“The program’s already live, even though it’s still Schedule I in Alabama.”

By Anna Barrett, Alabama Reflector

Alabama’s public health officials on Thursday withdrew their objection to the federal rescheduling of marijuana, a move officials characterized as procedural, following a July public hearing.

The governing body of the Alabama Department of Public Health (ADPH) in May voted to delay the rescheduling so that officials could have more time to determine how to implement it, but noted that they “fully intended” to reschedule the drug.

State Health Officer Dr. Scott Harris said Thursday morning that he did not see any issues with the change, and the public comments did not reflect the impact of rescheduling but rather marijuana itself.

“I would say there are a lot of really passionate people that had a lot of really strong feelings about it, and I don’t want to minimize that or oversimplify that,” Harris said. “The comments were people who really support medical marijuana or who really don’t support medical marijuana. The comments weren’t really about what we were trying to get at, which [was] ‘what are the consequences of rescheduling.’”

Conservative activists at the public hearing said the rescheduling would “harm children” and “worsen Alabama’s mental health crisis.” The only proponent of rescheduling at the public hearing said not doing so would instill distrust between patients and doctors.

Harris said ADPH’s legal team resolved all of the department’s concerns, like the impact to pharmacies and those seeking the medication.

In April, the U.S. Department of Justice (DOJ) moved marijuana from Schedule I—the Drug Enforcement Administration’s list of drugs with the greatest potential for abuse and least legitimate use—to Schedule III, with drugs considered to have a moderate to low potential for physical and psychological dependence, according to the U.S. Drug Enforcement Administration.

The order followed an executive order signed by President Donald Trump in December instructing the DOJ to move towards rescheduling.

Former President Joe Biden instructed DOJ to reschedule the drug in 2024, but hearings on the move were canceled in early 2025.

The federal order applies to state-licensed medical marijuana products in the states that allow medicinal use of the drug. The move means those businesses can deduct business expenses from their federal taxes and researchers have access to state-legal products. As a Schedule I drug, only cannabis grown in a federally approved facility could be studied, severely limiting the supply available to researchers.

Alabama’s medical cannabis program was created by the Legislature in 2021. Three dispensaries are open in the state, with seven more to open within the next few months. At the program’s full capacity, there will be nearly 40 dispensaries.

Harris said the rescheduling would not impact the state’s medical cannabis program.

“The program’s already live, even though it’s still Schedule I in Alabama. The reason is, the statute was written essentially to decriminalize it for people who are authorized to have it,” he said.

The committee unanimously withdrew its objection.

This story was first published by Alabama Reflector.

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Nixamide vape research has been brought up recently among vapers who are weaning off of nicotine. On social media and in early lab discussions, nixamide is being called a “nicotine alternative,” offering the same ritual without the chemical dependency. But where did this compound come from, and does it actually work the way it’s promoted? Researchers are starting to test nixamide, exploring the effects on the body, and questioning whether marketing claims are actually factual.

For vapers looking to make informed, mindful choices about what goes into their devices, understanding the science behind nixamide is a crucial part of that journey.

The Birth of the Idea: From Vitamin to Vapor

Nixamide is rooted in nicotinamide (a form of vitamin B3). In food and supplements, nicotinamide has a long safety history. When companies began marketing it as part of vape liquids, they described it as delivering “pleasure, satisfaction, and enjoyment” through a compound structurally different from nicotine. A 2024 review titled Marketing of nicotinamide as nicotine replacement discusses how nixamide is positioned as a kind of nicotine-free substitute—but also flags how little human inhalation data exist (pmc.ncbi.nlm.nih.gov).

The idea took hold because it promised the same calming ritual without dependence—a way to quit without giving up the experience. But as more scientists examine the chemistry, the distinction between perception and proof is becoming clearer.

What Is Nixamide, Really?

Before diving deeper into current nixamide vape research, it helps to understand what this compound actually is—and what it isn’t. Nixamide is often marketed as a “nicotine alternative,” but its origins are less mysterious than they sound. It’s derived from nicotinamide, a form of vitamin B3 that’s already well-known in nutrition and skincare science. The difference is how it’s being repurposed. When inhaled, nicotinamide’s behavior in the body may not mirror nicotine’s, which is where much of the current research and debate begins.

For readers looking to explore this background in more depth, What Is Nixamide: A Straight-Talk Guide to a New Nicotine Alternative breaks down how nixamide came to market, the chemistry behind it, and why it’s generating attention among vapers searching for non-nicotine options.

Understanding its foundation makes it easier to see why so many studies are focused not only on its chemical safety but also on whether it can truly deliver nicotine-like satisfaction without addiction.

What the Lab Tests Reveal (and Hide)

Mismatch Between Labels and Contents

A 2024 JAMA study tested e-liquid and disposable products marketed with nicotinamide, nixotine, nixodine, and nixamide labels. They found “substantial discrepancies” in what was on the label versus what was inside. Many products labeled as nicotinamide also contained traces of 6-methyl nicotine (a nicotine analog), often undeclared (jamanetwork.com).

In effect, some nixamide-labeled products are blends or contain analog compounds, which muddies the claim of being a pure “nicotine alternative.”

Unknown Toxicology, Speculative Pathways

A recent scoping review on emerging nicotine analogs (6-methyl nicotine and nicotinamide) highlights that safety profiles are largely unknown. The authors speculate possible modes of airway damage via oxidative stress, receptor activation, or inflammatory pathways, but emphasize these are hypotheses, not confirmed effects (researchgate.net).

This uncertainty has sparked comparisons between nicotine’s well-documented neural effects and the unknowns of nixamide. Nicotine’s influence on mood and focus is already well studied, as explored in Does Nicotine Cause Anxiety or Help It?—a resource that helps explain how nicotine interacts with brain chemistry and why many users feel both stimulation and calm. Nixamide, by contrast, hasn’t shown consistent evidence of interacting with those same receptors, leaving its psychological impact unproven.

Other research warns that some e-cigarette chemicals mimic nicotine and may bypass regulation altogether. In some tested devices, ingredient claims didn’t match content, and toxicologists note that “nicotine analogs are currently not subject to the FDA process and have not been studied for their health effects” (eurekalert.org).

Why Researchers and Regulators Are Raising Alarms

When a compound is marketed to deliver nicotine-like effects but escapes regulation, concerns multiply. A coalition of health and tobacco control organizations sent a letter to the FDA urging scrutiny of nicotine analog products, including nixamide, warning that they may be designed to evade oversight (lung.org).

Because analogs are structurally different, some manufacturers claim their products are exempt from tobacco regulation—yet the actual effects, addiction potential, and degradation byproducts remain opaque. For consumers, that means taking an informed approach is essential to staying safe and making conscious choices about what’s being inhaled.

How the Market and R&D Are Responding

Major players in the vaping industry are quietly exploring analogs and hybrid formulations. The push is toward chemicals that mimic nicotine’s binding properties but skirt regulation. That means nixamide is not alone—it’s part of a broader shift.

Still, companies acknowledge that complete inhalation safety testing will take years. Meanwhile, consumers, suppliers, and regulators are watching closely. For those navigating this new space, awareness is the best protection—knowing what’s inside a vape and how it’s represented helps each user make healthier, more informed decisions.

A Thoughtful Approach for Vapers Tracking Nicotine Alternatives

If you’re exploring nixamide or other nicotine alternatives, treat this as an evolving experiment—not a proven path. Here’s how to stay grounded:

• Demand transparency. Prefer products with third-party lab results or certificates of analysis that disclose all contents, including analogs.

• Taper with care. If you aim to reduce nicotine dependence, drop levels gradually rather than switching abruptly to analogs.

