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❤️ Is cannabis use bad for your heart?

Troubling studies, but far from conclusive results

Good morning.

Today, we’re saddened to hear of the passing of Troy Datcher, an industry leader and former CEO of The Parent Company, which was backed by Jay-Z among other notable figures. 

Datcher was one of the first, and among the very few, Black CEOs of a major cannabis firm. Reporters covering the industry can attest he was always generous with his time and insights. He’ll be missed.

- Jeremy Berke & Jay Rosenthal

💡What’s the big deal?

Troubling new study points to risks, but there’s a lot of uncertainty

Driving the news: A new study on how cannabis affects heart health paints a troubling picture, but the study’s design deserves some skepticism. 

Frequent cannabis use is associated with an increased risk of cardiovascular and other health conditions, including heart attacks and strokes. 

Daily cannabis use can increase the rate of heart attacks by 25% and strokes by 42%, according to the study published in the Journal of the American Heart Association. When controlling for tobacco use, daily cannabis use increased the risk of heart attacks by 50% and doubled the risk of strokes.

Even less frequent cannabis users — those that reported weekly use — showed an increase in heart attack and stroke rates.

The study’s authors looked at self-reported data from the Behavioral Risk Factor Surveillance Survey for adults between the ages of 18 and 74. Seventy-five percent of survey respondents said smoking was their primary consumption method. 

Yes, but: Studies of these nature are observational, and they have clear limitations in their application. They’re not causal. 

In simple English, that means that while there is a clear correlation between frequent cannabis use and heart attacks based on the survey data, the authors have not specifically found a mechanism in cannabis that actually causes these effects. So it’s unclear what’s really causing the uptick, as these studies are mostly unreliable at determining causation. 

It’s probably unfair to say these correlations are spurious — but the study could just as easily be saying smoking anything is bad for your heart, not that cannabis, or active compounds in the cannabis plant like THC, are bad for your heart.

What they’re saying: Experts caution taking these types of studies with a healthy grain of salt (or, perhaps not too much if you’re concerned about your heart!). 

Amanda Reiman, a social scientist and an expert on cannabis-related issues, told me that studies such as this one should ask more relevant and nuanced questions about consumption methods in order to help consumers make more informed decisions and disentangle the effects of smoking versus other methods.

Peter Grinspoon, a doctor and an expert on the medical applications of cannabis, pointed out on X that the authors didn’t consider that cannabis users may have been sicker in the first place — and that they used cannabis to self-medicate their symptoms. 

All the experts agreed that much more research is needed to help inform consumers and policymakers. 

Why it matters: The study got picked up in various outlets including CNN and The New York Times, among other places. Much of the breathless coverage around the study clearly conflates the correlation and causation problem, and does both cannabis consumers, and policymakers studying the issue, a disservice without that important context.

But still, this is the latest broad observational study to point to the fact that daily cannabis use might not be good for your heart. 

The American Heart Association in 2020 issued a public statement over the risks of cannabis use and cardiovascular health. 

Our take: Be cautious of pro-cannabis groups that dismiss these results outright, and anti-cannabis groups that say the sky is falling. Like most things, we don’t know what we don’t know. 

The jury is still out on whether THC, or compounds in the cannabis plant itself, are what actually causes negative impacts on cardiovascular health. 

Personally, I’d like to see researchers try and disaggregate the effects of various consumption methods, like edibles or vapes, compared to smoking and see if the cardiovascular or stroke risks remain the same. One of the beautiful things about legalization is consumer choice, but we need more data to suggest safer consumption methods to recreational and medical users alike. 

However, one thing is clear: Smoking anything, cigarettes and joints included, is probably not good for you. We’d encourage you to choose less risky methods like edibles or vaporizers if you’re a regular consumer.

If you’re a daily user, talk to your doctor about your concerns. For me, I’ll stick to edibles and vapes, and save the joints for rare special occasions. 

But the bottom line is this: We need much more research. 


🎤 Quotable

“I think there are a lot of folks that want to get it done,” Former Colorado Rep. Ed Perlmutter, a champion of the never-been-passed cannabis banking bill the SAFE Banking Act, told Marijuana Moment when asked about the bill’s prospects for this legislative session. “The problem is just that Congress has got to start functioning in a better way. And I hold out hope for that.” 

Perlmutter is now lobbying for the bill on behalf of the National Cannabis Roundtable, an industry trade group. In the interview, he also discusses why he disagrees with Rep. Barbara Lee’s comments that moving cannabis to Schedule III would set legalization back fifty years, and more. Read it all here.

More than half of Americans live in a state where recreational use is legal

What happened: Fifty-four percent of Americans live in a state where recreational cannabis use is legal, according to a new study from Pew Research — but the federal government still treats cannabis like heroin.

Beyond that, 74% of Americans live in a state where medical or recreational cannabis use is legal. The tide, as they say, is turning. 

Why it matters: Three-quarters of Americans live in states with some form of legalized cannabis. It’s time for the federal government to catch up.

As Cultivated readers know, the ball is firmly in the Drug Enforcement Administration’s court as to a decision about rescheduling, or, perhaps, removing cannabis from the list of federally controlled substances entirely and regulating it like alcohol. 

Powerful lawmakers like Senate Majority Leader Chuck Schumer and Sen. Elizabeth Warren have called on the DEA to remove cannabis from the list of federally controlled substances, but when that will actually happen is anyone’s guess. 

But the longer cannabis remains on Schedule I, the more of a farce the whole drug scheduling project will look like to the average American.

What else: There are nearly 15,000 dispensaries in the US — and 79% of Americans live in a county with at least one cannabis dispensary. 


👊 Quick hits

Florida-based cannabis firm Trulieve’s perhaps quixotic bid to get the federal government to pay back millions of taxes under the 280E law — which bars cannabis companies from deducting regular business expenses — might just be working. The company said it received $113 million in tax refunds but the company’s leadership didn’t say exactly how the refund was processed or where it came from, MJ Biz Daily reported

Housing Works Cannabis Co, one of the first legal dispensary operators in New York state, announced today that it was set to help open five new dispensaries as part of the state’s Conditional Adult Use Retail Dispensary (CAURD) license program. 

Delaware has released draft rules for regulating the sale of cannabis within the state.

🎒 What we’re reading

📊 Earnings round-up

Cannabis earnings season continues. On today’s docket:

  • Canadian cannabis company Cronos Group reported a $45 million net loss on $23.9 million of revenue, in a quarter that the company’s leadership said was hampered by the ongoing Israel-Hamas war, as Cronos has a big business unit in Israel. We have an interview with Cronos Group CEO Michael Gorenstein publishing next week. 

  • Trulieve reported a $33 million net loss on $287 million of revenue for the quarter. For the full year, Trulieve reported $1.13 billion in revenue.

  • Verano reported a $73 million net loss on $237 million in revenue for the quarter. The company reported $938 million in revenue for the last fiscal year, and highlighted its $73 million of free cash flow. 

  • Grown Rogue International reported a net loss of about $662,000 on $17.8 million in revenue for the last fiscal year. 

📈 Deals, launches, & partnerships

Vancouver-based cannabis software startup Elevated Signals raised just under $6 million in a round led by Yaletown Partners. The startup will use the capital to expand beyond the cannabis industry and into vertical farming and mining.

Cannabis firm MariMed has released a new line of flavors for its Vibations line of cannabis-infused electrolyte drink mixes. 

European medical cannabis company Somai Pharmaceuticals said it will acquire RPK Biopharma (Holigen) for $2 million in cash and assume $3.3 million in debt. 

New York cannabis company Etain is set to open a dispensary in White Plains later today. 

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