Tag: research

Australian Universities Receive $2.5 Million for Cannabis Research

The National Health and Medical Research Council gave Australian cannabis research a major shot in the arm this week, with the council awarding the research body $2.5 million for research.

The funds will be used to establish the Australian Centre for Cannabinoid Clinical and Research Excellence (ACRE), a national center to coordinate research into medicinal cannabis use. ACRE will focus on investigating quality and safety issues, including growing methods and safe formulation of plant material into medicines, and will eventually develop clinical trials.

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Researchers and clinicians from all over Australia will be involved in the national effort, which will be based at the University of Newcastle and University of Wollongong.

Federal funding for the new center was announced by Federal Health Minister Greg Hunt on Oct. 11.

In Australia, access to cannabinoids for medicinal purposes have been difficult due to restrictive licencing and import laws, along with a lack of ready-to-prescribe cannabis-based medicines for specific medical conditions.  ACRE hopes to change that.

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The center will be co-led by University of Newcastle professor Jenny Martin and professor Nadia Solowij of the University of Wollongong School of Psychology and the Illawarra Health and Medical Research Institute. Together, the two aim to make Australia’s eastern seaboard a hub for cannabis research.

“In many Australian states, people can now access cannabinoids for medicinal purposes under the supervision of a medical specialist, but it can be difficult to source reliable, consistent and suitable products that are known to be safe and effective for specific conditions,” Martin said.

“Recent legislation has improved the situation,” she added, “but appropriate research is needed to enable evidence to guide doctors on products and dosages that are safe and effective.”

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ACRE will undertake medical cannabinoid research, consolidate existing data into guidance, and link health outcomes from people currently accessing local and imported products to guide plant growing and product formulation into appropriate medicines, according to a press release.

The center’s investigators will link scientific research teams with specialist and national primary health care infrastructure to support information sharing, national monitoring, and linkage with government. They’ll also be training a new medical research workforce in the field and conducting basic research leading to clinical trials.

“At this critical juncture, where legislation around cannabis and cannabinoids is rapidly changing in Australia and worldwide, there is tremendous opportunity for Australia to establish world leadership in cautious and appropriately balanced management of the implementation of medicinal cannabinoids into specialist and primary health care settings,” Solowij said.

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The announcement comes as New South Wales’ conservative government has taken a hard stance on cannabis, moving to block laws decriminalizing possession of small amounts of cannabis for those suffering from serious medical conditions.

Despite the government’s stance, NSW is becoming one of the greenest states in Australia, attracting significant investment in medical cannabis industry and research. Already home to the $33.7 million Lambert Initiative at the University of Sydney, the state also recently attracted an enormous investment from Canadian firm PUF to build the largest legal cannabis facility in the southern hemisphere.

As the economic, technological, and medical benefits of becoming a hub for medical cannabis start to flow in, the NSW government may find it more difficult to maintain its hard-line stance cannabis.

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Could Cannabis Eventually Replace Anti-Anxiety Medications?

A recent study thought to be the first of its kind has found that regular cannabis use may make a person less prone to anxiety over time, even when sober.

The study, published in the medical journal Psychopharmacology, found that people who use cannabis daily or almost daily had a blunted stress reaction when exposed to a high-stress situation after a period of abstinence from marijuana. While non-cannabis users reported feeling anxious and experienced elevated levels of the stress hormone cortisol when stressed, chronic cannabis users reported lower levels of anxiety, and their cortisol levels remained the same under high stress as they they were under no stress.

“The potential effects of cannabis on stress do appear to extend beyond the period of intoxication.”

Dr. Carrie Cuttler, study co-author

The research involved 40 people who had used cannabis chronically over the previous year and 42 people who’d used cannabis no more than 10 times in their lives and not at all in the previous year. All participants abstained from using cannabis from 12 to 18 hours prior to the study.

“Based on our findings, the potential effects of cannabis on stress do appear to extend beyond the period of intoxication,” Dr. Carrie Cuttler, a researcher and clinical assistant professor at Washington State University and co-author of the study, told Leafly.

“But,” she cautions, “We’re not yet comfortable saying whether that muted stress response is a good thing or a bad thing.”

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We do know that too much cortisol is definitely a bad thing. It’s been associated with everything from anxiety and depression to digestive issues, heart disease, insomnia and memory problems. But too little cortisol can also be problematic, since the hormone helps us tap into stored energy and respond appropriately to stressful situations.

Cuttler says further research is needed to determine whether the lowered cortisol response exhibited by chronic cannabis users is ultimately therapeutic or detrimental when it comes to managing anxiety long-term. She adds that they did, however, make a promising finding regarding cannabis and dependency.

