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A new study out last month from researchers affiliated with DePaul University and John Hopkins University helped illuminate some notable differences between men and women who are prescribed medical cannabis. 

The study, published last month in the Journal of Women’s Health, found that women “are more likely to report decreased use of prescription medications to treat symptoms, and report lower levels of support from physicians for [medical cannabis] use,” and that subsequent research on gender differences among those who use medical cannabis treatment “may benefit from more detailed data related to symptomatology, utilization, dosing, and outcomes associated with [medical cannabis], and interactions with the health care system to extend these findings.”

The researchers surveyed 361 patients who participate in Illinois’ medical cannabis program. “We summarized participants’ qualifying conditions, symptoms treated with MC, perceived physician support for MC use, use of MC and prescription medications, then analyzed differences by participant gender,” the researchers wrote, noting that they found that “that men report higher levels of support for [medical cannabis] use from both specialist and primary care physicians,” while women “were significantly more likely to increase use of cannabis after acquiring an [medical cannabis] card, and to discontinue prescription medications through [medical cannabis] use,” and that “that being a woman, using [medical cannabis] to treat multiple symptoms, and reporting higher levels of support for [medical cannabis] use from a primary care provider significantly increased the likelihood of discontinuing prescription medication through [medical cannabis] use.”

Gender and Cannabis Use

Researchers have long explored differences between gender when it comes to cannabis use. In 2016, a study from researchers at Columbia University found that “prevalence of past-year marijuana use increased for both men and women between 2002 and 2014.” In that same period, researchers found, “more men reported past-year use than women, but since 2007, the rate of increase was greater for men than for women, leading to a widening of the gender gap in marijuana use over time.” But despite such differences, the researchers said it was difficult to pinpoint a clear explanation.

“These changes parallel national trends in decreased perceived harmfulness of marijuana use, and legalization of both recreational and medical use in over half of U.S. states,” said Dr. Hannah Carliner, one of the authors of the Columbia University study.  “However, changes in attitudes and legality do not sufficiently explain why we observe a sharp increase in use in 2007, or why this increase was greater in men than in women.”

Researchers in Brazil have found that cannabis oil can be an effective treatment for patients with fibromyalgia, according to the results of a clinical trial completed recently. An abstract of the study, “Ingestion of THC-rich cannabis oil in people with fibromyalgia: A randomized, double-blind, placebo-controlled clinical trial,” was published last week in the journal Pain Medicine.

To conduct the study, researchers tested the effectiveness of a plant-derived cannabis oil on 17 women with fibromyalgia (FM), a chronic pain syndrome characterized by widespread musculoskeletal pain and fatigue. The patients were treated over a period of eight weeks with a cannabis oil rich in THC. The initial dose was one drop per day, with subsequent dosage increases according to symptoms. The mean dose for those in the cannabis group was 3.6 drops per day, equating to a total of 4.4 milligrams of THC and 0.08 milligrams of CBD per dose.

Patients were separated into two groups, one of which received the cannabis oil, while the members of the control group received a placebo. The Fibromyalgia Impact Questionnaire (FIQ) was administered at pre- and post intervention moments and in five visits over eight weeks. The researchers reported that “the impact of the intervention on quality of life in the cannabis group participants was evident, resulting in reports of well-being and more energy for activities of daily living. Pain attacks were also reduced.”

First Gold-Standard Study

“To our knowledge, this is the first randomized controlled trial to demonstrate the benefit of cannabis oil – a THC-rich whole plant extract – on symptoms and on quality of life of people with fibromyalgia,” the investigators wrote. “We conclude that phytocannabinoids can be a low-cost and well-tolerated therapy for symptom relief and quality of life improvement in these patients, and we suggest that this therapy could be included as an herbal medicine option for the treatment of this condition in the Brazilian public health system.”

Because of the impact that fibromyalgia can have on the health of patients and the need for effective and affordable medicines to treat them, the researchers recommended further research to study cannabis as a treatment for the condition.

