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My Crystal Ball on Cannabis. Green is Pervasive and Disruptive. Go Green. Go Hemp. 1st Hemp USA 2023

November 1, 2023 – 1st Hemp USA – Florida

As many know, 2022 was a mixed bag for the cannabis industry. While new markets showed healthy growth, legal cannabis sales declined in many mature markets, slowing, or even reversing, growth in those markets. While some of this might be attributable to parallels experienced by the broader economy in the wake of COVID-19, it nevertheless resulted in numerous companies across the sector being hit by layoffs, cash crunches, and increased debt.

But 2022 wasn’t all bad news. Three more states enacted laws legalizing adult-use cannabis, while recreational sales kicked off in several other states. On the federal level, the Biden administration took steps toward reform, pardoning federal offenses of simple marijuana possession and directing review of cannabis’s classification under federal law. Congress also enacted the Medical Marijuana and Cannabidiol Research Expansion Act.

Below, we recap some of the biggest developments of 2022 and what we are currently experiencing in 2023. Possible 2024 predictions.

Market headwinds slowed down growth in 2022 and will likely persist throughout 2023.

After enjoying a sales surge during the early stages of the pandemic, the U.S. cannabis industry showed signs of slowing down in the face of regulatory and economic challenges, including declining demand. As a result, legal cannabis markets across the country, particularly mature markets, are facing a supply glut that is driving down wholesale and retail prices.

In California, for example, wholesale prices are reported to have crashed by as much as 95% since the state voted to legalize cannabis in 2016. (“How falling cannabis prices killed a 3rd generation family cannabis farm,” KSBW-TV Action News 8, Monterey Hearst Television Inc., Updated Dec. 14, 2022). And in Massachusetts, the retail price of an ounce has decreased from roughly $400 to under $250 over the last two years. (“Recreational cannabis prices in Mass. plummet as dispensary owners weigh future,” Boston.com, Dec. 13, 2022).

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At the same time, legal retailers continue to struggle with onerous taxes, regulations, and competition from the illegal market. Many of these same challenges are likely to persist throughout 2023, including the slump in wholesale and retail cannabis prices.

Federal legalization stalled in 2022, but there are glimmers of hope for 2023 and beyond.

While Congress once again failed to pass meaningful cannabis reform — and federal legalization remains unlikely in 2023 — federal reform efforts made incremental progress in 2022.

In October, President Biden released a statement pardoning federal offenses of simple marijuana possession. In addition, the president asked the Secretary of Health and Human Services and the Attorney General to review cannabis’s classification as a Schedule I drug — the highest level of classification — under federal law. Although not without drawbacks, rescheduling to Schedule II would be an overall boon to the medical marijuana industry, as (among other things) it would likely allow medical cannabis to be grown in one state and sold in another.

While the announcement marked the biggest shift in federal cannabis policy since the passage of the Controlled Substances Act (CSA) in 1970, its effects are not immediate. Administrative review of cannabis’s status under federal law does not have a set timetable and is unlikely to be completed in 2023. Moreover, because state cannabis convictions far outnumber federal convictions, most pardons will have to happen at the state — not the federal — level.

In December, Congress passed its first standalone piece of cannabis-related reform: the Medical Marijuana and Cannabidiol Research Expansion Act (MMCREA). The bipartisan legislation paves the way for more research into cannabis’s medicinal uses by rolling back federal restrictions on research and the cultivation of research-grade cannabis (which are presently conducted exclusively at the University of Mississippi). The MMCREA also promotes the development of U.S. Food and Drug Administration (FDA)-approved drugs using CBD and cannabis.

We anticipate that several federal legalization bills will be re-introduced in 2023. Congressional Democrats are likely to re-introduce the Cannabis Administration and Opportunity Act (CAOA) in the Senate and the Marijuana Opportunity and Reinvestment (MORE) Act in the House. Both bills were introduced in previous legislatives sessions and aim to end the federal prohibition on cannabis.

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The Secure and Fair Enforcement (SAFE) Banking Act is also likely to be re-introduced in 2023, which would provide protections to financial institutions and various other professional service firms doing business with state-legal cannabis businesses and is likely to get the most attention (as has been the case in previous years). The bill has now passed the House seven times and enjoys both bipartisan and industry support.

Another likely candidate for re-introduction is the States Reform Act (SRA), which would decriminalize cannabis at the federal level while deferring to state powers over prohibition and commercial regulation.

FDA guidance on CBD may finally be on the horizon.

It has now been nearly four years since the FDA asserted regulatory oversight over cannabidiol (CBD). Despite repeated calls for regulations from lawmakers and industry participants, the agency has yet to comprehensively address rules relating to CBD, leaving manufacturers and distributors without much guidance (aside from the periodic release of warning letters). 2023 is likely to be the year this finally changes.

