Cannabis Legalization Research Articles

Comparison of perceptions in Canada and USA regarding cannabis and edibles

BackgroundCanada took a national approach to recreational cannabis that resulted in official legalization on October 17, 2018. In the United States (US), the approach has been more piecemeal, with individual states passing their own laws regulating adult use. The objective of this study was to compare the two jurisdictions.MethodsTwo exploratory, quantitative surveys were administered in May of 2021 in both Canada and the US. One thousand forty-seven Canadian and 1037 US residents (age 19 and older) were surveyed on approaches to and attendant regulations of consumer cannabis. Tests of significance were performed to analyze differences between two groups.ResultsNo statistically significant differences exist between the two countries in terms of cannabis legalization acceptance. Usage rates among adults was similar with 45% of Canadians and 42% of Americans confirming they consume cannabis. Respondents maintain that they intend to increase their usage, with edibles attracting a rising level of interest from consumers.ConclusionsResults suggest that public policy in both Canada and the USA needs to change to reflect rapidly evolving acceptance of cannabis products in North America to realize potential economic returns.

Is legal recreational cannabis associated with cannabis use during pregnancy, beliefs about safety, and perceived community stigma?

BackgroundAmong pregnant and recently pregnant people we investigated whether legal recreational cannabis is associated with pregnancy-related cannabis use, safety beliefs, and perceived community stigma. MethodsIn 2022, we surveyed 3571 currently and recently pregnant English- or Spanish-speaking adults in 37 states. Primary outcomes included cannabis use during pregnancy and two continuous scale measures of beliefs about safety and perceived community stigma. Using generalized linear models and mixed effects ordinal logistic regression with random effects for state, we assessed associations between legal recreational cannabis and outcomes of interest, controlling for state-level and individual-level covariates and specifying appropriate functional form. ResultsThose who reported cannabis use during pregnancy were more likely to believe it is safe and to perceive community stigma compared to those who did not report use during pregnancy. Legal recreational cannabis was not associated with cannabis use during pregnancy, continuation or increase in use, frequency of use, or safety beliefs. Legal recreational cannabis was associated with lower perceived community stigma (coefficient: −0.07, 95% CI: −0.13, −0.01), including among those who reported use during (coefficient = −0.22, 95% CI: −0.40, −0.04) and prior to but not during (coefficient = −0.19, 95% CI: −0.37, −0.01) pregnancy. ConclusionFindings do not support concerns that legal recreational cannabis is associated with cannabis use during pregnancy or beliefs about safety. Legal recreational cannabis may be associated with lower community stigma around cannabis use during pregnancy, which could have implications for pregnant people’s disclosure of use and care-seeking behavior.

Discussing the Legalisation of Recreational Cannabis Supply Chain: Will It Weaken Drug Trafficking Organisations?

Since the Netherlands’ tolerance policy, which allows the purchase of cannabis at ‘coffeeshops’, has been linked to issues of public order and safety, as well as dangers made by drug trafficking organisations, there has been a long debate regarding legalising cannabis production and supply. It was so decided to launch an experiment with a restricted legal (‘closed’) cannabis supply chain for recreational use. This has international implications due to the ongoing illegal cannabis exports from the Netherlands, the importance of sharing knowledge about the effectiveness of cannabis policy, and the accumulation of evidence required to review and revise international treaties. We will detail and discuss the experiment’s background, general approach, and design. In this experiment, ten trusted cannabis growers are contracted to manufacture and supply cannabis to coffeeshops in intervention municipalities, with product quality control, legal enforcement against criminal interference, and preventive measures to decrease health hazards in place. The cannabis supply to coffee cafes in participating control municipalities will remain unchanged. A process study will determine if the chain of production to sale in the intervention towns is indeed closed. In a quasi-experimental study comparing intervention and control communities, the chain’s effects on public health, cannabis-related crime, safety, and public annoyance will be assessed. Earlier experiences with medical cannabis in the United States, as well as limited access and production models in Europe, have provided valuable insights. However, these amendments go far further, introducing a new area of cannabis policy. The absence of empirical knowledge on the effects of such measures presents a problem for policymakers. As a result, establishing future legal changes will require a thorough grasp of the specifics of each country. The literature comparing Colorado’s and the Netherlands’ models is limited. This study is based on a thorough analysis of the policies, regulations, and discussions related to criminal activities common to drug trafficking organizations. The research and analysis presented herein will provide policymakers with a better understanding of the laws and regulations governing legal cannabis in these jurisdictions, as well as highlight some potential impacts and challenges of cannabis reform that require further consideration to ensure public safety and health.

