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Marijuana withdrawal is real, study shows
A new study reveals that nearly half (47 percent) of people who use marijuana regularly and/or heavily experience cannabis withdrawal syndrome when they try to quit. It is widely believed that the drug is not addictive, but this meta-analysis involving 23,500 participants sets that myth to rest.
Marijuana withdrawal symptoms include nervousness, anxiety, sleeplessness, depression, restlessness, and irritability. They can also include physical symptoms like stomach pain, shakiness, tremors, sweating, fever, chills, and headaches.
Experts have known for some time that marijuana is addictive, but it was confirmed in 2013 when the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) was published. The manual recognized cannabis withdrawal syndrome as a bona fide disorder.
Read US News article here.
Read JAMA Network full text of the meta-analysis here.

Marijuana linked to
blood clots in trauma patients
A study presented at the Eastern Association for the Surgery of Trauma Annual Scientific Assembly finds that THC exposure increases the risk for deep vein thrombosis and pulmonary embolism in patients who were marijuana users before they were injured.
The two-year study involved an analysis of some 600,000 trauma patients of the American College of Surgeons Trauma Quality Improvement database. A total of 678 patients were matched. Those in the THC-positive group had significantly higher rates of deep vein thrombosis (6.6 percent vs 1.8 percent) and pulmonary embolism (2.2 percent vs 0.3 percent) than those in the THC-negative group. Resulting blood-clot complications in the THC-positive group were 9.3 percent versus 2.8 percent in the THC-negative group.
“’These data underscore the fact that we’re still flying in the dark regarding the effects of marijuana,’ said lead study author Jack Stupinski, MD, a surgical resident at the University of Arizona College of Medicine – Tucson. ‘Some doctors may be touting its benefits, but we still do not fully understand the risks of marijuana or how broad those risks may be.’”
Read General Surgery News article here.

Adverse effects of cannabidiol:
A systematic review and meta-analysis
of randomized clinical trials
Researchers conducted the first review of the adverse effects of pharmaceutical CBD across all medical indications. Twelve double-blind randomized placebo-controlled trials lasting seven or more days and involving 803 patients were included in the study.
Compared with placebo, pharmaceutical CBD was associated with an increased likelihood of withdrawal from the study:
  • for any reason
  • or due to adverse events
  • any serious adverse event
  • serious adverse events related to abnormal liver function tests
  • pneumonia
  • any adverse event
  • adverse events due to decreased appetite
  • diarrhea
  • somnolence, and
  • sedation. (See study for odds ratios.) 
Associations with abnormal liver function tests, somnolence, sedation, and pneumonia occurred only in childhood epilepsy studies where pharmaceutical CBD may have interacted with other medicines the children were taking. After excluding those studies, the only adverse outcome associated with pharmaceutical CBD was diarrhea.
Researchers conclude that pharmaceutical CBD is well tolerated and has relatively few serious adverse effects, although interactions with other medicines should be carefully monitored. Additional safety data from clinical trials outside of childhood epilepsy and studies of over-the-counter CBD are needed to determine whether a similar conclusion can be made about these products.

Notable are the footnotes, which provide access through Google Scholar to the studies in the meta-analysis.
Read Nature article here.

ASAM issues
public policy statement on e-cigarettes
The American Society of Addiction Medicine has issued a policy paper on e-cigarettes.
It includes information on:
  • background
  • youth use
  • smoking cessation
  • the evolving US regulatory landscape, and
  • nine specific recommendations. 
The recommendations include a call for consistent enforcement of the 21-year-old minimum purchase age, taxes on e-cigarettes similar to those on other tobacco products, and a ban on e-cigarette flavors “unless a flavor has been demonstrated to help current tobacco users to stop smoking, will not lead non-tobacco users to start, and does not increase risk of harm from using the product.”
Read full ASAM statement here.

Anchorage, Alaska, voters
reject on-site cannabis consumption
Here’s another case of citizens standing up to the marijuana industry. Voters overwhelmingly rejected a ballot initiative that would have allowed marijuana consumption on pot-shop premises.
Unofficial election returns show 64.3 percent of voters turned down the proposition.
By a vote of 7-4, the Anchorage Assembly had placed the measure on the ballot last October. It would have allowed customers to inhale marijuana, smoke marijuana, and eat marijuana edibles in the store where they bought those products.
Read Marijuana Business Daily article here.

Virus fuels pot industry’s
push for online sales, delivery
The marijuana industry is using coronavirus stay-at-home orders to push for further concessions from regulators. Because several legal states have declared pot shops “essential businesses,” the industry is not only celebrating such acceptance but using it to push for fewer restrictions.
An emergency executive order in Colorado, for example, is allowing online sales and curbside pick-ups during the COVID-19 crisis. But the pot shops are pushing for home deliveries as well. They are also pushing for passage of the co-called SAFE Banking Act to enable credit card companies to accept payment for marijuana purchases, which are illegal under federal law. Even so, the online orders for curbside pick-ups are being paid for with credit cards.
Colorado legislators passed new laws that allow medical marijuana home deliveries this year and recreational marijuana deliveries in 2021, but the state’s marijuana industry wants those to begin now.
Other states such as California, Washington state, Oregon, Massachusetts, Michigan, and Illinois have issued temporary orders to allow online sales and either curbside pick-ups or home deliveries.
Read Salt Lake Tribune article here.

Parenting just got a lot harder
with legal marijuana

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The Marijuana Report is a weekly e-newsletter published by National Families in Action in partnership with SAM (Smart Approaches to Marijuana).

Visit National Families in Action's website, The Marijuana Report.Org, to learn more about the marijuana story unfolding across the nation.

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The Marijuana Report Staff
Executive Editor, Sue Rusche. Editor, Nicole Carter. Proofreading, Harry Rusche, Professor Emeritus. IT Consultant, Lee Clontz. Social Media Coordinators, Margarita Eberline, Shannon Murphy, MD, FAAP, and Nicole Carter.
National Families in Action Board of Directors
William F. Carter, Chairman of the Board, Coldwell Banker Atlanta. Sue Rusche, President and CEO, Atlanta. Richard L. Brown, Secretary, Attorney (Ret.), Founder & Chairman, Sudden Cardiac Arrest Association, Lakewood Ranch, Florida. Jeannine F. Adams, Director, President and CEO, J. Addams & Partners, Atlanta. Jack L. Arbiser, MD, PhD, Director, Thomas J. Lawley Professor of Dermatology, Winship Cancer Institute, Emory University, Atlanta. LLP, Atlanta. Debbie Berndt, Director, Parent Movement 2.0, Walnut Creek, California. Margarita Eberline, Director, Strategy Director, Ultim Marketing, Atlanta. Robert Margolis, PhD, Director, Founder, Caron Solutions Intensive Outpatient Program, Roswell, Georgia. Shannon Murphy, MD, FAAP, Director, Birmingham, Alabama.
Senior Adviser
Kent “Oz” Nelson, Chairman and CEO (Ret.), United Parcel Service, Atlanta.

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