Author: Frank Schuler

No Next-Day Impairment Associated With Nighttime Use Of Cannabis Oil

Written by Frank Schuler on July 1, 2024. Posted in Science.

Cannabis-derived oils are very popular products in legal markets. Consumers and patients around the globe consume cannabis in oil form for various reasons, including that it is a smokeless delivery method.

Unfortunately, a growing list of legal jurisdictions are instituting per se cannabis DUI laws that punish consumers and patients for cannabis use that could be from the night before. A recent example can be found in Germany where the nation has adopted a 3.5 ng/mL threshold for THC in a driver’s system.

A recent study in Australia highlights the problem with per se THC limits, finding that impairment from consuming cannabis at nighttime does not carry over to the following day. Feasibly, a person could consume cannabis oil the night before, and exceed the 3.5 ng/mL for metabolized THC the following day even though they are not impaired. Below is more information about the recent Australian study via a news release from NORML:

Sydney, Australia: Insomnia patients exhibit no next-day impairment following the nighttime use of plant-derived cannabis extracts, according to the results of a randomized, placebo-controlled clinical trial published in the journal Psychopharmacology.

Australian researchers assessed next-day cognitive and psychomotor performance in a cohort of patients diagnosed with insomnia. Subjects in the study consumed either an oral cannabis extract containing 10 mg THC and 200 mg CBD or a placebo.

Investigators identified no differences among those who consumed cannabis or placebo in 27 of 28 performance tests. There were “no impairing effects” on simulated driving performance post-treatment.

The study’s authors concluded: “We found a lack of notable next day impairment to cognitive and psychomotor function and simulated driving performance following evening use of 10 mg oral THC, in combination with 200 mg CBD, in an insomnia population who infrequently use cannabis. … These findings confirm and extend on prior work by employing a randomized controlled trial design, a patient population that infrequently uses cannabis and who are, on average, older than participants in previous studies, and the use of a regulated product containing a higher ratio of CBD to THC.”

Clinical and observational trial data have reported that the use of cannabis products is associated with improved sleep quality in patients with insomnia.

Full text of the study, “Evaluating possible ‘next day’ impairment in insomnia patients administered an oral medicinal cannabis product by night: A pilot randomized controlled trial,” appears inPsychopharmacology. Additional information on cannabis and insomnia is available from NORML’s publication, Clinical Applications for Cannabis & Cannabinoids.

CBD-Infused Gel Relieves Osteoarthritic Hand Pain In Australian Clinical Trial

Written by Frank Schuler on June 24, 2024. Posted in Science.

International researchers estimate that as many as 595 million people worldwide had osteoarthritis in 2020. It is the most common form of arthritis, affecting 7.6% of the global population.

Osteoarthritis is a degenerative joint disease that often causes pain in the sufferer’s hands. The condition can result in stiffness, reduced range of motion, swelling, and/or difficulty gripping certain objects. In extreme cases, the condition can be completely debilitating.

A team of researchers in Australia recently conducted a clinical trial involving osteoarthritis patients experiencing hand pain and the application of CBD-infused gel. According to the results of the trial, patients reported experiencing relief after treatments. Below is more information about the study via a news release from NORML:

Sydney, Australia: The daily application of a transdermal gel containing CBD relieves pain and improves the quality of life of patients with hand osteoarthritis (OA), according to open-label trial data published in the journal Nature: Scientific Reports.

Australian researchers evaluated the self-reported efficacy of transdermal CBD in a cohort of 15 OA patients. Study participants applied CBD-infused gelatin three times a day for four weeks. Self-reported measures were assessed at baseline and throughout the trial via smartphone technology.

CBD application was associated with self-reported improvements in pain, grip strength, fatigue, muscle stiffness, and anxiety.

“Pain, grip strength and QoL [quality of life] measures … were shown to improve over time following transdermal CBD application suggesting feasibility of this intervention in relieving osteoarthritic hand pain,” the study’s authors concluded. “Proof of efficacy, however, requires further confirmation in a placebo-controlled randomized trial.”