“We looked at the withdrawal symptoms of chronic users to see if they experienced heightened levels of and cannabis cravings when stressed,” she reveals, “and surprisingly, we didn’t find any evidence that they did.”

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Anxiety disorders are the most common mental illness in the US. An estimated 40 million American adults, or just over 18% of the population, are affected by anxiety disorders every year.

Benzodiazepines like Xanax and Klonopin are often prescribed for short-term relief from acute anxiety and panic attacks. While they’re incredibly effective in the short term, side effects can include fatigue, confusion, and disorientation, and tolerance and dependency can develop quickly — in 2015, over 8,000 Americans died by overdosing on benzodiazepines.

Selective serotonin reuptake inhibitors (SSRIs) like Prozac and Zoloft are often prescribed for long-term relief from anxiety disorders, but they come with their own long lists of potential negative side effects ranging from insomnia and drowsiness to headaches, low libido, and increased risk of suicidal thoughts.

Anxiety is also among the most commonly cited reasons for cannabis use, and research suggests that it has relatively few negative side effects, low potential for addiction and virtually no risk for an overdose. But because it remains classified as a schedule 1 drug at the federal level, little research has been done to investigate the long-term therapeutic potential of cannabis to treat anxiety—until Cuttler’s recent study.

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Next, Cuttler and her colleagues plan to repeat the study with a longer period of cannabis abstinence to see whether their findings still hold true. They also eventually hope to replicate the study with rats to confirm their findings.

“One of the limitations of this research is that we can’t ethically manipulate who uses cannabis daily and who does not,” Cuttler explains. “So while our research indicates that they have a blunted stress response, it could be that people who are already less prone to stress are also more prone to being chronic cannabis users. With rats, we can manipulate both stress and cannabis.”

Another recent study published in Pharmacological Research found that cannabidiol (CBD) may enhance the efficacy of the neurotransmitter GABA, which works to counteract and calm the chemicals triggered by cortisol in the brain’s anxiety response, like glucose. While high doses of THC actually have the potential to cause increased anxiety, CBD is non-intoxicating, so it doesn’t carry the same same risk.

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While all of this emerging research is promising, Cuttler emphasizes that when it comes to anxiety, neither marijuana nor pharmaceuticals should ever be the first course of treatment.

“As a psychologist, I believe Cognitive Behavioral Therapy (CBT) is the ideal treatment for anxiety,” she says. “In the short term, anti-anxiety meds and CBT have equivalent outcomes, but long-term, the effects of eight to 10 CBT sessions outlast those of medications without any of the negative side effects. I see cannabis the same way — it may help treat the symptoms of anxiety, but it won’t address the root cause.”

Study Finds Top 5 Causes of Cannabis-Related Emergency Visits

A new review published in the American Journal of Health-System Pharmacy determined the most common causes of cannabis-related emergency department (ED) visits, giving policy makers and industry leaders a compass for improvement. This analysis specifically looked at data from Colorado.

Cannabis legalization helps solves many problems: it eases the toll of the opioid epidemic; it creates jobs; it generates tax revenue; and it keeps cannabis out of the hands of minors. But for all the good cannabis does, we can’t lose sight of public health concerns that must be solved in order to successfully implant legalization across the U.S. and beyond.

This review provides us with five concerns to prioritize: accidental pediatric ingestion, acute intoxication, cannabinoid hyperemesis syndrome, synthetic cannabinoids, and injuries related to production of butane hash oil (BHO).

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Pediatric Ingestion

As previously stated, legalization has not led to higher rates of underage use, but this review found an increase in accidental pediatric intoxication. “Children are at particular risk of cannabis toxicity because cannabis-containing food products, known as edibles, look extremely similar to regular candy,” the authors wrote. “Also, we have found that the severity of symptoms from marijuana exposure has worsened due to the high THC concentration in edibles.”

States have taken several measures to reduce accidental consumption by children. Some policies mandate that:

  • Packaging is childproof
  • Packaging does not contain cartoons or other imagery attractive to children
  • Edibles do not come in candies or other forms enticing to children

Guidelines like these may help to reduce accidental ingestion by children, but full responsibility falls in the hands of adults and parents. It may seem like an excessive measure, but lock your products away until you intend to take them. Kids can be incredible hack artists.

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Acute Intoxication

Acute intoxication refers to those who simply consumed too much cannabis. “The number of marijuana-related ED visits has nearly doubled since the drug’s use was legalized in Colorado,” authors wrote, “and the rate is higher for non-Colorado residents who are visiting the state.”