The importance of medical cannabis for solving the problem of providing analgesia to palliative patients in Ukraine

One of the ways to solve the problem of pain relief for palliative patients in Ukraine is to expand the arsenal of painkillers through the use of medical cannabis. In many palliative di­seases, cannabis is able to alleviate other symptoms that accompany patients with incurable diseases at the end of their lives: nausea, lack of appetite, seizures, anxiety, depression. The procedure for the legalization of medical cannabis in Ukraine is coming to an end, which is a timely decision of the legislators and the government. Before the full-scale medical cannabis war, 2.3 million patients were needed. Since its inception, this need has increased to 5.5–6 million. The Ukrainian agricultural market and the pharmaceutical industry will eventually be able not only to provide the country with the necessary amount of plant raw materials for the production of medicines and other cannabis products, but also to earn profits from exports, providing part of the growing demand for cannabis in Europe in other countries of the world. But this will require good conditions for investors and a consistent state policy in the adoption of by-laws and the practical implementation of already adopted laws. The medical effects of herbal cannabis and preparations containing it depend on the content of the narcotic TetraHydroCannabiol (THC) and the non-narcotic CanaBiDiol (CBD). Consumer preferences for recreational cannabis are gradually flooding the market with high-THC, low-CBD herbal cannabis, which increases the risk of faster addiction, the frequency and severity of cannabis side effects such as psychotic disorders and cardiovascular crises. Ukraine needs to be prepared for the increase in the use of illicit recreational cannabis along with the increase in the use of medical cannabis, including among children and adolescents, and to counter these phenomena. But even despite these risks, significant positive medical and social consequences can be expected from the legalization of medical cannabis for palliative patients and war victims with post-traumatic stress disorders. Keywords: chronic pain, hospices, narcotic painkillers, non-narcotic painkillers, PTSD.

Traceability and control as levers to prevent leakage from legal circulation when legalizing medical cannabis.

Aim: To reveal traceability and control as levers to prevent leakage from legal circulation when legalizing medical cannabis. Materials and Methods: The methodological basis of this research work is based on a systematic approach. Methods of structural and logical analysis, bibliosemantic, abstraction and generalization were used in this article. Results: The analysis of the regulatory framework and regulatory initiatives in the field of circulation of narcotic drugs, in particular, cannabis (in total 56 documents) demonstrated repeated attempts to reform it in Ukraine in order to increase the availability and efficiency of medical and pharmaceutical services. Recently adopted law on the legalization of medical cannabis pays special attention to the traceability of the circulation of medical cannabis and cannabis-based medicines (CbMs) by digitalization and creation of the appropriate electronic information system. Conclusions: With the adoption of the law on the legalization of medical cannabis Ukraine became the 57th country in the world to legalize such cannabis. The study and analysis of the regulatory framework of Ukraine, taking into account the best world practices, showed that the legalization of medical cannabis will allow for providing more effective care to many patients including wounded defenders.

Adverse outcomes of cannabis use in Canada, before and after legalisation of non-medical cannabis: cross-sectional analysis of the International Cannabis Policy Study

ObjectivesTo date, there is little evidence on the extent to which cannabis legalisation affects the prevalence of adverse events from cannabis at the population level. The current study examined trends...

