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Weekly Cannabis News

December 26th-January 2nd, 2022

Relying Only on pH and Bicarbonate Levels Can be Misleading in Cannabis Consumers with Type I Diabetes

pH and bicarbonate levels are important measures to understand type I diabetes phenotype.

A team of researchers at the University of Colorado aimed to differentiate between diabetic ketoacidosis (DKA) and hyperglycemic ketosis due to cannabis hyperemesis syndrome (HK-CHS) in patients with type I diabetes who presented to the emergency department. [1]

DKA is a serious medical condition which develops when the body does not have enough insulin to allow blood sugar into the cells to be used as an energy source and it common among type I diabetes patients. [2] Previous studies have shown that hyperglycemic ketosis may be related to HK-CHS, a condition in which patients present with frequent episodes of vomiting, nausea, and abdominal pain caused by long-term cannabis use. [3],[4],[5]

In this study, 68 patients with 172 DKA events were analyzed, and results showed that cannabis consumers had a significantly higher pH and bicarbonate levels compared to non-consumers.

The authors concluded: “our study suggested that relying only on pH and bicarbonate can be misleading in cannabis users with type 1 diabetes. With increasing cannabis use and cannabis-related emergency admissions in adults with type 1 diabetes, it is imperative for clinicians to differentiate typical DKA from HK-CHS.”

New State Cannabis Laws in 2022

As of January 1st, 2022, the states below will implement new regulation in their cannabis policies.

Montana:  Adults 21 years or older will be able to purchase up to one ounce of cannabis at a time at a 20% state tax on retail sales in “green counties” who voted in favor of legalization. Estimates indicate that recreational sales could reach up to $259.8 million in Montana, generating $52 million in tax revenues. [6]

Louisiana: In 2015, the state legalized medical cannabis to treat a wide range of diseases but only via the use of inhaled cannabis products (i.e., metered-dose inhalers). Louisiana Governor John Bel Edwards signed a bill in June 2021, authorizing the use of medical cannabis in raw or crude form, which will take into effect on January 1st, 2022, allowing consumers to expand the use of cannabis flower products. [7]

California: It was the first state to legalize cannabis for medical use in 1996 under proposition 215 and became fully recreational in 2016 under proposition 64. [8],[9] In September 2021, California Governor Gavin Newson signed the “Ryan’s Law”, allowing patients in critically terminally ill conditions to use medical cannabis for treatment and pain relief: “this bill, the Compassionate Access to Medical Cannabis Act or Ryan’s Law, would prohibit specified types of health care facilities from prohibiting or interfering with a terminally ill patient’s use of medical cannabis within the health care facility, subject to certain restrictions.” [10] It is named after Ryan Bartell, who died of pancreatic cancer in 2018. His father Jim pushed for the implementation of this law after facing battles to find a medical facility that would allow his son to use medical cannabis instead of opioid-based pain medications. He eventually found a facility that agreed for the treatment, and it dramatically improved Ryan’s quality of life during his last days. Jim stated: “he would sleep through the night and wake up pain-free”. [11]

Pennsylvania: Joining New York City and the State of Nevada, employers in Philadelphia will not be required to test for the presence of cannabis as a condition of employment for prospective employees under exceptions including law enforcement personnel, individuals with a commercial driving license as well as those caring for medical patients, children, and people with disabilities. [12]  Cannabis use in Pennsylvania is illegal for recreational use but authorized under specific medical conditions.

Programmers Use Cannabis to Enhance Performance Motivation in Daily Tasks

Cannabis usage increases motivation in programmers, a new study says.

Researchers at the University of Michigan Ann Arbor aimed to determine how if programmers used cannabis and if it influenced their daily motivation and job performance. [13] This study was the first empirical report of cannabis’ prevalence, perceptions, and usage motivations in programming environments.  

Results from online, anonymized, and confidential surveys from 803 programmers, including 450 full-time developers, showed that 35% have tried cannabis while programing with 18% using cannabis at least once a month.  It was reported that one of the reasons it was used during these tasks was to enhance creativity or cognitive performance rather than for medicinal reasons. Finally, they found that the cannabis use occurs at similar rates for programming employees, managers, and students despite differences in individuals may perceive cannabis’ legal and ethical states.

They stated: “our results have implications for programming workplaces that currently have anti-drug policies and motivate future research into the effects of cannabis use while programming.”

