Use of Medical Cannabis Can Expose Patients to Harmful Contaminants

PainRelief.com Interview with:
Maxwell C. K. Leung, Ph.D.
Assistant Professor
Systems Biology and Toxicology
New College of Interdisciplinary Arts and Sciences
Arizona State University, West Campus

PainRelief.com: What is the background for this study?

Response: Over 200 million Americans currently have legal access to medical cannabis, recreational cannabis, or both. Yet, cannabis remains an illicit Schedule 1 substance at the federal level. This limits the efforts of several federal agencies to regulate harmful contaminants – including pesticides, heavy metals, solvents, microbes, and fungal toxins – in cannabis.

Cannabis During Pregnancy May Have Long Term Mental Health Consequences for Children

David-Baranger
Dr. Baranger

PainRelief.com Interview with:

David A. A. Baranger, PhD
Department of Psychological and Brain Sciences

Dr. Brogdan

Ryan Bogdan, PhD
Associate Professor of Psychological & Brain Sciences
Department of Psychiatry
Washington University in St Louis
St Louis, Missouri



PainRelief.com: What is the background for this study? What are the main findings?

David Baranger: Prenatal cannabis use is increasing in the United States. Prior work from our group found that prenatal cannabis exposure, particularly when it occurred after mothers learned they were pregnant, was associated with worse mental health outcomes in children aged 9-10.

In this study we followed up with this same group of children, who are now as old as 12, to ask whether anything has changed. Have they improved, or gotten worse? To our surprise, we found that children with prenatal cannabis exposure still had worse mental health outcomes – things had not gotten better, nor had they gotten worse.  

Twin Study Find Cannabis Legalization Linked to Increased Marijuana Use in Adults

PainRelief.com Interview with:
Stephanie Zellers
Psychology
University of Minnesota

PainRelief.com: What is the background for this study?

Response: Many cross-sectional studies have found increases in adult cannabis consumption after the passage of recreational cannabis legalization. These studies, in large population samples across the USA, provide information about possible effects of recreational legalization in representative samples, but cannot draw causally informative conclusions. There are many confounders, like genes, pre-existing differences, and secular trends, that could be alternative explanations for any effects identified.

We utilized a longitudinal twin study to rule out many additional unmeasured confounds shared within families, like genes and aspects of the rearing environment. Importantly, we have data on identical twins before and after recreational legalization, and we have pairs where one twin lives in a recreationally legal state while their co-twin does not. By comparing these twins, we can estimate the causal impact of recreational legalization, after controlling for unmeasured confounds shared by individuals in a family.

Medical Marijuana Users Also More Likely to Also Use Tobacco

PainRelief.com Interview with:
Marc L. Steinberg, Ph.D.,
Professor, Department of Psychiatry, Rutgers RWJMS
Director, Doctoral Psychology Internship Program, Rutgers UBHC – Piscataway
Research Lab Website: Tobacco Research & Intervention Lab

Dr. Steinberg

PainRelief.com: What is the background for this study? What are the main findings?

Response: As the use of cannabis for therapeutic purposes (often called ‘medical marijuana’) has grown, my colleague, Dr. Mary Bridgeman, and I became interested in exploring more about the population who use marijuana for therapeutic purposes. My research has historically focused on tobacco use and so that was one issue in particular that we focused on in this study.

We know that individuals who use cannabis, in general, are more likely to smoke, but we did not know if that was also true for those who used cannabis for therapeutic purposes.  

Fewer Synthetic Cannabinoid Poisonings in States with Legalized Medical Marijuana

PainRelief.com Interview with:
Tracy Klein, PhD, ARNP, FAANP, FRE, FAAN
Assistant Director, Center for Cannabis Policy, Research and Outreach
Associate Professor, College of Nursing
Washington State University Vancouver
Vancouver, WA

PainRelief.com: What is the background for this study?

Response: This study evaluates data on illicit synthetic cannabinoid poisonings reported to the National Poison Data System (NPDS) which contains data from 55 poison centers in the US (https://aapcc.org/about/our-members). We correlated the 7600 poisonings reported between 2016 and 2019 with the reporting state’s status of cannabis legalization: restrictive, medical and permissive.

