Australian Cannabis Patients Turning to Prescriptions Over Illicit Market, Study Shows

New research from the University of Sydney’s Lambert Initiative seeks to take a closer look at cannabis consumers’ habits. The results found that most Australians medicate with illicit cannabis, though the number of patients accessing medicinal cannabis has risen dramatically over the years. The study’s findings were recently published in Harm Reduction Journal.

It’s the third Cannabis as a Medicine Survey (CAMS20), following two previous iterations, CAMS16 and CAMS18. The authors note that, even though Australia has had its legal framework for medicinal cannabis since 2016, prior surveys indicated most consumers were still using illicit cannabis products, while regulatory data indicated an increase in medicinal cannabis prescriptions since 2019.

Researchers administered a cross-sectional anonymous survey to 1,600 participants from September 2020 to January 2021. Participants were eligible if they were over 18 years of age, used cannabis for self-identified medical reason(s) in the past year, and a resident in Australia.

The survey ultimately found that 37.6% of respondents received a legal prescription for medical cannabis, a major increase from the 2.5% of respondents who reported prescription use in the 2018 iteration of the CAMS survey. Those who exclusively used prescription cannabis were often older, women, and less likely to be employed.

Prescribed participants were more likely to use cannabis to treat pain than those using illicit cannabis (52% vs. 40%) and were also less likely to treat sleep conditions (6% vs. 11%). Mental health conditions were also common indications for both groups (26% and 31%, respectively). Additionally, prescribed medicinal cannabis was predominately consumed through oral routes (72%), while illicit cannabis was more often smoked (41%).

As far as medicinal cannabis access, and despite the fact that medical patients in Australia have drastically increased over the past several years, few participants (10.8%) described the existing model for accessing prescribed medicinal cannabis as “straightforward or easy.”

Survey participants mostly called out the cost of medicinal cannabis as a barrier, with an average cost of $79 per week, highlighting the need to reexamine the cost of treatment for patients. People using illicit cannabis also reported that they had trouble finding medical practitioners with the ability or willingness to prescribe medicinal cannabis.

The study’s lead researcher, Professor Nicholas Lintzeris from the Faculty of Medicine and Health at the University of Sydney, said this data suggests that Australia has seen a transition from illicit use toward the legal use of medicinal cannabis.

“A number of benefits were identified in moving to prescribed products, particularly where consumers reported safer ways of using medical cannabis. People using illicit cannabis were more likely to smoke their cannabis, compared to people using prescribed products who were more likely to use oral products or vaporised cannabis, highlighting a health benefit of using prescribed products,” Lintzeris said.

Respondents also reported positive outcomes from their medical cannabis use overall, with 95% stating that using medical cannabis has improved their health.

Professor Iain McGregor, academic director of the Lambert Initiative for Cannabinoid Therapeutics, added that there are advantages in using medicinal cannabis instead of its illicit counterpart, including safer routes of administration, greater certainty of access, and better communication between patients and doctors.

“Patients can also be informed of the exact THC/CBD composition, which is an ongoing problem with illicit product,” McGregor said. “There should be further efforts to transition patients from illicit to regulated, quality-controlled, cannabis products.”

In the study conclusion, authors echo similar sentiments, noting the progress and uptick in medicinal cannabis prescriptions since the regulatory framework was first introduced in 2016. While they similarly note the benefits of using medicinal cannabis, authors recognized the barriers that may keep illicit cannabis users from securing a prescription.

In closing, the authors suggest further research to address the barriers respondents reported in accessing medical practitioners willing to prescribe medicinal cannabis in Australia. The CAMS series is conducted every two years, and if the stark contrast between this survey and the previous iteration is any indicator, hopefully the upcoming iteration will close some of these gaps in patient access to medicinal cannabis in the future.

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Positive Drug Tests for Pot Hit All-Time High

More Americans are failing drug tests because of pot than ever before, and the solutions to the problem range from blaming legalization to dropping drug testing for pot altogether.