• Start low. If testing nixamide products, begin with minimal concentrations and monitor any physical or psychological effects (e.g., jitteriness, mood shifts).

• Track regulation trends. Laws may evolve quickly—what’s legal now might face limits later.

• Keep alternative options in view. For vapers already exploring zero-nicotine, The Truth About Vaping Without Nicotine offers context on what those transitions actually feel like, including the mental and physical adjustments that come with dropping nicotine entirely.

Whether your goal is to quit nicotine or understand what’s new in the market, taking a research-first approach helps protect both your health and your progress. Articles like What Is Nixamide: A Straight-Talk Guide to a New Nicotine Alternative and Does Nicotine Cause Anxiety or Help It? expand this conversation, offering a clearer picture of how these compounds shape behavior, mood, and satisfaction in everyday use.

What “Nixamide Vape Research” Suggests About the Future of Nicotine Alternatives

After months of lab testing and debate, nixamide vape research continues to reveal more questions than answers. What began as a bold idea—to turn a form of vitamin B3 into a satisfying vape ingredient—has opened a new chapter in the conversation about what a nicotine alternative can be.

The early data suggest that nixamide may not behave like nicotine, but it’s still shaping how people think about harm reduction.

Studies confirm that some products labeled as nixamide contain nicotine analogs or inconsistent formulations, reminding researchers and consumers that regulation and transparency still lag behind innovation. Yet, that same uncertainty is what drives exploration forward. Each new study adds to a growing body of evidence that’s redefining what “nicotine-free” might mean in vaping culture.

If future research proves nixamide can create satisfaction without dependence, it could become a landmark step toward a safer nicotine alternative. Until then, the science invites curiosity—and caution. Understanding these findings helps vapers make informed choices as the industry continues to evolve toward options that feel familiar but support healthier habits.

At Ruthless Vapor, we believe knowledge drives better choices. Staying informed, questioning new ingredients, and putting your well-being first are what make harm reduction real—not just possible.

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A Diamond District jeweler took one of weed culture’s most temporary objects and tried to make it permanent. The finished piece looks like a luxury object. Getting there was not.

Reported with Cesar Soriano

Ahead of 4/20 last year, a bag of cannabis showed up at a Diamond District jewelry shop, and according to the crew, none of it got smoked. It wasn’t a gift for the staff. It was raw material. “We didn’t smoke any of it, of course,” said Angel, a jeweler on the TraxNYC floor. “It was for production.” The shop had never tried what it was about to: taking a real cannabis nug and turning it into solid gold.

This was not a gold-plated flower or a nug sealed inside a shell. The flower itself became the model, packed in plaster, burned out with heat, then replaced by molten metal that hardened inside the cavity it left behind. The weed disappeared. The gold kept the form, down to the texture.

For Maksud “Trax” Agadjani, who founded TraxNYC as a teenager in the early 2000s and has since made custom pieces for a long list of rappers and athletes, appeared in Uncut Gems and, this past January, went viral for a Diamond District brawl that ended with two rival jewelers under arrest, the pull was simple. “The fact that you could take a real flower and turn it into gold is amazing,” he said. He has a simpler word for the reaction it got: magic. “What catches people’s attention is magic,” he said.

The idea came from Cesar Soriano, who publishes under the name T.H.Caeczar and brought the concept to TraxNYC. He’d seen cannabis jewelry before, and credits two makers who sell under the handles @RasBoss_ and @BlingYourBud with getting there first. Their pieces relied on thin plating over a real flower, which could wear down and need refinishing. Soriano wanted the shape of the flower reproduced in solid metal instead, with no maintenance and nothing to wear off. He supplied the flower, from crosses he bred himself. He estimates he dropped off about three ounces, New York’s legal possession limit, though Angel remembered a bigger bag. Soriano stayed involved as the shop worked through the early failures, and later recorded the conversations that form the reporting backbone of this story.

The finished piece looks ready for a luxury showroom. Making it was considerably messier.

Soriano sat down with the TraxNYC crew to walk back through what happened, and High Times reviewed those recorded interviews. Nobody in them pretends the thing came easy. “Honestly, it wasn’t an easy process,” Angel said. “It took us, well, like two to three months.” They were chasing a 4/20 deadline and working blind. “That’s the first time I ever had something like that brought up to me,” he said.

Then the casts started popping and breaking apart. “I think the first five that we made kept popping on us,” Angel said. Once the nugs went into the metal, they came apart. Danny, the designer who took on the casting, watched most of the first run fail. “The first casting, when it was like ten pieces, only like three came out good,” he said. “It was like unique, one-of-a-kind shit really.”

The trouble was density. A nug packed too loose left air pockets, and air pockets wreck a cast. Most attempts failed before the team found flowers dense enough to cast clean. “It was super hazardous,” Angel said of the failures. When one finally held, he said, “it was like a caveman discovering fire.” Even then the yield was brutal: of four good candidates, he said, only two came out the way they wanted.

Moisture turned out to matter too, which answered the question that filled the comments once the shop posted video of the process: why use old weed? Because fresh flower doesn’t cast. Danny said his research pointed the other way from intuition. Drier, staler flower holds its shape in the mold. Wet flower ruins it.

The basic method was familiar to any jeweler. The material going into the mold was not. Instead of a carved wax model, the team used the actual flower. “The piece is dipped in plaster, the plaster hardens, and then you pour the molten metal,” Agadjani said. “It burns out the flower. It vaporizes it and takes its place with gold.” Anyone hoping a little of the plant survives inside is misreading the temperature. “If you’re burning it with a lighter, how do you expect it to be there after melting it with gold?” he said.

“This is way cooler. This has never been done before,” Agadjani said, and he’ll go further, calling it a first in human history. What the interviews establish is narrower. Casting real organic material into metal is an established technique, and Danny said he borrowed the approach from a casting contact who does it with real leaves, usually in brass. Nobody at TraxNYC had attempted it with cannabis before.

The only part harder than turning a flower into gold is agreeing on what happened next. Soriano and Danny described the finish as PVD, a coating they said was intended to add durability and preserve the color. Danny was loose on the specifics. “What it stands for I don’t know,” he said, “but it’s basically just like another coating on top.” Agadjani wasn’t sure it was on the piece at all. “I don’t remember using PVD on this piece, to be honest,” he said. “This should have been electroplated.” The interviews never resolve which finish the sold pieces actually got.

[[ IMAGE: Angel_XRF_Gun_Nug.JPG ]]
Caption: Angel scans the prototype with the shop’s XRF gun, under TraxNYC’s YouTube plaques. Photo by Cesar Soriano.
Alt: A TraxNYC jeweler scanning the gold cannabis pendant with an XRF gun

The metal, at least, is not in dispute. During the interview, Angel put Soriano’s own prototype under the shop’s XRF gun, which reads alloy content and, he noted, had never been pointed at the piece before. It came back at 10.81 karat, which Angel rounded to 11: a shade above the 10-karat core the prototype was built as, under a 22-karat dip. The screen broke out the rest of the alloy too, 39% copper, 10% silver and 5% zinc. The pieces TraxNYC sold were made in 18-karat gold, Angel said, with green diamonds set in the bail. A video the shop posted to Instagram is what turned the experiment into orders. Angel estimated it drew around three million views in its first day and several million since. The first sold about two weeks after it went up. The last went to a longtime client.

At least one buyer walked in with more than looks in mind. Jeff, who found the nug in the TraxNYC display window, knew on sight. “My response was like our old friend Wayne Campbell from Wayne’s World,” he said. “She will be mine. Oh yes, she will be mine.” Holding it sealed it. “Wow, that’s definitely heavy,” he remembered thinking. “It’s like a daddy falling in love with his newborn the first time he holds him.”