They also mention that acute intoxication has historically gone unreported, which helps to account for the notable increase. Naturally, people are more inclined to seek help for intoxication by a legal drug than one that is illicit.

Furthermore, with the uptick in cannabis tourism, this statistic is unsurprising: a tourist inexperienced in cannabis may lack the experience to know how much is too much. The review outlines a particular instance in which one man consumed three edibles before a flight “when he realized he could not take the brownies on the plane.”

Many Colorado dispensaries go above and beyond to educate their customers on the effects of cannabis, especially edibles. Continuing to get that message through, especially to out-of-town visitors, should remain a top priority of businesses in legal markets.

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Cannabinoid Hyperemesis Syndrome

Cannabinoid Hyperemesis Syndrome (CHS) is a condition that is coming to light in the medical field – though its characterization has been somewhat controversial and divisive among professionals.

It’s primarily characterized by regular vomiting episodes, which is why it’s often assumed to be cyclical vomiting syndrome (CVS). The cause of CHS, researchers speculate, has to do with heavy, regular cannabis consumption in some individuals – a speculation that is supported by the fact that symptoms tend to resolve after cannabis cessation.

This review describes an instance of CHS recorded in Denver:

“A 32-year-old man came to the Denver Health Medical Center ED with a 12-hour history of intractable vomiting and epigastric pain. Throughout the interview the patient was retching uncontrollably. The patient reported several similar episodes over the past 2 months requiring medical care. Laboratory tests were conducted but unremarkable other than a THC-positive urine drug screen.”

While more cannabis specialized doctors are coming to acknowledge this condition’s existence, there’s overwhelming agreement that more research needs to be conducted on CHS.

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Synthetic Cannabinoids

Synthetic cannabinoids – also called SCs, Spice, K2, Scooby Snax, etc. – are not cannabis (and by that right shouldn’t even be on this list). They are chemical analogues intended to mimic the effects of natural cannabis, but because of their clandestine production and high affinity for receptor sites, synthetic cannabinoids can cause a laundry list of severe symptoms and, in worst cases, death. This report describes a 24-year-old man (who was of legal age to buy natural cannabis) who was admitted to the ED and suffered a seizure after consuming SCs purchased at a head shop.

The fact that synthetic cannabinoids had to be included this report is disappointing. With legal cannabis widely available to adults over the age of 21, there’s no reason for anyone to turn to an unregulated, dangerous alternative. That being said, it’s clear that there’s much work yet to be done on the education front.

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Home Extraction Injuries

Once again, when there’s a legal, safe alternative, it’s disheartening to read about the injuries sustained by individuals attempting to produce butane extracts themselves. Professional extractors use state-approved equipment and processes to greatly reduce the risks associated with BHO production, but some individuals will take it upon themselves to make their own, “blasting” BHO in their homes often with butane cans and glass extraction tubes. Improper airflow can lead to explosions, injuring the person performing the extraction as well as others in the vicinity.

“In July 2015, a law was passed that explicitly made manufacturing hash oil using flammable solvents illegal,” the authors wrote. “Anecdotally, the effect of this legislation has had minimal effect on the number of burn patients admitted to our institution.”

If you’re interested in extracting cannabis at home, choose a safe method that doesn’t use dangerous solvents. Rosin, for example, is a solventless extract that simply uses heat and pressure to extract cannabinoids. It can be produced safely and affordably with a pair of strong hands and a hair straightener.

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The report ends with a single conclusory sentence: “Marijuana legalization in Colorado has been associated with an increase in marijuana-related ED visits.” In a young industry that attracts inexperienced consumers with novelty and newly gained legality, this report is not shocking.

But it’s important not to conflate this conclusion with “Legalization in Colorado caused an increase in public health issues.” Legalization may correlate with these increasing statistics, but it did not necessarily cause them. Cannabis legalization empowers people to report their emergencies. It’s also impossible to say that legalization is to blame for increases in synthetic cannabinoid use. It’s true that legalization invites more citizens to partake, but it’s up to us to assume responsibility and evolve cannabis – through education and research – in a direction that betters the lives of consumers and non-consumers alike.

What’s the Most Popular Fast Food Destination for Hungry Stoners?

Taco Bell has “Fourth Meal.” Jack in the Box has “Munchie Mash-Ups.” White Castle has an entire stoner comedy franchise. Although they don’t outright admit it, fast food chains seem to tacitly understand that hungry high customers make up a notable percentage of their sales. But of the many options available, from burgers to tacos to fried chicken, which franchise is the preferred place to quell the munchies?