Up to this point, the FDA has generally pursued limited enforcement activity regarding CBD, focusing primarily on food and beverage products that make unsubstantiated health claims. But recent shifts in the agency’s internal and external approach to regulating CBD products and other cannabinoids could be an indication of what’s in store for 2023, and beyond.

For example, in September, the FDA hired Norman Birenbaum — an experienced cannabis policy expert — as a senior public adviser at the Center for Drug Evaluation and Research. Industry watchers speculate that this could indicate that the agency is finally gearing up to develop a regulatory framework for cannabis-derived products, including CBD.

In addition, the FDA issued warning letters in the first half of 2022 to companies selling products containing Delta-8 THC, an intoxicating hemp-derived cannabinoid that is currently being sold on the unregulated market in certain states. And in November, the FDA again issued a series of warning letters, this time to companies selling CBD-infused food and beverages.

The FDA also announced in a recent interview with The Wall Street Journal that it is aiming to reveal its oversight plans in the coming months. (“FDA, Concerned About Safety, Explores Regulating CBD in Foods, Supplements,” WSJ.com, Updated Dec 29, 2022) The ultimate effect of the FDA’s forthcoming oversight plans remains uncertain, but will likely have a significant impact on the existing CBD industry. So, stay tuned!

States continue to lead the way on legalization and reform despite facing challenges.

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According to a recent report by NORML, lawmakers and voters enacted more than 40 cannabis-related reform laws in over a dozen states in 2022. On the adult-use front, three states — Rhode Island, Maryland, and Missouri — enacted laws legalizing and regulating the market. Meanwhile, Mississippi enacted legislation legalizing medical cannabis.

2022 also saw recreational cannabis sales kick off in New Jersey, Rhode Island, and (to a very limited extent) New York. Retail sales in Connecticut also began earlier this month. Retail markets in Maryland and Missouri are expected to launch later this year. As it stands, 39 states have legalized cannabis in some capacity, with 21 states (plus the District of Columbia) permitting recreational adult-use.

Given that public support for reform remains at an all-time high (See “Americans overwhelmingly say marijuana should be legal for medical or recreational use,” Pew Research Center, Nov. 22, 2022), we expect legalization and reform at the state level to continue in the year ahead. For example, lawmakers in Minnesota introduced a pair of bills earlier this month that would legalize recreational cannabis. Minnesota’s newly elected governor, a known cannabis legalization advocate, has stated that he could see legalization happening in the state in the coming year.

Pennsylvania also recently elected a pro-cannabis governor and saw Democrats Retake the State House, improving the Keystone State’s chances of legalization passing in 2023. Oklahoma has an opportunity to legalize recreational cannabis in March. Ohio’s Legislature is also considering a bill to legalize recreational cannabis, and lawmakers in several other states have already filed a handful of bills in the first few weeks of 2023 aimed at liberalizing cannabis laws (including Indiana and Kentucky).

But legalization is just the first step. The roll-out of state-legal cannabis programs can be complicated, time-consuming, and does not always progress in a linear fashion. For example, it has taken New York almost two years to launch its adult-use program, with the first sales occurring just at the end of December at a single location. To date, only 36 retailers in the state have been granted provisional licenses. Meanwhile, regulators have approved 318 conditional licenses for adult-use cultivators and processors, stoking fears that there may not be enough state-sanctioned stores, and that growers could be facing an oversupply issue. Early-stage growth of New York’s market has also been blunted by competition from the “legacy” (i.e., unregulated) market.

Several other states’ cannabis programs, including New York’s social equity component, are facing legal challenge on the basis that their licensing requirements violate the dormant commerce clause (DCC) of the U.S. Constitution, which prohibits states from discriminating against interstate commerce by favoring citizens of their states over others.

In August, a split 1st U.S. Circuit Court of Appeals panel affirmed that the DCC applies to the federally illegal cannabis industry and that a Maine law mandating local ownership of cannabis businesses is unconstitutional. The decision throws into question states’ ability to safeguard their cannabis industries from out-of-state competition and has been used as the basis for a New York federal court to partially enjoin New York’s Conditional Adult-Use Retail Dispensary (CAURD) program.

2023 still could be the year as the 2nd and 9th Circuits weigh in on this issue (as the same Michigan-based applicant has initiated litigation in New York and California on this ground).

Probably more importantly to the “Cannabis Future” is how we are using Hemp, the cousin of Cannabis, to impact our future in the industrial world. Something that is being missed, in the mix.

WHY HEMP IS IMPORTANT TO OUR FUTURE, AS IT WAS TO OUR PAST.

Hemp, In the Mix.

Hemp is not called the wonder crop for no reason. It is possibly the most important plant on earth. It offers many different uses that promote a more sustainable world. Hemp products can be recycled, reused, and are 100% biodegradable. Industrial hemp is a very robust, competitive plant that can out-compete weeds. Its cultivation and usage have significant environmental benefits.