Quest Diagnostics drug-tested over 11 million people during 2021, via urine, hair, and oral fluid drug tests, analyzed about 9 million of the tests, and found some startling trends. According to a Quest Diagnostics newsroom press release quietly released last month, more people are failing drug tests due to pot use than ever before.

The rate of positive drug test results among America’s workforce overall hit a 20-year peak as well. It’s the highest rate since 2001, up over 30% in the combined U.S. workforce from an all-time low in 2010-2012, according to the analysis.

For an interactive map of the Drug Testing Index (DTI) with positivity rates and trends, click here.

“Positivity rates for marijuana in the general U.S. workforce, based on more than 6 million urine tests, continued an upward climb, increasing 8.3% (3.6% in 2020 versus 3.9% in 2021), the highest positivity rate ever reported in the DTI,” the survey summarizes. “Over five years, positivity for marijuana in the general U.S. workforce increased 50% (2.6% in 2017 versus 3.9% in 2021).”

The Wall Street Journal pointed out the number of states that have legalized cannabis since 2017, when the rates of positive drug tests were lower. Fresh Toast, on the other hand, questioned whether or not it’s time for policymakers to reflect what is going on in the general workforce amid the report of record-high numbers.

Quest Diagnostics leaders acknowledged a disconnect between changes in society and the drug testing results they found. Drug tests not only impact job applicants and employees—but the retention rates employers grapple with.

“Employers are wrestling with significant recruitment and retention challenges as well as with maintaining safe and engaging work environments that foster positive mental and physical wellbeing,” said Keith Ward, General Manager and Vice President, Quest Diagnostics Employer Solutions. “Our Drug Testing Index data raises important questions about what it means to be an employer committed to employee health and safety. Eager to attract talent, employers may be tempted to lower their standards. In the process, they raise the specter of more drug-related impairment and worksite accidents that put other employees and the general public in harms’ way.”

Drug Testing for Cannabis Is Not Reliable Indicator of Impairment

A study associated with the National Institute of Justice found that THC levels are “unreliable indicators” of impairment. National Institute of Justice-supported researchers from RTI International studied how specific cannabis doses correlate with THC levels, and their findings were surprising.

“Laws regarding driving under the influence of marijuana vary from state to state, with a growing trend toward ‘per se’ laws that use a level of delta-9-tetrahydrocannabinol (THC, one of the psychoactive substances in marijuana) in the blood, urine, or oral fluid as a determinant of intoxication,” researchers wrote. “However, there is little evidence correlating a specific THC level with impaired driving, making marijuana per se laws controversial and difficult to prosecute.”

This aligns with what researchers from the Lambert Initiative, based at the University of Sydney in Australia, told High Times last year. Researchers at the Lambert Initiative focus some studies on cannabis impairment itself and the drug tests that are supposed to determine impairment.

“Unlike alcohol, you simply cannot infer whether some is affected by THC, or how affected they are, based simply on the amount of THC they have in their system,” Dr. Thomas R. Arkell told High Times last October.

He continued, saying it’s “ridiculous” to base laws and workplace rules on drug tests when it comes to cannabinoids.

Jobs That Don’t Drug Test

Do employers really need to drug test potential employees? Former President Ronald Reagan’s Drug Free Workplace Act was implemented in 1988. It started with 21% employers requiring drug tests in 1987, and that number shot to 81% by 1996.

The profound influence of state after state legalizing cannabis for medical or recreational purposes, combined with labor, is driving employers to reconsider pre-employment drug tests for cannabis among job applicants.

The most notable company to do so would probably be Amazon. On June 1, 2021, the company released a blog post based on its goal to become both “Earth’s Best Employer” and “Earth’s Safest Place to Work.” In that announcement, it confirmed that it would be adjusting its drug testing policy to avoid testing for cannabis.

Forbes profiled a search engine Phynally, founded by Damian Jorden in April last year. Phynally can save time for job seekers if they choose to consume cannabis in their own time.