For Jeff, the piece is less about showing off than marking what cannabis has meant in his life. “This piece for me is a trophy piece,” he said. “Over the years I’ve benefited in so many ways from the power of this plant, so now this piece is something to never let me forget that.” He sees the gold itself as part of the value too. “This particular one weighs out to exactly 1.5 ounces of gold bullion locked into the piece,” he said, “so for me it sort of doubles as an investment.” The price of a custom one-of-one piece reflects the design and labor as much as the metal, but the gold is real, and that permanence is the whole point for him.

Asked what he’d make next with no budget limits, Agadjani went somewhere stranger. “You could make a miniature grow farm where you could put a seed in, the pendant grows the bud and you grow it in there,” he said. It isn’t a production plan. It does say something about where a shop’s head goes after weeks of blowing up gold nugs to find out what was possible.

Cannabis flower is made to disappear. It gets broken apart, burned and gone by the end of the night. This one went too. What survived was the shape it left behind, fixed in a metal built to outlast everyone who handled it.

Editor’s note: Cesar Soriano (T.H.Caeczar) originated the jewelry project with TraxNYC, conducted the interviews and took the photographs used in this story, and has a commercial interest in the design. TraxNYC sells the pieces commercially. High Times owner Josh Kesselman saw the piece at TraxNYC before this story was pitched, and has appeared wearing it in TraxNYC’s own social media. High Times reviewed the interview recordings and written responses and verified the quotations before publication.

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Curaleaf Holdings, Inc on Tuesday sent a letter to Aurora Cannabis Inc. shareholders urging them to accept its bid to take over the company. In the letter, Curaleaf CEO and Chairman Boris Jordan said Aurora shareholders “have an important choice to make about the future” of their investment. 

“Accept a 45% premium and become an owner of the world’s leading cannabis company with strong growth prospects. Or remain invested in a standalone business stuck in a multi-year turnaround plan whose own management has guided revenue and adjusted EBITDA lower next year.” — Jordan in the letter 

In a statement, Jordan described Aurora as “a shrinking business that is burning cash and getting less profitable by the day.”    

Curaleaf announced its hostile takeover bid of the Canadian company in August. The offer to shareholders would see the Curaleaf purchase all of Aurora’s issued and outstanding shares at $4 per Aurora Cannabis share, which Curaleaf said is a 45% premium to Aurora’s 30-day volume-weighted average price (VWAP) and a 110% to Aurora’s 30-day VWAP excluding balance sheet cash. 

Earlier this month, Aurora urged its shareholders to reject the proposal, saying it is debt-free and currently holds CA$149 million in cash, while Curaleaf has debts exceeding CA$1 billion.  

In the letter to Aurora shareholders, Jordan said combining the two businesses “delivers immediate value while allowing shareholders to participate in the future upside of the largest, most diversified global cannabis platform” and that a combined company “would create the global cannabis leader with operations across 17 countries, more than US$1.5 billion of last twelve-month revenue, nearly US$350 million of adjusted EBITDA and at least US$40 million of expected annual cost synergies.”    

In a September 2 statement, Miguel Martin, executive chairman and CEO of Aurora, called the would-be transaction as “harmful to Aurora shareholders as the hostile bid is inadequate.” 

“Shareholders of Aurora should understand plainly: Curaleaf is not offering you fair value for your shares, and your cash, your rights and your future upside are at stake,” Martin said in the statement. “Curaleaf is attempting to use Aurora shareholders’ own cash to help finance this bid, acquire Aurora’s assets at a discount and shift material risks onto our shareholders. The Board strongly and unanimously recommends that shareholders reject the offer, by taking no action and do not tender their shares. Aurora has been built for the long-term and staying with our Company is the right decision.”   

Ganjapreneur: Offering daily insights since 2014, the leading digital business journal for cannabis industry professionals. Subscribe to the newsletter to join our community of over 40,000 ganjapreneurs.

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A federal bill to normalize banking for the cannabis industry has been reintroduced in Congress. The Secure and Fair Enforcement (SAFE) Banking Act, which would provide a create a legal framework for banking and financial services to serve state-legal cannabis businesses, has passed the House of Representatives several times but has never been voted on by the full Senate. 

 In a statement, Sen. Catherine Cortez Masto (D-NV), who first co-sponsored the legislation in 2017, said lawmakers “must make sure that businesses in states where marijuana is legal…have access to bank accounts and other financial services.”   

“I’m proud to support this legislation that will help Nevada small businesses and make our communities safer in the long run. It’s time to finally get this bill done.” — Cortez Masto in a press release 

The SAFE Banking Act would protect banks and their officers who provide financial services to legitimate, state-sanctioned cannabis businesses from criminal prosecution and liability and asset forfeiture, while maintaining banks’ right to choose not to offer those services. It would also provide protections for hemp and hemp-derived CBD related businesses and require banks to comply with current Financial Crimes Enforcement Network (FinCEN) guidance.  

Additionally, this bill would prevent federal banking regulators from prohibiting, penalizing or discouraging a bank from providing financial services to state-sanctioned and regulated cannabis business, or associated businesses, such as lawyers or landlords that provide services to the sector; terminating or limiting a bank’s federal deposit insurance primarily because the bank is providing services to a state-sanctioned cannabis business or associated business; recommending or incentivizing a bank to halt or downgrade providing any kind of banking services to these businesses; and taking any action on a loan to an owner or operator of a cannabis-related business. 

The proposal is co-sponsored in the Senate by Senators Lisa Murkowski (R-AK), Steve Daines (R-MT), and Elizabeth Warren (D-MA), Dan Sullivan (R-AK), Kevin Cramer (R-ND) and Patty Murray (D-WA).   

Ganjapreneur: Offering daily insights since 2014, the leading digital business journal for cannabis industry professionals. Subscribe to the newsletter to join our community of over 40,000 ganjapreneurs.

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Legalizing marijuana is a “no-brainer” move to help ward off a “fiscal time bomb” in Iowa that could otherwise lead to cuts in funding for education and public safety in the state, the Democratic candidate for governor says.

“I think we should treat it the way we treat alcohol. That seems like a no-brainer to me, right?” Rob Sand, the Democratic gubernatorial nominee, said at a town hall event in Dallas County on Wednesday in response to a question from a voter who said Iowa is “losing money” to other states that have legalized cannabis.

“Alcohol is a dangerous drug. You shouldn’t abuse it. Also, we’re not going to throw you in prison for having a beer,” Sand said. “Why is it any different for marijuana? It is a dangerous drug. You shouldn’t abuse it. We shouldn’t be throwing people in prison just for using it.”

The Democratic candidate said that “when I say treat it like alcohol, I literally mean treat it like alcohol.”

He then went through a list of common objections to cannabis legalization and explained how he would respond to them.

“So when I hear people say, ‘Well, I don’t want to smell it.’ Same. You shouldn’t be allowed to smoke it in public. Simple rule: you can’t drink alcohol in public, right?

People say, ‘Well, I’m worried about kids. I’ve heard cases in Colorado where they got colorful gummies, and the kids find them, and then the kids get sick.’ I agree. You shouldn’t be able to market it to children. You shouldn’t be able to use colorful designs on your packages. And if you’re doing gummies, they can look like an eraser, right? They don’t need to be red and blue and green and look like gummy bears.

People say, ‘Well, I don’t know, Rob. It’s a lot stronger than the stuff that I was smoking in the 70s.’ To which I say, ‘I wasn’t there. Whatever you say, I believe you.’ I don’t have a basis for comparison then or now. I actually haven’t used it. But how do we handle that with alcohol? When you buy a beer, you can see what the alcohol content is on the beer, right? We treat hard liquor differently, but you can see when you buy hard liquor what the content is on that, and that way you know what you’re getting into. We can do that with marijuana as well.”

