Closing the Loophole on Hemp-Derived Cannabis Products: A Public Health Priority (Journal of American Medical Association)

…due to limited regulation, psychotropic, hemp-derived cannabis products have marketing features that may appeal to youth. For example, such products are available as chocolates, gummies, cookies, and brownies and the packaging and advertisements often use bright and colorful designs. In addition, hemp-derived cannabis vape cartridges come in a wide range of sweet and fruity flavors, which increase appeal among youth and young adults. Because of their similarity to candy and food products, accidental exposure by children, adults, and animals is a concern. Between January 1, 2021, and February 28, 2022, national poison control centers received reports of 2362 cases of Δ⁸-THC exposures, of which 40% involved accidental exposure to Δ⁸-THC (82% among youth), 70% required evaluation at a health care facility, 8% were admitted to a critical care unit, and 1 pediatric death was reported.² Animal poison control centers have also seen an increase in reports of accidental pet exposure to Δ⁸-THC.²

The increasing marketing of psychotropic, hemp-derived cannabis products makes clear that a regulated hemp market that manufactures and sells products with more oversight and stricter safety standards is urgently needed. Many of the potential harms of hemp-derived cannabis products stem from a lack of regulation, including the potential for harmful contaminants, accidental exposure, cross-product sale with tobacco and alcohol, and youth appeal.

State and federal regulators should prioritize new hemp policies that ensure prohibition of sale to minors; set requirements for testing, packaging, and labeling; and place limits on potency and concentration of psychotropic products. The public health implications of psychotropic, hemp-derived cannabis products remain understudied. However, the lack of regulation over the marketing and synthesis of these products, combined with the widespread availability, warrants national surveillance and new hemp policies that close loopholes and prioritize public health.

For complete research Closing the Loophole on Hemp-Derived Cannabis Products: A Public Health Priority | Adolescent Medicine | JAMA

Cannabinoid Epigenotoxicity and Genotoxicity (A Response to Harlow)

Whilst the observations of Harlow and colleagues are welcomed, by failing to mention cannabinoid epi/genotoxicity they radically understate the case against multiple cannabinoid isomers.

It was shown long ago in vitro that many cannabinoids are genotoxic ¹ a finding which has since been confirmed in multiple human epidemiological studies ^2,3.  Moreover cannabinoid genotoxicity is widely agreed upon by producers, marketers and regulators and is referred to in FDA warnings for cannabinoid medicines.  Indeed it can be argued that it is the established fact of cannabinoid genotoxicity which makes an alternative parallel universe for cannabinoid regulation necessary given obviously serious concerns from FDA and comparable drug regulators internationally.

Cannabinoid genotoxicity has been classically expected to be expressed in terms of cancer, congenital anomaly and aging (CaCAAg) data ^2,3.  A growing body of evidence across all three domains provides strong support for the clinical implications of all three areas of potential public health relevance. 

Most concerning of all is an increasing stream of evidence from human, rodent and human embryonic stem cell data for epigenomic changes which implies multigenerational impacts to brain, heart and body wall development, cancer incidence and aging ^4,5.

Whist we are used to seeing studies across the CaCAAg spectrum performed in each of the three domains the most recent studies from leading groups indicate that genotoxic outcomes across the three CaCAAg domains can co-occur simultaneously.  Thus in a recent paper examining prenatally cannabis exposed (PCE) mouse heart development hearts were shown to be smaller at birth but then underwent a rapid growth spurt to become larger and more fibrotic and stiffer in the pre-adolescent period phenocopying aspects of cardiac aging, a syndrome which is known to predispose to later increased heart disease, the highest ranking killer disease internationally ⁵.  This finding potentially links teratogenesis, aging, adult disease and death.

Similarly in epigenomic studies both of human (and rodent) sperm and differentiated spermatogonial stem cells both autism and cancer-related genes (Prenatally Expressed Genes 3 and 10) were implicated following (modelled) PCE ⁴.  This finding links teratogenesis, neurotoxicity and cancerogenesis.

Other studies show that the pro-aging effects of cannabis on cellular age increase with age and age-squared across the lifespan.

These indications of the simultaneous effects of cannabis across the three CaCAAg domains suggest that cannabis epi/genotoxicity is a major public health player and implies that cannabinoids generally should urgently be regulated in line with all other known major epi/genotoxins.