The transdermal delivery of CBD has previously been associated with reduced levels of lower back and leg pain in patients with spinal stenosis.

Full text of the study, “An open-label feasibility trial of transdermal cannabidiol for hand osteoarthritis,” appears in Nature: Scientific Reports.

Study Finds No Link Between Cannabis Use And Sedentary Behavior

Written by Frank Schuler on June 17, 2024. Posted in Science.

The false ‘lazy stoner’ stereotype is as old as cannabis prohibition itself. For decades cannabis consumers were portrayed in mainstream media, film, and on television as lazy burnouts who lacked drive and motivation.

Of course, that stereotype could not be farther from the truth. Many professional athletes consume cannabis and they are some of the fittest humans to ever exist. Titans of the business world consume cannabis, and many other types of successful members of society also consume cannabis. The use of cannabis does not automatically equate to a reduction in motivation.

A team of researchers in Canada recently conducted a study examining cannabis use and the prevalence of sedentary behavior. The study found no link between the two. Below is more information about the study and its results via a news release from NORML:

Toronto, Canada: Young and middle-aged adults who consume cannabis are no less likely than non-users to engage in daily physical activity, according to data published in the journal Cannabis and Cannabinoid Research.

Canadian researchers assessed physical activity in a cohort of 4,666 US adults ages 18 to 59 years old. Subjects wore a portable accelerometer that tracked participant’s daily activity levels. Researchers collected data for a minimum of four days.

Investigators reported that cannabis consumers were slightly more likely than non-users to engage in light physical activity. Researchers reported no differences between the two groups with respect to median daily sedentary time, time spent engaging in vigorous physical exercise, or sleeping.

“Recent cannabis use in young to midlife adults was not associated with accelerometer-measured sedentary or MVPA [moderate-to-vigorous physical activity] time, but it was associated with a marginal increase in LPA [light physical activity] time,” the study’s authors concluded. “Our findings provide evidence against existing concerns that cannabis use independently promotes sedentary behavior and decreases physical activity.

“This study provides useful insight into the association between cannabis use and physical activity, which may help inform clinicians and prescribers with patient counseling, patients and their lifestyle choices, as well as policy makers around public health resource allocations.”

The findings are consistent with those of several prior studies “challenging the stereotype that marijuana … users are less active than their non-using counterparts.” Among those age 60 and older, marijuana use has been associated with increased exercise frequency.

Full text of the study, “Recent cannabis use and accelerometer-measured physical activity and sedentary behavior among young-to-midlife adults: An analysis of the National Health and Nutrition Examination Survey from 2011 to 2014,” appears in Cannabis and Cannabinoid Research.

U.K. MS Patients Report Quality Of Life Improvements Following Cannabis Therapy

Written by Frank Schuler on June 17, 2024. Posted in Science.

Multiple sclerosis (MS) is a serious health condition that impacts the lives of many suffering patients around the globe. It is estimated that as many as 2.8 million people suffer from MS worldwide and that a person is diagnosed somewhere on the planet with the health condition every 5 minutes.

MS is a progressive disease involving damage to the sheaths of nerve cells in the brain and spinal cord. Symptoms can include but are not limited to, numbness, impaired speech, impaired muscular coordination, blurred vision, and severe fatigue.

Studies and personal experiences around the world have found that cannabis may be a helpful form of treatment for MS patients. A growing list of patients have reported that cannabis helps them effectively and safely treat their condition.

According to a recent study in the United Kingdom, MS patients reported improvements in their quality of life after completing cannabis therapies. Below is more information about it via a news release from NORML:

London, United Kingdom: Multiple sclerosis (MS) patients report improvements in their health-related quality of life following the use of medical cannabis preparations, according to observational data published in the journal Multiple Sclerosis and Related Disorders.

British researchers assessed the use of cannabis-based medicinal products (CBMPs) consisting of either flower or oil extracts in 141 MS patients enrolled in the UK Medical Cannabis Registry. (Since 2018, British specialists have been permitted to prescribe cannabis-based medicinal products to patients unresponsive to conventional medications.) Researchers assessed changes in patient-reported outcomes measures at one month, three months, and six months.

