Marijuana Law, Policy & Reform

Editor: Douglas A. Berman
Moritz College of Law

Monday, July 13, 2020

Interesting accounting of Ohio medical marijuana program circa summer 2020

2133The Dayton Daily News has this interesting new piece on Ohio's medical marijuana program under the headline "$133M of medical pot sold in 1st year as pandemic legitimized industry."  Here are excerpts:

The coronavirus pandemic has wreaked havoc on the state’s economy, but those in the medical marijuana industry say the virus legitimized the fledgling program in Ohio. The medical marijuana program, which is run by the Ohio Board of Pharmacy and the Commerce Department, was fully functional in April 2019. Sales have significantly increased over the past year.

In May of last year, about $2.2 million and about 300 pounds of medical marijuana product was sold in the state of product has been sold, according to data from the Ohio Department of Commerce. Medical marijuana sales in Ohio then jumped from $7.7 million this past February to $12.9 million in March — more than 1,500 pounds, according to the Ohio Department of Commerce. About $10.9 million of medical marijuana product was sold in April.

As of June 14, the most recent data available, a total of $133.9 million and 16,225 pounds of medical marijuana product has been sold since the program started.

The state has collected about $3.8 million in sales tax on the medical marijuana program from July 2019 to March 2020, according to the Ohio Department of Taxation. The state of Ohio’s fiscal year runs from July 1 to June 30.Permissive sales tax collected statewide in that time was $942,673, the Department of Taxation said. Permissive sales tax is collected by local entities, like the county and regional transit authority. The state wouldn’t release county-by-county sales tax data. Larry Pegram is the president of Pure Ohio Wellness.... Dispensaries were deemed essential during the statewide coronavirus shut down issued in March and lasting through May. That was huge for the medical marijuana industry, Pegram said.“That legitimized the whole program,” Pegram said. “This has become more acceptable, people are now seeing it more as an alternative medicine. ”Medical marijuana sales have increased every month the dispensaries have been open, Pegram said. There are now 51 dispensaries operating in Ohio. Six more dispensaries have provisional licenses and are working toward opening in the state.

When the pandemic first started, Pegram said people rushed to get product. But when dispensaries were deemed essential, sales settled down a bit. “It was scary at first, I think for everyone,” Pegram said. “But we realized we needed to stay open for our patients. For some of them, we are their lifeline.”...

More than 109,000 Ohioans are registered medical marijuana patients as of May 31, the most recent data available. In May of last year, 35,162 Ohioans were registered patients. About 7% of those patients are veterans. More than 600 of Ohio’s medical marijuana patients have been diagnosed with a terminal illness. Many Pure Ohio Wellness patients are seniors who use medical marijuana for pain management, Pegram said.

Licensed dispensaries reported about 81,200 unique patients who purchased medical marijuana as of May 31, according to the Ohio Automated Rx Reporting System. In May 2019, about 20,000 unique patients purchased medical marijuana.Ohioans can get a doctor’s order to use medical marijuana if they have one of the qualifying conditions, including chronic pain, Alzheimer’s, cancer, epilepsy, fibromyalgia or HIV/AIDS.Gould said he believes the Ohio Medical Board should add anxiety, autism and opioid withdrawl to the approved list of conditions.

July 13, 2020 in Medical Marijuana Data and Research, Medical Marijuana State Laws and Reforms | Permalink | Comments (0)

Thursday, April 23, 2020

Student presentation on "CBD and its efficacy as a sleep aid"

Tuesday, April 7, 2020

Student presentation on "Driving Under the Influence of Marijuana, or 'High Driving'"

As I mentioned in this recent post, students in my Marijuana Law, Policy & Reform seminar are now "taking over" my class by making presentations on research topics of their choice. Though the COVID-19 crisis means my resilient students are doing their presenting to the class online, going online has been going pretty well so far.   

As regular readers know, students provide in this space a little background on their topic and links to some relevant materials before they present.  Our first presentation planned for this week will focus on marijuana-influenced driving, and here is how my student has described his topic along with background readings he has provided for classmates (and the rest of us):

Marijuana legalization proponents quite often compare marijuana use to that of alcohol, claiming that alcohol consumption is far more dangerous, especially when a vehicle is involved.  Legalization dissenters, on the other hand, often make the argument that legalization would lead to rampant use and, inevitably, increases in traffic fatalities and damages as the result of people driving while stoned.  The aim of my class presentation and paper is to explore three topics related to Driving Under the Influence of Marijuana, or, as I like to call it, "High Driving": (1) Marijuana’s effect on driving ability, (2) The different state approaches to testing and prosecuting High Driving, and (3) what research shows about the relationship between the different legal marijuana regimes, the prevalence of High Driving, and the resulting consequences.

