One out of six primary care patients said they used marijuana in a survey of cannabis use, with many saying their use was primarily for medical reasons. The study by researchers at the University of California Los Angeles also found that a third of cannabis consumers reported weed at levels that put them at moderate or high risk of cannabis use disorder.

The research, which was published by JAMA Open Network on Wednesday, suggests that many cannabis consumers use the drug for medicinal purposes, despite characterizing their use as recreational. The researchers behind the study say the findings indicate a need for routine cannabis screenings of primary care patients. Currently, few healthcare systems offer screenings for cannabis use in the primary care setting.

“Patients may not tell their primary care providers about their cannabis use, and their doctors may not ask about it,” lead author Dr. Lillian Gelberg, professor of family medicine at the David Geffen School of Medicine at UCLA and of health policy and management at the UCLA Fielding School of Public Health, said in a statement to UCLA Health.  “Not asking patients about their cannabis use results in a missed opportunity for opening up doctor-patient communication regarding use of cannabis generally and for management of their symptoms.”

In 2020, the U.S. Preventive Services Task Force recommended that primary care physicians screen their adult patients for the use of cannabis and other substances. The following year, the researchers who conducted the study launched a self-administered survey on cannabis use and medical cannabis use as part of the UCLA Health medical system’s universal electronic health record. Patients complete the survey via the system’s online portal as part of the pre-visit screening before visits for primary care.

UCLA Health is one of only a few healthcare systems that ask patients to complete a voluntary cannabis use assessment as part of the pre-visit process for primary care patients. UCLA Health uses the WHO Alcohol Substance Involvement Screening Test (ASSIST) to assess cannabis use.

The researchers used anonymized health record data collected by UCLA Health between January 2021 and May 2023 to determine the prevalence of cannabis use and the reasons patients are using the drug and to identify other factors that correlate with cannabis use. Approximately 176,000 patients completed the survey, including almost 30,000 (17%) who said they were cannabis users. Among those who self-reported cannabis use, 35% had results that suggested a moderate or high risk of cannabis use disorder.

Among cannabis users, 40% had consumed weed once or twice during the previous three months, 17% used marijuana monthly, a quarter (25%) used cannabis every week and nearly a fifth (19%) used weed on a daily or near-daily basis.

Nearly half (47%) of respondents said that they used cannabis medicinally. However, 76% used weed to manage symptoms such as mental health symptoms or stress (56%), sleep (56%) and pain (37%). Additionally, most patients who said they used marijuana recreationally had also used it to manage a symptom at some point in their lives.

The researchers note that the study had limitations, including a reliance on self-reported data. Additionally, while cannabis is legal in California, the stigma attached to the plant may mean that some patients did not fully disclose their cannabis use. The survey data was collected during the Covid-19 pandemic when the use of cannabis may have been higher than it would have been otherwise.

However, “given the high rates of cannabis use and medical cannabis use that we found in this large urban healthcare system, it is essential that healthcare systems implement routine screening of all primary care patients,” the researchers wrote.  “Integrating screening efforts to include information regarding cannabis use for symptom management could help enhance the identification and documentation of medical cannabis usage, particularly in the healthcare context.”

Dr. Benjamin Caplan, M.D., the author of The Doctor-Approved Cannabis Handbook, cited other shortcomings of the study, including its focus on cannabis use disorder. He says that the test used by the researchers is designed to assess multiple substance use disorders and lacks a detailed focus on cannabis users’ specific characteristics. 

Despite these and other study limitations, Caplan commended the researchers for “acknowledging important opportunities, like the need for informed conversations.” 

“Healthcare providers must integrate discussions about cannabis use into routine care, allowing patients to communicate their experiences openly,” he wrote in an email to High Time. “Doctors need to understand why patients choose cannabis over conventional treatments and be informed about both the risks and benefits of cannabis. This will lead to better management strategies and support systems for cannabis users, whether their use is medical or non-medical.”

Caplan added that the study “reveals a key takeaway: even patients within primary care are heavily reliant on cannabis for symptom relief. This underscores a critical issue that is seen throughout our medical system, which is that doctors are not adequately meeting patients’ needs for managing anxiety, sleeplessness, pain, and other symptoms. That is important news that isn’t discussed loudly enough.”

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Bill Walton’s widespread impact on so many people in so many corners of life was evidenced by the universal outpouring of despondent grief and fond remembrance after the legendary college and pro center, innovative live sports broadcaster and emblematic Deadhead, truly one of the most unique Americans to have ever lived, sadly succumbed to colon cancer on May 27 at age 71. 

Bill was renowned for a myriad of accomplishments, but perhaps most impressive of all was his progressive stance against perceived social injustices, including America’s greatest military folly, the Vietnam War. Bill was arrested during a 1972 war protest on the campus of UCLA, the prestigious public college where Walton happened to be the nation’s finest basketball player for the dynastic Bruins hoops squad. 

