Yes, states with legal marijuana have slightly higher rates of youth cannabis consumption compared to non-legal states. But the act of legalization doesn’t appear to be the primary factor behind that trend, according to a new study.
Instead, researchers concluded that “differences between states with and without legal non‐medical cannabis may partly be due to longer‐term patterns established prior” to legalization’s enactment.
A survey of more than 4,000 teenagers throughout the United States found evidence that legal states experience higher consumption rates “regardless of how long the policy had been implemented or whether markets had been established.”
The finding appears to run counter to claims made by legalization opponents. A primary concern when it comes to legalization, according to prohibition advocates such as Smart Approaches to Marijuana (SAM), is that establishing legal marijuana markets would cause more youth to seek out cannabis.
But this study, published in the journal Drug and Alcohol Review, came to a different conclusion.
“Relatively few differences were observed between states with an established market and those that only recently legalized, which suggests that differences between legal and non-legal states may be partly due to pre-established trends and a type of ‘self-selection’ effect, in that states that legalize non-medical cannabis typically have higher rates of cannabis use anyway,” the authors wrote.
Survey respondents were asked questions about their level of consumption, mode of use, perceptions of access and risk and driving under the influence.
When it comes to consumption patterns, there was a difference between legal and non-legal states: 13.3 percent of respondents in states without any legal marijuana laws reported using cannabis in the last month, whereas 17.6 percent of those in states with new recreational markets and 20.3 percent of those in states with long-established recreational markets reported consumption over the same time period.
However, the survey also revealed some interesting, behavioral differences between those in legal and non-legal states. Young people in states without recreational marijuana laws are slightly more likely to use marijuana with tobacco, they’re less likely to worry about future health issues developing as a result of their cannabis use and they’re more likely to report having driven a vehicle within two hours of consuming marijuana.
Another interesting tidbit: perceptions of harm from smoking marijuana are actually somewhat higher in states with long-established recreational marijuana states compared to flatly prohibitionist states.
That would appear to throw another wrench in arguments from anti-legalization groups about the end of prohibition causing young people to think cannabis use is totally without risk.
For instance, SAM’s FAQ suggests under a chart labeled, “Youth use rates in states that have legalized marijuana outstrip those that have not,” that “youth perception of the risks associated with drug use is perhaps the most important determinant of whether they will engage in illegal drug use.”
“In other words, young people who perceive a high risk of harm are less likely to use drugs than young people who perceive a low risk of harm from that drug.”
While there are plenty of studies that draw differing conclusions concerning the effects of legalization, this latest research raises serious doubts about the causal relationship between ending prohibition and youth marijuana use.
Here’s a selection of data points included in the study.
|Used cannabis in the last month|
|New, non-medical states||17.60%|
|Established, non-medical states||20.30%|
|Smoked cannabis WITH tobacco in a joint or blunt|
|New, non-medical states||30.60%|
|Established, non-medical states||20.50%|
|Not worried that using cannabis will damage your health in the future|
|New, non-medical states||55.90%|
|Established, non-medical states||63.80%|
|Driven a car or other vehicle within two hours of using cannabis|
|New, non-medical states||19.10%|
|Established, non-medical states||26.10%|
Psychedelic Therapists Petition Government For Permission To Dose Themselves In Order To Better Treat Patients
As a group of terminally ill patients in Canada awaits word from the minister of health on whether they can legally access psychedelic mushrooms for end-of-life care, their team of clinicians has tacked on an additional request: The therapists want to be able to dose themselves, too.
The group behind the request, Victoria, B.C.–based TheraPsil, a nonprofit that aims to expand access to psilocybin-based psychotherapy in Canada, says the additional step of providing safe access for therapists will ensure they gain firsthand experience into the psilocybin’s effects and its applications to psychotherapy.
“The fundamental reason to expose therapists to their own experiences with psychedelics is that, unless you have visited these realms, you are unlikely to understand their importance.”
“Part of ensuring a very high-quality psychedelic treatment for patients is to ensure high-quality training for therapists,” Spencer Hawkswell, TheraPsil’s executive director, told Marijuana Moment in an interview. “It’s greatly beneficial if therapists have had psychedelic therapy themselves.”
Few people, he offered by analogy, “would advise going to a sex therapist who’s never had sex before.”
TheraPsil, founded by clinical psychologist and psychotherapist Bruce Tobin, has been fighting for expanded access to psilocybin end-of-life care for years. In 2017, the group first filed a petition to exempt patients with certain terminal conditions from Canada’s ban on psilocybin. It was reportedly the first time a therapist had asked the Canadian government for such an exemption.