Green Market Report partnered with Consumer Research Around Cannabis to analyze multiple fast food marketplaces in areas with both a sizable population and legal cannabis. The result: while Taco Bell’s “Late Night Munchies” practically feel like a stoner stereotype, they’re no match for the iconic golden arches.

Most popular fast food restaurants among cannabis consumers (courtesy of Green Market Report)

Over 43% of adults polled who recently purchased legal cannabis visited a McDonald’s within four weeks of their dispensary purchase. Taco Bell and its ridiculously huge menu came in second, with just over 18% of cannabis customers making a “run for the border.”

Granted, McDonald’s has nearly 15,000 locations in the United States compared to Taco Bell’s 7,000, so “elevated” consumers may find it more convenient to find a nearby Mickey D’s than some Doritos Locos action. Subway, however, has almost 27,000 locations nationwide, yet peckish stoners prefer Burger King (which has about 7,500 locations) or Wendy’s (about 5,700 locations) over a footlong sub. (As they should; who craves Subway while high? Actually, their cookies are pretty legit.)

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McDonald’s proved most popular in each of the major markets Green Market Report analyzed: Denver, Las Vegas, Portland, Sacramento, and Washington, DC. Lest you think the franchise is surprised by this revelation, recall earlier this summer when one location put up this wink-wink billboard in Colorado:

(Sadly, the billboard was removed because it did “not meet [the company’s] standards.” You’re no fun, corporate headquarters.)

Check out Green Market Report’s full summary and see where franchises like Jack in the Box, Carl’s Jr, Chick-fil-A, and KFC stack up in certain cities. In the meantime, what’s your go-to fast food place when your bowl is cashed and your stomach’s rumbling?

Study Finds Most Cancer Patients Want MMJ Info, But Few Get It

How popular is medical cannabis among cancer patients in states that have legalized both medical and adult-use cannabis? Researchers at a National Cancer Institute-designated cancer center in Washington state set out to find out.

The survey, published this week in the medical journal Cancer, was conducted at the Seattle Cancer Care Alliance. Researchers found that 74% of eligible participants who completed the survey wanted information on medical marijuana from cancer providers.

Their chances of receiving that information, though, fell somewhere between slim and none.

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According to the same study, fewer than 15% of those patients received information about medical marijuana from their cancer physician or nurse.

Most sought out information from friends or family, newspaper articles, other cancer patients, and cannabis resource websites like Leafly. Of the 926 patients who completed the survey, only 73 (or 8%), said they did not want to receive any information on medical marijuana.

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6 Takeaways From Dr. Ethan Russo’s ‘Cannabis: An Unconventional Solution to the Opioid Crisis’

Ethan Russo is internationally renowned for his research on cannabis compounds and their roles in the body. As a neurologist and psychopharmacologist, Russo has established himself as a crucial champion of the integral roles plant-based medicine should play in modern therapeutics. After wrapping up a decade-plus run as Senior Medical Advisor for GW Pharmaceuticals in 2014, Russo co-founded PHYTECS, a biotechnology company devoted to researching and developing medical approaches to the human endocannabinoid system, for which Russo serves as Medical Director. (In his spare time, he hosts Reddit AMAs.)

(Courtesy of Ethan Russo)

Earlier this month, Dr. Russo joined forces with Americans for Safe Access (ASA) to address one of North America’s gravest problems: the opioid crisis, which now claims the lives of 60,000 Americans and 2,500 Canadians a year, with opioid overdoses killing 80 people a day. Russo’s ASA-sponsored webinar, ‘Cannabis: An Unconventional Solution to the Opioid Crisis?’ laid out the surprising history of the tandem use of cannabis and opioids, and highlighted contemporary research confirming the efficacy of mitigating the problems of opioids with cannabis. Here are six takeaways.

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1. Combining cannabis with opioids is nothing new.

As Leafly has reported, cannabis’ potential in fighting the opioid epidemic ranges from replacing or enhancing opioids in the treatment of chronic pain to serving as an exit drug for those fighting opiate addiction. As Dr. Russo explained, none of this is unprecedented.

“The bane of many opiates…is that the relief of the moment is purchased at the expense of tomorrow’s misery.”

Sir John Reynolds, physician to Queen Victoria

In the early 1800s, London physician Dr. John Clendinning chronicled his successful use of cannabis (then called “Indian hemp”) to treat migraines, noting that cannabis also helped lessen the intensity of a patient’s morphine withdrawal symptoms. During the US Civil War, cannabis was used as a tandem treatment with opium to treat dysentery. In 1868, Sir John Reynolds, physician to Queen Victoria, came out swinging for cannabis’ superiority as a painkiller: “The bane of many opiates…is that the relief of the moment is purchased at the expense of tomorrow’s misery,” wrote Reynolds, alluding to the withdrawal symptoms and gastrointestinal distress that can accompany opiate use. “In no one case to which I have administered Indian hemp, have I witnessed any such results.”