In an ESPN Classic Sports Century documentary, Walton admitted, “One of the saddest days for Coach Wooden was the day he had to bail me out of jail after I got arrested in an anti-Vietnam (War) protest.”  

UCLA Coach John Wooden was the highly successful–but extremely conservative–”Wizard of Westwood” who guided the Bruins to ten NCAA championships (two of which were won with Walton). 

As Bill recalled, his coach acknowledged Walton’s political conviction in his response: “(Wooden) said to me, “Bill, I know you feel very strongly about this, but I just don’t think you getting arrested and taking part in this demonstration is what it’s all about.”

Walton shifted from protesting to writing a letter to then-U.S. President Richard Nixon, demanding Nixon resign from office! (Nixon did actually resign in 1974, in the wake of the Watergate scandal).  

Walton’s participation in the protest that resulted in his arrest was even more impressively selfless when you consider he himself was at no risk of being drafted, as due to his immense size at 6-foot-11-inches, the military would have been unable to provide him with a custom uniform, boots, etc 

Thus, Walton’s actions were purely altruistic, and even potentially putting his pro career at jeopardy, though his supreme talent ensured he was still chosen by the Portland Trail Blazers as the #1 overall pick in the 1974 NBA Draft.  

Walton, who could pass the basketball as well as he could score it, led Portland to their only NBA title in 1977, and then he was named league MVP the following year. Severe foot and ankle injuries derailed Bill’s career until he made a storied comeback as “Sixth Man of the Year” (best player coming off the bench) and won another title with the NBA team many regard as the greatest ever, the 1986 Boston Celtics. On the day Bill died, the 2024 Celtics clinched yet another trip to the NBA Finals by beating Indiana, and their victory in the Eastern Conference Finals was dedicated to Bill Walton. 

For an added perspective on Bill’s life and legacy, we spoke with Grateful Dead historian David Gans, a recording and touring musician in his own right, as well as co-host of Tales From The Golden Road radio show on the Grateful Dead Channel on SiriusXM. 

Most people first saw Bill Walton on a basketball court, but for David Gans, it was appropriately enough at a Grateful Dead show, one which coincidentally took place 50 years ago last month: 

“I went to see the Dead at UC-Santa Barbara (on May 25, 1974). And we were sitting in the bleachers, and I remember my friends pointing to this giant red-haired dude walking around on the field. They told me he was a huge star for UCLA and that he was a Deadhead and that his name was Bill Walton. 

“It was remarkable, this giant college basketball star walking among us Deadheads. I didn’t know anything about basketball, so it was the first time I’d ever heard of him…but God knows it wasn’t the last.

“Being a radio host, I’ve interviewed BIll on several occasions over the years.  He and I had a sort of a low-key competition; every time I saw him: I’d say, ‘No, Bill, I’m the luckiest guy in the world.’ (Walton publicly referred to himself as “the luckiest guy in the world”). We agreed to disagree on that one.” 

Of course, this wouldn’t be a proper High Times profile without touching upon Bill Walton’s use and public praise of cannabis. While at UCLA, Walton had to be more discreet about his ganja consumption, although it’s been reported that Coach Wooden was acutely aware of his star center’s weed smoking, but realized there was little he could do to restrict Bill’s off-court activity. During his pro years winning awards and titles, Walton as well as his fellow UCLA center turned NBA superstar Kareem Abdul-Jabbar of the L.A. Lakers were both known to be prolific potheads. 

Walton overcame his public speaking difficulties (he was a stutterer) as well as debilitating injuries to become a professional broadcaster who brought a combination of insight and enthusiasm rarely seen behind the microphone.  In addition, he often quoted Grateful Dead song lyrics, incorporating them in his on-air analysis. 

And despite being employed by a confining corporate entity like ESPN, Walton was not intimidated to express his views, such as during a Feb 4, 2015 college hoops game between Oregon and Washington on ESPN2, when Walton made a conceptual connection that no other sports broadcaster in history ever even contemplated, when he declared: 

“You know how I talk every week, (and) complain about the NCAA not modernizing the rules?  There’s another rule they’ve got to modernize. This whole ‘war on drugs’ has been an absolute failure across the board. We’re looking for (then-President) Obama to step up and say, Why are we punishing people for things that are legal? Why are people languishing in jail for things that are legal?” 

This was followed by the classic moment in 2017 on the show ESPN Voices, when abruptly coming out of commercial, viewers were suddenly greeted by Walton dressed as the tallest Uncle Sam you’ll ever see, stating point-blank to his co-hosts (and by extension, everyone who was watching) that, “Marijuana should not be a Schedule I Drug, And all the people who’ve been in trouble for it for all these years, (President) Obama (should grant them) blanket amnesty, and just move on to the future.”