It wasn’t until this past January that TheraPsil finally heard back, Hawkswell said. “After three years of back-and-forth, they got back to us and said, ‘We’re going to be rejecting this application.’” The agency said there was no obvious medical necessity for the psychedelics.
TheraPsil was undaunted. “They say there’s no necessity,” Hawkswell said. “Maybe it’s because they haven’t met that person yet.”
In April, the group helped four more people with terminal illnesses file petitions with Health Canada and Health Minister Patty Hajdu seeking exemptions that will allow them to access psilocybin. In an interview with Marijuana Moment, Hawkswell said patients had gone months so far without a word from Hajdu, who with a stroke of a pen could allow the patients to access the drug.
“What we are working on right now is ramping up our messaging,” Hawkswell said. “We are going to try everything we can to get to the minister to make sure she sees these patients and responds to them.”
Dear @PattyHajdu, today marks the 75th day that palliative Canadians have been waiting on a reply from YOU re: their section 56 exemptions for compassionate access to #psilocybin. In the words of Dr. Bruce Tobin, TheraPsil's founder: "Please, do not make them wait any longer" pic.twitter.com/JRITGwtcMR
— TheraPsil (@TheraPsil) July 6, 2020
Efforts to allow TheraPsil’s clinicians to use psilocybin themselves are more recent. Dr. Sean O’Sullivan, an emergency room physician and psychotherapist who serves on TheraPsil’s board of directors, said the exemptions are necessary so that therapists can be better trained and more familiar with how psychedelics work in a therapeutic setting.
“The fundamental reason to expose therapists to their own experiences with psychedelics is that, unless you have visited these realms, you are unlikely to understand their importance,” O’Sullivan told Marijuana Moment. “The point is to allow therapists to understand the field they’re plowing in.”
Therapists need to be alert and able to recognize how psychedelic experiences manifest themselves in therapy, O’Sullivan said. Patients might bring up material having to do with their own birth, a traumatic experience or interactions with otherworldly beings. “If you’re not attuned to this possibility, not aware of this possibility, then it’s just going to slide by you,” he said.
“It’s a bit like describing Beethoven’s Fifth,” O’Sullivan added. “You can describe it all you like, but at some point you have to play the music.”
As psychedelic therapy is more widely sought by patients, O’Sullivan said, demand for qualified therapists is likely to go up. “We are expecting that as we get more permission for patients to access psilocybin at the end of life,” he said, “that there will be an increase in demand for therapists that have had that psychedelic experience.”
Public opinion in Canada generally supports allowing access to psilocybin therapy for the terminally ill, TheraPsil says. A poll released by the group last month found that 59 percent of Canadians support legal access. Including respondents who said they were “ambivalent,” TheraPsil said, acceptance increased to 78 percent.
“What’s unreasonable is the political decision” to deny patients access to psilocybin, Hawkswell argued. “It’s not a scientific one, it’s not a democratic one. It’s political.”
Patients facing their imminent death often experience feelings and fears that psychedelics can help to ease, he said. Among them are demoralization, anxiety and depression. Existing treatment includes pharmaceuticals, talk therapy and occasionally inpatient treatment.
Psychedelics play a role in treatment by inducing what Hawkswell and others refer to as a “mystical experience”—a collection of psychoactive and sometimes spiritual events that accompany a psychedelic journey. The experience can reorient a person’s way of thinking, dissolving barriers between an individual and the world around them. For end-of-life patients, he explained, it can help them embrace that death “is natural—just as natural as being born.”
Practitioners note that psychedelic therapy doesn’t work the same way as many other pharmaceutical drugs, such as antidepressants or even medical marijuana. Patients usually take those substances under their own supervision and allow them to work in the background. With therapeutic use of psilocybin and other psychedelics, patients typically take the drug and undergo guided psychotherapy. Psychedelics’ unusual, sometimes disorienting effects are believed to allow patients to better approach and engage obstacles, then emerge with a fresh perspective.
Another psychedelic therapy group, Field Trip, which uses ketamine in therapy, describes the treatment on their website as a way “to press reset on your mental health.”
The emerging promise of psychedelics in recent years have caught the attention of academics, public policy reformers and even the U.S. government. Last month, the University of North Carolina (UNC) announced a $27 million project funded by the department of defense to research and develop psychedelics-inspired drugs.
