Connect with us

Science & Health

Marijuana Seems To Reduce Opioid Use Among Chronic Pain Patients, Meta-Study Finds

Published

on

Legalization advocates have long argued that marijuana represents a potentially effective treatment option for chronic pain and could serve as an alternative to opioid-based painkillers—and according to a new scientific meta-analysis, they may be onto something.

Analyzing nine published studies on the subject, a team of graduate students at the University of Arizona’s College of Public Health found that patients reported a 64-75 percent reduction in opioid dosage when used in combination with medical cannabis.

“This review found a much higher reduction in opioid dosage, reduced emergency room visits, and hospital admissions for chronic non-cancer pain by [medical cannabis] users, compared to people with no additional use of [medical cannabis],” the authors wrote.

“There was 64%-75% reduction in opioid dosage for MC users, and complete stoppage of opioid use for chronic non-cancer pain by 32%- 59.3% of MC users, when compared to patients without additional use of MC.”

They noted, however, that design flaws and other limitations of the available research make it impossible to draw more detailed conclusions. Of nine available observational studies on the issue, the team wrote, many had “serious risk” of bias due to missing data or poor outcome measurement and the reliance on patient self-reports, while others failed to adequately describe their research methods or “had no clear study objectives.”

“Included cohort studies were assessed as having serious or critical risk of bias overall,” authors noted, underscoring “the need for caution in interpretation of findings.”

A preliminary version of the new meta-analysis—“Medical cannabis for the reduction of opioid dosage in the treatment of non-cancer chronic pain: A systematic review”—was posted online late last month. It has not yet been peer reviewed or published in a scientific journal.

In addition to the big reduction in opioid dosage when combined with medical cannabis, the review found that 32-59 percent of patients with non-cancer chronic pain reported marijuana as a substitute for opioids.

“One study reported a slight decrease in mean hospital admissions in the past calendar year and decreased mean emergency department visits in the past calendar year for patients who received [medical cannabis] as an adjunct to opioids in the treatment of non-cancer chronic pain compared to those who did not receive [medical cannabis],” the study states.

Despite the shortcomings in data, the research team concluded that evidence is “somewhat promising” that cannabis may reduce opioid use among chronic pain patients, noting marijuana’s “recognized analgesic properties” and the generally positive findings of past studies.

“The nine available studies included in this review suggest that cannabis was effective as an adjunct to opioid in reducing the dosage of opioids in study participants,” they wrote. “However, the design of included studies provides a limited basis on which to make a rational, evidence-based recommendation.”

Among the biggest unknowns remaining, researchers said, is the appropriate dosage of medical cannabis, which in some studies varied between 1.5 milligrams and 2,000 milligrams. Another concern is side-effects: “None of the included studies discussed potential adverse effects of using (medical cannabis) as an adjunct to opioids,” the new paper noted.

To address the gaps in research, the University of Arizona authors called for more experimental research into using medical marijuana in conjunction with, or as a replacement for, opioids, noting the potential to help avoid thousands of opioid-related overdose deaths.

“As the U.S. grapples with the opioid abuse epidemic and searches for less addictive alternatives, experimental studies are urgently needed to assess the effects of cannabis on non-cancer chronic pain as well as its potential to reduce the need for opioids,” the authors wrote. “If cannabis is found to be effective in reducing non-cancer chronic pain, it could serve as a viable substitute for prescription opioids, thus mitigating the opioid epidemic.”

“The availability of, and access to, [medical cannabis] in states with [medical cannabis] laws implies that patients with non-cancer chronic pain who do not obtain relief with common medications might consider [a medical cannabis] prescription. Patient caregivers might suggest trialing [medical cannabis] to relieve pain or avoid the undesirable side effects of long-term opioid use, including dependence and addiction.”

Another study released earlier this month found that cannabis can mitigate symptoms of opioid withdrawal.

In December, researchers determined that states with legal marijuana access experience decreases in opioid prescriptions, and a separate study released the previous month showed that daily marijuana consumption is associated with reduced opioid consumption among chronic pain patients.

Cannabis May Ease Opioid Withdrawal Symptoms, Johns Hopkins Study Finds

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.

Ben Adlin is a Seattle-based writer and editor. He has covered cannabis as a journalist since 2011, most recently as a senior news editor for Leafly.