Sand, who is currently Iowa’s state auditor, said the state currently has a budget surplus, but that annual spending is overtaking revenue.

“I call this a fiscal time bomb. Our budget is nine and a half billion,” he said. “Imagine the cuts to public education and to public safety if we don’t take action to fix this.”

“So we need to do something now,” he said, arguing that legalizing marijuana is “one of the things that we should do.”

“We would have hundreds of millions of dollars every single year if we just treat marijuana the way we treat alcohol,” Sand said, adding that the thinks the state should also put an income limit on school vouchers and make data centers pay fair taxes.

“All three of those would save us hundreds of millions of dollars a year alone,” he said. “So if we do all three of them, we do them right away, all of a sudden, our time horizon on how long that surplus is going to last gets a lot longer, and we can think about other ways to help address that and get back to having a balanced budget.”

Sand also spoke about his support for legalizing marijuana at an earlier event last month, saying that he thinks cannabis should be legalized and treated like alcohol, even if he thinks it’s “dangerous.”

“Marijuana is a dangerous drug,” he said at the time. “You shouldn’t abuse it, but we also shouldn’t throw people in prison just for using it. We should treat it the way we treat alcohol. Alcohol is a dangerous drug. You shouldn’t abuse it, but we don’t throw you in prison just for having a beer when you get home.”

The Democratic gubernatorial candidate said that Iowa is “spending perfectly good tax dollars to lock people up” for marijuana while people who want to use it are driving across the border to purchase it in other states.

“They’re spending their money in Illinois, or they’re spending it in Missouri. And then they’re driving back without their money,” Sand said. “The money stays there, and the tax dollars stay there.”

Republican gubernatorial nominee Zach Lahn reportedly opposes legalizing cannabis but doesn’t appear to have spoken extensively about the issue.

Josh Turek, the Democratic nominee in a U.S. Senate race, said this month that cannabis’s longtime restrictive Schedule I status is “ridiculous.” Marijuana “should be legalized and regulated, and let’s tax it,” he said.

Meanwhile, Iowa regulators are circulating proposed rules changes to remove the residency requirement for patients in the state’s medical cannabis program while also ensuring that military veterans qualify for reduced registration fees.

The residency-focused part of the regulatory change from the state Department of Health and Human Services is meant to comply with provisions of a bill that Reynolds signed into law in June.

In addition to allowing out-of-state residents to register in the medical cannabis program if they have a certification from an Iowa healthcare provider legislation, that legislation also doubles the number of medical cannabis dispensaries that are allowed to operate in the state.

Regulators said in the new rule filing that removing the residency requirement is expected to “primarily impact qualified Nebraska residents since Nebraska is the only bordering state that does not currently have an operational medical or adult-use cannabis program.”

“Although Nebraska has taken steps to establish a medical cannabidiol program, implementation has experienced significant delays and setbacks,” the regulatory explanation says.

Beyond the residency change that is part of the bill the governor signed this year, the new rule change also restores regulatory language that was “inadvertently removed during the 2023 Red Tape Review process” that allowed proof of military veteran status to be used to qualify for a reduced patient application fee of $25 instead of the standard $100.

Under prior law, Iowa’s limited medical marijuana program allowed only five dispensaries. That has doubled to 10 under HF 990, which the governor signed.

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The Iowa Medical Cannabidiol Board, which oversees the state’s medical marijuana program, recommended in a 2023 report that the state allow more licenses “in an effort to provide Iowans with greater geographical access to medical cannabis products.”

Under the program, patients with certain conditions can obtain cannabis products containing no more than at 4.5 grams of THC every 90 days. Flower and smoking are not allowed. Healthcare practitioners can allow greater amounts of THC for patients who are terminally ill or who have experience with the program and for whom the provider believes 4.5 grams is not enough.

Separately this session, Iowa lawmakers considered a bill to create a state-regulated therapeutic psilocybin program for patients with post-traumatic stress disorder (PTSD).

Last year, the governor vetoed earlier legislation that would have allowed doctors in the state to immediately prescribe a synthetic form of psilocybin in the event of federal approval of the psychedelic substance by the U.S. Food and Drug Administration (FDA), arguing that it “surrenders state authority to make an informed determination about classification to federal officials.”

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Washington has removed Venezuela from the group of countries deemed to have “failed demonstrably” in their anti-drug obligations while maintaining it on the broader list of major drug-transit and producing countries, citing growing cooperation with Delcy Rodríguez’s interim government. At the same time, U.S. oil companies and policymakers are rapidly deepening their involvement in Venezuela’s enormous crude reserves, raising questions about how energy, counternarcotics policy and Washington’s broader geopolitical strategy now intersect.

Since 2005, when former President Hugo Chávez was still governing Venezuela, Washington has presented the Latin American country as a central concern in its regional anti-drug policy. That has just changed.

On September 16, U.S. President Donald Trump announced that Venezuela was no longer among the countries Washington considers to have “failed demonstrably” to meet their international drug-control obligations, as reported by Diario Red. Venezuela, however, is still considered a major drug-transit or illicit drug-producing country—a different category that does not, by itself, imply that its government is failing to meet its anti-drug commitments.

How did Venezuela go, in a matter of months, from occupying a central place in the U.S. narrative on drug trafficking to being led by a government whose anti-drug cooperation Washington is highlighting?

This shift comes as another relationship central to both countries is also changing: oil.

From Adversarial Relations to Renewed Cooperation: What Happened to the Anti-Drug Narrative

To understand what changed, we first need to separate two classifications that are often confused. Every year, the president of the United States identifies countries considered major drug-transit or illicit drug-producing countries; this is known as the Major’s List. Venezuela remains on it: it’s one of the 23 countries included in the determination for fiscal year 2027.

But appearing on that list does not, by itself, mean that Washington believes the government of that country is failing to combat drug trafficking. The State Department has explained that the designation may be based on geographic, commercial, and economic factors that facilitate drug production or transit even when authorities implement control measures. The “failed demonstrably” category is different: it applies when the president determines that a country has failed to make substantial efforts to meet its international anti-drug obligations during the previous 12 months.

Here’s the relevant change. In September 2025, the White House included Venezuela, along with Afghanistan, Bolivia, Burma, and Colombia, among the five countries that had “failed demonstrably” to make those efforts. One year later, the list was reduced to four: Venezuela disappeared from that second classification, although it remained on the Major’s List.

Trump explicitly attributed that decision to the new relationship with Delcy Rodríguez’s interim government. In the determination sent to Congress, he argued that political changes in South America had opened new possibilities for cooperation and said Washington was already seeing results from its joint work with Caracas against cartels. “Given the positive steps” under Rodríguez, he said, Venezuela should no longer be considered a country that had demonstrably failed to meet its anti-drug commitments.

In September 2025, the Trump administration launched a military campaign in the Caribbean against vessels it claimed were linked to drug trafficking. The first known attack, on September 2, killed 11 people aboard a vessel from Venezuela; Trump said they belonged to Tren de Aragua and were carrying drugs, but at the time the U.S. government did not publicly release evidence about the identities of those on board or the cargo. Various experts, politicians, and news outlets questioned the legality of summarily killing people suspected of drug trafficking instead of arresting them.

Still, the campaign continued. On September 15, another U.S. attack on an alleged Venezuelan drug-trafficking vessel killed three people; once again, Trump did not publicly present evidence showing that the vessel was carrying drugs. By October, several similar attacks had already taken place.

And then came the decisive change: in January 2026, the United States captured Nicolás Maduro and Delcy Rodríguez took charge of the interim government. From that point on, Washington began working directly with that administration. Reuters describes the current situation explicitly: Trump attributed Venezuela’s removal from the “failed demonstrably” category to the results of cooperation with the Rodríguez government. The government Washington was dealing with had changed, and the bilateral relationship shifted dramatically with it.