A peer-reviewed study published in the research journal PLOS ONE demonstrates that MDMA-assisted psychotherapy is remarkably cost-effective when compared to currently available treatments for posttraumatic stress disorder (PTSD). It is estimated that a public healthcare payer or private insurer making MDMA-assisted psychotherapy available to 1,000 patients with PTSD would reduce general and mental health care costs by $103.2 million over 30 years. This treatment has not yet been approved by the FDA, does not work for everyone, and carries risks even in therapeutic settings.

Lead author Elliot Marseille, Dr.P.H., M.P.P., said, “MDMA-assisted psychotherapy is conducted by a licensed psychologist and trained clinician over the course of twelve sessions with three sessions lasting six or more hours. The cost of that time is not inconsiderable, but in just over three years, healthcare providers will break even on the costs of mental health and general medical care. These estimates are promising yet likely too conservative: the study did not measure the value of increased productivity or lower disability payments as patients recover from PTSD and is constrained by the limited availability of data on the long-term trajectory of PTSD. Further research will be needed to determine the full financial, personal, and societal benefits of MDMA-assisted psychotherapy for PTSD."

Berra Yazar-Klosinski, Ph.D., Deputy Director and Head of Research Development and Regulatory Affairs for MAPS Public Benefit Corporation and co-author, developed the treatment manuals governing MDMA-assisted psychotherapy. She notes, “A growing body of evidence suggests that MDMA-assisted psychotherapy is often more effective than currently available treatments for PTSD, a notoriously difficult-to-treat condition. Previous research has focused on safety and efficacy and indicates statistically significant improvements over currently available treatments with a reduction in symptoms for 82% of participants. This study should compel healthcare providers to include MDMA-assisted psychotherapy as a covered treatment for PTSD following FDA approval.”

Rick Doblin, Ph.D., Executive Director of MAPS and a study co-author, states, “The profound personal toll of PTSD can include a deterioration in physical health, relationships, and ability to participate in social activities along with the anxiety, insomnia, and suicidal ideation that mark the condition. By demonstrating a return of an average of 5.5 quality-adjusted life-years over 30 years, we have shown that MDMA-assisted psychotherapy has the potential to reduce more than the personal burden of PTSD, contributing to improved health outcomes and reduced healthcare burdens for payers and providers.”

The cost-effectiveness of MDMA-assisted psychotherapy from the U.S. healthcare payers’ perspective was constructed with a decision-analytic Markov model to portray the costs and health benefits of treating patients with chronic, severe, or extreme, treatment-resistant PTSD. Efficacy was based on the pooled results of six randomized controlled trials with the 105 subjects who participated in Phase 2 trials and a four-year follow-up of 19 of those subjects. Other inputs were based on published literature and on assumptions when data were unavailable. Results are modeled over a 30-year analytic horizon and conducted extensive sensitivity analyses. The model calculates expected medical costs, mortality, quality-adjusted life-years, and incremental cost-effectiveness ratio.

The outcome of the cannabis referendum has raised concerns about the availability of medicinal options.

Just over 53 percent of people voted no to legalisation, while 46 percent voted yes.

Medicinal cannabis company Cannasouth's chief executive Mark Lucas told Francesca Rudkin a yes vote would have helped more people gain better and cheaper access to medical cannabis.

"There's no denying that some patients will access medicinal cannabis currently from the black market,  and if there was a white market, if you like, they would have been accessing very basic formulations of cannabis from that market."

The official result of the referendum, including special votes, will be announced on Friday. 

While marijuana is typically advised against before surgery, many doctors and surgeons are speaking out about its effects for after-care. 

Breast implants are still a booming business. As one of the most popular surgeries in the U.S., over 300,000 women go under the knife annually. According to the American Society of Plastic Surgeons, Americans spent more than $16.5 billion on cosmetic surgery in 2018. 