In a time when we are not-so-gradually moving towards the destruction of our planet, the need for sustainable alternatives has increased. While the world is busy thinking of possible alternative solutions, Mother Nature has already provided us with one. All that is left to us is to make the most of it.

What are sustainable practices?

Sustainability is defined as the ability to maintain a balance of a certain process or state in any system. In recent times, the phrase sustainable practices is used in association with biological and human systems. Sustainability is expressed in human organization concepts such as eco-municipalities and sustainable cities, and for human activities such as sustainable agriculture and renewable energy.

For humans to live sustainably, it is imperative to use the Earth’s resources at a rate at which they can be replenished. But as is no surprise, the humans aren’t currently doing this. Let’s understand what sustainable practices truly mean.

The finest way to define sustainable practices is through the three pillars of sustainability.

Sustainability depends on three independent areas that are equally important–social implications, economic implications, and environmental implications.

Social Implications

Sustainable practices must ensure that global human rights are always respected. This spreads over areas such as inequality, poverty, social injustice, fair wages, and other human rights matters. True sustainability is achieved when farming and industrial practices must always leave a positive social impact.

Economic Effects

The mass adoption of sustainable agriculture has been, for some part, put off by its economic effect. While the benefits of sustainability don’t always translate to swift economic growth, they do prove safe for the environment and mankind. Sustainable practices can only be adopted when they fuel economic development.

Environmental Impact

Sustainability is, more often than not, synonymous with environmental impact. And there is a good reason for this association. The Earth is rich but it only has so many natural resources that we can exhaust. To ensure our survival as a species, it is important to manage them carefully.

Therefore, producers, cultivators, and consumers must pay attention to the impact they are leaving on the environment. It then becomes obvious that we need to adopt renewable energy and sustainable agricultural practices, among other things.

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Hemp — the Sustainable Crop

Hemp can, for the most part, alleviate the need for many other mass-produced modern raw materials. The large amounts of toxins and waste produced by fuel industry and other pharmaceutical products can be largely reduced by hemp. When compared to common resources (for example, cotton), the roots of the hemp plant not only result in environment-friendly fibers, cosmetics, fuels, and medicines but also protects the earth and enriches the land where it grows.

Hemp is a crop that leaves minimal or no footprint on the earth while addressing many of mankind’s present needs.

Growing Hemp — Environment-friendly Cultivation

Hemp is a more sustainable and eco-friendlier crop than the majority of crops dominating the human cultivation today. While many people feel that hemp propagates are against traditional crops such as cotton, they fail to understand that we are for environment. Though these crops have been growing on the land forever, the environment of the land has changed, and this has necessitated for a sustainable solution.

After its much controversial fate, hemp is beginning to the see the light of the day in people’s life yet again. And almost all the reasons for that are rooted in the crop’s sustainable and eco-friendly characteristics.

Competitive in Nature

Hemp is inherently a competitive plant that grows densely and literally chokes out the competing plants. Hemp naturally reduces pests and therefore does not require pesticides and herbicides.

Hemp is naturally resistant to pests, fungi, and diseases so cultivators do not have to focus on excessive amounts of chemicals for cultivating their crops.

Enriches the Soil where it grows.

Careless agricultural practices extract water and nutrients from the ground without allowing the soil to replenish itself. This results in soil degradation and soil pollution which in turn results in deforestation as well as threatens the productivity and overall health of our food crops.

Hemp is a sustainable crop because it returns a significant percentage of nutrients back to the ground during the process of retting. This results in healthier soil that helps in decelerating erosion and keeps our lands healthy for a longer period of time.

Can reduce Carbon emissions.

Industrial hemp is a high biomass crop that possesses the ability to sequester higher amounts of carbon through the process of photosynthesis. This carbon is then stored in the roots and the body of the plant. This carbon is then transferred into processed bio-fiber products.

Bio-products made from hemp are environment-friendly that can easily be replaced in compost or in landfills. Majority of hemp-based products are free of toxics, biodegradable, and renewable.

Requires less amount of Water.

Industrial hemp has a large tap root that is capable of penetrating deep into the soil profile to pick up the water and nutrients required by the plant for development. This is a benefit because hemp can recover the nutrients that might otherwise be leached below the root zone and enter the groundwater.

Moreover, hemp’s deep roots open up the soil and enhance it for future crops. Hemp requires one-third of the amount of water required by cotton and similar traditional crops. This value considerably cuts down on the water we dedicate to traditional crops for clothing and textile needs all the while producing more comfortable and durable products.

Can be made into biofuel.