For background on these three interrelated topics, please reference the resources below:

"It’s High Time: A Common Sense Approach To Marijuana-Impaired Driving"

"Crash Fatality Rates After Recreational Marijuana Legalization in Washington and Colorado"

"The effects of medical marijuana laws on cannabis-involved driving"

"Drug Impaired Driving/Marijuana Drug-Impaired Driving Laws" (slightly out of date)

"Marijuana Use and Highway Safety"

April 7, 2020 in Assembled readings on specific topics, Business laws and regulatory issues, Criminal justice developments and reforms, Medical Marijuana Data and Research, Recreational Marijuana Data and Research | Permalink | Comments (0)

Wednesday, April 1, 2020

Drug Enforcement and Policy Center conducting new survey on COVID-19 impacts on cannabis industry

The Drug Enforcement and Policy Center has just created a short new survey intended to help explore how COVID-19 is impacting the cannabis industry.  The survey link is here, and this is the basic set up:

As the COVID-19 pandemic surges across the United States, the crisis continues to affect every aspect of the economy.  In response to the pandemic, Congress passed the CARES Act to provide relief to small businesses across the country.

However, the cannabis industry is ineligible for the act’s benefits due to federal prohibition.  In addition, the particular challenges that small and minority-owned cannabis businesses face were not addressed in the early discussions about the industry’s ability to persevere throughout the crisis.

We want to hear from you.

In an effort to learn more about the issues cannabis businesses and consumers are experiencing during the pandemic, and how government entities could best address these issues, DEPC has created a 3-minute survey.

Please complete and share our survey with your networks.

Take the survey

April 1, 2020 in History of Marijuana Laws in the United States, Medical Marijuana Data and Research, Recreational Marijuana Data and Research | Permalink | Comments (0)

Thursday, February 13, 2020

"Medical marijuana and workers' compensation claiming"

The title of this post is the title of this notable new paper authored by Keshar Ghimire and Johanna Catherine Maclean appearing in the journal Health Economics.  Because I was just today talking with students about metrics for measuring the efficacy of medical marijuana programs, this new piece caught my eye.  Here is its abstract:

We study the effect of state medical marijuana laws (MMLs) on workers' compensation (WC) claiming among adults.  Medical marijuana is plausibly related to WC claiming by allowing improved symptom management, and thus reduced need for the benefit, among injured or ill workers.  We use data on claiming drawn from the Annual Social and Economic supplement to the Current Population Survey over the period 1989 to 2012, coupled with a differences‐in‐differences design to provide the first evidence on this relationship.  Our estimates show that, post MML, WC claiming declines, both the propensity to claim and the level of income from WC.  These findings suggest that medical marijuana can allow workers to better manage symptoms associated with workplace injuries and illnesses and, in turn, reduce need for WC.  However, the reductions in WC claiming post MML are very modest in size. 

February 13, 2020 in Medical Marijuana Data and Research | Permalink | Comments (0)

Spitballing metrics that might be important when evaluating medical marijuana programs

As noted in prior posts here and here, this week I have asked students in my marijuana reform seminar to reflect on how policymakers should assess the efficacy of medical marijuana programs.  Potentially important to this inquiry is figuring out just what basic metrics should matter — metrics related both to  the operation of medical marijuana programs and to the program's potential impact on individual and community well-being. 

Reflecting on these questions always lead me back to a range of challenging (and useful) policy questions about what fundamental values are of greatest importance as we consider and operationalize any form of marijuana reform.  Of course, there are always going to be plenty of basic medical research questions (and uncertainty) about whether and for whom marijuana might provide health benefits (after all, this article suggests medical science cannot conclusively answer whether adults should be drinking milk).  But beyond (or intertwined with) uncertainty about the medical use of marijuana, how should policy makers approach these (or many other) potentially important metrics:

-- Is the raw number of patients in medical marijuana programs, or the number of a particular type of patients, fundamental to judging the success of medical marijuana programs?

-- Should self-reports or health-care worker reports of patient satisfaction or the cost of this form of health care relative to others be central to assessing efficacy?

-- Should reductions (or increases) in opioid overdoses or other salient community health problems be a central consideration? 

-- How about potential health care cost savings (or cost increases) for the state?

-- How about other possible public health and safety concerns ranging from increased marijuana use by teens, or more reports of substance use disorders, or more accidents involving impaired drivers or even increased crimes around dispensaries?

-- How about tax revenues or number of jobs created as an important metric for medical marijuana programs (since we see this often discussed for recreational programs)?

