Rutgers Study Finds Modest Decrease in Non-Prescription Opioid Use with Cannabis Legalization, But Concentrated in People Addicted to Cannabis Interview with:
Hillary Samples, PhD, MHS
Assistant Professor of Health Systems and Policy
Rutgers School of Public Health
Core Faculty
Center for Pharmacoepidemiology and Treatment Science

Rutgers Institute for Health, Health Care Policy and Aging Research
New Brunswick, NJ 08901 What is the background for this study?

Response: Early studies suggesting that cannabis legalization is associated with lower rates of opioid-related harms received considerable media attention. At the time, overdose deaths were driven by prescription opioids, and medical cannabis was often framed as a policy approach to address the opioid epidemic. However, as research in this area grew, the relationship between medical cannabis legalization and opioid-related harms became less clear. Many studies of cannabis legalization were unable to examine opioid use by individual people, and individual-level studies outside the legal context showed links between cannabis use and higher risk of opioid-related harms. Thus, our goal was to build evidence of the relationship between medical cannabis legalization and individual-level opioid use.

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CAMH Study Finds Potential Risks to Baby from Cannabis Exposure During Pregnancy Interview with:
Maryam Sorkhou
PhD student at the Institute of Medical Sciences
University of Toronto What is the background for this study?

Response: While studies on animals strongly suggest that exposure to cannabis during pregnancy can affect brain development, the impact of using cannabis during pregnancy in humans is not yet clear. Some studies suggest potential negative effects, while others find no impairments.

In light of increasing trends towards legalization and potentially decreased perceptions about the risks of cannabis, our meta-analysis of 57 studies aimed to fill this gap by exploring the associations between prenatal cannabis use and birth and childhood outcomes.

Cannabis-Related Hospitalizations Following Legalization in Canada Interview with:
Daniel Myran, MD, MPH, CCFP, FRCPC
Canada Research Chair, Social Accountability, University of Ottawa
Investigator, Bruyère Research Institute 
Assistant Professor, Department of Family Medicine
Lecturer, School of Epidemiology and Public Health
Adjunct Scientist, ICES
University of Ottawa What is the background for this study?

Response: Canada legalized recreational, or non-medical, cannabis in October 2018. Legalization in Canada took a phased approach initially, only the sale of flower-based cannabis products and oils was permitted and there were very few legal cannabis stores and legal sales. Starting in early 2020, Canada allowed the sale of expanded products (e.g. cannabis edibles, vape pens, concentrates), and the number of retail stores began expanding. In this study, we took advantage of this evolution of the legal cannabis market to understand how different phases of legalization were associated with hospitalizations due to cannabis.  

Study Assesses Quality of Life After Cannabis Prescribed for Chronic Pain and Other Health Symptoms Interview with:
Margaret-Ann Tait | PhD candidate
Project Manager, The QUEST Initiative
Research Manager, Faculty of Medicine and Health
Sydney Nursing School, Cancer Care Research Unit
University of Sydney What is the background for this study?

Response: In 2016 Australia passed legislation that allows cannabis use for medicinal purposes. Since then, an estimated 800,000 patients have received medicinal cannabis prescriptions. We wanted to know if patients with chronic health conditions in Australia are reporting their health outcomes differently after being prescribed medicinal cannabis. We used validated questionnaires to assess their health-related quality of life, levels of fatigue, pain, sleep disturbance, anxiety, and depression before starting therapy and then at regular intervals for three months after. 

We had 2327 patients participating from across Australia aged between 18 and 97 (the average age was 51), and nearly two thirds were female. Half of our participants were prescribed medicinal cannabis for more than one condition, with chronic pain conditions reported more frequently, followed by insomnia, anxiety, and mixed anxiety & depression.

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Cannabis Use May Expose Users to Lead and Cadmium Interview with:
Tiffany R. Sanchez, PhD (she/her)
Assistant Professor
Environmental Health Sciences 
Columbia University Mailman School of Public Health What is the background for this study?

Response: We’ve known that the cannabis plant is good at accumulating metals, like lead and cadmium, and long-term exposure to these metals carry important health risks. What was unclear before our study was whether or not people who use cannabis actually have higher metal levels in their body compared to non-users.