An exploration of medical professionals’ attitudes, perceived knowledge and concerns around medical cannabis in the United Kingdom

Background In the UK, there are over 40,000 specialist clinicians who are eligible to prescribe cannabis-based medical products (CBMPs); however, only approximately 100 actively do so (0.25%). Since the legalization of medical cannabis in the UK in 2018, there has been a limited number of prescriptions issued by the National Health Service (NHS). Availability through private healthcare is rising, with current estimates suggesting that 25,000–30,000 patients are accessing medical cannabis though private clinics. Objective The objectives of this study were (1) to assess attitudes, perceived knowledge and concerns around medical cannabis among medical/health care professionals (HCPs) in the UK, and (2) to examine differences between professionals who had previously undertaken training on medical cannabis and those who had not. Methods Using a quantitative cross-sectional survey design, a questionnaire was presented to participants to explore their personal and professional perspectives towards medical cannabis. Questions addressed HCPs’ perceived knowledge, confidence and concerns about medical cannabis prescribing, alongside their personal experiences and attitudes toward legalization. Results A total of 72 HCPs completed the survey, of which 55.6% had received training in medical cannabis. HCPs trained in medical cannabis reported a statistically significant higher perceived knowledge of medical cannabis, greater confidence in prescribing and increased recognition of its value as a medicine compared to their non-trained colleagues ( p < 0.05 for all comparisons). Notably, trained individuals were significantly less concerned that use of medical cannabis lacks sufficient evidence of efficacy ( X2(1) = 8.74, ( p = 0.003). Barriers to prescription and cost of medical cannabis were the most endorsed concerns among both HCP groups. Conclusions The study found that undergoing medical cannabis training is associated with less hesitancy in prescribing CBMPs and increased confidence in its medicinal value.

Regulatory Challenges and Opportunities in the Cannabis Industry

As the legalization of cannabis gains momentum globally, it becomes imperative to understand the regulatory challenges and opportunities this industry faces. The objective of this study was to investigate these elements through qualitative insights from stakeholders within the cannabis industry, exploring the complex interplay between regulatory frameworks and industry dynamics. This qualitative study was based on semi-structured interviews with 26 stakeholders in the cannabis industry, including growers, retailers, policymakers, and industry consultants. Participants were selected using purposive sampling to ensure diverse perspectives. The data was analyzed using NVivo software to achieve thematic analysis and theoretical saturation. The analysis identified four main themes: Regulatory Complexity, Stakeholder Perspectives, Innovation and Adaptation, and Social and Economic Impact. These themes encompassed various subcategories such as Compliance Challenges, Legal Uncertainties, Market Entry Barriers, Growers' Concerns, Retailers' Strategies, Policymakers' Intentions, Product Development, Business Model Innovation, Community Engagement, and Economic Contributions. Each theme and its subcategories provided deep insights into the varied impacts of regulations on different stakeholders within the industry. The study concluded that navigating the cannabis regulatory landscape is highly complex and requires stakeholders to engage in continual adaptation to remain compliant and competitive. Effective regulatory frameworks should balance public health concerns with economic opportunities, supporting innovation while ensuring safety and compliance. The findings underscore the necessity for policies that are responsive to the evolving needs of this dynamic industry.

Awareness and interest in cannabis use for cancer management among cancer survivors.

We examined the awareness, interest, and information sources relating to cannabis use for cancer management (including management of cancer symptoms and treatment-related side effects) and determined factors associated with cancer survivors' awareness and interest in learning about cannabis use for cancer management. This was a cross-sectional study of adult cancer survivors (N = 1886) receiving treatment at a comprehensive cancer center. Weighted prevalence and multivariable logistic regression analyses were conducted. Among cancer survivors, 88% were aware and 60% were interested in learning about cannabis use for cancer management. Common sources of information to learn about cannabis use for cancer management were cancer doctors/nurses (82%), other patients with cancer (27%), websites/blogs (26%), marijuana stores (20%), and family/friends (18%). The odds of being aware of cannabis use for cancer management was lower among male compared to female survivors (adjusted odds ratio [AOR]: 0.61; 95% confidence interval [CI]: 0.41-0.90), non-Hispanic Blacks compared to non-Hispanic Whites (AOR: 0.36; 95% CI: 0.21-0.62), and survivors who do not support the legalization of cannabis for medical use compared to those who do (AOR: 0.10; 95% CI: 0.04-0.23). On the other hand, the odds of being interested in cannabis use for cancer management was higher among non-Hispanic Blacks compared to non-Hispanic Whites (AOR: 1.65; 95% CI: 1.04-2.62), and among cancer survivors actively undergoing cancer treatment compared to patients on non-active treatment (AOR: 2.25; 95% CI: 1.74-2.91). Awareness of cannabis use for cancer management is high within the cancer survivor population. Results indicated health care providers are leading information source and should receive continued medical education on cannabis-specific guidelines. Similarly, tailored educational interventions are needed to guide survivors on the benefits and risks of cannabis use for cancer management.