With many instances of news covering breast implant illness, where individuals who have received breast implants describe symptoms like chest pain, fatigue, hair loss, and chronic pain, more patients are asking about the risks associated with getting implants or having them removed. And, with medical marijuana and CBD available in more states each year, considerations should be made when combining marijuana and the addition of implants or their removal.

Marijuana and Implant Surgery

Whether patients are undergoing surgery for a reduction or receiving implants, many doctors spoke to us about the importance of a candid conversation about marijuana use. Dr. Nathan Castillo, who practices out of Atlanta, GA,  shared that patients should, “refrain from smoking marijuana for at least 4-6 weeks before surgery.” Studies have found a link between marijuana use before surgery and a risk of vasodilation during surgery, the latter of which occurs when blood pressure falls due to blood vessels relaxing. 

Additionally, a 2018 study published in the journal Heliyon, found that consuming marijuana before surgery could complicate outcomes during and after the procedure. The study found that marijuana’s effects were most prevalent one hour after the start of the surgery and lasted anywhere from 2-4 hours. With an increase in both airway obstruction and anesthetic doses administered, the study found patients who consumed marijuana before surgery carried more risks than patients who abstained. However, while marijuana is typically advised against before surgery, many doctors and surgeons are speaking out about its effects for after-care. 

Seniors are turning to cannabis to treat common symptoms of aging, with nearly 80% of those who reported using cannabis saying they did so for medicinal reasons, according to a study from researchers at the University of California San Diego. Results of the study, “Cannabis: An emerging treatment for common symptoms in older adults,” were published this month in the Journal of the American Geriatric Society.

To conduct the research, investigators surveyed 568 seniors at a geriatric clinic. All respondents were at least 65 years old, and 73% of those surveyed were older than 75. The researchers discovered that 15% of seniors had used cannabis in the last three years, among whom half reported using cannabis regularly. Cannabis was used primarily for medical reasons by 78% of those who reported its use.

“Pain, insomnia, and anxiety were the most common reasons for cannabis use and, for the most part, patients reported that cannabis was helping to address these issues, especially with insomnia and pain,” Christopher Kaufmann, Ph.D., assistant professor in the Division of Geriatrics and Gerontology in the Department of Medicine at UCSD and one of the study’s authors, said in a press release.

The researchers also found that 61% of respondents who used cannabis had begun doing so at the age of 60 or older, according to Kevin Yang, a third-year medical student at UCSD and another author of the study.

“Surprisingly, we found that nearly three-fifths of cannabis users reported using cannabis for the first time as older adults,” Yang said. “These individuals were a unique group compared to those who used cannabis in the past.”

In this article Dean Billington, Chief Operating Officer at Brains Bioceutical, discusses how medical cannabis can help the UK’s chronic pain problem.

Chronic pain is one of the most troubling and expensive issues for the NHS and patients. In fact, a recent study by The British Pain Society suggests that chronic pain affects more than 40% of the UK population, meaning that more than 26 million people in the UK are living with pain that has lasted three months or longer. The BMJ has suggested that this could rise to as high as 60% among those over the age of 75.

For many patients battling this silent epidemic, it is a hopeless exercise of jumping from one prescription drug to another and at a huge cost. For example, the associated treatment for these patients is estimated to account for 4.6m GP appointments each year at a staggering cost of £69m.

Unfortunately, treatment pathways often direct patients to opioid painkillers. A recent review published by Public Health England revealed that the UK now has the fastest-growing rate of opioid use across the world, with prescriptions rising by 22% over the past decade to 40 million prescriptions a year. This is despite the fact that NHS guidelines recommend that opioids should not be taken for more than a few weeks at a time as patients can become addicted to them. In addition to this, health experts have warned that opioid painkillers are not effective for 90% of people with chronic pain.

With the NHS now looking to move away from prescribing these addictive opioids or non-steroidal anti-inflammatory drugs (NSAIDs) –  following updated draft guidance issued by NICE last month –   there is an undeniable need for alternative medicines that are effective and affordable.