-- How should social equity and social justice concerns impact these issues: e.g., should we worry if only privileged people have access to and profit from medical marijuana and/or if arrest rates for low-level marijuana possession go up after a state implements a medical marijuana program?

I am sure I am leaving out lots of other important issues in this spitballing of metrics that might be important when evaluating medical marijuana programs. I eagerly welcome feedback and suggestions on this front from all readers.

A few recent related posts:

February 13, 2020 in Medical Marijuana Commentary and Debate, Medical Marijuana Data and Research, Medical Marijuana State Laws and Reforms, Who decides | Permalink | Comments (0)

Wednesday, February 12, 2020

Does official public data about Ohio's Medical Marijuana Control Program show its efficacy? Its ineffectiveness?

In a post from few days ago, I asked "How should policymakers assess the efficacy of medical marijuana programs? What are key metrics?".   I have asked students in my marijuana reform seminar to reflect on these questions, and I am wondering if official data on Ohio's "Medical Marijuana Control Program" can help answer these question in the Buckeye State. 

Specifically, here is link to a graphic that compares some data on Ohio's medical marijuana program from January 2019 and January 2020.  Because the 2019 data is from the "first day of sales," we see great growth in listed number over the course of a year (e.g., registered patients grew from 12,721 to 73,967).  Is this a mark of success for a program that became law in mid 2016?  Or does this show how slowly (or poorly) the program got launched?

Or consider this page of cumulative data as of Feb 7, 2020 

Dispensaries
  • 57 Provisional licenses
    • 49 Provisional licensees have received a Certificate of Operation
Patients & Caregivers (as of 12/31/2019)
  • 83,857 Recommendations
  • 78,376 Registered patients
    • 5,617 Patients with Veteran Status
    • 4,398 Patients with Indigent Status
    • 449 Patients with a Terminal Diagnosis
  • 55,617 Unique patients who purchased medical marijuana (as reported to OARRS by licensed dispensaries)
  • 8,259 Registered Caregivers
Physicians
  • 590 Certificates to Recommend
Sales Figures (as of 2/3/2020)
  • 8,174 lbs. of plant material
  • 393,726 units of manufactured product
  • 68.1 million in product sales
  • 534,913 total receipts
  • Historical Sales Data

Are any of these numbers especially important in judging the success of Ohio's medical marijuana program? What other metrics would be important to judging the success of Ohio's medical marijuana program?

February 12, 2020 in Medical Marijuana Commentary and Debate, Medical Marijuana Data and Research, Medical Marijuana State Laws and Reforms | Permalink | Comments (0)

Sunday, February 9, 2020

How should policymakers assess the efficacy of medical marijuana programs? What are key metrics?

The question in the title of this post are questions I have asked students in my marijuana reform seminar to be considering this week.  I am not sure I have good answers to these questions, so I am hoping my students can help answer them.

Notably, the group Americans for Safe Access (ASA) produces an annual report that gives letter grades to all states based on various criteria relating to medical marijuana programs.  (The 2019 version of  this lengthy and informative report  is summarized in this ASA blog post.)  But ASA is a medical marijuana advocacy group that grades states based primarily on how accessible marijuana is to individuals who want access -- i.e., ASA is focused on whether programs "ensure that all patients have access to the medicine they need" -- and it is not a given that all policymakers would be keen to adopt the ASA's grading criteria. (Tellingly, in these ASA reports, states with recreational marijuana programs consistently get the highest grades).

The Drug Enforcement & Policy Center last Fall released this survey report that "revealed immense dissatisfaction with the Ohio medical marijuana system" among likely medical marijuana consumers.  But again, the views of likely consumers may not be the best metric for assessing the efficacy of a medical marijuana program.  In some coming posts, I will focus on some existing data related to Ohio's and (some other states') medical marijuana program to further explore just what metrics ought to be key to assessing the virtues (and vices?) of these programs.

February 9, 2020 in Medical Marijuana Commentary and Debate, Medical Marijuana Data and Research, Medical Marijuana State Laws and Reforms | Permalink | Comments (0)

Leafly report claims "legal cannabis now supports 243,700 full-time American jobs"

Cannabis_Job_Growth_web_1921This story at Leafly, headlined "Cannabis Jobs Report: Legal cannabis now supports 243,700 full-time American jobs," reports on Leafly's effort to account for job creation in the legal marijuana industry.  Here are excerpts:

How many jobs are there in the legal marijuana industry?  Leafly’s annual Cannabis Jobs Report found 243,700 full-time-equivalent (FTE) jobs supported by legal cannabis as of January 2020.

Even in a down year, the marijuana industry added 33,700 jobs.  That’s a 15% year-over-year increase. Over the past 12 months the expanding industry has created 33,700 new jobs nationwide, making legal marijuana the fastest-growing industry in America.

