Monday, August 22, 2016
A darker view of a recent medical marijuana court victory: "10 things to hate about the McIntosh decision"
In this post over at my other blog, I flagged last week's Ninth Circuit panel ruling in US v. McIntosh, No. No. 15-10117 (9th Cir. Aug. 16, 2016) (available here), on a series of appeals concerning "whether criminal defendants may avoid prosecution for various federal marijuana offenses on the basis of a congressional appropriations rider that prohibits the United States Department of Justice from spending funds to prevent states’ implementation of their own medical marijuana laws." That ruling was hailed by many marijuana reform advocates as a victory because the court concluded that "at a minimum, § 542 prohibits DOJ from spending funds from relevant appropriations acts for the prosecution of individuals who engaged in conduct permitted by the State Medical Marijuana Laws and who fully complied with such laws."
But astute followers of the law and policies surrounding marijuana reform know that there is rarely simple story around any aspect of federal marijuana laws and policy, and John Hudak has this recent posting at a Brookings blog explaining reasons why "medical marijuana advocates should [still] worry" after the McIntosh decision. Here are excerpts from the start and the headings of his commentary:
[M]arijuana reform advocates applauded a federal appeals court decision limiting the power of the Department of Justice to prosecute certain marijuana growers. In United States v. McIntosh, the three judge panel (two Republican and one Democratic appointee) dealt explicitly with the Rohrabacher amendment — a rider to a congressional spending bill that barred the DOJ from spending funds on enforcing the Controlled Substances Act in states with medical marijuana reform laws.
Despite the rider being signed into law—by President Obama—the Obama administration continued to bust growers in medical marijuana states. The defendants in the 10 cases grouped together in this appeal hail from California and Washington and were indicted on a variety of federal charges. They fought the charges in lower courts on the basis of the rider without success, and brought their case to the 9th Circuit Court of Appeals.
After the usual judicial hoops of establishing jurisdiction and the appropriateness of the court stepping in at this time to intervene in an ongoing prosecution, the court ruled on the merits of the case. The 9th circuit decision explains that even though “the rider is not a model or clarity” (24) it “prohibits DOJ from spending funds from relevant appropriations acts for the prosecution of individuals who engaged in conduct permitted by the State Medical Marijuana Laws and who fully complied with such laws” (27).
If you’re a marijuana reform advocate, a grower, a cannabis enterprise executive, a patient, or otherwise related to the medical marijuana industry, this is great news, right?
Well, yes and no. The cork popping over the ruling in McIntosh may have been a bit premature. While the central holding of the case is a tremendous victory for the movement and offers a real barrier against executive enforcement power in the context of marijuana, the details of the decision are a bit more mixed. Namely, for the medical marijuana community, there are 10 things to hate about the McIntosh decision.
- The ruling has limited scope...
- McIntosh is about medical marijuana only...
- The Cole Memos are not the Great Savior many believe...
- State-level marijuana reforms do not legalize marijuana...
- State-level marijuana reforms do not legalize marijuana...
- This ruling may not always help current defendants or marijuana law violators...
- This ruling may not always help future defendants...
- This ruling may not always help future defendants...
- This ruling may not always help future defendants...
- This ruling may not always help future defendants
August 22, 2016 in Business laws and regulatory issues, Court Rulings, Federal court rulings, Federal Marijuana Laws, Policies and Practices, Medical Marijuana Commentary and Debate, Who decides | Permalink | Comments (0)
Sunday, August 21, 2016
This Washington Post article, headlined "Missing from Maryland’s legal marijuana growers? Black business leaders," reports on an all-too-common business pattern that tends to emerge as a state gets started with modern marijuana reforms. Here is how the article gets started:
Maryland set up its legal medical marijuana industry with hopes of racial diversity and equity in spreading profits, but none of the 15 companies that were cleared this week for potentially lucrative growing licenses is led by African Americans.
Some lawmakers and prospective minority-owned businesses say this is unacceptable in a state where nearly a third of the population is black, the most of any state with a comprehensive legal pot industry. They say the lack of diversity is emblematic of how, across the country, African Americans are disproportionately locked up when marijuana use is criminalized yet are shut out of the profits when drug sales are legalized. “We are not going to see this industry flourish in the state of Maryland with no minority participation,” said Del. Cheryl D. Glenn (D-Baltimore), chairwoman of the Legislative Black Caucus.
Glenn was a key player in the legalization battle, and the commission that awards medical marijuana business licenses and oversees the industry is named after her mother, Natalie LaPrade, who died of cancer. She is considering filing a legal injunction to halt the licensing process and is weighing other options, such as pushing the commission to award additional licenses to minority-owned companies.