Opportunities associated with cannabis sales pilot trials : the Cann-L project

In the context of an international trend of cannabis legalisation and regulation, Switzerland is now allowing strictly supervised local pilot trials of cannabis sales. One of these is the Cann-L project in Lausanne, which will evaluate the impact on cannabis consumption of an access to a non-profit, public health-oriented distribution model. Opening in December 2023, it already has more than 500 participants whose profiles differ from those usually found in population surveys. In addition, around twenty people have already contacted the study's referring doctor, demonstrating a need and interest in advice and support.

Up in Smoke: Bankruptcy by Contract in the Legal Cannabis Industry

Up in Smoke: Bankruptcy by Contract in the Legal Cannabis Industry

Cannabis Use Differences Among Sexual Minority Versus Heterosexual Females and Males in Oklahoma: The Roles of Mental Health, Cannabis Perceptions, and Cannabis Marketing Exposure.

Despite the high cannabis use rates among sexual minority (SM) individuals, less research has examined factors related to cannabis use among SM (vs. heterosexual) individuals, especially in places with legal medical cannabis retail markets and high structural stigma, like Oklahoma. Data were from a survey of Oklahoma adults, including 3020 females (18.6% SM) and 2279 males (10.1% SM). Bivariate analyses examined associations of sexual identity with cannabis-related factors (i.e., perceived harm, positive attitudes, marketing exposure, depressive symptoms, anxiety symptoms) and cannabis use and use severity (i.e., past 30-day use, daily/near-daily use, cannabis use disorder [CUD] symptoms). Logistic regression examined associations of sexual identity and cannabis-related factors with cannabis use and use severity among females and males, separately. SM (vs. heterosexual) females reported greater odds of past 30-day cannabis use and daily/near-daily use, lower harm perceptions, greater marketing exposure, and higher rates of depressive/anxiety symptoms. Lower harm perceptions and greater marketing exposure were associated with greater odds of past 30-day use, whereas marketing exposure was associated with greater odds of daily/near-daily use. SM (vs. heterosexual) males reported greater odds of daily/near-daily use and higher rates of depressive/anxiety symptoms. SM (vs. heterosexual) females reported higher rates of cannabis use, whereas SM (vs. heterosexual) females and males reported higher rates of daily/near-daily cannabis use. Potential targets for cannabis-related health campaigns aimed at reducing use differences include correcting misinterpretations of harm that may emanate from cannabis marketing efforts among females and addressing depressive symptoms among males.

Acute Effects of Ad Libitum Use of Commercially Available Cannabis Products on the Subjective Experience of Aerobic Exercise: A Crossover Study.

The present study aimed to examine the acute effects of legal-market cannabis on regular cannabis users' subjective responses to exercise in a controlled laboratory environment. Given the stereotype that cannabis is associated with extreme sedentary behavior, there are concerns that cannabis legalization may exacerbate the US physical inactivity epidemic. However, despite these concerns, recent years have seen considerable public interest in the use of cannabis concurrently with exercise (e.g., running). The present study compared participants' experiences of exercise without cannabis to their experiences of exercise after acute ad libitum use of one of two commercially available cannabis flower products: a Δ9-tetrahydrocannabinol-dominant or a cannabidiol-dominant product. Participants (N = 42) were regular cannabis users between the ages of 21 and 39years (mean = 30.81years, standard deviation = 4.72years). Although participants reported a more positive affect (p < 0.001), enjoyment (p < 0.001), and runner's high symptoms (p < 0.001) during their cannabis (vs non-cannabis) exercise appointment, they also reported more exertion (p = 0.04). Pain levels were very low and did not differ between appointments (p = 0.45). Effects appeared to depend, in part, on cannabinoid content; there was a larger difference in enjoyment (p = 0.02), and a smaller difference in exertion (p = 0.02), between the cannabis and non-cannabis exercise appointments among participants in the cannabidiol (vs Δ9-tetrahydrocannabinol) condition. To our knowledge, this is the first study to investigate the acute effects of commercially available cannabis on subjective responses to exercise in a laboratory environment. Our findings suggest that, among regular cannabis users who use cannabis in combination with exercise, cannabis use prior to exercise may lead to increases in both positive and negative aspects of the subjective exercise experience. Research using diverse samples, exercise modalities, and methodologies (e.g., placebo-controlled trials) is needed to establish the generalizability of these findings.