This year’s jobs count found Massachusetts, Oklahoma, and Illinois leading the employment expansion. As its adult-use market passed its one-year anniversary, Massachusetts added 10,226 jobs. Meanwhile, Oklahoma’s robust medical marijuana industry added more than 7,300 jobs in the past year.

Florida also saw amazing growth in 2019. With more than 300,000 registered medical marijuana patients, Florida now has the most medical patients of any state. That growth in the patient base, along with the start of smokeable flower sales, boosted Florida to a 93% increase in total sales....

California remains America’s biggest legal cannabis employer. But Colorado may be the nation’s biggest per-capita marijuana job market, with one job per 165 residents. California, by contrast, offers one job per 980 residents.

Colorado also continues to outpace Washington state. Both states legalized cannabis for all adults in 2012, but Colorado’s industry boasts nearly 10,000 more jobs than Washington, even though Washington boasts nearly two million more residents.

Both Colorado and Washington posted strong 8% growth six years after their retail stores opened, indicating that legal stores are still drawing customers away from illicit sellers, and steadily attracting more adult consumers from non-traditional demographics.

Leafly’s full report, which includes includes a state-by-state analysis of all medical and adult-use states, is available at this link.

February 9, 2020 in Employment and labor law issues, Medical Marijuana Data and Research, Recreational Marijuana Data and Research | Permalink | Comments (0)

Wednesday, January 15, 2020

Intriguing little survey on Ohioians views on marijuana a year after its medical program began

Download (7)The group Interact for Health recently released this report detailed the results of a survey focused on "Ohio adults’ knowledge of marijuana use and perception of its harm." Here are excerpts:

The Ohio Health Issues Poll (OHIP) is conducted every year to learn more about the health opinions, behaviors and status of Ohio adults. In 2016 Ohio legalized medical marijuana. It became available in early 2019....

OHIP in 2019 asked Ohio adults about their knowledge of marijuana use among friends and family members, their perception of harm and their participation in the medical marijuana program....

OHIP asked “Do you have a friend or family member who regularly uses marijuana?” About half of Ohio adults said yes (46%).

OHIP also asked, “How much do you think people risk harming themselves by regularly using marijuana?” About half of Ohio adults (47%) said they think regularly using marijuana is a great deal or somewhat harmful.

Responses varied the person knows someone who regularly uses marijuana. Three in 10 Ohio adults (30%) who have a friend or family member who regularly uses marijuana perceive marijuana as harmful. That compares with 6 in 10 Ohio adults (61%) who do not know someone who regularly uses marijuana.

OHIP asked several questions to learn how many Ohioans had explored the new medical marijuana options. OHIP asked, “Have you ever sought information about whether you have a medical condition that can be treated with medical marijuana in the state of Ohio?” About 8 in 10 Ohio adults (83%) have not sought medical marijuana information. Ohio adults who do not perceive marijuana as harmful are more likely (26%) than those who perceive marijuana as harmful (8%) to seek information.

OHIP then asked, “Has your doctor written you a recommendation for the use of medical marijuana?” Very few Ohio adults (2%) reported this. Among those who did, OHIP asked “Have you completed your registration with the Ohio Medical Marijuana Patient and Caregiver Registry?” Very few Ohio adults did.

January 15, 2020 in Medical Marijuana Data and Research, Medical Marijuana State Laws and Reforms | Permalink | Comments (0)

Friday, December 13, 2019

Eight Senators (all Dems) write to federal agencies inquiring about efforts to advance medical marijuana research

This webpage with the heading "Senators Request Update from Federal Agencies on Progress Towards Issuing Long-Delayed Licensing of Marijuana Manufacturing for Research Purposes" reports on a notable new letter from some federal lawmakers.  Here are the basics:

United States Senators Elizabeth Warren (D-Mass.), Ron Wyden (D-Ore.), Kamala Harris (D-Calif.), Kirsten Gillibrand (D-N.Y.), Cory Booker (D-Conn.), Jeff Merkley (D-Ore.), Edward J. Markey (D-Mass.), and Jacky Rosen (D-Nev.) sent a letter to the U.S. Department of Health and Human Services (HHS), the Drug Enforcement Administration (DEA), and the White House Office of National Drug Control Policy (ONDCP), requesting an update on the progress of the federal government's efforts to facilitate research on medical marijuana by issuing needed manufacturing licenses.  The senators seek guidance on how the DEA will make these licenses available to qualified researchers in a timely manner given that the federal government has a unique responsibility to coordinate medical marijuana research efforts -- and has delayed issuing these licenses in the past.