Beyond his progressive activism, Bill’s greatest heritage may be his unification of the often divisive hemispheres of drug-friendly counterculture and straight-laced sports.  When queried about that notion, David Gans quoted an interview he conducted with Bill from approximately 30 years ago: 

“Bill said, ‘The best thing anyone told me as a basketball player was that I made my fellow basketball players good.’ Bill and Jerry Garcia have many, many things in common, and Bill often compared his (basketball playing skills on a team) with Jerry’s (guitar skills in a band) in the sense of both being in a group doing collective improvisation. 

“It’s about recognizing that the whole is greater than the sum of its parts. And that you can be a very effective player by directing attention away from yourself and making the other guys look good, as Bill said. 

“And Jerry did the same thing; he knew all the eyes were on him, so he did what he could to direct attention elsewhere. He didn’t need the attention, so had the luxury and the gift of sharing the spotlight with (the other Dead members) around him and making them look good too.

“Bill learned from the Grateful Dead, and showed us that basketball and Dead-style music are similar in the sense of being improvisations within a structure, in which that sense of team consciousness transcends and is more important than any individual consciousness. 

“That’s what the Grateful Dead taught Bill, and that’s what he in turn taught us about the connection between sports and music.”

On a personal note, this author actually met Bill Walton in December 2003 before a concert by the post-Garcia iteration of the band then known as “The Dead”. This was outside of Oakland Arena in the “Shakedown” parking lot scene where fans do pre-show partying and acquire substances for getting even higher and tripping during the actual concert.  Bill was the tallest person I ever stood before, but he was kind to me as we briefly discussed Celtics legendary power forward (and Walton’s former teammate) Kevin McHale. McHale was one of the Celtics teammates who famously attended a Grateful Dead concert with Bill in Worcester, Massachusetts in November, 1985, Bill’s first season in Boston.  

David Gans added his own final reflection: “The one thing I would want mentioned is that whenever I ran into Bill, he knew who I was and he was always effusive in his praise for me and (radio co-host) Gary Lambert. He really went out of his way to make people feel welcome and accommodated and appreciated. 

“His positive energy was genuine as a giant, supportive Deadhead. I just had the sense that Bill Walton was the real deal. He really was that thoroughly decent and joyous human being that he presented himself to be.”

It was wonderfully appropriate that Bill lived long enough to see a major development in the struggle for pot legalization when the Dept of Justice announced this past May 16 its intention to reschedule cannabis from Schedule I to Schedule III under the Controlled Substances Act. This means that the USA can move a step closer, as Bill had so openly wished, towards no longer punishing people for using a plant that has done so much good for so many, including Bill Walton himself. 

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The California Department of Cannabis Control (DCC) granted $19,942,918 to 16 academic institutions with plans to research cannabis on April 26. The grants will be dedicated to research initiatives exploring the effectiveness of cannabis on “mental health of young people, novel cannabinoids like Delta-8 and Delta-10 THC, and a first-of-its kind study of California’s legacy cannabis genetics, intended to preserve the history, value, and diversity of the communities that steward them,” a press release stated.

According to DCC chief deputy director Rasha Salama, the goal is to have these particular initiatives lead the way in cannabis studies. “It is the Department’s aspiration that these studies will advance the body of scientific research, further our understanding of cannabis, and aid to the continued development and refinement of the legal framework,” said Salama. “These studies will provide valuable insights on topics of interest to California’s consumers, businesses, and policy makers and the Department looks forward to sharing them once they are completed.”

Grants were awarded to institutions in six categories, including cannabis potency, medicinal use of cannabis, health of the cannabis industry, monopolies and unfair competition, California legacy genetics and genetic sequencing, and “other” topics. A total of 98 proposals were considered, and 16 were chosen from that pool based on “strong scientific methodology, their ability to provide useful information for policymaking, their advancement of public understanding of cannabis, and their potential to generate foundational research that will support exponential future knowledge.”

The institution that received the highest grant amount of funds was Cal Poly Humboldt with $2,699,178, which will be sued to tackle the topic of “Legacy Cannabis Genetics: People and Their Plants, a Community-Driven Study.” 

According to a press release, a nonprofit organization called Origins Council and the Cannabis Equity Policy Council is partnering with the Cal Poly Humboldt to work on the initiative. “This research seeks to empower and protect California’s legacy cultivation communities who have overcome great adversity to innovate and steward one of the most important collections of cannabis genetic resources in the world,” stated Origins Council executive director Genine Coleman.

Additionally, the University of California, Irvine and University of California, Los Angeles (UCLA) received $2 million each, and both will be conducting cannabis potency studies.

UCLA-based studies secured six grants, and University of California, Berkeley (UCB) received grants for three. Other institutions included University of California, San Francisco, University of California, Davis, Cal Poly San Luis Obispo, and Cal Poly Humboldt.

