized in a podcast interview released in August that cannabis legalization has not led to increased youth use despite her prior fears, and she spoke about the therapeutic potential of certain psychedelics that have long been deemed “dangerous” under federal law.

The official has also emphasized the need to address substance misuse with a public health lens, rather than subject people to criminalization for using drugs.

She said in an op-ed earlier this month that “stigma remains one of the biggest obstacles to confronting America’s current drug crisis,” and the government bears some responsibility in perpetuating those stigmas.

“Government policies, including criminal justice measures, often reflect—and contribute to—stigma,” she said. “When we penalize people who use drugs because of an addiction, we suggest that their use is a character flaw rather than a medical condition. And when we incarcerate addicted individuals, we decrease their access to treatment and exacerbate the personal and societal consequences of their substance use.”

Volkow also talked about how decriminalization, coupled with increased treatment, would represent a superior alternative to incarcerating people over drugs in a recent interview with Marijuana Moment.

In other recent remarks, she argued that there’s no need for further research to prove that the criminalization of drugs has disproportionately impacted communities of color.

And when it comes to marijuana research, the official has said that scientists should be allowed to investigate products from state-legal dispensaries instead of using only government-grown plants.

NIDA separately submitted a report to congressional lawmakers emphasizing that the Schedule I status of controlled substances like cannabis is preventing or discouraging research into their potential risks and benefits.

It also said that current restrictions that block scientists from studying the actual cannabinoid products that consumers can purchase at dispensaries is impeding research to an extent that constitutes a public health concern.

Credit Unions Urge Congress To Pass Marijuana Banking Reform Through Defense Bill

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Science & Health

Dogs Are Being Exposed To Marijuana Through Human Poop And Pet Owners Should Beware, Study Finds

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A word of caution to dog owners: apparently some canines are getting intoxicated off marijuana by eating the feces of people who’ve consumed cannabis, according to a new study.

Dogs are natural scavengers, and so the instinct to eat poop—while gross—is just a fact of life. But a team of Australian researchers found that, in some cases, that instinct can become dangerous, warranting the attention of puppy parents.

The study, published in the Australian Veterinary Journal, looked at 15 cases of confirmed THC toxicosis in dogs who were suspected of, or observed to have, ingested human feces in Melbourne from 2011-2020.

The dogs presented symptoms of incoordination, dilated pupils, urinary incontinence and stupor. Urine tests from eight of the dogs showed THC metabolites in their system.

However, study author Clara Lauinger told Marijuana Moment that this shouldn’t necessarily be taken to mean that any level of THC is toxic in dogs.

“The animals in my study had ingested an unknown quantity of feces that contained an unknown concentration of THC and so one would assume this concentration would be at a level that clearly caused toxicity,” she wrote in an email. “However this does not mean that all THC ingestions can lead to toxicity.”

In fact, there are other studies where animals were administered a controlled dosage of THC and “not a single one of them displayed any adverse effects that we might see with toxicity,” she said.

“There are so so many anecdotal reports of the huge benefits that THC administration has on animals, albeit reports are from owners perception rather than peer reviewed research, but this does not mean the industry should disparage THC as a therapeutic agent,” Lauinger said.

Most of the dogs in her new study apparently ate the poop at local parks, while others ingested it at the beach, camp sites and walking trails.

“All dogs survived to discharge. Ingestion of human feces containing THC may lead to marijuana toxicosis in dogs,” the study states. “Veterinary staff and owners should be attentive in regard to using appropriate hygiene measures when managing these dogs.”

The authors said that there are a number of reasons that a dog might eat poop—or, put scientifically, engage in coprophagy. But they floated one possibility for the marijuana-specific feces-eating trend: “It is possible that the presence of marijuana in feces increases its attractiveness for ingestion by altering its scent, texture and/or taste.”

Also, while this study is limited to data on about two dozen dogs in one city of Australia, the authors also said that the habit “might be more common than what owners report,” pointing to Google search results from people reporting a dog ate feces and exhibited signs of lethargy.

The idea of dogs getting high off THC-containing human waste might seem like a stretch on its own, but the study also explains that canines have more cannabinoid receptors than humans, “making dogs more sensitive to the effects of THC.”