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Cannabis Smoke Exposure is Not Risk Free Interview with:
Beth Cohen, MD MAS
Professor of Medicine, UCSF
Co-Director, PRIME Internal Medicine Residency Program
Staff Physician, San Francisco VA Medical Center What is the background for this study?

Response: Though rates of tobacco use are declining, rates of cannabis use are increasing as it becomes more widely legal and available. Though there is not as much research on the long-term health effects of cannabis, cannabis and tobacco smoke contain many of the same carcinogens and toxins and both have particulate matter than is harmful when inhaled.

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EVALI – Vaping and Lung Injury – Storylines on Popular Medical Dramas May Change Behavior Interview with:
Beth Hoffman, PhD, MPH (she/her)
Postdoctoral Associate
Center for Social Dynamics and Community Health
Department of Behavioral and Community Health Sciences
University of Pittsburgh School of Public Health What is the background for this study?

Response: Previous studies suggested that hearing about EVALI in the news might stop people from vaping or get them to quit, but there had yet to be research examining if storylines on fictional medical television shows could have the same effects. There had also been few studies to date leveraging Twitter data, which allowed us to see how viewers were reacting to the storylines in real-time, in their organic viewing environment.

Stopping Pot May Reverse Some Loss of Male Fertility Interview with:
Jamie Lo, M.D., M.C.R.
Associate Professor of Obstetrics and Gynecology
OHSU School of Medicine
Division of Reproductive & Developmental Sciences
Adjunct Associate Professor of Urology, School of Medicine
Oregon National Primate Research Center (ONPRC)

Dr. Jamie Lo What is the background for this study?

Response: Cannabis use and potency are rising, especially during the COVID-19 pandemic, especially amongst reproductive age males in the United States. There is emerging literature suggesting it may impact male fertility, but it is hard to study in humans for many reasons, including often individuals using cannabis are also using other substances and there is no ability to test how much or often cannabis was used. As such, we wanted to use a translational animal model, the non-human primate, that is relevant to humans to study the direct effects of delta-9-tetrahydrocannabinol (THC, main component of cannabis) only on male fertility and to determine whether there is a benefit to abstinence from use.

Kidney Stones: Mayo Clinic Study Evaluates CBD Oil for Post-Procedure Kidney Stone Pain Relief Interview with:
Karen L. Stern M.D.
Associate Professor of Urology
Mayo Clinic Arizona
Phoenix, AZ 85054

Dr. Stern What is the background for this study? What are the main findings?

Response: Kidney stones are not rare and often require surgical intervention. One of the most popular and effective surgical interventions is ureteroscopy with laser lithotripsy. Essentially, the Urologist goes up to the kidney with a small scope and lasers the stone.

It is common after this procedure to leave a temporary stent – a small flexible tube that goes from the kidney to the bladder – which allows for urine to drain unobstructed during the healing process.

Unfortunately, that stent is associated with significant morbidity including urinary symptoms and pain.

There have been many studies looking at ways to alleviate this pain and discomfort, but this is the first to assess CBD in that capacity. We tested a low-dose FDA-approved CBD oil. We found it to be safe and well tolerated but we did not find any significant difference in postoperative pain.

Twin Study Finds Cannabis Legalization Did Not Cause Substantial Psychological Harm in Adults Interview with:
Stephanie Zellers PhD
Postdoctoral Researcher, Kaprio Group, FIMM
Dr. Zellers began this research as a graduate student at the
University of Colorado Boulder’s Institute for Behavioral Genetics (IBG)

Dr. Zellers PhD What is the background for this study?

Response: Proponents and opponents of cannabis legalization respectively cite various potential benefits and harms that these policies may cause. Many studies have evaluated these outcomes, but drawing causal conclusions is challenging due to the many confounds that may better explain observed effects.

 We investigated the effects of cannabis legalization on a broad range of psychological outcomes, like substance use, psychiatric symptoms, general functioning in daily life, and cognitive ability. We used a longitudinal twin sample with twin pairs living in different types of states (recreationally legal vs. recreationally illegal) to draw causally informative conclusions. Because identical twins share 100% of their genes, as well as environmental factors like the family rearing, SES, and community norms, co-twin control studies can rule out many alternative explanations for an observed relationship.