One particular collaboration between UC Irvine and UCLA will conduct the “first double-blind, placebo-controlled, federally compliant, drug-administration study evaluating the intoxicating effects of inhaled cannabis plant compared to inhaled concentrates. It is expected [to] establish a clinically significant threshold to define high and low THC concentrations.”

In February, the DCC also announced a new grant program offering $20 million to help support and expand the state’s cannabis industry. “Expanding access to California’s retail cannabis market is an important step towards protecting consumer safety and supporting a balanced market,” said DCC director Nicole Elliott. “The retail access grant program ultimately seeks to encourage legal retail operations in areas where existing consumers do not have convenient access to regulated cannabis.” The grant application window ends on April 28, and $10 million of the grant funds will be awarded by June 20. After that, an additional $10 million will be “available to previous awardees as they issue licenses.”

The DCC released a statement in early March regarding the enforcement statistics from the past two years. According to the agency’s report, the DCC led 61 search warrant operations in 2021, but conducted 155 in 2022. In 2021, the DCC seized more than 41,726 pounds of cannabis (approximately $77,772,936 in value), but that number increased to 144,254 pounds in 2022 (estimated to be more than $243,017,836 in value).

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Cannabis companies are crossing the line when they display claims such as CBD as a way to battle opioid addiction, a watchdog organization warns. Pennsylvania-based watchdog Spotlight PA looked at over 60 websites from cannabis retailers and businesses based in Pennsylvania and fact-checked the validity of health claims with health policy experts.

The report, “Unproven, unsafe” was published on February 21 and covered shortly after by the Pittsburgh Post-Gazette. 

Investigators listed several problems: “cherry-picking and misrepresenting parts of studies, making broad claims without citing any specific research, and providing incomplete information about what it takes to qualify for the state’s medical marijuana program.”

One claim was bothersome in particular: the claim that CBD can abate cravings for opioids and fight addiction. While early evidence shows that CBD could be useful in this department, medical experts say promoting these claims is dangerous.

Chelsea L. Shover, an epidemiologist and assistant professor-in-residence at the David Geffen School of Medicine at UCLA, said that promoting cannabis as an alternative for buprenorphine as an opioid use disorder treatment is “really dangerous.”

“That’s complete nonsense. If it were up to me, you wouldn’t be allowed to make claims like that,” Shover told the Pittsburgh Post-Gazette. “That’s kind of the worst-case scenario of this advertising.”

It’s also important to note that buprenorphine itself has a high risk for addiction and dependence, and causes respiratory distress and death when taken in high doses or when combined with other substances. But opioid addiction sometimes involves weaning, which CBD cannot do, under the supervision of a physician.

Among the other findings of Spotlight PA’s investigation:

• Seven websites cited a 2014 study that found U.S. medical cannabis laws were associated with lower rates of fatal opioid overdoses. But they chose not to cite a later study that showed different results. 
• Seven promoted the benefits of CBD for opioid addiction treatment, including to help with withdrawal or reduce cravings. But according to Spotlight PA, at least some of the messages go beyond the research.
• Governor Wolf’s administration says opioid use disorder should only be a qualifying condition for medical cannabis in certain circumstances, but at least 13 websites didn’t include those caveats when they described what it takes for addiction patients to qualify for cannabis.

“The findings reveal a somewhat deceptive strategy—whether intentional or not—adopted by many dispensaries and cannabis certification websites where very specific and limited scientific research is often cited to support very broad statements about cannabis’ benefits,” Stephanie Lake, a postdoctoral fellow at the UCLA Cannabis Research Initiative, wrote in an email. “The result of this strategy is an oversimplified and scientifically inaccurate message about cannabis.”

The warning serves as a reminder that individual studies are hardly conclusive—especially in the eyes of the medical community and in the eyes of authorities.

The Claim of CBD for Opioid Addiction

Early evidence suggests CBD could be used for opioid addiction, but regulators will not allow unproven medical claims to be displayed on products. A 2009 study found that CBD inhibits cue-induced heroin-seeking, but the study was limited to a rat model. A 2019 double-blind, randomized, placebo-controlled study found that CBD for the reduced cue-induced craving and anxiety in drug-abstinent individuals with Heroin Use Disorder.

Cannabis companies must abide by strict regulations such as avoiding unproven medical claims, or otherwise face the wrath of regulators such as the FDA. The FDA notes, for instance, that the CBD industry is especially overrun with cure-all claims.

That said, if you go out looking for benefits, you’ll find plenty of peer-reviewed evidence, and if you go out looking for negative effects, you’ll also find ample peer-reviewed evidence in support of those claims. The integrity of the scientific process means absorbing all reputable evidence—good or bad.

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