Albert Stuart Reece, MD, PhD | Department of Psychiatry, University of Western Australia, Edith Cowan University

References

1. Nahas GG et al. Effects of cannabinoids on macromolecular synthesis and replication of cultured lymphocytes. Federation proceedings. Apr 1977;36(5):1748.
2. Reece A.S., Hulse G.K. Cannabis, Cannabidiol, Cannabinoids and Multigenerational Policy Engineering. 2022; In Press.
3. Reece A.S., Hulse G.K. Epidemiological Overview of Multidimensional Chromosomal and Genome Toxicity of Cannabis Exposure in Congenital Anomalies and Cancer Development Scientific Reports. 2021;11(1):13892.
4. Lee, K., Laviolette, S.R. & Hardy, D.B. Exposure to Δ9-tetrahydrocannabinol during rat pregnancy leads to impaired cardiac dysfunction in postnatal life. Pediatr Res 90, 532–539 (2021). https://doi.org/10.1038/s41390-021-01511-9;
5. Robinson GI... Maternal Delta-9-Tetrahydrocannabinol Exposure Induces Abnormalities of the Developing Heart in Mice. Cannabis Cannabinoid Res. Oct 17 2022.

The Latest research out of the United States and it's ever unravelling 'legalization experiment' continues to confirm what was predicted by any objective researcher

Cannabis + Legalization = Greater Recreational Use (a 20% increase no less!) This may not just translate into a 20% increase in harms - it may do exponentially more, when you consider the layering impact of physical, mental and genetic harms of this highly engineered substance!

Impacts of recreational cannabis legalization on cannabis use: a longitudinal discordant twin study

First published: 24 August 2022  https://doi.org/10.1111/add.16016

ABSTRACT: To estimate the effect of recreational legalization on cannabis use frequency and sources of variance across legal environments.

Design: Longitudinal discordant twin and gene–environment interaction models in twins recruited from birth records and assessed prospectively.

Setting: The United States, including states with different recreational cannabis policies before and after 2014, when recreational cannabis was first legalized.

Participants: Two longitudinal, prospectively assessed samples of American twins aged 24–47 (n = 1425 in legal states, n = 1996 in illegal states), including 111 monozygotic pairs discordant for residence.

Measurements: Current cannabis use frequency (measured continuously and ordinally) was the primary outcome, and the predictor was recreational status of cannabis (legal/illegal) in the participant’s state of residence at the time of assessment. Covariates include age, sex and cannabis use frequency prior to 2014.

Findings: Accounting for pre-2014 use, residents of legal states used cannabis more frequently than residents of illegal states (b = 0.21, P = 8.08 × 10⁻⁵). Comparing 111 pairs of monozygotic twins discordant for residence confirmed the effect (b = 0.18, P = 0.014). There was inconclusive evidence for genetic influences on cannabis use frequency that were specific to the legal environment [χ² = 2.9 × 10⁻⁹, degrees of freedom (d.f.) = 1, P > 0.999]. Existing genetic influences were moderated by the legal environment, as the genetic correlation between marijuana use before and after legalization was lower in states that legalized (r_genetic = 0.24) compared with states that did not (r_genetic = 0.78, P_difference = 0.016).

Conclusions: In the United States, there appears to be a ~ 20% average increase in cannabis use frequency attributable to recreational legalization, consistent across increasingly rigorous designs. In addition, the heritability of cannabis use frequency appears to be moderated by legalization. (source https://onlinelibrary.wiley.com/doi/10.1111/add.16016)

We here at the Dalgarno Institute are no longer bewildered by the ignoring by policy makers of this disturbing and mounting evidence. The revisted 'Reefer Madness' as part of its new iteration, embraces the 'smokescreen' of pro-pot propaganda, that any 'minor negative outcomes, are not only insigificant, but will be remedied in the future, we don't doubt!' 

The replication of Big Tobacco playbook is crystal clear, but now the populace is not being cleverly misinformed - no, now with all the history and data we have in play - they chose, it seems, to be willfully ignorant. That is the key factor to 1) an unfettered #addiction for #profit #cannabisindustry having its way in our culture; but more concerningly 2) an absolute #publichealth disaster for the immediate, but shockingly, future generations. 