The law legalizing medical marijuana says regulators should “actively seek to achieve” racial and ethnic diversity in the industry. But the commission did not provide extra weight to applications submitted by minority-owned businesses because a letter from the attorney general’s office suggested that preferences would be unconstitutional without there being a history of racial disparity in marijuana licensing to justify the move.
A spokeswoman for the Maryland Medical Cannabis Commission said there will be future opportunities to expand minority participation when the agency awards dispensary licenses and when it considers issuing more cultivation licenses in 2018 if supply doesn’t meet demand. Businesses must also submit annual reports on the racial breakdown of their ownership and workforce, providing a more comprehensive look at the industry’s diversity. “The Commission believes a diverse workforce is in the best interest of the industry,” said Vanessa Lyon, the spokeswoman.
But Glenn and other critics say the state hasn’t done enough to ensure diversity in the blossoming business that’s already worth billions nationwide.
Friday, August 19, 2016
This local article, headlined "Could legalizing marijuana be West Virginia's pot of gold?," reports on this interesting new policy brief released by the West Virginia Center on Budget & Policy suggests. The article summarizes the themes of the report, which is titled "Modernizing West Virginia's Marijuana Laws: Potential Benefits of Decriminalization, Medical Marijuana and Legalization." This summary comes directly from the first two pages of the full 27-page report:
Over the last two decades, states across the country have modernized their marijuana laws to reflect the growing evidence that doing so will help reduce criminal justice costs, help treat some medical conditions, and boost tax revenues and their state’s economy. As of 2016, four states and the District of Columbia have legalized the recreational use of marijuana for adults, 25 states (and DC) allow for marijuana to be used for medical purposes, and 21 states have decriminalized possession of small amounts of marijuana. With several states considering ballot measures this November and public support for legalization rapidly growing (53% of Americans support legalization) among all age groups, the number of states taking action to undo restrictions on marijuana is likely to grow.
While most states have taken at least one step toward modernizing their marijuana laws, West Virginia has not. However, bi-partisan legislation has been introduced in West Virginia over the last several years to legalize medical marijuana and tax marijuana for retail sales to adults. A 2013 poll found that a majority of West Virginians supports decriminalizing marijuana and legalizing it for medical use, while 46 percent supported regulating it like alcohol.
As West Virginia continues to be plagued by large budget deficits (a projected $300 million for FY 2018), an undiversified economy with a fading coal industry, and poor health outcomes, modernizing the state’s marijuana laws could be a step in addressing these problems and could help save the state money in the long run.
This report provides an overview of the states that have modernized their marijuana laws in recent years– including decriminalization, medical marijuana, and recreational use – and the implications for West Virginia if it decided to pursue a similar path. It provides an overview of federal and state marijuana laws (Section 1), an estimation of the potential tax revenue from legalizing recreational marijuana in West Virginia (Section 2), an evaluation of some potential benefits from modernizing West Virginia’s marijuana laws (Section 3), and recommendations on reforming West Virginia’s marijuana laws (Section 4).
If marijuana was legalized and taxed in West Virginia at a rate of 25 percent of its wholesale price the state could collect an estimated $45 million annually upon full implementation. If 10 percent of marijuana users who live within a 200-mile radius of West Virginia came to the state to purchase marijuana, the state could collect an estimated $194 million.
In 2010, it is estimated that West Virginia spent more than $17 million enforcing the state’s marijuana laws. Legalizing or decriminalizing marijuana in West Virginia could reduce the number of marijuana-related arrests, especially among African Americans, which in turn, could reduce criminal-justice-related costs.
The marijuana industry has the potential to add jobs both directly and indirectly. As of September 2015, Colorado had 25,311 people licensed to work in its marijuana industry and over 1,000 retail marijuana businesses. If marijuana were legal in West Virginia it could also have the effect of increasing tourism to the state, particularly in regions with outdoor recreational activities.
Marijuana may potentially have a positive impact on West Virginia’s opioid-based painkiller and heroin epidemic by offering another, less-addictive alternative to individuals who are suffering from debilitating medical conditions.
August 19, 2016 in Business laws and regulatory issues, History of Marijuana Laws in the United States, Medical Marijuana Commentary and Debate, Medical Marijuana Data and Research, Recreational Marijuana Commentary and Debate, Recreational Marijuana Data and Research, Taxation information and issues | Permalink | Comments (0)
Thursday, August 18, 2016
The question in the title of this post is the headline of this timely Inc. article, which essentially answers the question via its lengthy subheadline: "The DEA denied the most recent petition to reschedule marijuana, citing a lack of scientific evidence to prove its medical benefits. But here's how Obama, or the next U.S. president, can reschedule the drug." Here is more from the article:
The U.S. Drug Enforcement Administration has denied the most recent petitions to reschedule marijuana. But Hillary Clinton says that if she becomes president, she will move marijuana to the same category as oxycodone and other opioid painkillers available by a doctor's prescription. Clinton, through her senior policy adviser Maya Harris, told The Cannabist that she will reschedule marijuana from its position as a Schedule I substance to Schedule II under the Controlled Substances Act.