So What Happened to the ‘Cartel of the Suns’?

Washington’s shift in tone raises another important question: what happened to the so-called “Cartel of the Suns,” a structure that the U.S. government itself presented for years as a drug-trafficking organization run from the highest levels of the Venezuelan state?

It is worth separating several things that are often conflated. One is the existence of drug-trafficking and corruption allegations against specific Venezuelan officials. Another is the allegation that state protection or corruption networks were linked to drug trafficking. And another, far more specific, is the claim that all of those activities constituted a centralized, hierarchical criminal organization called the “Cartel of the Suns.”

In 2020, the U.S. Department of Justice advanced precisely that last version. In the indictment filed against Nicolás Maduro and other senior Venezuelan officials, prosecutors alleged that Maduro, Diosdado Cabello, Hugo Carvajal, and Clíver Alcalá had acted as “leaders and managers” of the Cartel of the Suns and had used state institutions to facilitate shipments of cocaine to the United States. It is important to emphasize that these were criminal allegations, not convictions.

The Trump administration took that characterization even further in 2025. In July, the Treasury Department sanctioned the Cartel of the Suns as a global terrorist organization and said it was a criminal group “headed by Nicolás Maduro” and other senior officials. In November, the State Department also moved forward with its designation as a Foreign Terrorist Organization.

But just a few months after Maduro’s capture, the Justice Department filed a revised indictment that no longer describes the Cartel of the Suns in the same way it did in 2020. The new document accuses Maduro of participating in and protecting a “culture of corruption” in which Venezuelan elites enriched themselves through drug trafficking and the protection of traffickers, and defines the Cartel of the Suns as the name given to a “patronage system” directed from the top.

The change does not eliminate the drug-trafficking allegations against Maduro or the corruption allegations against Venezuelan officials. What it changes is something more specific: the characterization of the Cartel of the Suns as a formal, distinct, centralized criminal organization. The New York Times, comparing the two indictments, noted that the earlier document mentioned the Cartel of the Suns 32 times and presented Maduro as its leader, while the 2026 version sharply reduced those references and instead described the term as a system of corruption and patronage.

The Anti-Drug Allegations Also Had Economic Consequences

U.S. sanctions policy toward Venezuela was never based exclusively on drug-trafficking allegations. For years, Washington built a broader framework that brought together allegations of corruption, human rights violations, institutional deterioration, political repression, and links between senior officials and drug-trafficking networks.

Those different justifications ultimately translated into increasingly broad financial restrictions against officials, state-owned companies, and eventually entire sectors of the Venezuelan economy.

The anti-drug component was part of that framework. In 2017, for example, the Treasury designated then-Vice President Tareck El Aissami as an international drug trafficker under the Kingpin Act. The following year, it also sanctioned Pedro Luis Martín Olivares, a former senior Venezuelan intelligence official, and a network of individuals and companies that Washington said were involved in drug trafficking and money laundering.

A major escalation came in January 2019, when the Treasury directly sanctioned PDVSA (Venezuela’s state-owned oil and gas company, Petróleos de Venezuela S.A.), the country’s main source of foreign currency. But the U.S. statement itself makes clear that the measure did not serve solely as punishment for alleged acts of corruption. The Treasury presented the sanction as a way to ‘ramp up pressure’ on Maduro and support a political transition. It also said that the path to lifting sanctions on PDVSA involved transferring control of the company to the then-interim president recognized by Washington, Juan Guaidó, or to a subsequent, democratically elected government.

The political purpose of the sanctions regime was not implicit, either. The Treasury said these measures were intended to “change behavior” and could be lifted for those who took concrete actions to restore democratic order, rejected human rights abuses, or fought corruption. In another statement that same year, it reiterated that rationale, describing the sanctions as intended to bring about a “positive change of behavior.”

The pressure also extended to third parties that helped Venezuela maintain its oil revenues. In June 2020, the Treasury sanctioned a network of intermediaries that it said had helped PDVSA evade U.S. restrictions and resell more than 30 million barrels of Venezuelan crude oil.

Just three months earlier, Maduro and other Venezuelan officials had been charged with narcoterrorism, corruption, and cocaine trafficking. Prosecutors alleged that Maduro and his associates had used Venezuelan political and military institutions to protect those activities. These were U.S. criminal allegations, not judicial convictions.

Thus, oil, sanctions, corruption, drug trafficking, and political pressure all operated together within the U.S. strategy toward Venezuela. Official documents themselves intertwined them over time: a figure sanctioned for drug trafficking could also appear as a central player in schemes designed to maintain PDVSA exports; a narcoterrorism indictment against Maduro coexisted with restrictions aimed at cutting off his government’s oil revenues; and sanctions relief was explicitly linked to political changes Washington sought to promote.

Washington used access to oil, the financial system, and the U.S. market as tools of pressure against the Venezuelan government, while criminal and anti-drug allegations formed part of the stated rationale for those restrictions. Today, that isolation appears to be starting to ease.

How the U.S. Position on Oil and Drug Trafficking in Venezuela Changed

This economic isolation began to be dismantled rapidly after January 2026. Since then, the U.S. Treasury has issued a series of licenses that progressively reopened activities that had been restricted for years: the purchase and sale of Venezuelan oil, the sale of U.S. diluents, the provision of equipment and services for oil operations, new investments, and certain transactions directly involving PDVSA.

In March, OFAC (the U.S. Office of Foreign Assets Control) expressly authorized certain companies to make new investments, expand existing operations, and explore, produce, and develop oil and gas projects in Venezuela.

The easing continued throughout the year. On August 27, OFAC again modified several of those licenses, including those related to Venezuelan oil, the sale of diluents, the supply of goods and services, oil-company operations, and transactions with PDVSA. The Treasury itself explained that some of those changes were in response to “investment-related reforms” implemented by the Venezuelan government since January and said the U.S. sought to support American companies looking to “reinvest in Venezuela.”

The reopening is already having material effects. In January, Venezuelan oil exports jumped to around 800,000 barrels per day, up from about 498,000 in December, while companies such as Trafigura and Vitol began operating under new U.S. authorizations. Chevron was exporting around 220,000 barrels per day to the United States, making the U.S. market the leading destination for Venezuelan crude oil once again.

U.S. buyers also returned. In February, Reuters reported that Valero planned to import as much as 6.5 million barrels of Venezuelan crude during March for its Gulf Coast refineries, the company’s largest volume since the 2019 oil sanctions. Chevron, meanwhile, expected to increase its Venezuelan exports to around 300,000 barrels per day.

The shift reached a new level on September 16, the exact same day it became known that Venezuela would no longer be listed among countries that had “failed demonstrably” to meet their anti-drug obligations. That day, U.S.-based Continental Resources signed a memorandum of understanding with PDVSA to develop Ayacucho 2, a block in the Orinoco Belt with estimated resources of 30 billion barrels. The company expects to turn the preliminary agreement into a production-sharing contract and said extraction could begin in about 18 months.

The U.S.’s Longstanding Interest in Venezuelan Oil—and Why It Matters Now

Venezuela has the world’s largest proven crude oil reserves: around 303 billion barrels—approximately 17% of global reserves, according to the U.S. Energy Information Administration (EIA). Most of those reserves consist of extra-heavy crude oil from the Orinoco Belt. That gives the country extraordinary economic and geopolitical potential, although having enormous reserves does not guarantee prosperity on its own: turning them into revenue requires investment, infrastructure, technical capacity, markets, and the conditions needed to produce and export.