Hemp can be made into biofuels which can easily be used in the existing transportation vehicles. Gasoline produced from hemp is 85% greener than petroleum gasoline. Hemp biodiesel, as studies have found, are 97% more efficient than traditional gasoline (i.e. 97% of hemp oil can be converted to biodiesel) and can be used at lower temperatures than other biodiesels.

Carbon neutral buildings

Through its green concrete alternative, Hemp gives us an opportunity to produce carbon neutral building supplies including but not restricted to insulation, pressboard, flooring, wall, and concrete. Hempcrete is energy-efficient, non-toxic, and resistant to mold and, insects and fire.

Produces Higher Yield from the Same Space

One of the most interesting and beneficial characteristics of hemp is that it can grow in different soils and climates and thrives in small spaces. Multiple studies suggest that one acre of hemp can yield as much as 8.7 tons given the right conditions. This way, the hemp crop opens up a way for farmers to decrease their land usage without compromising on their yield or finances.

Can replace plastic.

We are all aware of the way plastic is destroying the earth. The need for an alternate solution to plastic is supercilious to all other needs. Hemp helps us here too. Hemp provides an option to create a non-toxic and completely bio-degradable plastic that can be used in the stead of regular plastic.

A hemp plastic bottle degrades within 10 days of discard.

This is not the first time that the world is hearing of hemp plastic. In fact, Henry Ford built a car out of hemp and soy plastic in the early 1940s. In 2008, the Lotus Eco Elite employed hemp in its composite body panels and spoiler. And since, many car manufacturers have switched to hemp composites for different parts of their cars such as door panels, columns, seat backs, instrument panels etc.

Hemp and Deforestation

Ending Deforestation By Switching to Hemp • SHIFT

The timber industry has been paramount in the production of jobs and manufacture of products in the world. But this income and these convenient products come at a heavy cost to our environment. In order to cater to the demands of the timber industry, our forests are destroyed, streams are hurt, flora and fauna are killed, species are wiped out, and environment is polluted.

In the present time, more than 90% of world’s paper is made from trees. Almost 60% of the world’s forests are used for timber. This fills the natural water sourced with nitrates which leaves terrible effects on the ecosystem. This is not even the entire tip of the iceberg.

What can be the solution?
Hemp.

Cannabis or industrial hemp gives us environment-friendly products to replace timber. Hemp grows like other industrial crops but with fewer necessities and in lesser space. This means that switching to hemp would save our forests from being needlessly wasted thus saving our waters, wildlife, and the environment on the whole.

Not only will hemp offer a softer and better paper, but it will also offer more yield per acre as well. This makes hemp one of the very few sustainable crops that are not heavy on the producer’s pocket.

Hemp and Global Warming

Another battle that the wonder crop can help us fight is the battle against the rising temperature of the planet. Hemp begins sequestering carbon the moment it is seeded. Conservatively, hemp yields an approximate sequestration ratio of 1.5 units of sequestration per unit produced. That is to say, 1 ton of harvested hemp fiber should ideally sequester 1.62 tons of carbon dioxide.

In addition

Hemp can also sequester carbon back into the soil through a process called Bio sequestration. The hemp crop captures the carbon emissions from the atmosphere and on slow-smoldering, hemp can be used to create carbon-free biochar which can be mixed with other nutrients and returned to the soil.

When used in the form of bio concrete, hempcrete undergoes calcination overtime and absorbs more carbon dioxide from the environment.

HEMPCRETE has no equal as a natural building product sequestering ...

Using Hemp — Environment-friendly Consumption

While hemp is a sustainable option for producers, it is a sustainable and healthier option for the consumers as well. As an industrial crop, hemp provides healthier alternatives to consumers. We have already established that hemp is free of toxins, does not contribute to pollution, and is completely biodegradable. But these are not the only reasons why hemp supports eco-friendly consumption.

Eco-friendly Consumption

While the products made from hemp are stronger, more durable, and biodegradable, hemp in itself can act as a nutrition storehouse for consumers. Hemp consumption is eco-friendly in the sense that the crop grows without any pesticides and herbicides, consumers lesser amount of water, and is a vegan product.

The fatty acid and amino acid profiles of hemp are identically aligned with the human DNA. Therefore, as a food source, hemp offers protein, omegas, and dietary fibre in perfect proportions for our nutritional needs. Hemp is naturally gluten-free and easily digestible in the form of seeds.

Beyond nutrition

Hemp provides the strongest, most durable, natural, and long-lasting fibre compared to the alternative sources. The flexible characteristics of the plant allow for the creation of durable clothing, building materials, shelters, and innumerable products that can satisfy the human needs and wants.

Hemp’s Environmental Impact in a Nutshell

Pollution-free: Hemp is among the fewest plants that can grow anywhere, in any climate. It does not need fertilizers or pesticides and naturally fights against fungus, diseases, and weeds. It cleans up toxins from the ground and can significantly reduce chemical pollution.