Science & Health

Impact Of Marijuana Legalization On Crime Reduction Is Being Underestimated, New Study Finds

Published

on

Studies have repeatedly identified an association between the legalizing marijuana and reductions in crime—but the impact of the policy change is being significantly understated because of limitations in the research methodology, a new paper co-authored by a federal official asserts.

Most studies looking at crime and cannabis rely on FBI data sourced from local police departments across the country. But reporting that data to the federal agency is entirely voluntary, leaving knowledge gaps that have underplayed the extent to which legalizing medical cannabis reduces violent and property crime.

That’s according to researchers from the U.S. Department of Agriculture’s (USDA) Economic Research Service and Appalachian State University, who published a working paper with their findings this month.

“U.S. drug policy presumes prohibition reduces crime. Recently states have enacted medical marijuana laws creating a natural experiment to test this hypothesis but is impeded by severe measurement error with available data,” the abstract states.

To account for those shortcomings, the researchers developed “a novel imputation procedure to reduce measurement error bias and estimate significant reductions in violent and property crime rates, with heterogeneous effects across and within states and types of crime, contradicting drug prohibition policy.”

“We demonstrate uncorrected measurement error or assuming homogeneous policy effects leads to underestimation of crime reduction from ending marijuana prohibition,” the authors said in the paper, which is titled, “Smoke and Fears: The Effects of Marijuana Prohibition on Crime.”

To improve upon existing research, the study authors said they used a “multiple imputation procedure for agency-level crime data to fill in the gaps in the [Uniform Crime Reporting] data that accounts for the inherent uncertainty in these imputed values in the subsequent statistical analysis.”

“Our results indicate that [medical marijuana laws] result in significant reductions in both violent and property crime rates, with larger effects in Mexican border states,” they wrote. “While these results for violent crime rates are consistent with previously reported evidence, we are the first paper to report such an effect on property crime as well. Moreover, the estimated effects of MMLs on property crime rates are substantially larger, which is not surprising given property crimes are more prevalent.”

While the study specifies that the USDA’s official’s involvement in the study “should not be construed to represent” the government’s position on the issue, it’s notable that an agency representative even participated and effectively reached the conclusion that the theory that criminalizing drugs—as the federal government has done for decades—reduces crime seems to be unfounded.

Other data has similarly challenged the notion that prohibition reduces crime.

In 2020, researchers looked at how adult-use marijuana legalization in Washington and Colorado affected crime rates in neighboring states, and the resulting study determined that passage of recreational cannabis laws may have actually reduced certain major crimes in nearby jurisdictions.

The previous year, a federally funded study found that legalizing marijuana has little to no impact on rates of violent or property crime. The policy change did seem connected to a long-term decline in burglaries in one state, however.

A 2018 study from the think tank RAND said county-level data from California suggested that there was “no relationship between county laws that legally permit dispensaries and reported violent crime,” the researchers wrote. What’s more, there was a “negative and significant relationship between dispensary allowances and property crime rates,” though it’s possible that’s the product of “pre-existing trends.”

That same year, researchers at Victoria University of Wellington and Harvard University found that medical marijuana laws essentially have a null effect of crime rates, with one big exception: A nearly 20 percent reduction in violent and property crimes in California following the legalization of medical cannabis there.

DEA marijuana seizures have significantly declined as more states have moved to legalize cannabis, a new study led by a top marijuana investigator for the federal government found. And at the same time, marijuana arrests are also dropping across the country, and they dipped significantly in 2020, recent FBI data shows.

Federal marijuana trafficking cases also continued to decline in 2020 as more states have moved to legalize, an analysis from the U.S. Sentencing Commission (USSC) that was released in June found.

Federal prosecutions of drug-related crimes overall increased in 2019, but cases involving marijuana dropped by more than a quarter, according to a report released by Supreme Court Chief Justice John Roberts that year.

A study released by the Cato Institute in 2018 found that “state-level marijuana legalization has significantly undercut marijuana smuggling.

DEA Proposes Dramatic Increase In Marijuana And Psychedelic Production In 2022, Calling For 6,300 Percent More MDMA Alone

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.
Continue Reading

Politics

DEA Proposes Dramatic Increase In Marijuana And Psychedelic Production In 2022, Calling For 6,300 Percent More MDMA Alone

Published

on

The Drug Enforcement Administration (DEA) is proposing a dramatic increase in the legal production of marijuana and psychedelics like psilocybin, LSD, MDMA and DMT to be used in research next year.