For much of Nicolás Maduro’s government, Venezuela was willing to sell that oil to the U.S. In fact, before the 2019 sanctions, the United States was the largest buyer of Venezuelan crude. In 2018, it imported around 505,000 barrels per day; Gulf Coast refineries had historically processed even larger volumes of heavy Venezuelan crude and are particularly well equipped to handle that type of oil.

The rupture, therefore, did not happen because Venezuelan oil had stopped being useful to the United States or because Caracas refused to sell it. Instead, it reflected a U.S. policy decision to restrict that relationship.

When the Treasury directly sanctioned PDVSA on January 28, 2019, it described the company as one of the country’s main sources of revenue and foreign currency. The title of the statement itself said the measure sought to “ramp up pressure” on Maduro, and the U.S. government explained that it was using its economic power to support a political transition it recognized as democratic (in contrast to Maduro’s government).

The United States did not control Venezuela’s oil reserves or determine how Caracas used resources within its territory. PDVSA and the reserves remained Venezuelan. What Washington could do—and did—was leverage the weight of its market, its currency, and its financial system to make that oil significantly more difficult to sell: blocking assets under U.S. jurisdiction, preventing certain transactions with PDVSA, and sanctioning companies, intermediaries, and vessels involved in transactions Washington had decided to restrict.

That pressure was not even limited to bilateral trade. The United States also acted against third parties transporting Venezuelan oil to other countries. Cuba is one of the clearest examples: in April 2019, the Treasury sanctioned shipping companies and identified dozens of vessels as blocked property, including ships used to transport Venezuelan crude oil to the island. Washington described the oil industry at the time as a “lifeline” for Maduro’s government and also targeted Cuban support for Caracas.

In other words: for years, Washington used its financial and commercial power not only to restrict U.S. purchases of Venezuelan oil, but also to raise the costs and risks for other actors participating in that trade. Meanwhile, much of the oil Venezuela managed to sell shifted toward markets such as China. The EIA notes that, following the 2019 sanctions, a significant proportion of Venezuelan exports went to China, including some under debt-repayment arrangements.

After the U.S. operation that ended with Maduro’s capture in January 2026, oil appeared almost immediately at the center of Washington’s plans for the new phase.

On January 3—the same day Nicolás Maduro was captured and imprisoned in the U.S.—Trump said U.S. oil companies would invest billions of dollars to restore Venezuela’s deteriorated infrastructure and increase its production. Reuters noted at the time that the country’s heavy crude oil is particularly useful for U.S. Gulf Coast refineries.

The following day, Secretary of State Marco Rubio was even more explicit about the geopolitical component. “No more using the oil industry to enrich all of our adversaries around the world,” he said, after stating that Washington would not allow the Western Hemisphere to become a base of operations for U.S. “adversaries, competitors, and rivals.” He also specifically mentioned Iran and Hezbollah among the actors whose influence Washington intended to eliminate from Venezuela.

A few days later, the U.S. and the new Venezuelan government agreed to redirect up to $2 billion in sanctioned Venezuelan oil to the U.S. market, in an operation that also sought to divert some of the shipments that had previously gone to China.

Thus, U.S. oil interests did not emerge months later as a consequence of the current price crisis: they were on the table from the first days after Maduro’s removal. What happened afterward was that the international situation considerably increased the strategic value of that access.

Since late February, the war involving the United States and Israel against Iran and the subsequent disruptions in the Middle East have hit some of the world’s main energy supply routes and sources. By September, Brent and WTI had surpassed $100 per barrel, while the inventories that had initially cushioned the impact of the conflict were shrinking. Chevron CEO Mike Wirth warned that those buffers were being depleted and that upward pressure on prices could persist.

The situation is particularly sensitive for the United States when it comes to refined fuels. In September, diesel surpassed $6 per gallon, reaching record levels amid global refining and supply constraints.

Venezuela occupies a particular place in this equation. Its heavy crude oil is not simply “more oil”: it is a type of feedstock that U.S. Gulf Coast refineries are familiar with and are equipped to process.

For years, the United States used its economic power to limit the Venezuelan government’s oil revenues, restricted PDVSA’s operations, and even sanctioned third parties for transporting the country’s crude. Washington’s sanctions were explicitly designed to constrain the revenues available to Maduro’s government from Venezuela’s oil sector; U.S. officials described those measures at the time as instruments of pressure intended to change the government’s behavior.

Now, following Maduro’s removal, the Trump administration is promoting U.S. investment to increase production of that same oil, redirecting Venezuelan barrels from China to the United States, and presenting control over those flows as part of its national security interests. And it is doing so just as an international energy crisis makes the heavy crude oil Venezuela can provide especially valuable.

This does not prove that oil alone explains the U.S. operation in January or that the recent decision to remove Venezuela from the category of countries that “failed demonstrably” to meet their anti-drug commitments was made in exchange for access to its reserves. But the timing makes it reasonable to examine both processes as part of the same broader transformation in Washington’s policy toward Caracas.

Venezuela’s oil reserves have not changed, and the underlying drug-trafficking concerns have not disappeared. What has changed is who governs Venezuela, that government’s relationship with Washington, and the role Venezuelan resources now play within U.S. energy and geopolitical strategy.

How Does Trump’s Pardon of Silk Road’s Founder Fit With His Administration’s Anti-Drug Policy?

The two cases show markedly different uses of executive power in drug-related contexts.

While his government presented drug trafficking as a national security issue and cited it to justify fatal attacks on vessels in the Caribbean, economic sanctions, and ultimately a military operation inside Venezuela in which Maduro was captured, Trump used his pardon power to free Ross Ulbricht, the founder and operator of one of the largest dark web drug markets of its time.

On January 21, 2025, just one day after returning to the White House, Trump granted a full and unconditional pardon to Ross Ulbricht, founder and operator of Silk Road. Ulbricht had spent more than a decade in prison and was serving two life sentences plus 40 years after a federal jury convicted him on seven counts, including narcotics distribution, narcotics distribution over the internet, conspiracy to distribute drugs, engaging in a continuing criminal enterprise, and money laundering.

Silk Road was hardly a marginal platform either. According to the Department of Justice, between 2011 and 2013 it was used by thousands of vendors to distribute hundreds of kilograms of illegal drugs to more than 100,000 buyers, in addition to other illicit goods and services. Transactions conducted through the site exceeded $200 million, while Ulbricht earned more than $13 million in commissions.

Trump publicly justified the pardon in terms very different from those he later used regarding Venezuela. In announcing it, he called the people who had worked to secure Ulbricht’s conviction “scum” and linked his case to what he considers the “political weaponization” of the U.S. justice system. Reuters also noted that the pardon fulfilled a campaign promise made to libertarian groups that considered the life sentence excessive.

Ulbricht spoke at the Republican Midterm Convention in September 2026 and returned to that same argument during his speech. According to The Economic Times, he said Trump had empathized with him because “both had been victims” of state institutions allegedly used politically against them.

In Ulbricht’s case, Trump overturned a final conviction for crimes connected to a marketplace that facilitated hundreds of millions of dollars in illegal drug sales, arguing that the defendant had been the victim of a politicized justice system. In Venezuela’s case, his administration used drug-trafficking allegations that were still being litigated as part of the justification for a military operation inside a foreign state.

What Objective Facts Does Washington Cite to Justify Venezuela No Longer Being on the List?

So far, Washington’s public explanation for the change has focused primarily on growing cooperation with Delcy Rodríguez’s interim government. Trump attributed the decision to that cooperation and highlighted as a concrete result the operation that ended with the death of Niño Guerrero, leader of Tren de Aragua. The determination does not, however, detail a quantified reduction in drug trafficking, increased seizures, or other indicators that would make it possible to measure how much the situation has actually changed since 2025. In fact, Trump himself said he expects to see “continued and measurable” progress in the future.

