Legal Marijuana Shops Refuse Sales To Underage Customers, Study Finds

Marijuana Shops Refuse Underage

Marijuana Shops Refuse Underage

Marijuana Shops Refuse Underage.

Objective

The purpose of this study was to measure compliance with age and personal ID regulations by state-licensed recreational marijuana stores in two states.

Method

Recreational marijuana stores (N = 175) in Colorado and Washington State were each visited twice by pseudo-buyer assessment teams in September 2016 to April 2017. The observer entered the store first, performed an environmental scan, and observed the buyer’s purchase behavior. In both Washington State visits and in the first visit in Colorado, a young-adult buyer attempted to enter the store and purchase marijuana without showing a state-approved ID (i.e., valid driver’s license). In the second Colorado visit, a buyer age 18–20 showed an underage driver’s license and attempted to enter the store and purchase marijuana.

Results

All stores (100%) requested an ID. Stores refused buyers in 73.6% of visits at the entrance, 88.3% cumulative before the counter, and 92.6% by the time of a purchase attempt. Refusal was lower in Washington State (at entry, 53.1%; before the counter, 80.5%; and at purchase attempt, 86.6%) than in Colorado (at entry, 95.3%, p < .01; before the counter, 96.5%, p < .01; and at purchase attempt, 98.8%, p < .01), but it did not differ by buyer protocol (p > .05).

Conclusions

Compliance with laws restricting marijuana sales to individuals 21 or older with a valid ID was high. Compliance in Washington State might be improved by having store personnel check IDs at the store entry. Although recreational stores may not be selling marijuana directly to youth, no information was collected on straw purchases.

Everyday Marijuana Use Reduces Opioid Consumption By Chronic Pain Patients, Study Finds

Marijuana Reduces Opioid Consumption

Marijuana Reduces Opioid Consumption

Marijuana Reduces Opioid Consumption.

Frequency of cannabis and illicit opioid use among people who use drugs and report chronic pain: A longitudinal analysis.

Background

Ecological research suggests that increased access to cannabis may facilitate reductions in opioid use and harms, and medical cannabis patients describe the substitution of opioids with cannabis for pain management. However, there is a lack of research using individual-level data to explore this question. We aimed to investigate the longitudinal association between frequency of cannabis use and illicit opioid use among people who use drugs (PWUD) experiencing chronic pain.

Methods and findings

This study included data from people in 2 prospective cohorts of PWUD in Vancouver, Canada, who reported major or persistent pain from June 1, 2014, to December 1, 2017 (n = 1,152). We used descriptive statistics to examine reasons for cannabis use and a multivariable generalized linear mixed-effects model to estimate the relationship between daily (once or more per day) cannabis use and daily illicit opioid use. There were 424 (36.8%) women in the study, and the median age at baseline was 49.3 years (IQR 42.3–54.9). In total, 455 (40%) reported daily illicit opioid use, and 410 (36%) reported daily cannabis use during at least one 6-month follow-up period. The most commonly reported therapeutic reasons for cannabis use were pain (36%), sleep (35%), stress (31%), and nausea (30%). After adjusting for demographic characteristics, substance use, and health-related factors, daily cannabis use was associated with significantly lower odds of daily illicit opioid use (adjusted odds ratio 0.50, 95% CI 0.34–0.74, p < 0.001). Limitations of the study included self-reported measures of substance use and chronic pain, and a lack of data for cannabis preparations, dosages, and modes of administration.

Conclusions

We observed an independent negative association between frequent cannabis use and frequent illicit opioid use among PWUD with chronic pain. These findings provide longitudinal observational evidence that cannabis may serve as an adjunct to or substitute for illicit opioid use among PWUD with chronic pain.

Alcohol-Related Car Crashes Declined In Idaho After Washington Legalized Marijuana Next Door

Crashes Declined After Legalized Marijuana

Crashes Declined After Legalized Marijuana

Crashes Declined After Legalized Marijuana.

Are alcohol and marijuana substitutes? For years, there has been extensive academic debate in the literature of medicine, public policy, and economics on the relationship between the two substances. The recent legalization of marijuana by several states provides new opportunities to study the relationship between marijuana and alcohol and the public health effects of legalization in neighboring states. This research examines the effects of Washington’s legalization of marijuana on alcohol consumption in neighboring Idaho.