Cannabis-related arrests and convictions in Canada: Differences by race/ethnicity, individual socioeconomic factors, and neighborhood deprivation

Racialized individuals were disproportionately impacted by cannabis prohibition in Canada; however, the role of socioeconomic factors and neighborhood deprivation are not well understood. The current study examined race/ethnicity, individual socioeconomic factors, and neighborhood deprivation in relation to arrests and convictions for cannabis-related offenses. Repeat cross-sectional data were analyzed from two waves of the International Cannabis Policy Study (ICPS), a web-based survey conducted in 2019 (n = 12,226) and 2020 (n = 12,815) in Canada among those aged 16 to 65. Respondents were recruited through commercial online panels. Respondents’ postal codes were linked to the INSPQ deprivation index. Multinomial regression models examined the association between race/ethnicity, individual socioeconomic factors, neighborhood deprivation, and lifetime arrests or convictions for cannabis offenses. Overall, 4.4% of respondents reported a lifetime arrest or conviction for a cannabis-related offense. Black and Indigenous individuals had more than three times the odds of conviction than White individuals (AOR = 3.90, 95% CI = 2.07–7.35, p = <0.01; AOR = 3.24, 95% CI = 1.78–5.90, p = <0.01, respectively). Differences were still statistically significant after adjusting for cannabis use and socioeconomic factors; however, after adjusting for neighborhood deprivation, only the difference for Black individuals remained. Neighborhood deprivation was associated with cannabis-related convictions: the odds of a conviction among the “most privileged” and “privileged” neighborhoods were approximately half of those in the “most deprived” neighborhoods (AOR = 0.50, 95% CI = 0.29–0.86, p = 0.01; AOR = 0.50, 95% CI = 0.27–0.92, p = 0.03, respectively). Arrests and convictions for cannabis-related offenses were disproportionately higher among racialized individuals and those living in the most marginalized neighborhoods. Future research should examine whether inequities change following the legalization of recreational cannabis in Canada.

Relationships Between Alcohol and Cannabis Policies in U.S. States, 1999-2019.

A crucial question regarding the public health impacts of cannabis legalization is its impact on alcohol consumption and alcohol-related harm. However, little is known about whether these changing cannabis policies are occurring in liberal or in restrictive alcohol policy environments, either of which likely affect public health outcomes. We constructed comprehensive state-level alcohol and cannabis policy indices and explored relationships between them. We assessed relationships between the Alcohol Policy Scale (APS) and the Cannabis Policy Scale (CPS) from 1999 to 2019. The APS and CPS were based on 29 and 17 state-level policies, respectively, and each policy was weighted for its relative efficacy and degree of state-year implementation. From 1999 to 2019, average state APS scores increased modestly (became more restrictive) by 4.11 points (2019 M = 43.23, range: 24.44-66.31) and average CPS scores decreased (became less restrictive) by 15.33 points (2019 M = 76.40, range: 29.40-95.74) on a 100-point scale. In 2019, average APS scores were similar among states that prohibited (criminalized) possession of cannabis (42.00), decriminalized possession (41.33), legalized medical cannabis (44.36), and legalized recreational cannabis (43.32). Across states, there was no correlation between the restrictiveness of state-level alcohol and cannabis policies (r = .03, p = .37) in unadjusted models, although there was some variation by time, geographic region, and political party, with a weak negative correlation in state fixed-effects models. Although cannabis policies liberalized rapidly from 1999 to 2019, alcohol policies stayed relatively stable and did not differ by degree of cannabis policy liberalization. In general, there were weak associations between cannabis and alcohol policies among states; however, there was some temporal, regional, and political variation.