Sustainable Agriculture: In addition to using zero fertilizers, hemp replenishes the soil where it grows with nitrogen, carbon, and other nutrients restoring the health and fertility of the soil.

Carbon Sequestration: Hemp grows quickly and absorbs carbon from the air storing it back to the earth.

Clean Industry: Processing hemp fiber for cloth and paper does not require any chlorine which is one of the major polluters.

Eco Fuel: When used as a bio-diesel fuel, hemp emits 80% carbon dioxide, as compared to fossil fuels, with almost no sulphur dioxide. The hemp fuel, therefore, does not destroy the ozone layer and thus generates less greenhouse gas. Hemp fuel also does not contribute to acid rain.

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Water-saving: Compared to wood and cotton plantation, hemp requires 1/3rd the amount of water.

Land-saving: 1 acre of usable fiber equates to 4 acres of usable fiber of trees and 2 acres of usable fiber of cotton. Cultivating hemp could save the land cleared for agricultural means and help in deforestation.

Oxygen release: Hemp plants are proven to release a lot of oxygen given their high carbon sequestration percentage.

Durable Products: Hemp produces stronger fiber than cotton and other plants and can be recycled a greater number of times. Efficient Land Use: Hemp yields 4 times an average forest can. A hemp crop is harvested in 90 days as compared to 25 years taken by trees.

We, at Inspirational Technologies are at the forefront of Inspirational and Frontrunners on the frontier of current technology.

We are often faced with our own personal conflicts which directly influence our interactions with our peers and family. 

When Inspirational Technologies is an endorsement of the “Cannabis” approach to the medical condition, we say, let’s let the look at the data and the people who say that they benefit for cannabis alternatives.

Beginning in Late November 2023 Inspirational Technologies will promote the long-awaited series, “In the Weeds with Steve “. An Inspirational Technologies production under their own “Background Noise Productions Studios.

 

Steven M Smith InspirationalTech.org

CEO since 2013.

#IntheWeedswithSteve

Thank you for consideration.

 

 

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What Cannabis Can (and Can’t) do for Chronic Pain. Pot for Pain Relief?

What Cannabis Can (and Can’t) do for Chronic Pain. Pot for Pain Relief?

(Story by Karen Weintraub, USA TODAY) reprinted 1/26/2023. 

A growing, but still incomplete body of research suggests the cannabis plant, the source of marijuana, can help fight some kinds of pain.

Rob Sims grew up hearing stories about what opioid addiction could do. The former Detroit Lions guard, whose father, Mickey, also played in the NFL, watched a number of his dad’s friends get hooked. Some died. He vowed his own story would be different.

Then, playing for the Seattle Seahawks in 2008, early in his pro football career, Sims tore a pectoralis muscle in his chest. Primed for his best year ever, Sims was sidelined.

After surgery, he received an open-ended prescription for opioids. “Take when you have pain,” the bottle read. “That’s seared in my memory,” he said. As a football player, “I have pain all the time.”

Scared by the lesson he had learned as a child and with little to do besides focus on his recovery, he remembers thinking: “This could go in a bad way.”

That’s when he turned to marijuana.

It remains unclear whether cannabis can be an effective treatment for pain. Plenty of circumstantial evidence supports the idea, but exactly how, what kinds of products and what can be expected from them has yet to be determined.

“There’s some caveats before it’s ready for broad, prime-time usage for chronic pain,” said Dr. Devan Kansagara, a professor of medicine at Oregon Health & Science University and a staff physician at the VA Portland.

It’s possible that cannabis helps with the psychological aspects of pain, said Dr. Nora Volkow, head of the National Institute on Drug Abuse. “Cannabis may improve pain indirectly, for instance, through decreasing anxiety so that someone may be able to deal with pain better,” she said.

Rob Sims was a guard with the Detroit Lions and now runs a cannabis business with fellow former Lion Calvin Johnson Jr., right. © Carlos Osorio, AP

Detroit Lions guard Rob Sims during the game against the Green Bay Packers at Lambeau Field, Dec 9, 2012.

Detroit Lions guard Rob Sims during the game against the Green Bay Packers at Lambeau Field, Dec 9, 2012.© Benny Sieu, USA TODAY Sports

One recent examination of previous studies found the benefits of cannabis were equal to the benefits of a placebo, which means that if people thought it would help, it did.

“There’s very limited evidence out there to support that cannabis is effective against pain,” said Karin Jensen, the Swedish neuroscientist who led the study. So far, most of the information showing its usefulness is anecdotal.

“People who use cannabis to relieve pain may have the experience that it helps – there is no doubt about that,” she said. “What’s needed is solid scientific evidence to determine how much of the relief is due to the cannabis and how much is due to other things, such as the placebo effect.”