Patients reported sustained improvements in their physical and mental health following cannabis therapy. They reported few serious adverse health effects during treatment.

“This case series demonstrates a potential association between [the] initiation of CBMPs and improved patient reported outcomes in sleep, anxiety and general HRQoL [health-related quality of life] measures, over six months,” the study’s authors concluded. “Additional measures for HRQoL, including various physical and mental health subdomains, also exhibit improvements up to six months when compared to baseline.”

A prescription cannabis spray (nabiximols aka Sativex) consisting of specific ratios of THC and CBD is currently available in several countries, including Canada, France, Germany, Spain, and the United Kingdom. The drug is not approved in the United States for treatment of any condition.
Full text of the study, “Clinical outcome analysis of patients with multiple sclerosis – Analysis from the UK Medical Cannabis Registry,” appears in Multiple Sclerosis and Related Disorders. Additional information on cannabis and multiple sclerosis is available from NORML’s publication, Clinical Applications for Cannabis & Cannabinoids.

Cannabis Extracts Reduce Disease Burden In Israeli Pain Patients

Written by Frank Schuler on June 17, 2024. Posted in Science.

Researchers estimate that roughly 20% of the world’s population suffers from chronic pain. It is possible that due to various factors, many cases go undiagnosed in some regions of the world, and that the actual number of chronic pain sufferers could be much greater.

A patient experiencing temporary pain is not the same as chronic pain. Chronic pain occurs when patients still suffer from it well after the expected recovery time for an injury or illness, sometimes lasting weeks or even years.

Investigators in Israel recently conducted a study in which they examined reported disease burden rates and cannabis extract use among chronic pain patients. Below is more information about the study and its results via a news release from NORML:

Haifa, Israel: Patients’ use of cannabis oil extracts is associated with long-term improvements in their pain intensity and related symptoms, according to data published in the journal Pain Reports.

Israeli researchers assessed the safety and efficacy of cannabis extracts in a cohort of 218 middle-aged chronic pain patients (mean age: 54) over six months. Patients consumed sublingual extracts containing standardized THC and CBD concentrations.

Cannabis treatment was associated with sustained reductions in pain intensity, opioid use, anxiety, depression, and sleep deprivation. Though some subjects did report “mild to moderate” side effects from cannabis, these events did not interrupt their “continuous use” of marijuana extracts throughout the study period.

“Cannabis seems to have an impact on the ‘disease burden’ of chronic pain,” the study’s authors concluded. “It also has a positive effect on functioning and health-related quality of life.”

The researchers’ findings are consistent with those of other larger observational studies involving thousands of pain patients enrolled in medical cannabis access programs.

Full text of the study, “Cannabis oil extracts for chronic pain: What else can be learned from another structured prospective cohort,” appears in Pain Reports. Additional information on cannabis and chronic pain is available from NORML’s publication, Clinical Applications for Cannabis & Cannabinoids.

THC Use Associated With Increased Survival Time In German Cancer Patients

Written by Frank Schuler on June 17, 2024. Posted in Science.

Germany first legalized cannabis for medical use in 2017. Since that time, Germany’s medical cannabis program has become the largest in Europe, with the nation’s program serving hundreds of thousands of suffering patients.

Thanks to the recently implemented CanG law in Germany, medical cannabis in Germany is set to undergo a significant transformation in the coming years, with cannabis no longer being on the nation’s Narcotics List, caps on domestic medical cannabis production being removed (Germany imported over 34 tons of medical cannabis in 2023), and the German medical cannabis supply chain being streamlined.

Researchers in Germany recently examined survival time rates among palliative cancer patients who consumed medical cannabis products containing THC. Below is more information about it via a news release from NORML:

Berlin, Germany: The daily use of 5mg of oral THC is associated with increased survival times in palliative cancer patients, according to data published in the journal Medical Cannabis and Cannabinoids.