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2. A key appeal of early medical cannabis was its ability to kill pain without inducing nausea or sleep.

As 19th-century Philadelphia physician Hobart Hare wrote, “The advantages in [cannabis] use over opium consist chiefly in the absence of prostration and nausea after its ingestion, and in the partial lack of soporific power which it possesses compared to the opiate, for in certain cases sleep is not always desirable when pain is to be removed….I have found the efficient dose of a pure extract of hemp to be as powerful in relieving pain as the corresponding dose of the same preparation of opium.”

3. Using cannabis to treat opiate addiction is also nothing new.

In 1902, the American doctor Thomas D. Crothers hailed cannabis’ “temporary removal of the worst symptoms” of opioid addiction, and in 1944, the LaGuardia Commission tested extracts of cannabis on incarcerated opiate addicts and found they had much less severe withdrawal symptoms.

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4. Opioids kill 80 Americans a day. Cannabis has never killed anyone. The reason? The way cannabinoid receptors are deployed in the brain.

Opioid overdoses routinely cause death by overloading the opioid receptors in the brain’s cardiorespiratory centers, with the result being “respiratory depression” that causes users to simply stop breathing and die. As Dr. Russo noted, while the brain is rich in cannabinoid receptors, there are almost no cannabinoid receptors in the brain’s cardiorespiratory centers—which is why no one has ever gotten so high they stopped breathing.

5. It’s not just THC. CBD also has a place in fighting the opioid epidemic.

Studies of opiate-addicted rats have shown that administering CBD inhibits opiate-seeking behavior. Dr. Russo noted that high doses of CBD can effectively deactivate the drug-seeking part of brain, with no psychoactive “high” effect.

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6. While the US struggles to get up to speed on cannabis’ opioid-replacing potential, 29 other countries are racing forward.

Nabiximol is the legal-in-29-countries-but-not-the-US oral cannabinoid spray that effectively proves cannabis’ ability to replace opioids in pain-management plans. Dr. Russo noted the two-week cannabis trial among a European hospice population with opioid-resistant pain, where steady doses of Nabiximol brought a 30% reduction in patients’ pain. What’s more, researchers found significant success in sustaining the pain-killing properties of Nabiximol without escalating the dose—a veritable miracle in the world of pain management, where opioid dose escalation has previously been the name of the game.

To see video of Dr. Russo’s webinar in full, visit Americans for Safe Access.

New FBI Report Shows Drug Arrests Are Still Increasing

Despite the continuing expansion of legal cannabis in states around the country, the federal Drug War continues to rage on.

According to the FBI’s latest Uniform Crime Report released today, law enforcement agencies in the country made more than 1.57 million arrests for drug law violations in 2016, a 5.63% increase over previous years.

The data indicate that nationwide one drug arrest is made every 20 seconds, while there are three times more arrests for those types of crimes than for all violent crimes combined.

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Unlike previous years, the FBI has not yet made data public on arrests for specific drugs, like cannabis, or for specific offenses such as drug possession or drug sales.

For example, in 2015, 84% of all drug arrests were for simple low-level drug possession, with 43% of all drug arrests were for cannabis law violations… a total of 643,121 arrests. 574,641 of those arrests were for simple cannabis possession.

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“Criminalizing drug use has devastated families across the US, particularly in communities of color, and for no good reason,” said Maria McFarland Sánchez Moreno, executive director of the Drug Policy Alliance. “Far from helping people who are struggling with addiction, the threat of arrest often keeps them from accessing health services and increases the risk of overdose or other harms.

Discriminatory enforcement of drug laws continues to be an issue. African Americans comprise 13% of the US population and consume drugs at similar rates as other demographic groups. However, African Americans comprise 29% of those arrested for drug law violations, and 35% of those incarcerated in state prison for drug possession.

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According to the NAACP, the imprisonment rate of African Americans for drug charges is almost six times that of whites.

Just a few weeks ago, Leafly reported that cannabis consumption by US teenagers fell in 2016 to a new 20 year low.

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How Cannabis Can Combat the Opioid Epidemic: An Interview with Philippe Lucas

Philippe Lucas has deep roots in Canada’s cannabis culture. After co-founding the Vancouver Island Compassion Society medical dispensary in 1999, Lucas applied himself to cannabis science, working as a graduate researcher with the Center for Addictions Research of British Columbia and serving as founding board member of both the Multidisciplinary Association of Psychedelic Studies Canada and the Canadian Drug Policy Coalition. In 2013, he received the Queen Elizabeth II Diamond Jubilee Medal for his research on medical cannabis.