"With millions of American adults having access to recreational marijuana and a growing number seeking the drug for medicinal purposes, the federal government is not providing the necessary leadership and tools in this developing field," wrote the lawmakers.  "Evidence-based public policy is crucial to ensuring our marijuana laws best serve patients and health care providers."

The lawmakers have requested responses no later than January 10, 2020, to better understand both the DEA's decision-making, and its work with HHS and ONDCP to expand medical marijuana research.  "This research is crucial to developing a thorough understanding of medical marijuana and would be invaluable to doctors, patients, and lawmakers across the nation," wrote the lawmakers.

The full letter is available at this link, and it starts this way:

We write to inquire about your respective agencies' ongoing efforts with regard to scientific research on the potential health and therapeutic benefits of marijuana when used for medical purposes ("medical marijuana"). In light of the Drug Enforcement Administration's (DEA) most recent announcement that it will issue additional marijuana manufacturing licenses for research purposes — an announcement that comes three years after a similar yet unfulfilled DEA commitment — we are also requesting written guidance on how the DEA will make these licenses available to qualified researchers in a timely manner.

December 13, 2019 in Federal Marijuana Laws, Policies and Practices, Medical Marijuana Data and Research, Who decides | Permalink | Comments (1)

Saturday, December 7, 2019

Rounding up some recent notable marijuana social science research

Busy times over the last couple weeks has kept me from finding time to blog about a lot of notable recently-published marijuana research.  Making up for the silence, here is a review of the pieces that recently caught my attention:

"Using recreational cannabis to treat insomnia: Evidence from over-the-counter sleep aid sales in Colorado" by authored by Jacqueline Doremus, Sarah Stith and Jacob Vigil published in Complementary Therapies in Medicine

"What Have Been the Public Health Impacts of Cannabis Legalisation in the USA? A Review of Evidence on Adverse and Beneficial Effects" authored by Janni Leung et al. published in Current Addiction Reports

"Are Marijuana and Alcohol Substitutes? Evidence from Neighboring Jurisdictions" authored by Benjamin Hansen as a working paper

"Frequency of cannabis and illicit opioid use among people who use drugs and report chronic pain: A longitudinal analysis" authored by Stephanie Lake et al. published in PLOS Medicine

"Trends in college students’ alcohol, nicotine, prescription opioid and other drug use after recreational marijuana legalization: 2008-2018" authored by Zoe Alley, David Kerr and Harold Bae published in Addictive Behaviors

"Postmaterialism and referenda voting to legalize marijuana" authored by John Frendreis and Raymond Tatalovich published in the International Journal of Drug Policy

"Psychotic disorders hospitalizations associated with cannabis abuse or dependence: A nationwide big data analysis" authored by Manuel Gonçalves‐Pinho, Miguel Bragança and Alberto Freitas published in International Journal of Methods in Psychiatric Research

December 7, 2019 in Medical Marijuana Data and Research, Recreational Marijuana Data and Research | Permalink | Comments (0)

Wednesday, November 20, 2019

"The Complicated Relationship Between Marijuana Use and Parenting"

The title of this post is the title of this new paper recently posted to SSRN and authored by Kathryn Foust, a recent graduate The Ohio State University Moritz College of Law.  This paper is the sixteenth paper in an on-going series of student papers supported by the Drug Enforcement and Policy Center.  (The fifteen prior papers in this series are linked below.)    Here is this latest paper's abstract:

The intersection between marijuana and parenting is both highly controversial and largely unexplored.  Despite the trend of legalization (medicinal and recreational) across the country, there is a widening discrepancy between criminal laws and child welfare policies.  Even in states where marijuana is recreationally legal, a parent might still be charged with child abuse or neglect as a result of his or her marijuana use.  Although second-hand marijuana smoke has proven to be a relatively low risk of harm to children, other areas of concern have not been adequately studied, such as the effects of marijuana use during pregnancy and/or breastfeeding.  Despite the lack of reliable scientific studies on the impact of ingestion by children, some initial studies have shown a marked increase in frequency of accidental ingestions and resulting hospital treatment in states that have legalized marijuana.  The palatability and attractiveness of “edibles” is likely the cause of this measurable and dramatic increase. Overall, parental marijuana use has been inadequately studied by science, but some reliable data is available which could be used overhaul existing children’s services policies.