It’s a great time for cannabis in the U.S., with a wide variety of quality products reaching different areas of the country. While marijuana is not legal on a federal level, U.S. states seem to be more open to the possibility of cannabis as a valid option for people struggling with different illnesses or who want to consume it recreationally.

There are thousands of medicinal cannabis products available for purchase online, but the Internet can be a hard (and questionable) place to buy stuff unless well-informed aobut what you’re looking for. Here are five of the most common products that consumers may want to learn more about.

Medical cannabis oil

This product is mostly administered through an oral syringe and made up of a dark coloured liquid containing a mixture of components within the cannabis plant. Offering cannabinoids and terpenoids, many cannabis oils are high in antioxidant features and have painkilling and anti-inflammatory properties. Cannabis oils have been reported to be helpful in treating a variety of ailments and can even be prepared at home.

CBD hemp oils are easier to acquire in most U.S. states since a medical card is not needed to purchase. / Photo: iStock / Getty Images PlusPhoto: iStock / Getty Images Plus

CBD hemp oil

This product is made from hemp plants with low THC and high CBD content. Since these hemp products contain almost no THC, they’re non-psychoactive, which means that they won’t get a user high. CBD hemp oils are easier to acquire in most U.S. states since a medical card is not needed to purchase.

Oct. 17 marked the first day of medical cannabis sales in Missouri, and the state’s two operational cannabis retailers, N’Bliss and Fresh Green, have had quite the journey to serving patients in the nascent market.

N’Bliss, a subsidiary of Nirvana Investments, opened its first two stores in Manchester and Ellisville on Oct. 17, while Fresh Green opened for business in Lee’s Summit on Oct. 19.

“It was exciting—the energy is real,” N’Bliss Managing Partner and CEO Bradford Goette tells Cannabis Business Times and Cannabis Dispensary of opening weekend.

Goette says the dispensary could have opened earlier, but the N’Bliss team took their time to ensure a great experience for its first customers.

“Your first sale and transaction should be memorable, but it should be right,” he says. “You should be doing this for the patient, and we want that to go smooth. We know with all the software systems, moving parts [and] compliance, there’s a lot of room for error. We wanted to test things and make sure things were working prior to opening.”

MediPharm Labs Inc has initiated a clinical trial to research and evaluate the effectiveness of the company’s cannabis-derived medicines for the treatment of end-stage renal disease or Chronic Kidney Disease (CKD).

Chronic kidney disease involves kidney damage over a long period of time that impacts on the organ’s ability to filter blood, meaning toxic wastes build up in the body. The progressive condition can result in major complications including eventual kidney failure and death.

It’s prevalence is quite shocking – according to Kidney.org, 37 million American adults have CKD and heart disease is the major cause of death for all people with the condition. The main causes of chronic kidney disease are diabetes and high blood pressure. Combined, these are responsible for up to two-thirds of  cases.

MediPharm Labs has partnered with Canadian firm OTT Healthcare Inc. for the trial, which will initially investigate dosing and safety profile of cannabinoid formulations, as well as assess pain and Quality of Life scores of patients receiving the medicines – the details of which weren’t revealed in the announcement.

Data gathered from this investigation will then support randomized double-blind clinical trials to establish the safety and efficacy of these products.

More than 40% of patients with multiple sclerosis have used cannabis or cannabinoid products in the last year, according to a study by researchers at the University of Michigan. The study, “Cannabinoid use among Americans with MS: Current trends and gaps in knowledge,” was published recently in Multiple Sclerosis Journal – Experimental, Translational and Clinical.

To conduct the research, investigators with the University of Michigan collected data from a nationwide sampling of more than 1,000 patients with multiple sclerosis. The study revealed that 42% of respondents reported using cannabis or cannabinoid-based therapies such as cannabidiol (CBD) in the prior year, a rate of use that is nearly twice that of the national average, according to the National Organization for the Reform of Marijuana Laws (NORML).

“These national survey data highlight the rising prevalence of cannabinoid use in Americans with MS, and, among users, an abiding perception of benefit for multiple chronic symptoms,” the researchers wrote. 