Philippe Lucas

(Full disclosure/fun fact: He’s also Vice President of Patient Advocacy at Tilray, the cannabis production company owned by Privateer Holdings, which also owns Leafly.)

Most recently, Lucas is the author of a new study: “Rationale for cannabis-based interventions in the opioid overdose crisis,” published last month in the Harm Reduction Journal. In the study, Lucas lays out a variety of roles that cannabis might play in combatting the opioid epidemic, which currently kills 38,000 people in the U.S. and Canada each year and ranks as the leading cause of death among Americans under 50.

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His study added an important perspective to the growing body of evidence supporting the notion of cannabis as healing tool in the opioid crisis. That idea is quickly moving into mainstream thought, as we’ve seen recently with the public pronouncements of Utah Sen. Orrin Hatch and, just this week, Dr. Oz.

Over the phone from his office in Nanaimo, Lucas let me interrogate him about specifics of the study.

Dave Schmader: What inspired you to undertake this study?

Philippe Lucas: Whether it’s medical use or recreational use, cannabis appears to be having an impact on the rates of opioid abuse. This study is a summation of the evidence, and I’ve taken that summation to suggest three opportunities for cannabis to intervene in the opioid crisis.

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And those are…?

First is introduction—if physicians start recommending the use of medical cannabis prior to introducing patients to opioids, those patients that find cannabis to be a successful treatment for their chronic pain might never have to walk down the very tricky path of opioid use that all too often leads to abuse or overuse or overdose.

“Patients that find cannabis to be a successful treatment for their chronic pain might never have to walk down the very tricky path of opioid use.”

The second opportunity is reduction, for those patients who are successfully using opioids in the treatment of their chronic pain or other conditions but are worried about increasing their use of opioids over time. The evidence suggests you can introduce cannabis as an adjunct treatment and reduce the cravings for opioids, therefore potentially steering people away and reducing the risk of opioid overdose and opioid dependence.

The third part is cessation. Once individuals have become dependent on opioids and they recognize that dependence and are seeking treatment for it through opioid replacement therapy like methadone and suboxone, you can potentially introduce cannabis as an adjunct treatment to increase the success rate of the methadone or suboxone treatment. The reason this point is so important is that when people with an opioid dependence fail out of treatment, that’s the period where they become the most vulnerable to potential overdose. Replacement therapy has failed, they’re at their most vulnerable, and they go back to the illicit drug market, potentially risking overdose.

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A key concept in the study is the “substitution effect.”

Yes. The substitution effect is an economic concept that suggests that the use of one substance never stands alone. In fact, the use of one substance can affect the use of another. When it comes to psychoactive substances, the use of a substance can be affected by changes in price, changes in legality or regulatory access, or changes in the product itself in terms of potency. And that can really affect the use of another drug.

“In medical cannabis states, there was a 25 percent reduction in opioid overdose deaths.”

A 2014 study showed that in medical cannabis states, there was a 25 percent reduction in opioid overdose deaths compared to neighboring states that didn’t have medical cannabis programs. There’s a growing body of research showing that simply making medical cannabis available in a number of US states and in Canada has reduced rates of not just opioid use, but also the use of alcohol, tobacco, and illicit substances,

often leading to total abstinence of those substances. So we’re looking at cannabis as a potential therapeutic agent, but also as a harm reduction agent when it comes to problematic substance use. This evidence suggests cannabis could be an exit drug to problematic substance use and addiction.

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In the study you write, “Cannabis augments the pain-relieving potential of opioids and can re-potentiate their effects.” Tell me about re-potentiation.

Research suggests that when you use cannabis alongside opioids in the treatment of chronic pain, you seem to get a synergistic effect—a greater effect than you might have if each was taken individually. People who have been using opioids for some time sometimes have to increase their dose, and cannabis presents another option for physicians, so instead of increasing the dose of opioids they can instead prescribe medical cannabis as an adjunct treatment in order to keep the patient at a lower dose of opioids, thereby reducing the risk of overdose.

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Another study quote: “[I]t would seem logical to seek to develop policies and associated education strategies to increase physician support for cannabis for therapeutic purposes in the treatment of chronic pain.” This does seem logical. What are the chances of it happening?

Right now we’re facing this tremendous public-health threat around the opioid overdose crisis. Opioid overdose is the most common cause of accidental death in Canada and the US right now. The over-prescription of opioids seems to be leading the way, in that four out of five people currently injecting opioids say that they started by using prescription opioids. There’s an oversaturation of the market and an over-availability on the black market.