Prior student papers in this series:

November 20, 2019 in Medical community perspectives, Medical Marijuana Commentary and Debate, Medical Marijuana Data and Research, Recreational Marijuana Commentary and Debate, Recreational Marijuana Data and Research | Permalink | Comments (0)

Wednesday, October 30, 2019

"The Impact of Medical Marijuana Laws and Dispensaries on Self-Reported Health"

S21946191The title of this post is the title of this notable new article authored by Elena Andreyeva and Benjamin Ukert published in the Forum for Health Economics & Policy. Here is its abstract:

Growing evidence suggests that medical marijuana laws have harm reduction effects across a variety of outcomes related to risky health behaviors.  This study investigates the impact of medical marijuana laws on self-reported health using data from the Behavioral Risk Factor Surveillance System from 1993 to 2013.  In our analyses we separately identify the effect of a medical marijuana law and the impact of subsequent active and legally protected dispensaries.

Our main results show surprisingly limited improvements in self-reported health after the legalization of medical marijuana and legally protected dispensaries.  Subsample analyses reveal strong improvements in health among non-white individuals, those reporting chronic pain, and those with a high school degree, driven predominately by whether or not the state had active and legally protected dispensaries.  We also complement the analysis by evaluating the impact on risky health behaviors and find that the aforementioned demographic groups experience large reductions in alcohol consumption after the implementation of a medical marijuana law.

October 30, 2019 in Medical community perspectives, Medical Marijuana Commentary and Debate, Medical Marijuana Data and Research | Permalink | Comments (0)

"Cannabinoids for the treatment of mental disorders and symptoms of mental disorders: a systematic review and meta-analysis"

Download (6)The title of this post is the title of this notable new article by multiple authors published in The Lancet Psychiatry. Here is its "Summary":

Background

Medicinal cannabinoids, including medicinal cannabis and pharmaceutical cannabinoids and their synthetic derivatives, such as tetrahydrocannabinol (THC) and cannabidiol (CBD), have been suggested to have a therapeutic role in certain mental disorders.  We analysed the available evidence to ascertain the effectiveness and safety of all types of medicinal cannabinoids in treating symptoms of various mental disorders.

Methods

For this systematic review and meta-analysis we searched MEDLINE, Embase, PsycINFO, the Cochrane Central Register of Controlled Clinical Trials, and the Cochrane Database of Systematic Reviews for studies published between Jan 1, 1980, and April 30, 2018.  We also searched for unpublished or ongoing studies on ClinicalTrials.gov, the EU Clinical Trials Register, and the Australian and New Zealand Clinical Trials Registry.  We considered all studies examining any type and formulation of a medicinal cannabinoid in adults (≥18 years) for treating depression, anxiety, attention-deficit hyperactivity disorder (ADHD), Tourette syndrome, post-traumatic stress disorder, or psychosis, either as the primary condition or secondary to other medical conditions.  We placed no restrictions on language, publication status, or study type (ie, both experimental and observational study designs were included). Primary outcomes were remission from and changes in symptoms of these mental disorders.  The safety of medicinal cannabinoids for these mental disorders was also examined. Evidence from randomised controlled trials was synthesised as odds ratios (ORs) for disorder remission, adverse events, and withdrawals and as standardised mean differences (SMDs) for change in symptoms, via random-effects meta-analyses.  The quality of the evidence was assessed with the Cochrane risk of bias tool and Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach.  This study is registered with PROSPERO (CRD42017059372, CRD42017059373, CRD42017059376, CRD42017064996, and CRD42018102977).

Findings

83 eligible studies (40 randomised controlled trials, n=3067) were included: 42 for depression (23 randomised controlled trials; n=2551), 31 for anxiety (17 randomised controlled trials; n=605), eight for Tourette syndrome (two randomised controlled trials; n=36), three for ADHD (one randomised controlled trial; n=30), 12 for post-traumatic stress disorder (one randomised controlled trial; n=10), and 11 for psychosis (six randomised controlled trials; n=281).  Pharmaceutical THC (with or without CBD) improved anxiety symptoms among individuals with other medical conditions (primarily chronic non-cancer pain and multiple sclerosis; SMD −0·25 [95% CI −0·49 to −0·01]; seven studies; n=252), although the evidence GRADE was very low.  Pharmaceutical THC (with or without CBD) worsened negative symptoms of psychosis in a single study (SMD 0·36 [95% CI 0·10 to 0·62]; n=24). Pharmaceutical THC (with or without CBD) did not significantly affect any other primary outcomes for the mental disorders examined but did increase the number of people who had adverse events (OR 1·99 [95% CI 1·20 to 3·29]; ten studies; n=1495) and withdrawals due to adverse events (2·78 [1·59 to 4·86]; 11 studies; n=1621) compared with placebo across all mental disorders examined.  Few randomised controlled trials examined the role of pharmaceutical CBD or medicinal cannabis.