In a notice scheduled to be published in the Federal Register on Monday, the agency said there’s been a “significant increase in the use of schedule I hallucinogenic controlled substances for research and clinical trial purposes,” and it wants authorized manufacturers to meet that growing demand.

DEA had already massively upped its proposed 2021 quota for cannabis and psilocybin last month, but now it’s calling for significantly larger quantities of research-grade marijuana and a broader array of psychedelics to be manufactured in 2022.

It wants to double the amount of marijuana extracts, psilocybin and psilocyn, quadruple mescaline and quintuple DMT. What especially stands out in the notice is MDMA. The agency is proposing an enormous 6,300 percent boost in the production of that drug—from just 50 grams in 2021 to 3,200 grams in the coming year—as research into its therapeutic potential continues to expand.

LSD would see a 1,150 percent increase, up to 500 grams of the potent psychedelic.

Marijuana itself would get a 60 percent boost under DEA’s proposal, up to 3.2 million grams in 2022 from the 2 million grams last year.

Here’s a visualization of the proposed quota increase from 2021 to 2022 for marijuana and cannabis extracts:

For all other THC, psilocybin, psilocyn and MDMA:

And for other psychedelic substances like LSD, mescaline and DMT:

DEA said in the Federal Register notice that it has been receiving and approving additional applications to “grow, synthesize, extract, and manufacture dosage forms containing specific schedule I hallucinogenic substances for clinical trial purposes” to achieve these ambitious quotas.

“DEA supports regulated research with schedule I controlled substances, as evidenced by increases proposed for 2022 as compared with aggregate production quotas for these substances in 2021,” the agency said, adding that it working “diligently” to process and approve marijuana manufacturers applications in particular, as there’s currently only one farm at the University of Mississippi that’s permitted to cultivate the plant for research.

“Based on the increase in research and clinical trial applications, DEA has proposed increases in 3,4- Methylenedioxyamphetamine (MDA), 3,4-Methylenedioxymethamphetamine (MDMA), 5-Methoxy-N,N-dimethyltryptamine, Dimethyltryptamine, Lysergic acid diethylamide (LSD), Marihuana, Marihuana Extract, Mescaline, Psilocybin, Psilocyn, and All Other Tetrahydrocannabinols to support manufacturing activities related to the increased level of research and clinical trials with these schedule I controlled substances.”

Here are the exact numbers for the proposed 2021 and 2022 quotas:

Substance 2021
2022 proposed
Marijuana 2,000,000 3,200,000
Marijuana extract 500,000 1,000,000
All other tetrahydrocannabinol 1,000 2,000
Psilocybin 1,500 3,000
Psilocyn 1,000 2,000
MDMA 50 3,200
LSD 40 500
Mescaline 25 100
DMT 50 250
5-MeO-DMT 35 550
MDA 55 200

A 30-day public comment period will be open after the notice is formally published on Monday.

It’s difficult to overstate just how significant the proposed 2022 increases are, but it’s certainly true that scientific and public interest in marijuana and psychedelics has rapidly increased, with early clinical trials signaling that such substances show significant therapeutic potential.

National Institute on Drug Abuse (NIDA) Director Nora Volkow told Marijuana Moment in a recent interview that she was encouraged by DEA’s previous proposed increase in drug production quota. She also said that studies demonstrating the therapeutic benefits of psychedelics could be leading more people to experiment with substances like psilocybin.

Advocates and experts remain frustrated that these plants and fungi remain in the strictest federal drug category in the first place, especially considering the existing research that shows their medical value for certain conditions.

A federal appeals court in August dismissed a petition to require the DEA to reevaluate cannabis’s scheduling under the Controlled Substances Act. However, one judge did say in a concurring opinion that the agency may soon be forced to consider a policy change anyway based on a misinterpretation of the therapeutic value of marijuana.

Separately, the Washington State attorney general’s office and lawyers representing cancer patients recently urged a federal appeals panel to push for a DEA policy change to allow people in end-of-life care to access psilocybin under state and federal right-to-try laws.

Singer Melissa Etheridge And Activist Van Jones Promote Psychedelics Reform As Movement Grows

Image element courtesy of Kristie Gianopulos.