If the publicly available evidence specifically related to drug enforcement is relatively limited, it is worth looking at what other dimensions of the bilateral relationship changed over exactly the same period.

That makes the simultaneous transformation in the U.S.-Venezuela oil relationship particularly relevant to the question.

Cover photo created with AI.

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Using medical marijuana helps people who suffer from lower pain significantly reduce their opioid use as well as experience lower pain intensity and functional disability, according to a new study that involved hundreds of patients.

Researchers with Tel Aviv University, Rabin Medical Center and Clalit Health Services in Israel enrolled 1,000 patients with chronic low back pain (CLBP) who had previously never used cannabis and tracked their pain, disability status and medication usage annually for a period of 10 years at a specialized orthopedic pain clinic.

After a decade, opioid use, measured in morphine milligram equivalents, “decreased substantially” by 90 percent.

“Opioid reduction was rapid in the first year and remained stable through Year 10,” the researchers wrote.

Pain intensity also dropped by 84 percent, and functional disability was reduced by 30 percent.

The study, published in the European Spine Journal, also looked at how many patients achieved significant pre-specified thresholds for the outcome measures.

For reduced opioid use, 91 percent of patients met the target of at least 50 percent reduction in opioid use.

The goal of 30 percent of greater reduction on a pain intensity scale was achieved by 62 percent of participants. Sixty-two percent of patients reached the targeted decrease in functional disability scores of 10 points or more on a standardized scale.

“Medical cannabis therapy was associated with reductions in opioid use, pain intensity, and functional disability over 10 years, accompanied by polypharmacy reduction and acceptable tolerability.”

There was also a “substantial” reduction in use of other non-opioid medications among patients who completed the study.

“Tramadol/tapentadol use decreased from 89.7% to 5.6% (−84.0% points), benzodiazepines from 78.8% to 5.3% (−73.5 pp), SSRIs from 77.7% to 5.8% (−71.9 pp), and gabapentinoids from 31.3% to 0.6% (−30.7 pp),” the study said. “These reductions were clinically driven rather than protocol-mandated, reflecting individual physician-patient decisions based on symptom response. The pattern of polypharmacy reduction paralleled opioid reduction, occurring primarily in the first 2 years.”

The reduction in use of several different kinds of medications suggests that “medical cannabis may address multiple symptom domains simultaneously,” the researchers wrote.

“Chronic pain patients frequently require polypharmacy to manage pain, sleep disturbance, anxiety, and depression, each of which carries risks of adverse effects and drug interactions,” the said.

Participants in the study used marijuana products that included dried flower for vaporization and cannabis oils for oral/sublingual administration. There was some patient drop off as the study went on, and 638 of the 1,000 who enrolled ended up completing the final follow-up observation.

The researchers cautioned that the single-arm observational nature of the study means that causality cannot be inferred. They also noted that the size of the reductions in the outcome measures in the study “substantially exceeded” those from previously published randomized controlled trials, suggesting that “observational biases contribute to these findings.”

Nonetheless, they said their study is the “longest follow-up of medical cannabis therapy specifically in CLBP patients and demonstrates sustained, clinically meaningful improvements exceeding pre-specified [minimal clinically important difference] thresholds for opioid reduction, pain relief, and functional disability.”

“In this 10-year single-arm observational study, medical cannabis therapy was associated with reductions in opioid use (−89.8%), pain intensity (−84.2%), and functional disability (−30.4%), with high proportions of patients achieving pre-specified MCID thresholds,” the study concluded. “Substantial polypharmacy reductions and acceptable tolerability were observed.”

This is far from the only study supporting the efficacy of marijuana in the treatment of pain—nor is it the first to suggest cannabis can serve as a substitute for conventional therapies such as opioids.

A study published earlier this year found that medical cannabis use by people with chronic lower back pain leads to “large, sustained, and statistically robust improvements.”

In April, a study found that using medical marijuana appears to help people reduce the use of other medications, including opioids, sleeping aids and antidepressants. They also experience far fewer negative side effects after switching to cannabis from prescription drugs, the study involving more than 3,500 patients determined. 

About one in three Americans who use CBD say they take it as an alternative or supplement to at least one medication—particularly painkillers—according to a federally funded study published in February.

Similarly, another recent federally funded study, published by the American Medical Association (AMA), added more evidence that marijuana can serve as an effective substitute for opioids in chronic pain treatment.

Other AMA-published research has found that legalizing marijuana for medical or recreational purposes is “significantly associated with reduced opioid use among patients diagnosed with cancer.”

A separate paper published last year similarly found that medical marijuana legalization is “associated with significant reductions in opioid prescribing.”

In August, meanwhile, Australian researchers published a study showing that marijuana can serve as an effective substitute for opioids in pain management treatment.

Another study published last year in the journal Drug and Alcohol Review found that, among drug users who experience chronic pain, daily cannabis use was linked to a higher likelihood of quitting the use of opioids—especially among men.

Other research also found that legalizing medical cannabis appeared to significantly reduce monetary payments from opioid manufacturers to doctors who specialize in pain, with authors finding “evidence that this decrease is due to medical marijuana becoming available as a substitute” for prescription painkillers.

Further research also showed a decline in fatal opioid overdoses in jurisdictions where marijuana was legalized for adults. That study found a “consistent negative relationship” between legalization and fatal overdoses, with more significant effects in states that legalized cannabis earlier in the opioid crisis. Authors estimated that recreational marijuana legalization “is associated with a decrease of approximately 3.5 deaths per 100,000 individuals.”

“Our findings suggest that broadening recreational marijuana access could help address the opioid epidemic,” that report said. “Previous research largely indicates that marijuana (primarily for medical use) can reduce opioid prescriptions, and we find it may also successfully reduce overdose deaths.”

Another recently published report into prescription opioid use in Utah following the state’s legalization of medical marijuana found that the availability of legal cannabis both reduced opioid use by patients with chronic pain and helped drive down prescription overdose deaths statewide. Overall, results of the study indicated that “cannabis has a substantial role to play in pain management and the reduction of opioid use,” it said.

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Chains reorder every two weeks and earn twice the discounts. Independents stock the same breadth of product and win on everything that isn’t a spreadsheet.

Dispensaries generally fall into one of two camps: part of a multi-state chain, or an independent operator. Those independents might own several stores within one state (a single-state operator), or they might be a classic “mom & pop” shop with a single location. Consumers have good reasons to shop at either, and sometimes it just comes down to location and convenience. However, when pressed, it seems renegade cannabis consumers prefer the indies.

Consistency and Pricing

One argument for chain dispensaries is consistency. Shoppers who travel between legal states may prefer a recognizable name — if they know a brand from their home state, they can trust the product selection will be reliable. These customers may worry about wasting a trip on a local independent store that doesn’t carry the brands they’re used to. Chains may also be able to secure better prices simply because they’re buying inventory at scale. According to Chain Store Age, 85% of respondents cited lower prices as their reason for shopping at a chain, while 71% cited greater product variety.

Better Pricing

“The economies-of-scale assumption holds,” said Mitch Barton, VP of Transformation at Sun Theory, which operates in the wholesale market described here. The company has collected recent data looking at wholesale orders across five states, broken down between independents and chains. Barton said chains earn roughly twice the discounts and credits that independents do — about 4% to 5% of sales versus 2%. Per unit, the edge is modest, but he said it’s consistent, and it favors scale.

He added, “One of the biggest takeaways from our wholesale data is that the difference between chains and independent dispensaries isn’t how much they buy at one time; it’s how often they buy. Across our five-state wholesale network, chain operators accounted for roughly 54% of active retail accounts but nearly 73% of wholesale volume, because they reordered about every two weeks, compared with roughly every 24 days for independent retailers. That consistency has a meaningful impact on inventory planning, forecasting, and the entire supply chain.”