“In conclusion, this case series suggests that ingestion of feces produced by a human marijuana user may lead to signs of marijuana toxicosis,” the researchers said. “Clinical signs of toxicosis were similar to those previously reported for dogs with conrmed marijuana toxicosis though gastrointestinal signs were not the most common feature despite coprophagy.”

“Veterinary staff and owners should be mindful of this exposure source to ensure appropriate hygiene measures are taken when managing these dogs,” the study says.

Lauinger said that there “needs to be an industrywide understanding of the fact that there are so many different strains of cannabis and each of these strains has different cannabinoid profiles that have possible potential for beneficial therapeutic effects.”

“These strains could be researched with a focus on what ones are suitable for animals and at what dose rather than blanketing all strains as being toxic,” she said. “I hope the public can be patient and also get behind us researching the dosing more.”

While there are clear concerns about dogs ingesting excess levels of THC, studies have found promising results when it comes to the therapeutic potential of other cannabinoids like CBD for pets.

For example, dogs with epilepsy experience considerably fewer seizures when treated with CBD oil, a study published in the journal Pet Behaviour Science in 2019 found.

The prior year, a separate study determined that CBD can alleviate the symptoms of osteoarthritis in dogs.

The Food and Drug Administration (FDA), for its part, has repeatedly warned pet owners about using CBD to treat firework-related anxiety in pets around the July 4 holiday.

“You should be aware that FDA has NOT evaluated these products and can’t say whether they are safe or effective, how they are manufactured, or whether they contain CBD,” the agency said this year.

Germany Will Legalize Marijuana And Promote Drug Harm Reduction, Governing Party Coalition Officially Announces

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Science & Health

Psychedelics Use Associated With 55 Percent Decrease In Daily Opioid Consumption, Study Finds

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The use of psychedelics like LSD, psilocybin, mescaline and DMT is associated with a significant decrease in illicit opioid consumption, according to a new study.

Researchers looked at data from “three harmonized prospective cohorts of community-recruited” people with substance misuse disorders. A total of 3,813 individuals were involved, including 1,093 who reported illicit opioid consumption and 229 who said they’d used psychedelics in the past six months.

“Recent psychedelic use was associated with 55% reduced odds of daily opioid use,” the Vancouver-based study, published last week in the Journal of International Drug Policy, found.

While there have been numerous studies connecting legal marijuana access to reduced opioid use and fewer overdose deaths, this is “the first longitudinal study to link psychedelic use with lower daily opioid use,” the paper says.

“Over study follow-up after adjusting for a range of potential confounders, psychedelic use remained independently associated with a significantly reduced odds of subsequent daily opioid use,” the study states. “While confirmation in other settings is required, these findings align with growing evidence that psychedelic use may be associated with detectable reductions in subsequent substance use including illicit opioid use.”

While there’s not a clear explanation for the trend—and the researchers urged additional studies—psychedelics like psilocybin and MDMA have been touted as potentially powerful tools in mental health treatment, effectively treating conditions like severe depression, post-traumatic stress disorder and addiction.

“These findings align with growing evidence demonstrating that psychedelic use may be associated with detectable reductions in subsequent opioid use, and warrant further research on psychedelics for opioid and other substance use disorders,” the study’s lead author, Elena Argento of the University of British Columbia, told Marijuana Moment.

“This study found naturalistic psychedelic use to be independently associated with a significantly reduced odds of subsequent daily illicit opioid use among a community-based sample of [people who use drugs],” the study concluded. “More research with controlled trials and longer-term follow-up is required to elucidate the therapeutic potential of psychedelics to augment existing interventions for substance use disorders, including among more diverse populations. Additional qualitative studies would also provide opportunities to improve understanding of the possible psycho-social mechanisms underpinning psychedelic experiences.”

Another recent study found that when people use cannabis together with psychedelics, it was “associated with higher scores of mystical-type experience, ego-dissolution and visual alterations.”

With respect to marijuana alone, a study published earlier this year found that cannabis use is associated with significant reductions in dependence on opioids and other prescription drugs, as well as an increase in quality of life

Another study released last year determined that states with active medical marijuana laws saw certain opioid prescription rates drop nearly 20 percent compared to prohibition states.

Using Marijuana With Psychedelics Intensifies The Mystical Experience, Study Finds

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