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Higher Potency Cannabis Associated With Greater Risk of Addiction

PainRelief.com Interview with:
Kat Petrilli, PhD Student
Addiction and Mental Health Group (AIM)
Department of Psychology
University of Bath

PainRelief.com:  What is the background for this study? 

cannabis marijuana weed pot

Response: Cannabis is the third most used drug globally, after alcohol and nicotine. Experimental studies show that THC, the main psychoactive component, causes intoxication, cognitive impairments, as well as symptoms of anxiety and psychosis-like experiences and these effects are dose-dependent, which means that higher potency cannabis products (products with high THC concentrations) could increase the risk of harm to cannabis users. 

Previous studies have shown that concentrations of THC in cannabis have increased over the years. In the US and Europe concentrations of THC in cannabis have more than doubled over the past 10 years. In addition, new legal markets have facilitated the appearance of cannabis products with higher potencies than earlier products, such as cannabis concentrates. We also know from previous studies that cannabis use is associated with mental health disorders and 22% of people who use cannabis are estimated to meet the criteria for cannabis use disorder (CUD) or cannabis addiction. 

International increases in cannabis potency and the availability of higher potency cannabis products makes it especially pressing to understand the association of cannabis potency with mental health outcomes. 

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Real World Study Evaluates Medical Cannabis for Cancer Pain Relief

PainRelief.com Interview with:
David (Dedi) Meiri PhD
Principal Investigato
Laboratory of Cancer Biology and Cannabinoid Research
Technion
Israel Institute of Technology

PainRelief.com:  What is the background for this study? 

Response: We encountered numerous cancer patients that asked us whether medical cannabis treatment can benefit their health, however, while there is a lot of anecdotal evidence regarding the effectiveness of medical cannabis for pain, not much was known regarding its effectiveness in particular for the treatment of cancer-related pain; and there were no validated clinical studies. This motivated us to conduct an organized and thorough study that can serve patients and government ministries alike.

This study, which was conducted by Dr. Joshua Aviram as part of his postdoctoral fellowship, is the first to assess the possible benefits of medical cannabis for cancer-related pain in oncology patients, gathering information from right before they started the treatment and with repeated follow-ups for an extended period of time. Over a span of six months, we investigated the effectiveness and safety of medical cannabis treatment based on sound real-world evidence.

Australian Study Finds Most Medical Cannabis Obtained Without Prescription

PainRelief.com Interview with:
Janni Leung, PhD
National Health and Medical Research Council Emerging Leadership Fellow
National Centre for Youth Substance Use Research (NCYSUR)
The University of Queensland

PainRelief.com:  What is the background for this study? 

Response: It is important to know the prevalence and source of medical cannabis use because non-prescribed use may put individuals at risk.

More Kids Poisoned by Cannabis Since Legalization

PainRelief.com Interview with:
Daniel Myran, MD, MPH, CCFP, FRCPC
Family and Public Health and Preventive Medicine Physician 
CIHR Fellow, Ottawa Hospital Research Institute 
Department of Family Medicine Innovation Fellow
University of Ottawa 

Dr. Myran

PainRelief.com:  What is the background for this study? 

Response: Canada legalized recreational, or non-medical, cannabis in October 2018. Canada took phased approach to legalization initially only allowing flower-based cannabis products and oils and after one year permitting the sale of commercial cannabis edibles (e.g. THC containing candies, baked goods, and drinks). In this study we took advantage of this phased roll out of legal cannabis to understand the impact of legalization on cannabis exposures or poisonings in children aged 0-9 years and the contribution of different types of cannabis products to these events. 

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Study Finds Medical Cannabis Not Likely to Solve Opioid Crisis for Pain Patients

PainRelief.com Interview with:
Carsten Hjorthøj, senior Researcher
Copenhagen Research Center for Mental Health – CORE, Mental Health Center Copenhagen, Copenhagen University Hospital
University of Copenhagen, Department of Public Health
Section of Epidemiology, Copenhagen, Denmark.

PainRelief.com:  What is the background for this study?  What are the main findings?

Response: Denmark introduced a pilot program of medical cannabis in 2018. Medical cannabis, and cannabis-based medicine, has gained a lot of both attention and controversy as a possible way to treat pain disorders, but the evidence base is still sparse. The Danish nationwide unselected registers allow us to perform a high quality pharmacoepidemiologic study with propensity score matched controls.

The main findings are that medical cannabis and cannabis-based medicine did not reduce the use of opioids in pain patients, and might actually lead to an increase in use of opioids. However, patients with neuropathic pain disorders appeared to reduce their use of gabapentin, their use of overall medication (but not opioids!), and the number of days spent in hospital, compared with controls.

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