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I think that if we can shift prescription patterns by physicians—so that instead of first prescribing opioids and then, if those opioids fail, moving on to medical cannabis—we can modernize those policies and instead focus on introducing medical cannabis first. That’s based on all the available evidence, which indicates that it’s far less harmful than prescription opioids in terms of dependence and risk of overdose.

Right now in Canada and in US states with medical marijuana, physicians are encouraged to prescribe opioids first and if those don’t work, cannabis is considered as a third- or fourth-line treatment option. We need to flip that around and make cannabis the second-line treatment option and move opioids to third or fourth options if indeed cannabinoids are not successful.

Cannabis Consumption Has Increased, but Not Because of Legalization

Adult cannabis consumption in the United States has been increasing since 2005, but a new study says that increased use does not appear to be due to the legalization of cannabis.

According to the report, published by William Kerr and the Public Health Institute, cannabis consumption among American men has increased by 14.7% since the turn of the millennium. Going back a little further and looking at the years from 1984 to 2015, Kerr found that cannabis consumption among women doubled from 5.5% to 10.6%.

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Since 2015, 12.9% of all adults report that they regularly consume marijuana. That’s up from 6.7% ten years earlier.

Since 2012, nine states have legalized recreational cannabis. Nationwide, 30 states have legalized medical marijuana. According to the new study, the ability to purchase cannabis legally in some states is not the reason for the increase among adults.

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“Results …did not show significant increases in use related to medicinal marijuana legislation,” Kerr said in a statement. “It appears that the passage of these policies reflects changing attitudes toward marijuana use, rather than the other way around.”

The study also found that people aged 50-59 have been consuming a whole lot more cannabis. Since 2005, men in that age group have seen a 2,220% increase in consumption, from .5% to 11.6%, while women have seen a 7,200% increase, from 0.1% to 7.3%.

The increase of cannabis consumption by people aged 50-59 shouldn’t be a total surprise, as the bulk of the Baby Boom generation–who are far more experienced and comfortable with cannabis than their elders–moved into that age cohort during the years studied.

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Why Does Cannabis Make Music Sound So Good?

You close your eyes and take a breath from your vaporizer as the music begins to play. You’ve listened to this album on numerous occasions, but this time the individual notes, rhythms, and melodies seem to resonate with a particular richness, intensity, and gravitas that together arouse your senses on a whole new level.

As Lindsey Buckingham of Fleetwood Mac once said, “If you’ve been working on something for a few hours and you smoke a joint, it’s like hearing it again for the first time.” The connection between music and cannabis has a rich history, dating back to the emergence of jazz in the early 20th century. Many pioneers in this improvisational art form were regular users of cannabis, including Louis Armstrong and Dizzy Gillespie.

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But why does music sound so good when you’re high?

While scientific research investigating this topic is rare, there are several hypotheses that attempt to explain the pleasurable duet that is cannabis and music.

How Cannabis Can Aid Music Production

Some theorists postulate that cannabis’ effects on an individual’s sense of timing might be responsible for its appeal amongst musicians. Previous studies have shown that cannabis speeds up our internal clocks, making external “real world” time appear to pass slower. For example, one study demonstrated that a 15 second time interval was “expanded” to an average of 16.7 seconds while under the influence of cannabis (while sober controls correctly estimated this interval).

One study demonstrated that a 15 second time interval was “expanded” to an average of 16.7 seconds while under the influence of cannabis.

“If you look into the literature on timing, it seems to be that the brain systems that are influenced by cannabinoids are producing a state of mind in which there seems to be a slower backward counting,” says Jorg Fachner, professor of music, health, and the brain at Anglia Ruskin University in the United Kingdom. “And that means your timing units, the time frames that you are overseeing, seem to be enlarged. So those who are improvising seem to have a bit more time to foresee the melodic developments in improvisation and to fine grain the rhythmic patterns.”

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Indeed, some anecdotal reports suggest that this subjective expansion of time benefits an improvisational art form like jazz because musicians are able to mentally squeeze more notes in a given number of musical bars. These claims, however, have yet to be substantiated by empirical studies.

Why Cannabis Makes Music Sound Better

How does this change in timing affect listeners consuming cannabis?

Focus and Attention

According to individual user reports, modifications in internal time can alter our attentional spotlight, facilitating changes in auditory perception.

“When your time perception changes, your focus of attention changes,” says Fachner. “So when you put on a stereo headset you might have an enhanced ability to select certain information and disregard other information, which could help distinguish the individual sounds a bit more intensively.”

According to Fachner, this enhanced attentional focus to see “the space between the notes” results in music that is perceived to be “much more lively, much more clean, and much more distinct.”