Further reading

• Marijuana with high THC levels linked to addiction, psychiatric illness, study finds
• United Nations Report Scolds Countries for Cannabis Legalization
• Pediatric cannabis intoxication trends in the pre and post-legalization era
• Cannabis Legalization and Detection of Tetrahydrocannabinol in Injured Drivers
• Changes in cannabis use modes among Canadian youth across recreational cannabis legalization: Data from the COMPASS prospective cohort study
• Legalization of cannabis sparks curiosity in people who haven’t used it in years – or ever
• Changes in Healthcare Encounter Rates Possibly Related to Cannabis or Alcohol following Legalization of Recreational Marijuana in a Safety-Net Hospital: An Interrupted Time Series Analysis

by Research & Communication Team, Dalgarno Institute

Fake News is a label thrown about by anyone at everyone who presents a view different from the egocentric agenda a party is wanting to promote. In this now entrenched utterly subjective ‘journalistic arena’, confirmation bias is the only research tool used when crafting one's ‘unassailable’ position of ‘rightness’. Any contrary data and even facts are ignored, dismissed; or worse still, buried by emotive diatribes awash with sound-byte memes ranted and chanted by those who think they control the ‘microphone’ in the public square.

There are few places this has happened more (in a policy space at least) than with cannabis.

One of the single most significant ‘justifiers’ of legalizing this, now completely unnatural product, was it’s potential to generate an entire new stream of revenue. Not only will legalizing and commercializing this drug reduce law enforcement costs, it will increase an ever burgeoning cornucopia of excess revenue that will be used to educate and rehabilitate. Even beyond that, the state of Colarodo had boasted it would build new schools and increased recreational services for their communities.

However, NONE of this has happened. And we are heading for a decade of this experiement being in play. The first couple of years saw fits and starts and the ever-easy caveat of ‘well, we expected the revenue stream to be slow as we start this new experiment, but in no time at all, the fount of cannabis cash would gush forth its ‘green gold’!

Tax cuts are planned to shore up this failing 'legal weed' market! Not an increase, but decrease in revenue stream.

On top of that Pot Protagonists didn’t expect (or at least didn’t talk about) the new level of enforcement. No, not the increase policing around criminal outcomes due the increased use of this psychotropic toxin; not the increased policing of breaches and harms in road safety. Those costs alone have eclipised any 'savings' from policing use of the product. No, we are talking about the ‘enforcement’ that is licensing and regulation for this new addiction for profit industry. Remember under prohibition few of these costs and liabilities existed, and certainly not the ever increasing financial burden of bureaucracy!

The following two quick snap shots reveal yet more of what any sober-minded non drug-using person understood. The wilful ignorance and in many instances bltantant mocking of the many warnings tabled by the prevention sector are ‘producing’ and increasing the mess this ‘progress’ was supposed to fix.

The US now has Three Marijuana Markets and the one that was supposed to ‘help’ is the one in crisis! 

See Then There were Three – Marijuana Markets paper

Tax Foundation (US) – Marijuana Legalization and Taxes: Lessons for Other States from Colorado and Washington

• Colorado, Washington, and Oregon have all taken steps to reduce their marijuana tax rates, with Alaska considering it, after initial rates of 30 percent or more did not reduce the black market sufficiently. More recent ballot initiative proposals across the country propose rates between 10 and 25 percent.
• Tax rates on final retail sales have proven the most workable form of taxation. Other forms of taxation that have been proposed, such as taxing marijuana flowers at a certain dollar amount, taxing at the processor or producer level rather than the retail level, or taxing products by their level of THC, have faced practical implementation difficulties.
• Medical marijuana is usually more loosely regulated and less taxed than recreational marijuana. In Washington, moving non-medical sales to the retail market has proven difficult given the enormous differentials in tax rates and regulatory structure, and officials there wish the two systems had been tackled simultaneously.
• While the revenue can be in the tens or even hundreds of millions of dollars, it takes a lead time to develop. Revenues started out slowly in Colorado and Washington, as consumers became familiar with the new system and after state and local authorities spent time and money setting up new frameworks and regulatory infrastructure. ¹
•  Gov. Gavin Newsom on Friday proposed a temporary tax cut for the state’s struggling legal marijuana industry, but businesses said it falls far short of what’s needed to revive a foundering pot economy.
• Broad legal sales began in California in 2018, but the industry has been burdened by hefty taxes that can approach 50% in some areas, costly regulation and competition from a flourishing illegal marketplace, which industry analysts estimate is at least twice the size of the legal one.
• Meanwhile, a glut of cannabis from corporate-scale farms has sent wholesale prices into a tailspin, leaving some growers unable to make a profit. California was once envisioned as a national model for legal sales, but industry leaders warned Newsom – a Democrat – in December that the state’s licensed industry was verging on collapse and needed immediate tax relief and a swift expansion of retail outlets to survive.
• If the state isn’t taking in enough cannabis tax money to support a range of education, law enforcement and other programs — a total of $670 million each year — the excise tax could be stepped up to cover that gap as soon as January 2024, though not necessarily to the 19% level. Additionally the state is putting up a one-time $150 million stream of funds to help cover those costs. ²