That project’s researchers seem to believe they can separate psychedelics from what they describe as “disorienting” side effects, despite what Hawkswell and others say about the importance of a “mystical experience.”
“Although drugs like ketamine and potentially psilocybin have rapid antidepressant actions, their hallucinogenic, addictive, and disorienting side effects make their clinical use limited,” said Bryan L. Roth, a professor of pharmacology at UNC School of Medicine and the research team’s leader. The government partnership, UNC said, “aims to create new medications to effectively and rapidly treat depression, anxiety, and substance abuse without major side effects.”
In September of last year, Johns Hopkins University announced the launch of the nation’s first-ever psychedelic research center, a $17-million project to study the use of psychedelics to treat conditions such as opioid use disorder, Alzheimer’s disease, depression, anxiety and post-traumatic stress disorder.
Meanwhile, activists in the United States have advocated for state- and local-level reforms to research, decriminalize and in some cases even legalize psychedelics themselves.
At the municipal level, Denver became the first U.S. city to enact such a reform, with voters in May 2019 approving a measure to effectively decriminalize possession of psilocybin mushrooms. Soon after, officials in Oakland, California, decriminalized possession of all plant- and fungi-based psychedelics. In January of this year, Oakland activists unveiled plans to allow go further and legalize the commercial sale of natural entheogenic substances. That same month in nearby Santa Cruz, the City Council effectively decriminalized psychedelics by voting to make the enforcement of laws against them among the city’s lowest enforcement priorities.
Reformers are now pushing for similar changes in other jurisdictions. In Washington, D.C. this month, Decriminalize Nature D.C. submitted signatures to qualify a measure for November’s ballot that would decriminalize all natural psychedelic drugs, including psilocybin, ayahuasca and ibogaine.
Other reform efforts are ongoing in Oregon, where voters later this year will decide whether to legalize psilocybin therapy—the very therapy TheraPsil’s patients are pushing Canadian Health Minister Hajdu to allow. Oregon voters will also see a separate measure to decriminalize the possession of all drugs and expand access to treatment for problem use on their November ballot.
Lawmakers in Hawaii earlier this year approved a plan to study psilocybin mushrooms’ medical applications with the goal of eventually legalizing access.
In Canada, for now, psilocybin remains illegal. Hawkswell of TheraPsil, however, believes a constellation of other national policies—including medical marijuana, safe injection sites, and physician-assisted dying—support extending psilocybin access to patients in palliative care. And Canada already permits certain religious groups to use ayahuasca as religious sacrament, Hawkswell noted.
“At this point psilocybin is a reasonable medical choice for these individuals,” he told Marijuana Moment. “This is about the minister being compassionate and using her ministerial abilities to help give patients access to something that’s going to help them.”
Patients waiting to hear back from Hajdu’s office, he said, don’t have time to wait for lengthy, bureaucratic processes. “We’re not just going to keep waiting,” he told Marijuana Moment. “We do have a legal team prepared, but that’s all I’ll say.”
Photo courtesy of Wikimedia/Workman
CBD-Infused Mouthwash Works Better Than Regular Products, Industry Study Shows
Is marijuana the future of mouthwash? Companies racing to develop cannabis-based health products say cannabidiol (CBD) and other cannabis-derived compounds are emerging as promising new tools to prevent oral health issues such as plaque and gingivitis.
In a recent study out of Belgium, researchers reported that cannabinoid-infused mouthwash was just as effective at killing certain plaque-related oral bacteria as chlorhexidine, an active ingredient in many prescription mouthwashes. The cannabinoid mouthwash was also more effective at killing bacteria than two popular over-the-counter products.
Authors said the efficacy of the mouthwashes, which separately contained CBD and cannabigerol (CBG), “demonstrate the potential of cannabinoids in developing efficient and safer mouthwash products and next generation oral care products.”
“Most of the reported studies show chlorhexidine containing mouthwash as the most effective mouthwash, however tooth staining is an unacceptable side effect of chlorhexidine,” the study says. “Mouthwash products with cannabinoids infusion offer a safer and effective alternative without any fluorides or alcohol.”
The study, published late last month in the peer-reviewed Journal of Cannabis Research, evaluated mouthwashes made by CannIBite, a Belgium-based company that develops cannabinoid-based dental products. The company designed and funded by the study, and Veronica Stahl, a dental practitioner and the founder of CannIBite, was one of the two co-authors.