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Study Shows Roadside THC Tests Do Not Indicate Impairment

As the laws surrounding cannabis relax around the world, drug impairment and driving is a growing concern. Each country has its own method of dealing with this issue. For many governments, the best option has been to use roadside THC saliva tests. However, when it comes to determining cannabis impairment, saliva samples are not accurate. […]

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CBGA More Effective For Seizures Than CBD, Study of Mice Finds

Researchers in Australia say they’ve discovered the “mother of all cannabinoids,” and it isn’t THC or CBD. For the first time, a study reports that three acidic cannabinoids found in cannabis, notably cannabigerolic acid (CBGA), reduced seizures in a mouse model of Dravet syndrome, an intractable form of child epilepsy.

The three acidic cannabinoids—CBGA, cannabidivarinic acid (CBDVA) and cannabigerovarinic acid (CBGVA)—”may contribute to the effects of cannabis-based products in childhood epilepsy,” and were noted with “anticonvulsant potential.” CBGA, however, demonstrated the most potential for certain anticonvulsant effects.

“From the early nineteenth century cannabis extracts were used in Western medicine to treat seizures but cannabis prohibition got in the way of advancing the science,” said Associate Professor Jonathon Arnold from the Lambert Initiative for Cannabinoid Therapeutics and the Sydney Pharmacy School. “Now we are able to explore how the compounds in this plant can be adapted for modern therapeutic treatments.” The study was recently published in the British Journal of Pharmacology

CBGA is the precursor “granddaddy” molecule of CBDA and THCA, which eventually convert to THC and CBD, among other compounds. CBGA is part of a protective system for cannabis, produced by trichomes that triggers targeted plant cell necrosis—natural self-pruning to allow the plant to focus energy on the flower. 

“We found that CBGA was more potent than CBD in reducing seizures triggered by a febrile event in a mouse model of Dravet syndrome,” Lead author of the study, Dr Lyndsey Anderson, said. “Although higher doses of CBGA also had proconvulsant effects on other seizure types highlighting a limitation of this cannabis constituent. We also found CBGA to affect many epilepsy-relevant drug targets.”

Fight Against Dravet Syndrome with CBGA

The mission for the team at the Lambert Initiative for Cannabinoid Therapeutics is simple: develop a better cannabis-based treatment for Dravet syndrome—an intractable form of child epilepsy.

In 2015, Barry and Joy Lambert made a hefty donation to the University of Sydney to push forward scientific research on medicinal cannabis. Barry and Joy’s granddaughter Katelyn suffers from Dravet syndrome.

“After using hemp oil for treatment, we got our daughter back. Instead of fearing constant seizures we had some hope that our daughter could have a life worth living. It was like the noise cleared from her mind and she was able to wake up. Today Katelyn really enjoys her life,” said Michael Lambert, Katelyn’s father.

In order to learn more, the research needs to be continual. “Our research program is systematically testing whether the various constituents of cannabis reduce seizures in a mouse model of Dravet syndrome,” said Associate Professor Jonathan Arnold. “We started by testing the compounds individually and found several cannabis constituents with anticonvulsant effects. In this latest paper we describe the anticonvulsant effects of three rarer cannabinoids, all of which are cannabinoid acids.”

The Entourage Effect

In the meantime, anecdotal evidence from cannabis consumers abroad suggests that there is more to cannabis’ healing powers than THC and CBD, although the science is limited.

Families like the Lamberts have noticed significant drops in seizures when children facing intractable epilepsy take cannabis extracts, although the source makes huge differences.

Supporting the concept of the Entourage Effect, there are unknown benefits from lesser known cannabinoids. Many people believe that the presence of terpenes and other compounds in cannabis make it more effective.

Harvard Professor, Dr. Lester Grinspoon, said that you need more than THC and CBD if you want cannabis’ full effects. It should be called the Ensemble Effect, not the Entourage Effect, he said. Dr. Grinspoon believed THC should be taken with CBD and other phytochemicals in order to be more effective. Any chemical in isolation does not perform the same way as it is found in nature, he believed.

Dr. Raphael Mechoulam is best known for his extensive work in cannabis acids, as well as Dr. Ethan Russo. In 1996, Japanese researchers found that CBGA is a precursor to CBDA and other compounds.

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