Cannabis Legalization: Social Risk Assessment and Economic Forecast

Abstract The paper considers the problem of the economic feasibility of cannabis legalization in the Russian Federation. The paper also analyzes attitudes towards cannabis legalization among 584 residents (291 female and 293 male, 18.8 ± 1.4 for men, 18.3 ± 1.6 for women) from two different Russian regions (with the highest (Republic of Khakassia, Chelyabinsk Region, Moscow Region, Amur Region, and Saint-Petersburg) and lowest (Chukotka Autonomous District, Nenets Autonomous District, Chechen Republic, Arkhangelsk Region, and Orel Region) per capita drug use in the Russian Federation). All participants were interviewed via the Internet. In the first stage, a keyword analysis categorized articles into medical (48 %) and non-medical (52 %) cannabis use, revealing varied perspectives on its benefits and risks. The second stage surveyed Russian citizens, indicating regional differences in attitudes toward cannabis legalization based on per capita drug use. The third stage conducted a PEST analysis, highlighting economic consequences and offering recommendations. Practical implications include the need for targeted prevention programs, effective curriculum modules, and collaborative efforts to address the complex challenges associated with cannabis legalization. The study found that the public attitude towards the legalization of drugs for non-medical purposes is negative. In regions with the highest per capita soft drug use, the legalization of non-medical cannabis is unlikely to cause an increase in the level of usage. Teenagers living in regional centers tend to be more engaged in trying and using cannabis (11.9 %) compared to other cities (8.8 %, p ≤ 0.05) and rural areas, where the rate of cannabis use was the lowest (5.4 %, p ≤ 0.05). This research underscores the importance of tailored interventions and educational strategies to address diverse attitudes toward cannabis legalization. The findings contribute valuable insights for policymakers, educators, and health professionals, guiding the development of informed approaches to substance use prevention. The recommendations emphasize the necessity of proactive measures, such as outreach programs and collaborative efforts, to navigate the multifaceted implications of cannabis legalization and promote overall societal well-being.

Cannabis use in the United States and its impact on gastrointestinal health.

In recent years, the legalization and social acceptability of cannabis use have increased in the United States. Concurrently, the prevalence of cannabis use has continued to rise, and cannabis products have diversified. There are growing concerns regarding the health effects of regular and high-potency cannabis use, and new research has shed light on its potentially negative effects. Here, we review evidence of the gastrointestinal (GI) effects of cannabis and cannabinoids. Dysregulation of the endocannabinoid system might contribute to various GI disorders, including irritable bowel syndrome and cyclic vomiting syndrome, and endocannabinoids have been found to regulate visceral sensation, nausea, vomiting, and the gut microbiome. Cannabis has been shown to have antiemetic properties, and the US Food and Drug Administration has approved cannabis-based medications for treating chemotherapy-induced nausea and vomiting. Yet, chronic heavy cannabis use has been linked to recurrent episodes of severe nausea and intractable vomiting (cannabinoid hyperemesis syndrome). Given the considerable heterogeneity in the scientific literature, it is unclear if cannabinoid hyperemesis syndrome is truly a distinct entity or a subtype of cyclic vomiting that is unmasked by heavy cannabis use and the associated dysregulation of the endocannabinoid system. The changes in cannabis legalization, availability, and public risk perceptions have outpaced research in this area and there is a need for robust, prospective, large-scale studies to understand the effects of cannabis use on GI health.