“To our knowledge this is the first report on such efficient mouthwash product with natural key ingredients including cannabinoids and without any kind of fluoride or alcohol.”
The products tested do not include THC, the main intoxicating ingredient in marijuana.
Traditional mouthwashes serve a variety of purposes. Most freshen breath, and simple swishing (even with water alone) can remove food and other particles stuck between teeth.
A major reason for using mouthwash is to reduce harmful oral bacteria that can build up and cause problems such as plaque and gingivitis. As the study notes, chlorhexidine is considered the industry-standard microbial rinse, and people with periodontal diseases are frequently prescribed mouthwashes containing the drug, though some evidence suggests it can also pose health threats by disrupting beneficial bacteria.
In any case, mouthwash today is a multibillion-dollar industry, and companies that make cannabis-derived health products now want a piece of it.
In the study, oral bacteria from plaque samples of 72 adults were grown in a lab and then treated with fives different mouthwashes: a solution of 0.2 percent chlorhexidine, a solution with CBD and spearmint oil, a solution with CBG and spearmint oil, and two common over-the-counter products—one with essential oils and alcohol as well as an alcohol-free mouthwash with fluoride. After periods of either 24 or 36 hours, the samples were measured to see how the mouthwashes affected bacterial growth.
Results of the experiment indicated that the two cannabinoid-infused mouthwashes significantly inhibited the growth of bacteria—on par with the chlorhexidine. The two over-the-counter mouthwashes, meanwhile, had little to no detectable effect.
“Cannabinoids (CBD / CBG) infused mouthwashes together with other natural key ingredients shows promising bactericidal activity in vitro against total-culturable aerobic bacterial content in dental plaque,” the study says, “with efficiency equivalent to or better than that of the gold standard (0.2% chlorhexidine).”
“Cannabinoid infused mouthwash products perform equal or better than that of chlorhexidine 0.2%”
Photos of agar plates published along with the study underscore the findings. Areas treated with cannabinoid mouthwashes or the chlorhexidine solution appear as circles free of visible bacteria. Samples treated with over-the-counter mouthwashes are covered in a filmy, speckled haze.
Given that chlorhexidine has side effects including tooth discoloration, the study says, cannabinoid-based mouthwashes could offer appealing alternatives that are more effective at killing germs than over-the-counter products.
“Based on our in vitro study, the cannabinoids infused CannIBite mouthwash products offer a much safer, efficient and natural alternative to alcohol and/or fluoride containing mouthwashes,” the authors wrote. “It will be interesting to study the in vivo performance of CannIBite mouthwash products in future to examine for other properties such as tooth discoloration and to examine the oral health benefits.”
CannIBite, which also makes toothpaste and a “protective oral spray,” has patents pending for the application of cannabinoids in dental care. But the company is hardly alone in trying to capitalize on cannabis in oral hygiene. Other companies, such as Impression Healthcare in Australia and San Diego-based Axim Biotechnologies, which also make cannabis-based oral-care products, are testing CBD toothpaste and mouthwash formulas of their own.
John W. Huemoeller II, CEO of Axim, told Forbes last month that “CBD is a powerful antibiotic and anti-inflammatory, so we have found it has great benefits in relation to oral care after year of offering our patented CBD-based chewing gum.”
With companies scrambling to roll out new products to curious customers, it could be only a matter of time before more cannabinoid-based dental products make their way to store shelves.
“As CBD comes to light as a health supplement with a range of potential treatments,” Huemoeller said, “the FDA is already feeling the pressure from the CBD industry and its consumers to allow the non-psychoactive compound to be added into foods and beverages.”
Photo courtesy of Chris Wallis // Side Pocket Images
‘Lazy Stoner’ Stereotype Smashed By Study Finding Marijuana Consumers Exercise More
Does marijuana ruin an exercise routine? You might be surprised. A new study of older Americans found that cannabis consumers tended to do more formal exercise and engage in more physical activities than non-consumers during the course of a four-month trial.
While authors cautioned the findings are preliminary, they contribute to a growing body of evidence challenging the lazy-stoner stereotype.
“Compared to older adult nonusers,” says the study, out of the University of Colorado at Boulder, “older adult cannabis users had lower [body mass index] at the beginning of an exercise intervention study, engaged in more weekly exercise days during the intervention, and were engaging in more exercise-related activities at the conclusion of the intervention.”
In other words, not only were adults over 60 who used marijuana generally in better shape than their peers who abstained from cannabis, they were also more responsive to an assigned four-month “exercise intervention trial”—essentially a regimen of physical activity prescribed by a clinician.