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.
Continue Reading

Science & Health

Head Of Federal Marijuana Farm’s Study Says Illegal Cannabis Seizures Have ‘Decreased Dramatically’ Amid Legalization Movement

Published

on

State-level marijuana legalization has left the Drug Enforcement Administration (DEA) with far fewer samples of seized illicit cannabis to analyze, a study led by a top marijuana investigator for the federal government says.

That finding backs up the claim often made by legalization advocates that as more legal markets come online, consumer demand for unregulated cannabis from illicit channels will decline.

“The number of samples received over the last 5 to 6 years has decreased dramatically owing to the legalization of marijuana for either medical or recreational purposes in many U.S. states,” the study, authored by Mahmoud ElSohly, who runs the nation’s only federally authorized cannabis cultivation facility at the University of Mississippi, found.

Seizures have “precipitously declined over time, starting in the year 2011 (>2342 exhibits) to 2019 (<100 exhibits),” the study, published in the journal Biological Psychiatry earlier this year, says. “This is possibly the result of the legalization of cannabis for medical or recreational use in many states that has curtailed DEA enforcement efforts.”

The dwindling seizure numbers reported in the study are only the latest indication of the unregulated market’s shrinkage as the cannabis legalization movement continues to have success in a growing number of states.

At the same time that DEA marijuana seizures are declining, marijuana arrests are also dropping across the country, and they dipped significantly in 2020, recent FBI data shows.

Federal marijuana trafficking cases also continued to decline in 2020 as more states have moved to legalize, an analysis from the U.S. Sentencing Commission (USSC) that was released in June found.

Federal prosecutions of drug-related crimes overall increased in 2019, but cases involving marijuana dropped by more than a quarter, according to a report released by Supreme Court Chief Justice John Roberts that year.

A study released by the Cato Institute in 2018 found that “state-level marijuana legalization has significantly undercut marijuana smuggling.

Even as the number of DEA illicit cannabis samples has gradually decreased amid the legalization movement, the more limited supply still shows that THC potency has increased over time, according to the recent study published in Biological Psychiatry.

The average THC potency in seized marijuana increased from 9.75 percent in 2009 to 14.88 percent in 2018 and then slightly decreased to 13.88 percent in 2019, the study found. The researchers also noted that there’s been a more recent shift over the past two years with cannabis containing more balanced ratios of THC to CBD, a non-intoxicating cannabinoid.

Average CBD concentrations in seized marijuana decreased from 0.4 percent in 2009 to 0.14 percent in 2017. But then the concentration of the cannabinoid “climbed to approximately 0.6 percent in 2019.”

Again, this data comes from illicit cannabis that was obtained by DEA, not marijuana that’s legally available in state markets. Researchers are currently unable to study the cannabis that consumers actually purchase in licensed dispensaries, but that could change under legislation that’s advancing in Congress.

“These results are in agreement with other potency monitoring programs in several European countries,” the study authors wrote. “There appears to be a recent trend of the inclusion of higher CBD levels containing chemovars in illicit cannabis.”

ElSohly’s cannabis cultivation facility at the University of Mississippi is currently the only place authorized by the federal government to grow marijuana for research purposes. And advocates, scientists and lawmakers have complained that research relying on the government’s cannabis is compromised because it generally contains significantly lower levels of cannabinoids compared to products available in state-legal dispensaries.

DEA is in the process of approving additional manufacturers, however, with the hope to expanding the supply of cannabis for scientists and producing studies that more accurately account for what consumers are getting from state-licensed retailers.

The agency also recently proposed a massive increase in the production of marijuana and psilocybin for research purposes, with the intent of aiding in the development of new federally approved therapeutic medications.

ElSohly, for his part, said in 2019 that he’s confused as to why consumers would want marijuana containing 15 percent or more THC when, according to him, even eight percent is too high.

Skeptics and opponents of cannabis reform have placed a large emphasis on THC potency and its rise over recent years. At one point in 2019, a key Republican Senate committee chairman suggested that he would be unwilling to advance a bill to protect banks that service state-legal marijuana businesses unless businesses were required to cap THC at two percent.

Top Federal Drug Official Gives Maryland Lawmakers Marijuana Legalization Advice At Workgroup Hearing

Photo courtesy of Mike Latimer.

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.
Continue Reading
Advertisement

Marijuana News In Your Inbox

Support Marijuana Moment

Marijuana News In Your Inbox

Marijuana Moment