German researchers evaluated the impact of THC dosing in a cohort of 9,419 advanced cancer patients enrolled in Specialized Palliative Outpatient Care (SAPC). SAPC offers team-based home care for patients with advanced and progressive diseases whose life expectancies are limited to days, weeks, or months.

Researchers reported that patients’ daily use of 4.7mg of THC was associated with significantly increased survival time, whereas lower doses were not.

The study’s authors concluded: “The data … show a significant impact of THC on survival in ambulatory palliative care patients [who] … use more than 4.7 mg/day. Median survival time was prolonged by 15 days – from survival time of 25 days without THC therapy to 40 days with a daily THC dose higher than 4.7 mg per day. This prolongation by more than two weeks can be considered substantial. In addition to mere survival, patients [treated] with THC become more mentally and physically active. … The increased activity and improved quality of life might enable the patients to renew social contact with relatives and friends and to settle essential affairs before dying.”

The study’s findings are consistent with data published in 2021 that similarly reported that THC was associated with increased survival times in German hospice patients, particularly among women ages 75 and older.

Full text of the study, “The use of tetrahydrocannabinol is associated with an increase in survival time in palliative cancer patients: A retrospective multicenter cohort study,” appears in Medical Cannabis and Cannabinoids.

cannabis leaf leaves plant cannabis leaf leaves plant

Osteoarthritis Patients Report Sustained Benefits From Cannabis In UK Study

Written by Frank Schuler on May 27, 2024. Posted in Science.

Osteoarthritis is the most common form of arthritis found in adults around the world. Osteoarthritis is a degenerative joint disease, in which the joint tissues degenerate as the patient ages. The health condition is characterized by chronic pain and loss of mobility.

Global researchers estimate that 595 million people worldwide suffered from osteoarthritis in 2020, which is roughly 7.6% of the world’s population. The 2020 rate is an increase of 132.2% in total cases compared to 1990.

Investigators recently conducted a study in the United Kingdom in which they examined the cannabis plant’s ability to treat osteoarthritis. Below is more information about the study and its results via a news release from NORML:

London, United Kingdom: Patients diagnosed with osteoarthritis report pain-specific improvements following their use of medical cannabis preparations, according to observational data published in the Journal of Pain & Palliative Care Pharmacotherapy.

British researchers assessed the use of cannabis-based medicinal products (CBMPs) consisting of either flower or oil extracts in a cohort of osteoarthritis patients enrolled in the UK Medical Cannabis Registry. (Since 2018, British specialists have been permitted to prescribe cannabis-based medicinal products to patients unresponsive to conventional medications.) Researchers assessed changes in patient-reported outcomes measures over a one-year period.

Patients reported symptom improvements at one-month, three-months, six-months, and at one-year.

“Commencement of CBMP treatment was associated with reductions in pain-specific PROMs [patient-reported outcome measures] at all time points in patients with osteoarthritis,” researchers reported. Patients also reported improved sleep. Contrary to the results of several other studies, patients prescribed opioids did not decrease their opioid intake following their initiation of medical cannabis.

Investigators documented few serious side-effects associated with cannabis. “AEs [adverse events] were mainly mild or moderate in severity,” they wrote. “Fatigue was the most common AE in this study.”

The study’s authors concluded: “These results suggest an improvement in pain-related outcomes for patients with osteoarthritis following the initiation of CBMP treatment. Furthermore, there was an improvement in general HRQoL [health-related quality of life] metrics across the follow-up period. CBMPs also appeared to be well-tolerated at 12-month follow-up. … Hence, this study supports the development of RCTs [randomized clinical trials] for CBMP use in osteoarthritis.”

Other studies assessing the use of cannabis products in patients enrolled in the UK Cannabis Registry have reported them to be effective for those suffering from chronic pain, anxiety, post-traumatic stress, depression, migraine, inflammatory bowel disease, and other afflictions.