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These anecdotal changes in perception have also been shown to have possible neurological underpinnings.

In 2002, Fachner conducted a study investigating the link between cannabis usage, music perception, and changes in brainwave activity. Using an electroencephalogram (EEG), a device capable of detecting small changes in electrical activity throughout the brain, Fachner first measured the subject’s brainwave activity while sober (both with and without the presence of music).

In order to reduce biases in behavior that could arise from an artificial laboratory setting, the experiments were conducted in the comfort of a living room. The selected music consisted of three songs that included ensemble chamber music, folk-punk, and a Beatles cover. After a 30-minute rest period, participants then smoked cannabis containing 20mg of THC and listened to same music while their brainwave activity was recorded.

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The results indicated that music-listening cannabis users experienced changes in parietal, right temporal and left occipital cortices—brain areas that have previously been associated with attentional strategy, auditory processing, and spatial processing, respectively.

More specifically, the parietal (attentional strategy) cortex showed stronger activity in a particular frequency range called alpha. Interestingly, previous EEG studies have shown that students who are gifted in mathematics also display similar increases in alpha patterns in this brain region while solving problems, indicating that this activity pattern might be indicative of more efficient information processing than the average person.

“One of the interpretations that I had from this data is that when it comes to attention, subjects were focusing a bit more on the sound, and that this attention also required less mental energy,” says Fachner. “So it’s easier to listen, to focus, and to relax.”

In addition, increased activity in the right temporal brain region was also observed in stoned music-listening subjects. Because this area is primarily responsible for processing auditory information, these findings further demonstrate that a change in neural processing strategy could underlie altered music perception.

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Visual Processing

Fachner also observed cannabis-induced changes in the left occipital area, a region in the back of the brain that normally processes visual information.

When you listen to music, it always has a spatial dimension to it,” he says. “We need to know where the sound objects are coming from—that is evolutionarily important. And of course the visual centers process this.”

Changes in this visual processing might be connected with individual reports of synesthesia, or the blending of different sensory systems, while intoxicated. For instance, “there are people that say they have enhanced visual imagery to the music” after smoking, says Fachner.

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While high on cannabis, “you tend to shift your attention more rapidly if it is an interesting-sounding piece of music.”

Jorg Fachner, professor of music, health, and the brain at Anglia Ruskin University

Yet, it is important to note that this EEG study only tested four subjects, each of which might have different perceptual strategies for listening to music and varying tolerances to cannabis. Thus, the results lack sufficient statistical reliability to make wide-reaching claims about the intermingling of cannabis and music on a neurological level.

Other studies from the 1970s have also suggested that that stoned individuals have enhanced auditory intensity (i.e. loudness) perception, an increased tendency of “hearing” hallucinated sounds, as well as dose-related preferences for higher frequency sounds.

Memory

Fachner also proposes an alternative explanation for cannabis-induced changes in music perception that involves disruptions in memory processing. While high on cannabis, “you tend to shift your attention more rapidly if it is an interesting-sounding piece of music,” he says.

Because you are rapidly shifting attention and assimilating more information than you have the capacity to retain, you end up “emptying” your short-term memory more often. As a result of this “compressed” memory, the listener is thought to be more present, more in-the-moment with the music, and can cultivate a greater focus on each individual sound.

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Stated differently, “A subject becomes less able to integrate past, present and future, his awareness becomes more concentrated on present events; these instances, in turn, are experienced as prolonged or timeless when they appear isolated from the continual progression of time,” wrote Frederick Melges, a psychiatrist at Stanford University.

In summary, “we have a different acoustic space that we perceive, a different time scale for the auditory events, and a different attention strategy for focusing on what is happening in the music,” says Fachner. “And all that seems to be connected to what is happening at the onset of cannabis activity.”

Future Research and Application

The auditory enhancing effects of cannabis might also have potentially therapeutic applications. Fachner notes that based on his results and anecdotal evidence, cannabis could help those with hearing impairments fine tune their listening ability, more effectively differentiate the source of sounds, and hear higher frequency sounds more clearly.

“You have a different perception of the acoustic space, and the higher frequencies give you more information about where the sound source is in the room,” says Fachner.

Yet, scientists continue to face many barriers in their ability to test this and many of the other hypotheses put forth surrounding cannabis and auditory processing. Despite the decriminalization of cannabis in many states across the country, it is still difficult for scientific studies involving controlled substances to clear scientific review boards.

But despite these setbacks to the scientific understanding of cannabis’ transcendent effects on the musical experience, most users tend to agree that this partnership shows no signs of slowing down.