The general public is already largely convinced.

Marijuana remains illegal in 12 states, but as of 2019, 18% of U.S. adults reported using cannabis at least once in the previous year, and 4% to 5% use it daily or nearly daily, Kansagara said.

In a 2017 study, the majority of people who used medical marijuana or self-medicated with the drug said they did so to relieve pain, and 65% of those who requested medical marijuana licenses said they wanted it to treat pain.

The marijuana plant provides a wide range of chemicals, including THC, which has psychotropic effects.

The marijuana plant provides a wide range of chemicals, including THC, which has psychotropic effects/

But cannabis comes with cautions.

At least 5% of Americans ages 12 and up abuse or are dependent on marijuana, and the risk for dependence increases the younger someone starts. Marijuana use directly affects parts of the brain responsible for memory, learning, attention, decision-making, coordination, emotion and reaction time. And long-term or frequent marijuana use, particularly at higher doses, has been linked to increased risk of psychosis or schizophrenia.

It’s not possible to predict ahead of time who will react badly to marijuana, said Dr. Charles Berde, co-founder of a pediatric pain clinic at Boston Children’s Hospital.

THC, the part of the plant that has psychotropic effects, “has narrow uses for nausea and appetite stimulation in patients with severe weight loss due to AIDS or cancer,” but the data for CBD for treatment of chronic pain is “murky,” Berde said. “All the more reason to be hesitant to prescribe it.”

Cannabis and pain relief

When a body is in pain, the brain releases its own pain relievers. There are special receptors in the brain designed to take in these natural cannabinoids and offer relief.

Ingesting or inhaling weed fills up those receptors, too.

Providing more cannabinoids than these receptors can accept overloads them making the person’s own internal cannabinoids ineffective, said Dr. Jordan Tishler, a cannabis specialist physician in Cambridge, Massachusetts, and founder and president of the Association of Cannabinoid Specialists.

That’s why higher doses don’t provide any additional pain relief compared with lower ones and can have “all sorts of risks,” he said. Side effects from cannabis can include increased heart rate, dizziness, impaired concentration and memory, slower reaction times and, more rarely, increased risk of heart attack and stroke and dependence.

Tishler said many patients come to him taking far too much cannabis, which increases the risk for side effects. He works to convince them that 5 mg to 20 mg a day will treat their pain better than the 200 mg they’re using.

Cannabis is now sold in many different forms.

Cannabis is now sold in many different forms.

“Just because (cannabis) doesn’t lead to breaking the law and incarceration and those sorts of troubles doesn’t mean people can’t have their lives significantly altered by getting overly involved with this particular substance,” he said.

There are also open questions about cannabis, including whether the pain-killing benefits seen in short-term studies will last. Some painkillers, like opioids, can actually make people more sensitive to pain. It’s not yet clear whether cannabis can have this effect.

“You’d like to see what happens with these products over a longer period of time, ideally,” Kansagara said. “I would like to see that before recommending wholesale to patients.”

Although legalization and decriminalization are making a difference, cannabis remains hard to study. Until recent years, it was extremely difficult to gain access to cannabis for research, and there was little federal funding for such work. In early December, President Joe Biden signed a law that will make it easier to research cannabis.

Dr. Donald Abrams, speaking in support of the Adult Use of Marijuana Act ballot measure in San Francisco on May 4, 2016.

Dr. Donald Abrams, speaking in support of the Adult Use of Marijuana Act ballot measure in San Francisco on May 4, 2016. © Jeff Chiu, AP

Gold-standard studies compare a treatment versus a placebo, but it’s impossible to keep people in the dark about whether they’re getting high, said Dr. Donald Abrams, an oncologist and professor emeritus at University of California, San Francisco, who studies cannabis.

When Abrams studied cannabis use in his HIV patients, some critics thought patients must be too stoned to notice their pain. But Abrams said the patients reported that it did alleviate their pain.

Dosages of cannabis aren’t standardized, which adds to the difficulty of comparing one study against another, he said.

That’s why trials of cannabis for pain relief have shown mixed results, said Wil Ngwa, an associate professor of radiation oncology at Johns Hopkins Medicine, who’s working to create such standards for drug trials.

This lack of standardization also means people have to use trial and error to find an effective dose for them, according to Staci Gruber, who directs the Marijuana Investigations for Neuroscientific Discovery (MIND) program at McLean Hospital, a Harvard-affiliated psychiatric hospital outside Boston.

In one study, Gruber followed 37 volunteers using cannabis for chronic pain. After six months of treatment, participants reported lower levels of pain, better sleep, more coherence and less use of conventional painkillers.

‘Positives, not negatives’

Sims experienced the same benefits.

Daily marijuana use after his pec injury helped cut the pain, allowing him to lift more weight and recover faster. “I was able to come back stronger than I was before.”