Interpretation

There is scarce evidence to suggest that cannabinoids improve depressive disorders and symptoms, anxiety disorders, attention-deficit hyperactivity disorder, Tourette syndrome, post-traumatic stress disorder, or psychosis. There is very low quality evidence that pharmaceutical THC (with or without CBD) leads to a small improvement in symptoms of anxiety among individuals with other medical conditions.  There remains insufficient evidence to provide guidance on the use of cannabinoids for treating mental disorders within a regulatory framework.  Further high-quality studies directly examining the effect of cannabinoids on treating mental disorders are needed.

October 30, 2019 in Medical community perspectives, Medical Marijuana Commentary and Debate, Medical Marijuana Data and Research | Permalink | Comments (0)

Friday, September 6, 2019

"Ohio's Medical Marijuana Control Program: Online Survey of Consumer Satisfaction"

Image-of-report-1024x585The title of this post is the title of this new report authored by Nicholas Maxwell, who this summer served as a Research Fellow at Harm Reduction Ohio and who put together this report in conjunction with Ohio State's Drug Enforcement and Policy Center (which I help run).   The report will be one of a number of topics discussed at this DEPC event tonight, and here is its "summary and key findings":

An online survey of more than 600 Ohioans, most of whom reported being regular users of marijuana, revealed immense dissatisfaction with the Ohio medical marijuana system.  Consumers were surveyed on a range of topics, from their marijuana consumption habits to their experience with the Ohio MMCP.  The price of medical marijuana in Ohio was the primary driver of consumer dissatisfaction.  Contributing to this dissatisfaction was also reported inconvenience of registering for the program and traveling the sometimes-significant distance to the nearest dispensary.  The vast majority of respondents stated that they preferred to purchase marijuana from medical dispensaries, but reported that Ohio’s existing medical marijuana regime presented significant barriers that deterred them from doing so.
  • 78% of 647 surveyed Ohioans reported a qualifying condition under the medical marijuana program.  Most respondents reporting a qualifying condition reported that they had chronic, severe, or intractable pain, which is consistent with the population of Ohio enrolled in its medical marijuana program.

  • 81% of the 505 people who reported a qualifying condition also reported that they currently use marijuana.

  • Only 45% of the 407 people who reported a qualifying condition and to be currently using marijuana have received a doctor’s recommendation under the MMCP.

  • 67% of all 647 respondents reported being “very dissatisfied” or “somewhat dissatisfied” with the Ohio medical marijuana program, with only 16.7% of people reporting being somewhat or very satisfied.

  • 87% of all 647 respondents indicated preference for purchasing marijuana from a legal dispensary if product was similarly priced to product available via the unregulated market.

  • On average, people were willing to pay a 16.9% price premium to buy marijuana at legal dispensaries instead of the unregulated market.  At current levels, the premium stands at more than 100%.

September 6, 2019 in Business laws and regulatory issues, Medical Marijuana Commentary and Debate, Medical Marijuana Data and Research, Medical Marijuana State Laws and Reforms, Who decides | Permalink | Comments (0)

Monday, August 26, 2019

"DEA Announces Steps Necessary to Improve Access to Marijuana Research"

US._Dept_of_Justice_DEAThe title of this post is the title of this notable new Department of Justice press release.  Here is its full text:

The Drug Enforcement Administration today announced that it is moving forward to facilitate and expand scientific and medical research for marijuana in the United States. The DEA is providing notice of pending applications from entities applying to be registered to manufacture marijuana for researchers. DEA anticipates that registering additional qualified marijuana growers will increase the variety of marijuana available for these purposes.

Over the last two years, the total number of individuals registered by DEA to conduct research with marijuana, marijuana extracts, derivatives and delta-9-tetrahydrocannabinol (THC) has increased by more than 40 percent from 384 in January 2017 to 542 in January 2019. Similarly, in the last two years, DEA has more than doubled the production quota for marijuana each year based on increased usage projections for federally approved research projects.

“I am pleased that DEA is moving forward with its review of applications for those who seek to grow marijuana legally to support research,” said Attorney General William P. Barr. “The Department of Justice will continue to work with our colleagues at the Department of Health and Human Services and across the Administration to improve research opportunities wherever we can.”

“DEA is making progress in the program to register additional marijuana growers for federally authorized research, and will work with other relevant federal agencies to expedite the necessary next steps,” said DEA Acting Administrator Uttam Dhillon. “We support additional research into marijuana and its components, and we believe registering more growers will result in researchers having access to a wider variety for study.”

This notice also announces that, as the result of a recent amendment to federal law, certain forms of cannabis no longer require DEA registration to grow or manufacture. The Agriculture Improvement Act of 2018, which was signed into law on Dec. 20, 2018, changed the definition of marijuana to exclude “hemp”—plant material that contains 0.3 percent or less delta-9 THC on a dry weight basis. Accordingly, hemp, including hemp plants and cannabidiol (CBD) preparations at or below the 0.3 percent delta-9 THC threshold, is not a controlled substance, and a DEA registration is not required to grow or research it.

