Welcome to Senior Cannabis Digest. This week we look at another state that has legalized recreational cannabis, cannabis and surgery, using CBD for arthritis pain and more. Enjoy.
Legalization Marches On
Another state—Connecticut—has joined the ranks of those where the recreational use of cannabis is legal. As of January 10, 2023 adults 21 and older can legally purchase up to a fourth of an ounce, or seven total grams, of marijuana (per transaction) for recreational consumption. Medical cannabis has been legal in the state since 2012.
According to Jenel Stelton-Holtmeier, writing for Green Market Report, as of January 9, 2023, nine retailers had been approved, though not all of them launched recreational sales on day one.
Stelton-Holtmeier noted that most forecasts estimate first-year sales will be around $200 million and according to the state’s Office of Fiscal Analysis, that could bring in more than $12 million in additional tax revenue for the state.
Anticipating robust sales once retailers are open for business, the state’s Department of Consumer Protection (DCP) encouraged registered medical marijuana patients to purchase their cannabis prior to Tuesday to avoid long lines and traffic that may develop around hybrid retailers once the adult-use market opens.
Said DCP Commissioner Michelle H. Seagull, “While we hope there will be no disruption or inconvenience to patients, it is always best to be prepared. Patients who can make purchases ahead of time, or have their medicine delivered, are advised to do so. Although many of the hybrid retailers will provide separate checkout counters or cash registers for Medical Marijuana Program patients, they may still experience increased traffic, as well as crowds in and around the hybrid retailers in the opening days of the market.”
Stelton-Holtmeier points out that medical cannabis users will still be able to purchase up to five ounces per month and will continue to have access to products with higher THC content than non-medical users.
If you are keeping score at home, that makes 21 states where recreational cannabis is legal—22 if you count the District of Columbia—and 37 states that have medical marijuana programs.
To learn more, we suggest reading the article by Jenel Stelton-Holtmeier in the January 10, 2023 issue of Green Market Report.com.
www.greenmarketreport.com/connecticut-opens-doors-to-adult-use-cannabis-sales/
Cannabis and Surgery
A leading medical association has released guidelines that suggest all patients should be screened for cannabis use prior to surgery.
In a statement, the American Society of Regional Anesthesia and Pain Medicine (ASRA Pain Medicine) cited concerns that regular cannabis consumers can experience more post-op pain and nausea.
According to TG Branfalt, who covered the story for Ganjapreneur, the guidelines—prepared by a group of 13 experts that included anesthesiologists, chronic pain physicians, and a patient advocate—recommend anesthesiologists screen all patients for cannabis consumption, including asking about the type of cannabis product consumed, the amount and how it was consumed or used, how recently it was consumed, and at what frequency.
ASRA Pain Medicine president, Samer Narouze, MD, PhD, believes anesthesiologists should be prepared to possibly change the anesthesia plan or delay the procedure in certain situations if the patient uses cannabis.
Said Narouze, “They (anesthesiologists) also need to counsel patients about the possible risks and effects of cannabis. For example, even though some people use cannabis therapeutically to help relieve pain, studies have shown regular users may have more pain and nausea after surgery, not less, and may need more medications, including opioids, to manage the discomfort. We hope the guidelines will serve as roadmap (sic) to help better care for patients who use cannabis and need surgery.”
What we find interesting is that it appears the Society is attempting to be informative and helpful and accepts cannabis use as a fact of life.
Also, as we have stated before, to use cannabis responsibly consumers have to be aware of the consequences, particularly when it comes to how cannabis can interact with certain pharmaceutical drugs.
To learn more, we suggest reading TG Branfalt’s article in the January 9, 2023 issue of Ganjapreneur.com.
Cannabis and Pain Management
It’s been estimated that as many as one in five US adults suffer from a chronic pain condition that lasts for six months or more and requires medical intervention.
If you are one of those individuals and have turned to using cannabis to manage the pain, a new study published in JAMA Open Network reveals that you are not alone.
That’s the word from Alejandra O’Connell-Domenech, reporting for The Hill. She says the study, conducted by researchers at Michigan Medicine, found that more than a quarter of U.S. adults suffering from chronic pain said they use cannabis to manage their discomfort.
O’Connell-Domenech also noted that of those who said they consumed cannabis to help alleviate pain, more than half reported that the drug led to lower use of prescription opioids, non-opioids and over-the-counter pain medications.
Also, according to the study, less than one percent of those queried said their cannabis use resulted in more opioid, non-opioid or over-the-the-counter pain medication use.