Full text of the study, “Assessment of clinical outcomes in patients with osteoarthritis: Analysis from the UK Medical Cannabis Registry,” appears in theJournal of Pain & Palliative Care Pharmacotherapy. Additional information on cannabis and arthritis is available from NORML’s publication, Clinical Applications for Cannabis & Cannabinoids.

CBD Effectively Treats Acute Dental Pain In Randomized Clinical Trial

Written by Frank Schuler on May 27, 2024. Posted in Science.

The cannabis plant contains dozens of cannabinoids, each with its own characteristics and potential to provide wellness benefits. For many decades tetrahydrocannabinol (THC) was the focus of much of the cannabis research conducted by scientists.

However, in recent years other cannabinoids have risen in popularity, and that has shifted some of the focus of cannabis researchers. Cannabidiol (CBD) is a very popular cannabinoid these days among consumers, patients, product developers, and researchers.

According to a recent randomized clinical trial conducted in Scotland, CBD can effectively treat acute dental pain. Below is more information about the study via a news release from NORML:

Kilmarnock, Scotland: The administration of a purified formulation of plant-derived CBD (aka Epidiolex) provides significant short-term relief to patients suffering from acute toothaches, according to placebo-controlled clinical trial data published in the journal Evidence-Based Dentistry.

A pair of Scottish scientists assessed the use of Epidiolex versus placebo in 61 patients with moderate-to-severe dental pain. Forty patients received CBD in doses of either 10 or 20 mgs. Twenty-one subjects received a placebo. Patients’ pain was monitored for three hours following dosing.

Patients who consumed CBD, on average, experienced a greater than 50 percent reduction in their pain, investigators reported. By contrast, those receiving placebo experienced a 37.5 percent decrease in pain.

“Based on this randomized clinical trial, pure CBD drug Epidiolex demonstrates effective analgesia against acute toothache,” the study’s authors concluded.

The US Food & Drug Administration approved the prescription use of Epidiolex as an anti-epileptic drug in 2018. The DEA removed Epidiolex from the Controlled Substances Act in 2020.

Full text of the study, “Cannabidiol – an effective analgesic for toothache,” appears in Evidence-Based Dentistry.

German Patients Report Improvements Following Use Of High-THC Flower

Written by Frank Schuler on May 6, 2024. Posted in Science.

Doctors in Germany started legally prescribing cannabis to suffering patients in 2017, and since that time the nation’s medical cannabis program has grown in size by a considerable amount. Germany is now home to the largest legal medical cannabis program in Europe.

Unlike many other nations that only permit access to limited medical cannabis products, such as cannabis-derived pharmaceuticals, Germany allows patients to consume cannabis flower for therapeutic purposes.

An international team of researchers recently conducted a survey of German medical cannabis patients, focusing on the reported effects and benefits of high-THC cannabis flower consumption. Below is information about the survey’s findings via a news release from NORML:

Hannover, Germany: Patients prescribed high-THC prescription-grade cannabis chemovars report them to be safe and effective, according to data published in the journal Pharmacopsychiatry.

An international team of investigators surveyed more than 1,000 German patients authorized to use medical cannabis. (Plant cannabis and cannabinoid treatments, such as dronabinol, were legalized by prescription use in Germany in 2017.) Survey respondents obtained lab-tested cannabis flower from regional pharmacies. Potency of the most frequently used chemovar was 22 percent.

The overwhelming majority of patients surveyed reported medical cannabis to be effective at treating their symptoms. Patients reported no significant differences between chemovars, most of which were dominant in THC and low in CBD content. The most commonly reported side effects were dry mouth, increased appetite, and somnolence.

“Patients self-reported very good efficacy and tolerability [to] medical cannabis,” the study’s authors concluded.

Pharmaceutical-grade cannabis flower in Europe, Israel, and elsewhere typically contain THC levels of 20 percent or greater.

The study’s findings push back against claims that cannabis strains higher in THC pose unique risks to health or that there is an absence of research supporting the efficacy of medical cannabis chemovars above 10 percent THC.

Full text of the study, “Medical use of different cannabis strains: results from a large prospective study in Germany,” appears in Pharmacopsychiatry.