Among the survey respondents who used cannabis or cannabinoid products, 90% said that their cannabis use was medicinal. The researchers noted that many patients with MS experience chronic symptoms that have an insufficient number of quality treatment options. More than half of all patients experience chronic pain, which can also affect sleep. At least 60% experience sleep disturbances, which can lead to fatigue and other chronic symptoms.

The lack of effective treatment options leads many patients with MS to seek out alternative therapies, including cannabis and cannabinoid products such as CBD. However, little information on the proper use and dosage of cannabis needed to effectively treat MS is available, leading the study’s authors to call for more research on the subject.

Missouri's first licensed marijuana dispensaries opened this weekend in the St. Louis area with long lines.

The two dispensaries run by N'Bliss opened Saturday in Ellisville and Manchester. Another dispensary is expected to open Monday in the Kansas City area nearly two years after Missouri voters approved a constitutional amendment to allow the sale of medical marijuana.

To buy the drug, people need approval from a doctor and a state medical marijuana card. Prices are expected to be high initially because the supply is limited in the state at this stage. N'Bliss was charging $125 for an eighth of an ounce of marijuana when it opened Saturday.

Kim Haller said she stood in line Saturday because she has long been frustrated with the high cost of medications and injections she uses to treat her multiple sclerosis. Recently, Haller said she had been buying marijuana from a licensed caregiver.

"It helps with my spasticity, which means my muscles don't move like I like them to, and sleep," Haller, 54, of St. Peters, said of the marijuana treatment.

A 10-year-old boy with Tourette Syndrome says CBD has helped him and he’s wondering if it could do the same for others.

Bryson Jones recently released a video, marking Mental Health Day, in which he details his experience with Tourette Syndrome and how CBD has worked for him.

The affable and active Oklahoman, a patient with the Oklahoma Medical Marijuana Authority (OMMA) who has his licence, relays that he uses CBD before going to school and before karate and boxing classes.

The 4:1 medication he takes “does not make you high,” he emphasizes in the video. “What it actually does, it makes you not nervous, it makes you calm and it doesn’t make you tic.”

Making clear that he’s 10 years old and not a doctor, he says medical marijuana may not be for everyone.

Some know it as cannabis, while others know it as marijuana or weed, especially because it has been trendy in pop-culture music and because it has been immortalized in western films.

Whatever you call it, cannabis is the world’s most popular drug and is the highest value therapeutic crop known at the moment, despite being illegal in many parts of the world.

It wasn’t until Monday, October 12, that a cabinet meeting approved guidelines that allow the growing of cannabis in Rwanda, which drew mixed opinions from people.

Cannabis is a multi-billion dollar industry and it’s believed to be the world’s most valuable cash crop from the absolute value perspective.

One study, which analysed data from the UN Food and Agriculture Organisation as well as UN World Drug reports, estimated cannabis to be valued at $47.7 million per square kilometer.

France has announced a medical cannabis trial that is expected to begin in Mar. 2021, will run for two years and will see 3,000 patients receive pharmaceutical-grade cannabis products for free, Le Monde reports.

France’s Ministry of Health and Solidarity will oversee the trial, which was approved by the National Assembly in 2019. The program will focus on the efficacy of cannabis therapy to treat conditions such as epilepsy, neuropathic pain, multiple sclerosis and the side effects of chemotherapy, and will be limited to smokeless products like oils, tinctures and capsules.

Cannabis is illegal in France for recreational use and has been banned for medical use since 1953. In September, the country implemented a fixed fine of 200 euros (about $300) for cannabis consumption, rather than taking individuals into custody.

Though the plant is widely consumed, not everyone is in favour of cannabis reform.

Last month, in an interview with Le Parisien, Gérald Darmanin, France’s Minister of the Interior, called cannabis legalization “shit.”

According to a Centers for Disease Control and Prevention survey of more than 5,400 people, almost 11% of United States adults reported seriously contemplating suicide in June.