Said Mark Bicket, MD, PhD, Assistant Professor in the Department of Anesthesiology at the University of Michigan School of Medicine and co-director of the Michigan Opioid Prescribing Engagement Network (OPEN), “The fact that patients report substituting cannabis for pain medications so much underscores the need for research on the benefits and risk of using cannabis for chronic pain.”
Those who want to learn more can read the article by Alejandra O’Connell-Domenech in the January 6, 2023 issue of The Hill.com.
thehill.com/policy/healthcare/3802887-study-1-in-4-adults-with-chronic-pain-turning-to-cannabis/
CBD and Arthritis Pain
While we are on the topic of pain, it should be noted that a recent study suggests that, for many, CBD can help to manage arthritis pain. This is good news for the estimated 54 million Americans who currently suffer from debilitating arthritis.
The research team, led by Nicholas Frane of the Core Institute of the Banner University Medical Center in Phoenix, Arizona, evaluated the perceived effectiveness of CBD for the treatment of arthritis. A self-selected sample of 428 individuals was recruited through online methods including social media accounts and newsletters.
In general, study participants reported improvement in pain resulting from their use of CBD, with 83 percent of study subjects reporting a decrease in pain, 66 percent an improvement of physical function, and 66 percent improvements in sleep quality. The individuals with osteoarthritis reported the most significant reduction in pain.
In addition, the research team also found that the majority of participants reported a reduction in the use of other medications after CBD use, including anti-inflammatories, acetaminophen, and opioids. In some cases, participants said that they had stopped using other medications all together after using CBD.
Although CBD is available for purchase without consultation with a doctor, the authors did recommend that patients discuss using CBD with their doctor before making it part of their wellness routine. CBD, in some instances, can interact with other medications in a way that diminishes the effectiveness of those medications.
Given that the benefits of CBD recorded by the research group were self-reported, the investigators felt that future research should focus on exploring the benefits of CBD use in this patient population with clinical trials.
You can learn more by reading the study results, which appeared in the August 24, 2022 issue of the Journal of Cannabis Research.
www.ncbi.nlm.nih.gov/pmc/articles/PMC9400326/
Cannabis and Older Adults
When it comes to older adults using cannabis, the news is not all rainbows and unicorns. For some, particularly new consumers, there can be a downside.
According to a study that appeared in the Journal of the American Geriatric Society, cannabis-related emergency department visits in California rose sharply among seniors from 2013 to 2017, but leveled off after 2017 following implementation of the state’s legalization program.
The researchers did note that the legalization of recreational marijuana does not appear to correlate with higher number of emergency room visits among elderly adults.
According to Gianna Melillo, reporting for Yahoo!News, seniors can be at risk for some negative effects resulting from cannabis use, such as slow reaction time and impaired attention, which could lead to falls and other injuries. In some older individuals, cannabis use can also increase the risk of psychosis, delirium, and paranoia, interact with other prescription medications in a negative manner and worsen pulmonary or cardiovascular diseases.
Said lead study author Benjamin Han, a geriatrician at the UC San Diego School of Medicine, “Many patients assume they aren’t going to have adverse side effects from cannabis because they often don’t view it as seriously as they would a prescription drug. I do see a lot of older adults who are overly confident, saying they know how to handle it — yet as they have gotten older, their bodies are more sensitive, and the concentrations are very different from what they may have tried when they were younger.”
The research team contends that asking about cannabis use and providing education about its use should be a part of routine medical care for older adults.
The bottom line is that if you are an older adult who is new to using cannabis or you’ve decided to try it again after not using it for many years, the best approach is to go “slow and low.” Start by trying a cannabis product with a lower THC content or perhaps start with a CBD product and transition to something with THC after getting your “sea legs.”
It’s also wise to tell your doctor that you are using cannabis or plan to, particularly if you are using it to manage pain or as a sleep aid. Your doctor may want to adjust the dosage of some of your medications that can be less effective when they interact with cannabis.
You may also want to use the buddy system and confide in a veteran consumer you trust who can offer some insight on what to expect from the experience.
To learn more, we suggest reading the article by Gianna Melillo that appeared in the January 10, 2023 issue of Yahoo!News.com.
news.yahoo.com/cannabis-related-emergency-room-visits-204114797.html?fr=yhssrp_catchall
You can also read the study that appeared in the January 9, 2023 issue of the Journal of the American Geriatric Society.
agsjournals.onlinelibrary.wiley.com/doi/abs/10.1111/jgs.18180
Senior Cannabis Digest is compiled and edited by Joe Kohut and John Kohut. You can reach them at joe.kohut@gmail.com and at 347-528-8753.