Playing NFL ball, Sims said, is like living through a train wreck every Sunday. The best players – the ones whose careers last the longest, he said – “have learned how to recover quicker and get ready for that next train wreck.”

During his career, marijuana helped Sims rebound and improved his sleep, which allowed him to push his workouts.

Asked about side effects from his marijuana use, Sims pointed to his athletic and financial successes. “I wouldn’t call those side effects,” he said, laughing. “I see positives, not negatives.”

In 2021, Sims co-founded the cannabis company Primitiv Group with fellow former Lion Calvin Johnson Jr. Sims and Johnson acknowledge they used cannabis during their professional careers, though there was a zero tolerance policy then, which has loosened only slightly since. Both men believe the restrictions should be lifted.

About a decade ago, Sims persuaded his wife, Natalie, to try cannabis, when a bout with the bowel syndrome Crohn’s disease left her on a morphine drip in an emergency room.

“This can’t be how we live for the rest of our lives,” he told her. She uses cannabis now and finds relief, Sims said.

“It made me very passionate about pain and help for pain.”

Challenges of cannabis care

Cannabis doesn’t make pain go away, like Advil might get rid of a headache, Tishler said.

Instead, “it makes it so it doesn’t bother you so much,” he said. “It divorces the pain from the suffering.”

Whether it’s the THC or the CBD in cannabis or both that might be helpful against pain remains an open question, Kansagara said. THC is what makes people feel “high.” CBD appears to have anti-inflammatory properties, which may be useful to some.

Smoking joints isn’t a good approach for relieving chronic pain, said Tishler, who recommends his patients use edibles instead. The effect of inhaled cannabis wears off in three to four hours, while a gummy might last eight to 12 hours.

The yo-yo effect, when pain comes and goes over a few hours, can exacerbate suffering, Tishler said. “Short-acting actually turns out to be a bad approach in general in pain management.”

In Massachusetts, where medical cannabis has been legal since 2013 and recreational since 2016, doctors are more comfortable giving their patients permission to use cannabis, Tishler said. But they rarely bring it up themselves.

So, Tishler is trying to educate his peers. “If you were thinking the patient needs opioids, think cannabis first. Don’t wait for the patient to bring it up – it’s your job to bring it up,” he tells them.

Similarly, he’d like to get cancer patients on cannabis early in their care, rather than waiting until agony sets in. “Once people are at the end of their rope, things are worse and harder to treat than if we had started when things were still kind of OK.”

Most of the advice on what product to use now comes from the patient care advocates or “budtenders” who work behind the counter at dispensaries, Gruber noted with some concern. They typically don’t know the person’s medical history or history of cannabis use or whether they use other substances such as alcohol, other drugs or prescription medication. Product labels can often be misleading about their THC and CBD content.

The trial-and-error approach can be difficult and challenging for patients with major medical problems.

“Knowing what’s in your weed is critical, but also how you’re going to respond to it is an important consideration. And that’s something we don’t spend a lot of time on,” Gruber said. “You have to educate patients. They’re desperate for it, but it’s not easy, because we’re all different and cannabis is not a ‘one size fits all’ solution.”

Research may change future use.

For cannabis to reach its full potential as a painkiller, more research is needed, experts say.

“It’s really untapped right now, because of that lack of research,” Johnson said.

That’s why NFL players and owners have been supporting cannabis research. Owners have donated more than $1 million this year to two cannabis research programs.

“We need to become better educated about all these issues,” said Dr. Allen Sills, the NFL’s chief medical officer.

Dr. Allen Sills, the NFL's chief medical officer

Dr. Allen Sills, the NFL’s chief medical officer© Rebecca Blackwell, AP

Ngwa, at Hopkins, collaborates with Sims and Johnson to lead some of that research.

He’s also looking at better ways to treat cancer pain with cannabis.

His studies suggest that not enough of the painkiller gets to a tumor when the cannabis is inhaled or ingested, so he has been exploring smart-drug delivery systems than can target the drug directly to the tumor. So far, he has tested only pancreatic tumors but hopes to rapidly expand to other cancer types.

Ngwa is concerned that preliminary research like his will encourage people to self-medicate, taking doses that may not be helpful. “You really have to wait for the clinical trials, but when people are desperate, they just do (anything). I definitely worry about that,” he said.

Until more is known, Sims will keep up his cannabis routine.

Now 39, he has dropped 50 pounds from his 320-pound playing weight, which has helped reduce the lingering bone-on-bone pain in his right knee. He rubs a Primitiv topical on it knee every day.

“My passion behind the plant and what it’s done for my family reigns supreme.”

Contact Karen Weintraub at kweintraub@usatoday.com.

Health and patient safety coverage at USA TODAY is made possible in part by a grant from the Masimo Foundation for Ethics, Innovation and Competition in Healthcare. The Masimo Foundation does not provide editorial input.