Perceptions, Attitudes, and Knowledge of Cannabis and its Use: A Qualitative Study among Herbal Heart Study Young Adult Cannabis Consumers in South Florida

Growing cannabis use among young adults in the United States surpasses research and public understanding, raising health concerns despite potential benefits. Limited research focuses on their knowledge, attitudes, risks, and motivations, especially in states with limited legalization. This study explores cannabis knowledge and attitudes among healthy young adult cannabis consumers to understand their risk and benefit perceptions. Data include a subsample of participants in the Herbal Heart Study, a cohort to examine subclinical cardiovascular risk among healthy young adult (18–35 years old) cannabis consumers and non-consumers. A qualitative thematic analysis of the interviews was performed using a deductive approach driven by the theory of the Health Belief Model to generate categories and codes. Dedoose was used to organize transcripts and coding. A total of 22 young adult cannabis consumers (M age = 25.3, SD = 4.4) were interviewed between May 5, 2021- September 23, 2022. Participants were predominantly female (n = 13) and Hispanic (n = 9) or non-Hispanic Black (n = 7). Five themes were identified: perceived health benefits and risks associated with cannabis use, motivation for cannabis use, knowledge of cannabis, and perceived barriers to cannabis use. Participants discussed knowledge, positive/negative attitudes toward cannabis, and perceived risks/benefits based on personal experience and gathered information. Some showed knowledge deficits, and most wanted more health-related cannabis research. Given the current climate of rising cannabis legalization, availability of novel cannabis products, and societal acceptance, further research and evidence-based cannabis literacy for young adults are essential to keep pace with liberalization trends.

THERAPEUTIC CANNABIS USE: UNIQUE CONTEXTS FOR OLDER ADULTS

Abstract Nationwide cannabis use prompts new questions about its therapeutic use. Self-administered cannabis among older adults demands careful study on their treatment outcomes and consumption patterns, in light of a more accessible, legalized cannabis market. Changing sentiments toward the illicit drug urges new research into its viability as a treatment for conditions in older adults. Ailshire uses the 2018-2021 Behavioral Risk Factor Surveillance System (BRFSS) surveys to compare cannabis use by age group. The data, which is representative of 39 U.S. states, indicate that medical marijuana use increases with age. Furthermore, Kaskie’s Cannabis and Older Persons Study (COPS) uncovers the influence of age on cannabis use and motives for consumption. The study is grounded in three core objectives: distinguishing senior consumers from other age groups, distinguishing therapeutic and recreational use, and distinguishing life-time and naive cannabis consumers. With the support of the National Cancer Institute, Fahey conducts a cross-sectional study on consumption patterns of cancer patients over the age of 65, analyzing patient reported outcomes of symptom management through cannabis. Finally, Bluthenthal and Cohen perform quantitative, health surveys among 429 community-recruited people who inject drugs (PWID) to understand the potential benefit of a legal cannabis as a substitution for criminalized substances and alcohol. The papers in this symposium provide updated insights into widespread cannabis use among older adults. These findings may help forward conversations about the political and clinical changes that must be made in order to protect the therapeutic needs of older adults amidst a rapidly expanding cannabis industry.

Prenatal Exposure to Tobacco and Cannabis in Six Race/Ethnicity Groups during the First Three Years after Legalization of Cannabis for Recreational Use in California.

There are known health concerns linked to prenatal tobacco and cannabis exposures. This study aims to objectively determine the level of exposure to tobacco and cannabis in pregnant individuals from six race/ethnicity groups (Black, Hispanic, Asian Indian, Native American, Vietnamese, and White) in the first three years following legalization of recreational marijuana use in 2018 in California. We used a cross-sectional sample of prenatal screening program participants (2018-2020) from southern and central California (N = 925). Exposures were estimated by a lab analysis of cotinine (tobacco) and 11-hydroxy-Δ9-tetrahydrocannabinol (OH-THC, cannabis) in banked serum. Disparities in tobacco exposure were evident, with Black subjects experiencing the highest smoking rate (16%) followed by Native American (10%) and White (8%) subjects, and ≤2% among Hispanic, Asian Indian, and Vietnamese subjects. Environmental tobacco exposure generally showed a similar pattern of exposure to tobacco smoking across race/ethnicity groups. Cannabis detection ranged from 5% among Hispanic subjects to 12% and 13% among White and Black subjects, respectively, and was higher among tobacco users and those exposed to environmental tobacco smoke than those with no cotinine detected. Tobacco and cannabis exposure were generally greatest in younger subjects and those with indices of a lower economic status; however, among Black subjects, cannabis exposure was greatest in older subjects and those with a higher socioeconomic status. Race/ethnicity, age, and socioeconomic factors can inform targeting of high-exposure groups for intervention.