Legalization in Washington spurred interest in marijuana dispensaries in Idaho

Using data from Google searches, Dr. Hansen identifies a significant increase in the number of web searches for dispensaries by individuals in Idaho after the legalization. This demonstrates an increased interest in marijuana products in Washington’s neighboring state.

Legalization in Washington reduced alcohol-related car crashes in Idaho

Using data on vehicle miles traveled and car crashes in Idaho, Dr. Hansen finds that the number of crashes involving alcohol decreased by 18 percent after the legalization of marijuana in Washington. This finding fades out for Idaho counties as the distance from Washington increases and provides evidence of consumers substituting marijuana for alcohol.

For Idaho counties that directly border Washington, the legalization of marijuana reduced car crashes involving alcohol by 21%.

For Idaho counties one hour away from Washington, the legalization of marijuana reduced car crashes involving alcohol by 18%.

For Idaho counties three hours away from Washington, the legalization of marijuana reduced car crashes involving alcohol by 10%.

For Idaho counties six hours away from Washington, the legalization of marijuana was not associated with a reduction in car crashes involving alcohol.

Dr. Hansen’s research suggests that marijuana and alcohol are substitutes. As marijuana becomes easier for consumers to access, individuals, drink less, as seen in fewer alcohol-related car crashes in Idaho. Policymakers should consider that there are trade-offs involved in setting drug and alcohol policies that influence public safety and the prevalence of dangerous driving.

Using recreational cannabis to treat insomnia: Evidence from over-the-counter sleep aid sales in Colorado

Recreational Cannabis To Treat Insomnia

Recreational Cannabis To Treat Insomnia

Recreational Cannabis To Treat Insomnia.

This study seeks to understand whether people substitute between recreational cannabis and conventional over-the-counter (OTC) sleep medications. UPC-level grocery store scanner data in a multivariable panel regression design were used to compare the change in the monthly market share of sleep aids with varying dispensary-based recreational cannabis access (existence, sales, and count) in Colorado counties between 12/2013 and 12/2014.

We measured annually-differenced market shares for sleep aids as a portion of the overall OTC medication market, thus accounting for store-level demand shifts in OTC medication markets and seasonality, and used the monthly changes in stores’ sleep aid market share to control for short-term trends. Relative to the overall OTC medication market, sleep aid market shares were growing prior to recreational cannabis availability. The trend reverses (a 236% decrease) with dispensary entry (−0.33 percentage points, 95% CI −0.43 to −0.24, p < 0.01) from a mean market share growth of 0.14 ± 0.97.

The magnitude of the market share decline increases as more dispensaries enter a county and with higher county-level cannabis sales. The negative associations are driven by diphenhydramine- and doxylamine-based sleep aids rather than herbal sleep aids and melatonin. These findings support survey evidence that many individuals use cannabis to treat insomnia, although sleep disturbances are not a specific qualifying condition under any U.S. state-level medical cannabis law.

Investigations designed to measure the relative effectiveness and side effect profiles of conventional OTC sleep aids and cannabis-based products are urgently needed to improve treatment of sleep disturbances while minimizing potentially serious negative side effects.

The impact of cannabis access laws on opioid prescribing

Impact Of Cannabis Access Laws

Impact Of Cannabis Access Laws

The Impact Of Cannabis Access Laws On Opioid Prescribing.

While recent research has shown that cannabis access laws can reduce the use of prescription opioids, the effect of these laws on opioid use is not well understood for all dimensions of use and for the general United States population.

Analyzing a dataset of over 1.5 billion individual opioid prescriptions between 2011 and 2018, which were aggregated to the individual provider-year level, we find that recreational and medical cannabis access laws reduce the number of morphine milligram equivalents prescribed each year by 11.8 and 4.2 percent, respectively.

These laws also reduce the total days’ supply of opioids prescribed, the total number of patients receiving opioids, and the probability a provider prescribes any opioids net of any offsetting effects. Additionally, we find consistent evidence that cannabis access laws have different effects across types of providers, physician specialties, and payers.

