Newly released data published in last month’s issue of the Journal of Addiction Medicine concluded that marijuana treatments for young people have declined following legalization.

The data, presented by researchers at Temple University, “were extracted from the Treatment Episode Dataset—Admissions and used to calculate trends in the number and proportion of criminal justice referrals” for cannabis use disorder treatment. They sought to investigate “whether the proportion of referrals to cannabis use disorder (CUD) treatment from the criminal justice system declined among adolescents (aged 12–17 years) and young adults (aged 18–24 years) following state recreational (adult use) cannabis legalization in the United States between 2008 and 2019.” And they said that difference-in-differences analysis [used to measure a cause and effect of a certain policy] “was used to estimate the effect of recreational legalization on the state-level proportion of criminal justice referrals as a share of all admissions.”

The researchers said that, nationwide, “the number and proportion of adolescent and young adult criminal justice referrals to [cannabis use disorder] treatment declined over the study period.”

“The proportion of young adult criminal justice referrals declined significantly more rapidly after recreational legalization as compared with before (β = −0.045; 95% confidence interval, −0.079 to −0.010; P = 0.01),” the researchers wrote. “Among adolescents, the trajectory of decline in the proportion of criminal justice referrals did not change significantly following recreational legalization (β = −0.033; 95% confidence interval, −0.073 to 0.008; P = 0.11).”

The researchers concluded that their results “indicate that the proportion of referrals to CUD [cannabis use disorder] treatment from the criminal justice system fell following recreational legalization in the United States among young adults, likely due to post-legalization declines in cannabis-related arrests,” as quoted by NORML’s write-up of the data.

“The decline in the proportion of young adult criminal justice referrals to [cannabis use disorder] treatment following recreational legalization is likely due to falling cannabis-related arrests. Although cannabis criminalization may result in court-mandated CUD treatment for some young adults without CUD, the decline in CUD treatment admissions during a period of increasing CUD risk factors associated with recreational legalization represents a key health concern. Promoting screening and other CUD treatment referral sources, such as through primary care, may be warranted,” they concluded.

The findings represent a welcome development for legalization advocates, who have long contended that the end of prohibition would free up resources in the criminal justice system.

NORML’s Deputy Director Paul Armentano said that most people “arrested for violating marijuana possession laws do not require mandatory drug treatment, and historically, these referrals were provided primarily to divert people away from the criminal justice system.”

“In addition to ending tens of thousands of needless low-level marijuana arrests, cannabis legalization is also freeing up space in drug treatment centers for those people who truly need it,” Armentano said in a statement on the findings.

Marijuana legalization is still in its infancy in the United States, and researchers are continuing to learn more about the social and political outcomes of the policy reform. 

A long-term study released earlier this year found that the legalization of marijuana is not associated with drug abuse.

The study looked at various sets of twins (more than 4,000 individuals total) to examine the effect of living in states that permit recreational cannabis.

Although it was not linked to substance abuse disorder, the researchers did find that it often resulted in increased pot use.

“In the co-twin control design accounting for earlier cannabis frequency and alcohol use disorder (AUD) symptoms respectively, the twin living in a recreational state used cannabis on average more often, and had fewer AUD symptoms than their co-twin living in an non-recreational state. Cannabis legalization was associated with no other adverse outcome in the co-twin design, including cannabis use disorder. No risk factor significantly interacted with legalization status to predict any outcome,” they wrote.

“Recreational legalization was associated with increased cannabis use and decreased AUD symptoms but was not associated with other maladaptations,” wrote researchers. “These effects were maintained within twin pairs discordant for residence. Moreover, vulnerabilities to cannabis use were not exacerbated by the legal cannabis environment. Future research may investigate causal links between cannabis consumption and outcomes,” the researchers added.

Another study released last year found that marijuana legalization has led to a reduction in filled prescriptions through that state’s Medicaid program.

“These results have important implications,” said Shayam Raman, one of the researchers involved in the study. “The reductions in drug utilization that we find could lead to significant cost savings for state Medicaid programs. The results also indicate an opportunity to reduce the harm that can come with the dangerous side effects associated with some prescription drugs.”

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Smoking too much cannabis and it’s beginning to affect your life in negative ways? Pretty soon a drug in capsule form could be the answer, if pharmaceutical drug developers get their way.

South Florida-based clinical research network Segal Trials announced it will conduct a Phase 2B study to investigate a new drug, AEF0117-202, created by Aelis Farma to treat cannabis use disorder (CUD), according to an October 5 press release. It is a randomized, double-blind, placebo-controlled, 4-arm, parallel-group, prospective, multicenter study, determining the efficacy of a drug that reacts to the same receptors as THC.

Under a new pharmacological class of drugs, called sCB1-SSi, AEF0117-202 is the first clinical candidate for the treatment of CUD, which is often defined as the inability to stop using cannabis—even if it’s causing health and social problems.

How much is too much pot? For this study, the criteria to meet CUD is defined as people who consume cannabis at least five times per week or more. To determine if the pill works, the orally administered drug will be given to a group of study participants, and a second group will receive a placebo. Then researchers will begin their work to determine the efficacy of the drug.

Three doses—1.0, 0.3, and 0.1 mg—and a placebo were given to study participants in capsules. “AEF0117 acts in the same parts of the brain as THC (tetrahydrocannabinol), the active ingredient of marijuana, and may temporarily alter some of cannabis’s effects,” researchers wrote in the summary. They explained their reasoning in the press release:

“Chronic marijuana use can drastically impact individuals’ social and professional lives in many ways, from poor work or school performance to mood disorders,” said Rishi Kakar, MD, chief scientific officer and medical director at Segal Trials. “This Phase 2B study gets us closer to the prospect of effectively treating people who want to end their reliance on cannabis but don’t have the tools to quit.”

“Addiction” can mean many different things, ranging from severe physical withdrawal symptoms from drugs like opiates or alcohol, or unhealthy psychological patterns. This study’s summary describes cannabis withdrawal symptoms as including irritability, mood and sleep difficulties, decreased appetite, cravings, restlessness, and occasionally physical discomfort.

According to the Centers for Disease Control and Prevention, one study estimated that approximately 3 in 10 people who consume cannabis have CUD. Another study estimated that people who use cannabis have about a 10% likelihood of becoming addicted.

Researchers Blame Potency for Rise in CUD

The rise in dabbing, and better and more powerful concentrates has been pinpointed as the culprit in the rise in cases of cannabis use disorder.

“The potency of cannabis products has increased significantly over the past twenty years,” which may have contributed to the rise of cannabis-related adverse effects,” said Dr. Kakar. “With no approved drugs available to treat chronic cannabis use, Aelis Farma’s drug has the potential to make a significant, positive impact for millions of marijuana users seeking to end their dependence on cannabis.”

The Segal team will conduct the trial at its Center for Psychedelic and Cannabis Research, which was specifically built using pharmaceutical and regulatory feedback to create a structured inpatient environment that ensures both patient safety and patient comfort. 

Interestingly, the team has also worked with psychedelics. Segal Trials also recently announced it was the first in the United States to conduct a large, randomized clinical trial to investigate MM-120 (LSD D-tartrate) to treat Generalized Anxiety Disorder (GAD).

Segal has already succeeded in developing 54 FDA-approved medications and devices. The company says that its trials focus on psychiatry, neurology, addiction, insomnia, infectious diseases, vaccine development, and women’s health.

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