“These findings suggest that it may be easier for older adults who endorse using cannabis to increase and maintain their exercise behavior, potentially because cannabis users have lower body weight than their non-using peers,” wrote the study’s authors, a team at CU’s Department of Neuroscience and Psychology. “At minimum, the evidence suggests that cannabis use does not hinder older adults’ ability to engage in physical activity, to participate in a supervised exercise program, or to increase their fitness as a result of physical activity.”
“In this study, current cannabis use was associated with lower BMI and more exercise behavior in healthy older adults wishing to increase their physical activity.”
Researchers said the analysis, published this month, is especially important because more and more older Americans are consuming marijuana for medical or personal use. “Adults over the age of 50,” the study notes, “are the fastest-growing population of cannabis consumers in the US, with national prevalence rates estimated at up to 9.1% in 2013.” Of that group, people 65 and older showed even greater increases in use.
While those numbers may be several years old, the trend of rising marijuana use among older adults has continued.
“We haven’t seen a big spike in consumption” across most age groups, then-Colorado Gov. John Hickenlooper (D) told Rolling Stone in 2018. “The only increase in consumption is among senior citizens, which we think is either Baby Boomers coming home to roost or arthritis and the aches and pains of growing older—people finding that marijuana is better pain solution than opioids or other things.”
Yet with so many older Americans failing to meet recommended daily activity levels, the researchers in the new study wanted to better understand how cannabis might affect exercise routines.
“Given the plethora of negative health consequences associated with inactivity and the protective factors associated with exercise,” they wrote, “efforts must be made to understand factors, like cannabis use, that may affect older adults’ engagement in exercise.”
The study looked at American adults age 60 and older who researchers classified as sedentary, defined as completing less than 80 minutes of moderate physical activity per week. Some were assigned to a training program of moderate physical activity, while others were put in a program with low-intensity exercises. A total of 164 participants completed the study through the eight-week checkpoint, with 153 making it through the 16-week timepoint.
Researchers measured participants’ body mass index (BMI) and other health parameters at the beginning, midpoint and end of the study period. Participants also self-reported their exercise behavior in journals. All participants’ exercise programs included supervised training at the research facility three days per week, the paper notes. “Thus, we would expect both groups to be exercising a minimum of 3 days per week.”
“These preliminary data suggest that current cannabis use status is not associated with a negative impact on fitness and efforts to increase exercise in sedentary older adults.”
Researchers admit they’re not entirely sure why cannabis use is associated with lower BMI scores or why people who consumed marijuana were better at sticking to their workout schedules. “Future work,” the paper says, “should employ methods that allow for a target exploration of the mechanisms by which cannabis might be associated with exercise, be it via lower body weight, increased enjoyment, decreased pain, or faster recovery.” All of those potential factors, the team noted, have been hinted at by existing research.
A separate study out of the University of Colorado published last year found that a majority of marijuana consumers reported that cannabis use before or after exercising improves the experience and aids recovery.
The new study highlights an association between cannabis use and exercise, but it leaves many questions unanswered. Researchers didn’t ask participants, for example, about whether they used marijuana before, during or after their exercise. And the study’s measure of cannabis use, the authors wrote, “was coarse and lacked detail,” such as how often and how much marijuana each participant consumed.
“We did not query what form of administration (ie, smoked, vaporized, edible, topical) or cannabinoid content (ie, THC and/or CBD potency) was used,” the study says. “We also did not query whether users’ perceptions of any relationship between cannabis use and exercise, such as increased enjoyment of and/or recovery from exercise, or decreased perceptions of pain, might be driving the association between cannabis group membership and exercise.”
Nor did the researchers ask participants about any negative side-effects of their marijuana use.
Limitations aside, the researchers argue that their findings should encourage further research into how marijuana and exercise might coexist. “It may be that different types of exercise, such as those that that require minimal fine motor coordination or present low injury risk, might be most positively associated with cannabis use,” they write.
Perhaps most optimistically, the authors suggest cannabis could even be used to encourage older adults to stay active. “Whereas the results are preliminary,” the study says, “with both more extensive and rigorous additional research needed, the discovery of a role for cannabis as a potential facilitator of physical activity among older adults may hold promise.”
The paper begins on page 420 of the July edition of the American Journal on Health Behavior.
Photo courtesy of the Drug Policy Alliance, Sonya Yruel.