One policy option that has the potential to reduce opioid prescriptions and opioid-related deaths is the passage of cannabis access laws. These state laws facilitate access to cannabis by removing state legal barriers—though possession of cannabis remains illegal under federal law. Recreational cannabis laws (RCLs) allow adults over 21 to possess and consume a limited amount of cannabis. Medical cannabis laws (MCLs) allow patients with eligible conditions, which are listed in the law and often include some form of intractable pain, to obtain cannabis upon the recommendation or certification of a healthcare provider.

Medical Marijuana Patients With ADHD Use Fewer Prescription Drugs, Study Finds

Medical Marijuana Patients With ADHD Use Fewer Prescription Drugs

Medical Marijuana Patients With ADHD Use Fewer Prescription Drugs

Medical Marijuana Patients With ADHD Use Fewer Prescription Drugs.

When people with attention-deficit hyperactivity disorder (ADHD) consume more medical marijuana they tend to use fewer prescription drugs, including powerful, habit-forming psychostimulants, according to a new study.

Patients who used medical cannabis components—cannabinoids themselves as well as terpenes— also “reported a higher occurrence of stopping all ADHD medications,” the researchers, whose findings were published late last month in the Rambam Maimonides Medical Journal, wrote.

“In this study, we demonstrated that patients treated with [medical cannabis] stopped their ADHD medications, especially in the high MC dose and in the low ADHD symptoms frequency subgroups.”

This is a departure from previous research into ADHD and cannabis, the researchers noted. Prior studies had “considered cannabis as a single product in ADHD research, disregarding its inherent complexities and variability between cultivars and combinations of cultivars,” they wrote.

Most patients had previously obtained medical cannabis licenses (the terminology used in Israel) for chronic pain or cancer treatment rather than neurological disorders that coexist with ADHD.

Forty-seven patients in the study, which was funded by the Evelyn Gruss Lipper Charitable Foundation, reported either smoking or vaporizing their cannabis.

The cannabis consumers were divided into two subgroups: high dose and low dose. Cultivar combinations were complicated: There were 27 different combinations of varieties but, in addition to CBN, the cannabinoids most associated with reduced or eliminated ADHD medication use including THC, THCV and CBD.

Exactly how various combinations of cannabinoids and terpenes “modulate the circuitry involved in both ADHD and comorbid psychiatric conditions” is still unclear, the researchers said. But the study also suggests that finding the proper dose and the proper cultivar—and cultivar combination—may require significant experimentation on the part of the patient.

And patients in Israel enjoy more reliable access to more regulated cultivars than patients anywhere else in the world—suggesting that most American patients, with a basic understanding of THC and CBD and not a lot else, still have a ways to go.

“This indicates a more complex story than simply stratifying treatment based on THC and CBD alone,” the researchers wrote.

Workers’ Compensation Claims Decline In States With Medical Marijuana, Study Shows

Workers Compensation Claims Decline In States With Medical Marijuana

Workers Compensation Claims Decline In States With Medical Marijuana

Workers’ Compensation Claims Decline In States With Medical Marijuana, Study Shows.

Legalizing medical marijuana leads to fewer and cheaper workers’ compensation claims, according to a new study.

Researchers from the University of Cincinnati Ash Blue College and Temple University concluded that permitting medical cannabis “can allow workers to better manage symptoms associated with workplace injuries and illnesses and, in turn, reduce need for [workers’ compensation].”

The first-of-its-kind research, published last week in the academic journal Health Economics, shows a 6.7 percent decline in such claims in states after enacting medical marijuana laws.

“Our estimates show that, post [medical marijuana law], [workers’ compensation] claiming declines, both the propensity to claim and the level of income from WC.”

By analyzing survey data, which featured annual interviews from 150,000 U.S. residents aged 15 or older spanning from 1989 to 2012, the authors describe the effects as “quite modest in size,” finding a 0.1 percent drop in “propensity to claim” and a 0.8 percent reduction in the monetary amount of claims when medical marijuana was available. The authors concluded that the result “may not reflect economically significant changes” despite the results being “statistically significant.”

“These findings offer suggestive evidence that, post [medical marijuana law], workers use marijuana medically to treat symptoms associated with work-related injuries and illnesses and that marijuana is effective in reducing symptom burden associated with these ailments.”