References

1. https://taxfoundation.org/marijuana-taxes-lessons-colorado-washington/
2. https://sacramento.cbslocal.com/2022/05/13/newsom-california-pot-industry-tax-cut-proposal/

Research and Communication Team – Dalgarno Institute

“At the 2022 International Congress of the Royal College of Psychiatrists, Danish researcher Carsten Hjorthøj, (an associate professor at the University of Copenhagen and research leader at Copenhagen Research Center for Mental Health), presented the following data. The International Congress is the annual conference of the Royal College of Psychiatrists, which oversees the practice of psychiatry in Great Britain suggested that cannabis might be responsible for 25 percent of new cases of schizophrenia in young men.

This figure is far higher than previous estimates, which generally ranged from 5 to 10 percent. It would translate into tens of thousands of additional cases of new-onset schizophrenia annually in the United States and Europe.

To put a 25 percent figure in context, genetic factors are generally said to account for about half of the risk of schizophrenia. This estimate would imply that cannabis use now carries roughly half as much as risk overall as a genetic predisposition to the illness.

Schizophrenia is among the most serious mental illnesses, causing lifelong unemployment and disability in many patients and reducing their life expectancy by about 15 years on average. Untreated schizophrenia is also a high risk factor for extreme violence.” (Source: Cannabis may now cause one in four new cases of schizophrenia in men (substack.com))

Hospitalization for psychosis associated with cannabis use and cannabis legalization in the United States Submit to: Psychiatry Research

• Hospitalizations for psychosis/cannabis use more likely in areas where cannabis legalized.
• Recreational cannabis legalization associated with greater rate of hospitalization for psychosis associated with cannabis use.
• Findings warrant future longitudinal studies to evaluate psychosis in U.S. states

Abstract: The 2017 National Inpatient Sample database was utilized to investigate the association between cannabis legalization in the United States and hospitalizations for psychosis associated with cannabis use. We compared the odds of hospital discharges for psychosis associated with cannabis use in adults between the Pacific census division (where most states legalized recreational cannabis use) and other divisions using multivariable logistic regression, adjusting for confounders…There was a significant correlation between the cannabis legality score and proportion of hospital discharges for psychosis associated with cannabis use (r = 0.67, p<0.05). In conclusion, we observed a higher proportion of hospital discharges for psychosis associated with cannabis use in areas with more liberal cannabis legalization laws. (For complete research https://www.sciencedirect.com/science/article/abs/pii/S0165178122000014 )

When Cannabis Use Goes Wrong: Mental Health Side Effects of Cannabis Use That Present to Emergency Services – Canada

Cannabis use is a modifiable risk factor for the development and exacerbation of mental illness. The strongest evidence of risk is for the development of a psychotic disorder, associated with early and consistent use in youth and young adults. Cannabis-related mental health adverse events precipitating Emergency Department (ED) or Emergency Medical Services presentations can include anxiety, suicidal thoughts, psychotic or attenuated psychotic symptoms, and can account for 25–30% of cannabis-related ED visits. Up to 50% of patients with cannabis-related psychotic symptoms presenting to the ED requiring hospitalization will go on to develop schizophrenia.

With the legalization of cannabis in various jurisdiction and the subsequent emerging focus of research in this area, our understanding of who (e.g., age groups and risk factors) are presenting with cannabis-related adverse mental health events in an emergency situation is starting to become clearer. However, for years we have heard in popular culture that cannabis use is less harmful or no more harmful than alcohol use; however, this does not appear to be the case for everyone. It is evident that these ED presentations should be considered another aspect of potentially harmful outcomes that need to be included in knowledge mobilization. In the absence of a clear understanding of the risk factors for mental health adverse events with cannabis use it can be instructive to examine what characteristics are seen with new presentations of mental illness both in emergency departments (ED) and early intervention services for mental illness. In this narrative review, we will discuss what is currently known about cannabis-related mental illness presentations to the ED, discussing risk variables and outcomes both prior to and after legalization, including our experiences following cannabis legalization in Canada. We will also discuss what is known about cannabis-related ED adverse events based on gender or biological sex. We also touch on the differences in magnitude between the impact of alcohol and cannabis on emergency mental health services to fairly present the differences in service demand with the understanding that these two recreational substances may impact different populations of individuals at risk for adverse events.