Variety

Another reason shoppers may end up at a chain versus an indy store is better selection. That variety is likely a function of size. Research on retail generally, not cannabis specifically, Updated in The Review of Economic Studies found that chain stores are two to five times larger in square footage than independent shops, and on average generate forty times the revenue and twenty-five times the profit of their independent counterparts. Bigger footprints also tend to mean more parking — a real convenience, since nobody likes circling the block or hiking in from a far-off spot.

Sun Theory’s data, however, doesn’t bear that pattern out in the cannabis industry. “Independents are often described as carrying a narrower or more curated selection,” Barton said. “Here, both buyer types stock the same breadth of the line, around eight SKUs per order across a comparable catalog. The character shows up in how they sell, not in how much of the line they carry.”

“The character shows up in how they sell, not in how much of the line they carry.”

Mitch Barton, VP of Transformation, Sun Theory

Character

The argument for independent stores usually comes down to character. Without a corporate parent dictating consistency and brand standards, owners are free to give their stores whatever personality they want. It could be a zen theme with a living plant wall and fountain, or a muscle-cars-and-fire aesthetic. Edgy or laid-back, there’s plenty of room for creativity.

Indy stores can also feel more in tune with local flavor. Owners are usually from the area and know what resonates with their customers. They may also be more inclined to work with small local producers who get overlooked by larger chains because they can’t supply at the scale big stores demand — reinforcing that homegrown connection.

Adolphus A. Busch V, CEO of Teal Cannabis, whose company opened the independent dispensary Current Cannabis in the St. Louis area, said, “As a local operator, we are part of the community. We live here, work here, and build relationships here. That gives us a firsthand understanding of our customers’ preferences, interests, and values.”

Scale

While chains are perceived as offering lower prices, they also carry larger overhead. Pricier real estate and the cost of supporting a bigger operation don’t always translate into savings for the customer. Smaller, more nimble businesses with lower overhead can often pass those savings along to shoppers.

“Nimbleness is the independent’s superpower,” said Shavon Sullivan Wright, CEO and founder of The Grass Cab. “A larger operator is still routing a deal through procurement in another state while I’ve already shaken the grower’s hand, texted my regulars, and probably fed everyone lunch. We move at the speed of relationships; they move at the speed of spreadsheets.”

“We move at the speed of relationships; they move at the speed of spreadsheets.”

Shavon Sullivan Wright, CEO and founder, The Grass Cab

Adam Stettner of cannabis lender FundCanna said, “Chains and operators with multiple locations have real purchasing power, but that’s not the same as running a smarter business. The challenge that operators with multiple locations face is that consumer behavior shifts county to county, even neighborhood to neighborhood. If they’re running on their own data plus a source like Headset or BDSA, they can still buy for local demand. It’s a question of scale and efficiency, not whether one model is inherently smarter than the other.”

Freedom of Choice

“Here’s the part people get wrong: independent and multi-state aren’t opposing teams,” said Wright. “Someone once told me, ‘If you don’t like multi-state operators, build your own’ — and that stuck. My goal isn’t to stay small forever; it’s to grow without losing the character that makes an independent worth driving across town for. Because people don’t go out of their way for ‘fine.’ They show up because a place feels like theirs. The real question for this industry isn’t chain versus indy — it’s whether you can scale and still keep a soul.”

Luckily for consumers, they have the freedom to choose between an independent store and a chain outlet. There are roughly the same number of stores in each category across legalized states. However, some states have regulations that favor independents — Vermont, for example, limits operators to one license — while others are more comfortable with larger operators.

A small, unscientific poll I ran on X asked my followers which type of store they preferred. Sixty percent chose indies.

“People do not typically drive past three dispensaries just because one has the lowest price on a product,” added Busch. “They go where they trust the recommendations, where they feel welcomed, where the staff knows them, and where they can discover products they may not find everywhere else.”

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From exposure to death: how the calculation works

It is a study that has attracted considerable attention. As part of the Global Burden of Disease Study (GBD), a project led by the IHME (Institute for Health Metrics and Evaluation, University of Washington), whose estimates are notably used by the WHO when stating that “a given cause kills a certain number of people worldwide,” second-hand smoke was estimated to have been responsible for 1.66 million deaths worldwide in 2023. The figure has been widely reported by media outlets around the world. Here, we take a closer look at the methodology used to produce it.

Published on September 7, 2026, in the scientific journal The Lancet Public Health¹, the research is the work of more than 1,000 researchers. As is often the case with research on smoking, it was funded by Bloomberg Philanthropies and the Gates Foundation, two organizations also known for funding numerous studies critical of vaping.

Methodologically speaking, there is little point beating around the bush: this research is about as state-of-the-art as it gets for this kind of exercise. Its limitations do not stem from any lack of rigor on the part of the researchers, but simply from the fact that it is impossible to do much better. The aim was to determine the number of deaths caused by second-hand smoke over an entire year and across 204 countries. Since it is not possible simply to count all death certificates recorded around the world, modelling is required, and with it comes an unavoidable degree of uncertainty.

To arrive at their result, the researchers first estimated the number of people exposed to second-hand smoke worldwide: 2.71 billion, including 767 million children. This figure is itself an estimate based on numerous factors.

They then estimated the number of deaths caused by second-hand smoke from the number of people exposed. This was done using a standard epidemiological method that combines two pieces of information: relative risk (RR) and exposure prevalence.

Relative risk is derived from decades of previous research. For each disease associated with second-hand smoke — heart disease, stroke, lung cancer and others — it indicates how much more likely an exposed person is to die from the disease compared with someone who is not exposed.

By combining this relative risk with exposure prevalence (P), a standard statistical formula can be used to calculate the proportion of deaths from a given disease that is attributable to second-hand smoke. This is known as the population attributable fraction (PAF).

This percentage is then applied to the total number of deaths from that disease, which has already been estimated independently by the GBD programme, to obtain the number of attributable deaths. The calculation was repeated for every disease, in each of the 204 countries studied, and by age group and sex, before all the results were added together to produce the final figure: 1.66 million (95% UI 1.33–2.07). In other words, there is a 95% probability that the true number of deaths attributable to second-hand smoke in 2023 lies between 1.33 million and 2.07 million.

The limitations of the method

Of course, this type of study has a number of limitations. The main ones are as follows.

First, the researchers used what could be described as an “all-or-nothing” model. The intensity of second-hand smoke exposure was not taken into account, and each person was classified as either exposed or unexposed. As a result, a child whose parent systematically smokes at the dinner table was classified as exposed in the same way as a child whose parent only smokes by an open window or on a balcony.

Public places were also excluded. The research measured exposure only at home and in the workplace. Bars, restaurants and other public places where smoking is still permitted in some countries were not included.

In addition, the model applied exposure levels from 2023 to mortality rates from that same year. This poses a problem because some diseases associated with second-hand smoke, such as lung cancer, can take several decades to develop after exposure. The study therefore attributed the current disease burden to present-day exposure, even though for several diseases that burden actually reflects exposure in the past.

Finally, almost every new edition of the GBD changes its methodology. It is therefore not possible to directly compare the results of this study with those from previous years. That said, such a comparison would not have been possible anyway, since this is the first time second-hand smoke has been studied as an independent risk factor.

Sources and references

1. GBD 2023 Second-hand Smoke Collaborators. (2026). Global, regional, and national prevalence of second-hand smoke and attributable disease burden in 204 countries and territories, 1990–2023: A systematic analysis for the Global Burden of Disease Study 2023. The Lancet Public Health. https://doi.org/10.1016/S2468-2667(26)00168-4

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