Additionally, the study reports other positive effects that expanding access to medical cannabis can have in the workplace, including increasing “work capacity among older adults, reduce work absences, improve workplace safety, and reduce [workers’ compensation] claiming and the pain and suffering associated with workplace injuries.”

The researchers wrote the study adds to the small, but steady, growing body of research observing the impacts medical marijuana laws have on labor markets. Other research points to the economic power cannabis access can have on business. One recent study found that “a multitude of positive effects” on firms headquartered in states that have medical marijuana laws on the books.

Petition to Repeal Local Ban on Marijuana Retailer in City of Camas, WA

Repeal Ban on Marijuana Retailer in Camas Washington

Sign our petition

Repeal Ban on Marijuana Retailer in Camas Washington.

Ballot Title

Initiative to Repeal Local Ban on Marijuana Retailer in City of Camas, WA.

Ballot Summary

Initiative Measure No. 1 is an Initiative to Repeal Local Ban on Marijuana Retailer in City of Camas, WA. The initiative proposes repealing a local ban on marijuana retailers passed by the City of Camas (Ordinance No. 2712) after WA voters passed WA State Initiative 502 (I-502) legalizing marijuana in WA (passed 11/06/2012) where there was no specific or exclusive delegation of authority under I-502 to local governments to enact cannabis-related ordinances. The initiative would result in the legalizing of one marijuana retailer within the City of Camas, and would not repeal the part of the Ordinance that banned marijuana processors or producers.

Should this measure be enacted into law?

Yes / No

Background

After WA voters passed WA State Initiative 502 (I-502) on 11/06/2012, the City of Camas Council enacted Ordinance No. 2712 (10/20/2014) which banned marijuana processors, producers, and retailers within the city limits of Camas. Ordinance No. 2712 when passed had an expiration date. Approximately one year later, the City of Camas held a public hearing (10/26/2015) to consider allowing marijuana retail sales within the City of Camas. The Camas Planning Commission recommended allowing the sale of retail marijuana within city limits. Despite this, the Camas City Council ultimately voted to repeal that part of Ordinance No. 2712 that would have caused the ban to expire (Ordinance 15-024); the effect of this was to indefinitely ban marijuana processors, producers, and retailers within the City of Camas. Since then, Clark County has legalized marijuana processors, producers, and retailers (subject to land use regulations and zoning regulations).

Initiative

This initiative by petition, to be put to the voters of the City of Camas, WA, proposes the repeal of that part of Ordinance No. 2712 and 15-024 that bans marijuana retailers in Camas. Because the Washington State Liquor and Cannabis Board (“LCB”) controls issuance of retail marijuana licenses, the effect of the repeal would be to allow one marijuana retailer within the City of Camas. Repeal of the parts of Ordinance No. 2712 and 15-024 that bans marijuana retail would result in the will of the people, shown by the passage of I-502, to take effect in Camas, and would make Camas consistent with the bulk of Clark County, WA. There have been no specific grants of exclusive power to local jurisdictions to adopt cannabis-related regulations under I-502 or by the legislature.

The initiative would not request authorization for the presence of marijuana processors or marijuana producers in the City of Camas, WA. The initiative would not propose a change to the number of marijuana retail licenses allowed for the City of Camas (as of 1/22/2020 the number of retail licenses allowed for the City of Camas is one; LCB alone has the authority to determine the number of marijuana retail licenses available for each county and city).

The registered voters of the City of Camas, by submitting this initiative by petition, request that the Camas City Council repeal that part of Ordinance No. 2712 and 15-024 that bans marijuana retailers within the City of Camas, and requests that the Camas City Council make all necessary changes to the Camas Municipal Code to accomplish the will of the registered voters of the City of Camas.

The foregoing should be interpreted in view of applicable laws, regulations, and legal precedent.

We would like to thank you for your support in our initiative to Repeal Ban on Marijuana Retailer in Camas Washington.

Matched pilot study examining cannabis-based dronabinol for acute pain following traumatic injury

Cannabis Based Dronabinol For Acute Pain

Cannabis Based Dronabinol For Acute Pain

Matched pilot study examining cannabis-based dronabinol for acute pain following traumatic injury.