"Marijuana is already being used for medical purposes in states across the country, and it has the potential for even further medical use," said Harris in a statement. "As Hillary Clinton has said throughout this campaign, we should make it easier to study marijuana so that we can better understand its potential benefits, as well as its side effects."
Presidential candidates make all sorts of promises, but could a president actually reschedule marijuana unilaterally? The answer is yes, but not with a stroke of a pen.
John Hudak, senior fellow at the Brookings Institute, explains that there are certain procedures in the Controlled Substances Act that must be followed. "A president cannot reschedule a substance by executive order, that is against the Controlled Substance Act," says Hudak. "It is against the letter of the law." Hudak says there is a suggestion in the CSA that the attorney general might be able to reschedule a substance unilaterally through an order, but that would fly against the long-established administrative procedure and might bump up serious legal challenges.
Mark Kleiman, a professor of public policy and the director of the Crime Reduction & Justice Initiative at New York University's Marron Institute, explains how Hillary, if she wins, can follow through on her promise. "She is not making it up. She can reschedule marijuana. It's not that complicated," says Kleiman. The power to reschedule a substance, Kleiman says, has been delegated to the attorney general (who in turn delegates to the DEA) and to the Department of Health and Human Services (which in turn delegates its clinical testing to the FDA). "But, yes," he adds. "Those people work for the president, and, yes, the president can tell them to reschedule marijuana."
The logistical process of rescheduling, Kleiman says, would involve redefining what "current accepted medical use" means in the Controlled Substances Act. Again, it's up to the agencies (attorney general with the DEA; HHS with the FDA) to define what that term means. "All the DEA has to do is explain how they have overruled themselves and will be going back to what DEA administrative law judge Francis Young said in 1988, that 'medical use' means a bunch of physicians believe something is useful," says Kleiman. "The DEA could say how they take notice that a lot of physicians are recommending marijuana and how 25 state legislatures agree with the doctors. We are now saying this has accepted medical use, but it still has high abuse potential; we're putting it in Schedule II."
As the CSA gave authority to the attorney general, who in turn delegated to the DEA, those agencies are allowed to interpret statutes in varying degrees, unless the decisions are "obviously unreasonable, arbitrary, or capricious," says Kleiman. That means if Clinton wanted to reschedule marijuana if she makes it to the White House, she could....
It should be noted, however, that rescheduling will not make the state-sanctioned recreational markets in Alaska, Colorado, Oregon, Washington state, and Washington, D.C. legal, nor will it make the medical marijuana markets in 25 states legal. If marijuana becomes a Schedule II drug, it will still be illegal federally to use, produce, or manufacture. If marijuana were down-scheduled, it would still be federally illegal to produce and sell because Schedule II drugs cannot be given out without a prescription. A prescription can only be written for an FDA-approved drug, and there are no FDA-approved drugs made with the whole cannabis plant. (Marinol, which is FDA approved, is made with synthetic THC.)
As for the industry's hope that the whole plant will be FDA-approved, Hudak says not a chance. Hudak says if cannabis-based medicines are approved in the future, the medicines will not be botanical. Like other FDA-approved drugs, specific chemicals will be extracted and isolated at the molecular level in a method that is replicable and consistent. "You might see cannabinoid compounds rescheduled and put on the market, but whole flower smoked marijuana will never be approved," says Hudak.
August 18, 2016 in Campaigns, elections and public officials concerning reforms, Federal Marijuana Laws, Policies and Practices, History of Marijuana Laws in the United States, Medical community perspectives, Medical Marijuana Commentary and Debate, Who decides | Permalink | Comments (0)
Tuesday, August 16, 2016
The title of this post is the title of this notable new paper authored by Ryan Boudin Stoa and available via SSRN. Here is the abstract:
As the era of marijuana prohibition draws to a close, one can’t help but wonder how the legal marijuana industry will take shape. The legalization movement is largely driven by ballot initiatives at the state level, and state regulators and lawmakers often lack easy answers to tough questions facing the industry. Marijuana legalization presents challenges on a number of fronts, including distribution, financing and taxation, consumption, security, and public health.
The agricultural dimension of the marijuana industry presents a number of regulatory challenges as well, with important questions that have not been answered. One of these questions is paramount: will marijuana agriculture become consolidated and commoditized, producing vast quantities of indistinct marijuana, or will small-scale farmers thrive by producing unique and localized marijuana?