Cannabis Decriminalization is Associated with a Reduction in Racial Disparity Among Both Blacks and Whites

Can decriminalization of cannabis decrease racial disparity?

A team at the University of California San Diego aimed to determine whether cannabis decriminalization was associated with a decrease in racial disparity in arrests for possession of cannabis between Blacks and Whites in the US. [14] This study was the first to investigate the relationship between decriminalization of cannabis and racial disparity in cannabis arrests between Blacks and Whites. Using the FBI Uniform Crime

Report data from 2000 to 2019, they found that arrests linked to cannabis possession was reduced over 70% in adults and over 40% in the youth after the cannabis decriminalization laws in 11 states (e.g., California, Connecticut, Delaware, Illinois, Massachusetts, Maryland, New Hampshire, New Mexico, North Dakota, Rhode Island, and Vermont). Interestingly, there was only evidence of racial disparity among Blacks and Whites adults but not youth.

The authors concluded: “these findings suggested that cannabis decriminalization had its intended consequence of reducing arrests and may have potential to reduce racial disparity in arrests at least among adults.”

References

[1] Akturk HK, Snell-Bergeon J, Kinney GL, Champakanath A, Monte A, Shah VN. Differentiating Diabetic Ketoacidosis and Hyperglycemic Ketosis Due to Cannabis Hyperemesis Syndrome in Adults With Type 1 Diabetes. Diabetes Care 2021. DOI: 10.2337/dc21-1730

[2] https://www.cdc.gov/diabetes/basics/diabetic-ketoacidosis.html

[3] Akturk HK, Taylor DD, Camsari UM, Rewers A, Kinney GL, Shah VN. Association Between Cannabis Use and Risk for Diabetic Ketoacidosis in Adults With Type 1 Diabetes. JAMA Intern Med 2019;179(1):115-118. DOI: 10.1001/jamainternmed.2018.5142

[4] Kinney GL, Akturk HK, Taylor DD, Foster NC, Shah VN. Cannabis Use Is Associated With Increased Risk for Diabetic Ketoacidosis in Adults With Type 1 Diabetes: Findings From the T1D Exchange Clinic Registry. Diabetes Care 2020;43(1):247-249. DOI: 10.2337/dc19-0365

[5] Galli JA, Sawaya RA, Friedenberg FK. Cannabinoid hyperemesis syndrome. Curr Drug Abuse Rev 2011;4(4):241-9. DOI: 10.2174/1874473711104040241

[6] http://bber.umt.edu/pubs/Econ/CannabisStudy2020.pdf

[7] https://legis.la.gov/legis/BillInfo.aspx?i=240303

[8] https://vigarchive.sos.ca.gov/1996/general/pamphlet/215text.htm

[9] https://ballotpedia.org/California_Proposition_64,_Marijuana_Legalization_(2016)

[10] https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201920200SB305

[11] https://socalrecord.com/stories/606581148-grieving-father-calls-on-lawmakers-to-allow-cannabis-in-hospitals-for-pain-relief-of-the-terminally-ill

[12] https://phila.legistar.com/LegislationDetail.aspx?ID=4694094&GUID=5FE67F42-4DE4-4BAA-8605-A47C3F6EF3CF&Options=ID%7CText%7C&Search=200625&FullText=1

[13] Endres M, Boehnke K, Weimer, W.  Hashing It Out: a Survey of Prgrammers’ Cannabis Usage, Perception, and Motivation. ICSE 2022. DOI: 10.1145.

[14] Gunadi C, Shi Y. Cannabis decriminalization and racial disparity in arrests for cannabis possession. Soc Sci Med 2021;293:114672. DOI: 10.1016/j.socscimed.2021.114672.

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Author Yoel H. Sitbon

Yoel is a Medical Writer in the Medical Content division at Csequence. His scientific expertise is in Neuroscience (neural mechanisms behind drug addiction) and Molecular & Cellular Pharmacology (molecular mechanisms behind mutations induced cardiovascular diseases). Yoel has over five years of scientific writing experience as evidenced by 8 peer-reviewed publications in scientific journals. He is an effective oral communicator having presented his PhD thesis work at many biomedical conferences nationally. He also has strong mentorship and leadership experience. Yoel has a B.S in Neuroscience at the University of California, Los Angeles and a Ph.D. in Molecular & Cellular Pharmacology at the University of Miami, Miller School of Medicine.

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