Abstract

Background, to determine whether adjunctive dronabinol, a licensed form of delta-9-tetrahydrocannabinol, reduces opioid consumption when used off-label for managing acute pain following traumatic injury.

Methods, this matched cohort study included patients who were admitted with a traumatic injury between 1 March 2017 and 30 October 2017. The hospital pharmacy database was used to identify patients who received dronabinol (cases), and they were matched 1:1 to patients who did not receive dronabinol (controls) using age, cause of injury and hospital length of stay. The primary outcome, change in opioid consumption, was calculated using morphine milligram equivalents (MME). The change in MME was calculated for cases as total MME over 48 hours with adjunctive dronabinol minus 48 hours prior to dronabinol, and for controls as total MME 48–96 hours from admission minus 0–48 hours from admission. Data are presented as mean and SE or median and IQR. Statistical analysis was performed using paired t-tests and McNemar’s tests.

Results, there were 66 patients included: 33 cases and 33 matched controls. Dronabinol was initiated 55 (28–107) hours from admission. Cases and controls were well matched. Cases had a significant reduction in opioid consumption with adjunctive dronabinol (−79 (20) MME, p<0.001), while opioid consumption was unchanged for controls (−9 (20) MME, p=0.63). This resulted in a ninefold greater reduction in opioid consumption for cases versus controls that was statistically different between pairs (p=0.02). Nineteen (58%) cases reported using marijuana; in this subset, opioid consumption was reduced with adjunctive dronabinol (−97 (24) MME, p<0.001) versus a non-significant increase in opioid consumption in matched controls (11 (29) MME, p=0.70); difference between groups, p=0.01.

Conclusions, the results of this study suggest adjunctive dronabinol reduces opioid consumption following traumatic injury. The opioid-sparing effect of dronabinol may be greater in patients who are marijuana users.

The efficacy of medical marijuana in the treatment of cancer related pain

Medical Marijuana Treatment of Cancer Pain

Medical Marijuana Treatment of Cancer Pain

The efficacy of medical marijuana in the treatment of cancer related pain.

Abstract

Background, The efficacy of medical marijuana in the treatment of cancer related pain, The opioid epidemic has spurred investigations for nonopioid options, yet limited research persists on medical marijuana’s (MMJ) efficacy in managing cancer-related symptoms.

Objective, We sought to characterize MMJ’s role on symptomatic relief and opioid consumption in the oncologic population.

Design, Retrospective chart review of MMJ-certified oncology patients was performed. Divided patients into MMJ use [MMJ(+)] versus no use [MMJ(−)], and Edmonton Symptom Assessment System (ESAS)-reported pain cohorts: “mild-moderate” versus “severe.”

Measurements, Medical records were reviewed for ESAS, to measure physical and emotional symptoms, and opiate consumption, converted into morphine milligram equivalents (MME). Minimal clinically important differences were determined. Wilcoxon signed-rank tests determined statistical significance between MMJ-certification and most recent palliative care visit.

Results, Identified 232 patients [95/232 MMJ(−); 137/232 MMJ(+)]. Pain, physical and total ESAS significantly improved for total MMJ(−) and MMJ(+); however, only MMJ(+) significantly improved emotional ESAS. MMJ(−) opioid consumption increased by 23% (97.5–120 mg/day MME, p = 0.004), while it remained constant (45–45 mg/day MME, p = 0.522) in MMJ(+). Physical and total ESAS improved in mild-moderate-MMJ(−) and MMJ(+). Pain and emotional symptoms worsened in MMJ(−); while MMJ(+)’s pain remained unchanged and emotional symptoms improved. MMJ(−) opioid consumption increased by 29% (90–126 mg/day MME, p = 0.012); while MMJ(+)’s decreased by 33% (45–30 mg/day MME, p = 0.935). Pain, physical, emotional, and total ESAS scores improved in severe-MMJ(−) and MMJ(+); opioid consumption reduced by 22% in MMJ(−) (135–106 mg/day MME, p = 0.124) and 33% in MMJ(+) (90–60 mg/day MME, p = 0.421).

Conclusions, MMJ(+) improved oncology patients’ ESAS scores despite opioid dose reductions and should be considered a viable adjuvant therapy for palliative management.