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Light Up, Hempsters! Or Not?

 — North Carolina is the latest state considering a ban on smokable hemp, a product that’s exploding along with the health craze surrounding a compound in the plant known as CBD.

Besides federal regulations laid out in the Hemp Farming Act of 2018, the Food and Drug Administration has no additional regulations on smokable hemp, leaving states to figure out how to govern it themselves.

This year, Indiana, Louisiana and Texas banned smokable hemp entirely, while Kansas banned products including hemp cigarettes and cigars. Tennessee prohibited smokable hemp sales to minors.North Carolina’s House is considering a smokable hemp ban after it recently passed the state Senate.

The legislation focuses primarily on expanding the state’s pilot hemp growing program, which has more than 1,000 licensed hemp growers and 600 registered hemp processors, to position it as a leader in the burgeoning industry. The bill would place more regulations on hemp but also create a hemp licensing commission and establish a fund for regulation, testing and marketing.

North Carolina law enforcement wants the ban, saying officers have no way of distinguishing smokable hemp from marijuana.

Hemp and marijuana are both cannabis plants. Dried, smokable hemp looks and smells the same as marijuana but contains less than 0.3% of tetrahydrocannabinol, or THC, the compound that gives marijuana its high. Hemp has cannabidiol, or CBD, which many believe helps with pain, anxiety and inflammation, though there’s limited scientific research to support those claims. It’s turning up in products ranging from lotions and cosmetics to diet pills and juices.

The proposed ban would impose a civil penalty of up to $2,500 for anyone who manufactures, sells or possesses smokable hemp.

But scores of farmers in the traditional tobacco state have told lawmakers a ban would hurt them as many deal with hurricane damage and decreased tobacco prices.

Three years ago, Shane Whitaker grew 275 acres of tobacco on his farm in Climax. This year, the second-generation tobacco farmer planted only 75 acres of his former cash crop and decided to grow hemp.

“We’re hoping for a lot of this hemp to replace tobacco,” he said. “I’m not for taking part of it off the market.”

So far, he said that hemp has been a good source of revenue to keep his farm running.

Second-year hemp farmer Lori Lacy, who has invested more than $190,000 on her 13-acre Franklin hemp farm, said she can make $1,000 for a pound of smokable hemp flower.

“I don’t want our infrastructure and everything that we have built up to this point to go away,” Lacy told lawmakers at a May hearing. “I will have to fire people.”

Smokable hemp is lucrative partly because farmers just need to dry the hemp flowers. Other products require a complicated, costly process for extracting CBD oil.

Jamie Schau, who analyzes CBD markets for the research firm Brightfield Group, said the market for smokable hemp flower is projected to grow to $70.6 million in 2019, up from $11.7 million in 2018. However, she said stigmas around smoking help keep smokable hemp at only about 1.4 percent of the overall market.

Smokable hemp is especially popular in the South, where no states have legalized recreational marijuana and many haven’t legalized medicinal marijuana, said Eric Steenstra, president of advocacy group Vote Hemp. Still, its popularity has been a surprise, he said: “Nobody really anticipated that anybody would want to smoke (hemp).”

North Carolina’s Senate voted to delay the ban until December 2020 to allow more time to figure out regulation, but a House committee subsequently moved the date a year sooner. That version is continuing to move through the House.

Bill co-sponsor Republican Sen. Brent Jackson of Sampson County prefers the later effective date because he thinks portable tests will be available soon to differentiate hemp from marijuana.

The State Bureau of Investigation and the North Carolina Association Chiefs of Police say delaying the ban would be a “de facto” legalization of marijuana, since people could disguise marijuana as hemp.

Last month, police in Four Oaks charged Amanda Furstonberg, 32, with marijuana possession after they saw her smoking what she says was hemp.

“They had me in tears,” she said.

Furstonberg started smoking hemp after a February car accident left her with chronic back pain. To avoid opioids, she tried taking CBD-infused gummies as a pain reliever but wanted something stronger and turned to smokable hemp.

“Within three and five seconds of being able to smoke it, I could tell that my body was starting to feel so much better —the throbbing was going away,” she said.

Police Chief Stephen Anderson defended his officers, saying he believed Furstonberg disguised marijuana as hemp. Her case is pending.

For now, farmers continue to grow smokable hemp. This year, Whitaker will plant roughly 30 acres of organic hemp with about 2,400 plants per acre, along with another 800 in a greenhouse.

Driving past empty greenhouses that once held tobacco, Whitaker said farming requires adapting to constant changes.

“It’s the Wild West right now,” Whitaker said.

– Inspirational Technologies does not Endorse or Encourage the Smokable form of Hemp, however believes in sharing opportunities in health and wellness.-

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