Before making decisions on these pending applications, DEA intends to propose new regulations that will govern the marijuana growers program for scientific and medical research. The new rules will help ensure DEA can evaluate the applications under the applicable legal standard and conform the program to relevant laws. To ensure transparency and public participation, this process will provide applicants and the general public with an opportunity to comment on the regulations that should govern the program of growing marijuana for scientific and medical research.

August 26, 2019 in Federal Marijuana Laws, Policies and Practices, Medical Marijuana Data and Research, Recreational Marijuana Data and Research, Who decides | Permalink | Comments (0)

Friday, August 9, 2019

"The Effects of Recreational Marijuana Legalization and Dispensing on Opioid Mortality"

The title of this post is the title of this notable new article recently published in the journal Economic Inquiry authored by Nathan Chan, Jesse Burkhardt and Matthew Flyr.  Here is its abstract:

This study documents how the changing legal status of marijuana has impacted mortality in the United States over the past two decades.  We use a difference‐in‐difference approach to estimate the effect of medical marijuana laws (MML) and recreational marijuana laws (RML) on fatalities from opioid overdoses, and we find that marijuana access induces sharp reductions in opioid mortality rates.  Our research corroborates prior findings on MMLs and offers the first causal estimates of RML impacts on opioid mortality to date, the latter of which is particularly important given that RMLs are far more expansive in scope and reach than MMLs.

In our preferred econometric specification, we estimate that RMLs reduce annual opioid mortality in the range of 20%–35%, with particularly pronounced effects for synthetic opioids.  In further analysis, we demonstrate how RML impacts vary among demographic groups, shedding light on the distributional consequences of these laws. Our findings are especially important and timely given the scale of the opioid crisis in the United States and simultaneously evolving attitudes and regulations on marijuana use.

August 9, 2019 in Medical Marijuana Data and Research, Recreational Marijuana Data and Research | Permalink | Comments (0)

Monday, August 5, 2019

"State Of The States Report: An Analysis Of Medical Cannabis Access In The United States"

The title of this post is the title of this huge new version of an annual report produced by Americans for Safe Access. Here is part of the introductory letter from Steph Sherer, the President and Founder of ASA, at the start of the 178-page report:

Each year, Americans for Safe Access (ASA) analyzes, summarizes, and critiques legislation and regulations as they become law and develops this report to assess how these programs are serving the needs of patients.  In 2014, when we first started writing this report, only 22 states were analyzed and graded.  Now, six years later, we are analyzing 47 states in over 50 categories surrounding Patient Rights and Civil Protection from Discrimination, Access to Medicine, Ease of Navigation, Functionality of the Program, and Consumer Safety and Provider Requirements.

Through this report, ASA also recommends how states can improve programs, and we take great pride in knowing that these recommendations are frequently followed and incorporated by regulators and policymakers.  While we are excited to see the number of states with medical cannabis programs increase, we know this patchwork of laws is not working to provide access to everyone who needs this medicine.  Patients can still not travel to other states with their medicine, and some states only offer protections that cover a small subset of patients using a certain type of medicine.  The types of medicine available, method of administration, purchase limits, training requirements for staff, labeling requirements, etc. are different depending on the state that you are lucky, or unlucky, enough to live in.

August 5, 2019 in Medical Marijuana Commentary and Debate, Medical Marijuana Data and Research, Medical Marijuana State Laws and Reforms | Permalink | Comments (0)

Tuesday, July 16, 2019

"Is Cannabis a Gateway Drug? Key Findings and Literature Review"

The title of this post is the title of this lengthy report published in November 2018 produced by the Federal Research Division of the Library of Congress in conjunction with the National Institute of Justice.  For some reason, I missed this notable report when it was first released and tripped across it just this past week.  Here are the three lead findings of the full report:

1. The existing statistical research and analysis show mixed results and do not clearly demonstrate scientific support for cannabis use leading to harder illicit drug use.  As a result, FRD has determined that no causal link between cannabis use and the use of other illicit drugs can be claimed at this time.

2. The current state of research on this topic is very limited and existing studies suffer from difficulties in gathering information and applying the findings to a larger population.

3. While many of the studies reviewed in this report did find statistically significant associations between cannabis use and one’s later use of other illicit drugs, there is not yet conclusive evidence to assert that cannabis is a gateway drug. Moreover, the practical significance of these findings was limited.

July 16, 2019 in Medical Marijuana Data and Research, Recreational Marijuana Data and Research | Permalink | Comments (1)