The most stunning moments in my years of involvement in the marijuana legalization movement were when someone told me, “I haven’t tried to kill myself since I started using marijuana.” 

I am not a doctor, a psychologist, or even a counselor, so I was really unprepared for that. I have had cancer patients tell me that if they had not had a few tokes of marijuana to help them with the extreme nausea from chemotherapy, they would have chosen to die from the cancer rather than endure the hellish side effects from the chemo. The pharmaceutical antiemetics had stopped working.

Even in 1991, “More than 44% of the respondents report recommending the (illegal) use of marijuana for the control of emesis to at least one cancer chemotherapy patient. Almost one half (48%) would prescribe marijuana to some of their patients if it were legal. As a group, respondents considered smoked marijuana to be somewhat more effective than the legally available oral synthetic dronabinol ([THC] Marinol;” 

And I have known patients who did kill themselves rather than go to prison and be tortured to death by a regime that would watch them die in pain rather than allow them to use that plant. 

The two of you, plus others in your support network, are a team working to achieve one goal: your well-being.

The decades-long stigmatization of cannabis can make initiating conversations about its use awkward and difficult, particularly with your doctor. Add to that the knowledge — or even a hunch — your doctor may be skeptical about the benefits of cannabis, raising the topic can be downright intimidating. But it doesn’t have to be.

Your medical doctor is among the most educated and trained professionals you invite into your circle of trust. In addition to four years of undergraduate school, another four years in medical school and three to seven years of residency, being a doctor requires constant continuing education and recertification.

But throughout their education and training, your doctor was taught that natural remedies have limitations, and when the body can’t function on its own, it needs therapies beyond natural remedies to make you better. What’s more, the federal prohibition against cannabis — which has until recently included all forms of CBD — U.S. physicians have not been exposed to a lot of credible research and clinical trials.

In other words, if your doctor is a cannabis skeptic, it’s not entirely their fault. Years of training combined with the law of the land shaped those opinions. But it’s also important to remember that your physician is invested in your health. Long before he or she embarked on the long journey to become a doctor, they likely just wanted to help people. After they put in the long hours at school and hands-on training in residency, they swore an oath to help you. They want a good health outcome for you as much as you do. The two of you, plus others in your support network, are a team working to achieve one goal: your well-being.

Arkansas medical marijuana dispensaries are experiencing a shortage of the flower form of the product and a spokesman for Alcoholic Beverage Control said the agency is looking into the supply issue.

The number of medical marijuana patients in the state has surged past 80,000. The state has only four cultivators in operation, and dispensaries report having trouble getting some strains entirely. The supply of other products, such as tinctures, vape cartridges and edibles, is sufficient, dispensary owners say. 

“As of now, what we know is there have been shortages across the state of specific strains,” spokesman Scott Hardin said. “We have not seen any dispensaries that are totally out of product altogether. Typically, [the strain issues] have been resolved in a brief period of time.”

Fort Cannabis Co. in Fort Smith has run out of flower on a couple of occasions but the supply has generally been replenished within a day, according to Fort Cannabis General Manager Jordan Mooney. 

“It’s never too long, like days at a time, or anything like that,” Mooney said. Sales of flower, however, account for the majority of its business, Mooney said. 

A new study has found cannabis use is becoming more common among older adults in the USA – and it’s being used mostly for medical purposes.

University of California San Diego School of Medicine researchers surveyed 568 patients 65 years and older and found 15% had used cannabis in the past three years. Half of those reported using it regularly and 61 per cent started using cannabis after the age of 60.

“New users were more likely to use cannabis for medical reasons than for recreation,” said Kevin Yang, one of the UC San Diego researchers involved. Mr. Yang said this group were more likely to use cannabis topically rather than by smoking it or using edibles.

“Also, they were more likely to inform their doctor about their cannabis use, which reflects that cannabis use is no longer as stigmatized as it was previously.”

46% of the group using cannabis daily or weekly were using cannabidiol-only products.