The demands of cannabis users on emergency services both ED and EHS are one of the more unmet needs of research on how cannabis impacts healthcare systems and are of pressing importance as more jurisdictions move toward legalization. (For complete Research https://www.frontiersin.org/articles/10.3389/fpsyt.2021.640222/full )

Full Research Hospitalization_for_psychosis_associated_with_cannabis_use_and_cannabis_legalization_in_the_US.pdf

Dalgarno Institute Research & Communication Team 

Pro-cannabis promotors declared unwaveringly and repeatedly that,

• The illegal market would almost certainly disappear.
• Massive savings in law enforcement costs.
• Revenue streams so vast that it would not only pay for any unlikely (or very low) dependency issues, but the excess would also build parks and schools.
• Minimal impact to health services and no real increase in service demands. (Even though the repeated mantra from the pro-drug activists is that drug use is ‘not a criminal issue, it’s a health issue!’

Of course, anyone not caught in the smoke-bank of weed-mania (or perhaps better labelled, neo-reefer madness?) knew none of these promised outcomes would emerge. However, the very cashed up pro-pot lobby and their propaganda juggernaut overwhelmed the underprepared lawmakers and politicians – or perhaps weary and willing ones? Regardless,  the ‘experiment’ not only is failing, but has failed, and is continuing to increase harms to our communities the longer it runs.

Research is always slow to catch up, due to both time and money, but another emerging and important piece has just been published in the Journal of Studies on Alcohol and Drugs. This study only scratches the surface of the why of the subject matter, as anecdata continues to bring up the fact that not only is illegal product cheaper and easier to get, but still a revenue stream for anyone who wants to grow and sell their own.

Of course, ‘policing’ around this now three market arena has taken on a new look. New regulations come in and policing is required. And, of course, we now have an entire new bureaucracy that needs an every increasing funding.

Hmmm, who knew?

Again, only the community caring, best-practice pursuing and family building actors, who care more for people than for ‘getting high’ and making a fast buck on the back of an addiction for profit industry.

Reasons for Purchasing Cannabis from Illegal Sources in Legal Markets: Findings Among Cannabis Consumers in Canada and U.S. States, 2019–2020

Journal of Studies on Alcohol and Drugs, 83(3), 392–401 (2022). Published Online: May 23, 2022

Abstract

Objective: Nonmedical cannabis is legal in Canada and several U.S. states. Displacing the illegal market is a primary goal of legalization; however, there are little data on factors that predict consumers’ transition from the illegal to the legal market. The current study aimed to examine reasons for purchasing illegal cannabis and, thus, potential barriers to purchasing legal cannabis among consumers in Canada and U.S. states.

Method: Data are from the 2019 and 2020 International Cannabis Policy Study, a repeat cross-sectional survey conducted among 16- to 65-year-olds. Reasons for purchasing illegally in the past 12 months were asked of male and female cannabis consumers in Canada and U.S. legal states (n = 11,659). Changes over time in reasons for illegal purchasing were tested. Analyses among Canadians also examined associations between reasons for illegal purchasing and objective data on cannabis prices and retail density.

Results: In both years, the most commonly reported barriers to legal purchasing were price (Canada: 35%–36%; United States: 27%) and inconvenience (Canada: 17%–20%; U.S.: 16%–18%). In 2020 versus 2019, several factors were less commonly reported as barriers in Canada, including inconvenience (17% vs. 20%, p = .011) and location of legal sources (11% vs. 18%, p < .001). Certain barriers increased in the United States, including slow delivery (5% vs. 8%, p = .002) and requiring a credit card (4% vs. 6%, p = .008). In Canada, consumers in provinces with more expensive legal cannabis were more likely to report price as a barrier, and those in provinces with fewer legal retail stores were more likely to report inconvenience as a barrier (p < .001).

Conclusions: Higher prices and inconvenience of legal sources were common barriers to purchasing legal cannabis. Future research should examine how perceived barriers to legal purchasing change as legal markets mature.

For complete research https://www.jsad.com/doi/10.15288/jsad.2022.83.392

Further Reading:

Then There were Three – Marijuana Markets

'The legal stuff is garbage': why Canada's cannabis black market keeps thriving

How Legal Marijuana Is Helping the Black Market

 California Cannabis Industry Sending SOS To State Leaders as Black Market Continues to Thrive

Video: Kevin Sabet Addresses the United Nations INCB, May 2022 – Cannabis

By Communications Team