This Article presents the case for American Cannabicultural Areas (ACAs). Adopting a system of appellations (in which designations of origin are legally protected) offers several benefits to farmers, consumers, and regulators. Appellations protect state and local economies and farming communities, create a market for unique agricultural products, and allow regulatory bodies to establish minimum standards for cultivation to ensure that marijuana agriculture is safe and sustainable. Challenges to this model are significant but not intractable. The legal marijuana industry is still in its infancy, but ACAs represent a promising regulatory model for marijuana agriculture.
Sunday, August 14, 2016
This recent USA Today piece, headlined "As states OK medical marijuana laws, doctors struggle with knowledge gap," puts a needed spotlight on what I think may be the most under-examined aspect of modern state medical marijuana reforms. Here are excerpts:
Medical marijuana has been legal in Maine for almost 20 years. But Farmington physician Jean Antonucci says she continues to feel unprepared when counseling sick patients about whether the drug could benefit them. Will it help my glaucoma? Or my chronic pain? My chemotherapy’s making me nauseous, and nothing’s helped. Is cannabis the solution? Patients hope Antonucci, 62, can answer those questions. But she said she is still “completely in the dark.”
Antonucci doesn’t know whether marijuana is the right way to treat an ailment, what amount is an appropriate dose or whether a patient should smoke it, eat it, rub it through an oil or vaporize it. Like most doctors, she was never trained to have these discussions. And, because the topic still is not usually covered in medical school, seasoned doctors, as well as younger ones, often consider themselves ill-equipped. Even though she tries to keep up with the scientific literature, Antonucci said, “it’s very difficult to support patients but not know what you’re saying.”
As the number of states allowing medical marijuana grows – the total has reached 25 plus the District of Columbia – some are working to address this knowledge gap with physician training programs. States are beginning to require doctors to take continuing medical education courses that detail how marijuana interacts with the nervous system and other medications, as well as its side effects.
Though laws vary, they have common themes. They usually set up a process by which states establish marijuana dispensaries, where patients with qualifying medical conditions can obtain the drug. The conditions are specified on a state-approved list. And the role of doctors is often to certify that patients have one of those ailments. But many say that, without knowing cannabis’ health effects, even writing a certification makes them uncomfortable. “We just don’t know what we don’t know. And that’s a concern,” said Wanda Filer, president of the American Academy of Family Physicians and a practicing doctor in Pennsylvania.
This medical uncertainty is complicated by confusion over how to navigate often contradictory laws. While states generally involve physicians in the process by which patients obtain marijuana, national drug policies have traditionally had a chilling effect on these conversations. The Federation of State Medical Boards has tried to add clarity. In an Aug. 9 JAMA editorial, leaders noted that federal law technically prohibits prescribing marijuana and tasks states that allow it for medical use to “implement strong and effective ... enforcement systems to address any threat those laws could pose to public safety, public health and other interests.” If state regulation is deemed insufficient, the federal government can step in.
That's why many doctors say they feel caught in the middle, not completely sure of where the line is now drawn between legal medical practice and what could get them in trouble. In New York, which legalized marijuana for medicinal purposes in 2014, the state health department rolled out a certification program last October. (The state’s medical marijuana program itself launched in January 2016.) The course, which lasts about four hours and costs $249, is part of a larger physician registration process. So far, the state estimates 656 physicians have completed the required steps. Other states have contacted New York’s Department of Health to learn how the training works.
Pennsylvania and Ohio are also developing similar programs. Meanwhile in Massachusetts, doctors who wish to participate in the state medical marijuana program are required to take courses approved by the American Medical Association. Maryland doesn’t require training but encourages it through its Medical Cannabis Commission website, a policy also followed in some other states.
Physicians appear to welcome such direction. A 2013 study in Colorado, for instance, found more than 80% of family doctors thought physicians needed medical training before recommending marijuana. But some advocates worry that doctors may find these requirements onerous and opt out, which would in turn thwart patients’ access to the now-legal therapy, said Ellen Smith, a board member of the U.S. Pain Foundation, which favors expanded access to medical cannabis.
Education is essential, given the complexity of how marijuana interacts with the body and how little physicians know, said Stephen Corn, an associate professor of anesthesiology, perioperative and pain medicine at Harvard Medical School. Corn also co-founded The Answer Page, a medical information website that supports the New York program and is also bidding to supply information for the Pennsylvania program, Corn said....
From a medical standpoint, the lack of information is troubling, Filer said. “Typically, when we’re going to prescribe something, you’ve got data that shows safety and efficacy,” she said. With marijuana, the body of research doesn’t match what many doctors are used to for prescription drugs.
Still, Corn said, doctors appear pleased with the state training sessions. More than 80% of New York doctors who have taken his course said they changed their practice in response to what they learned. But even now, whenever Corn speaks with doctors about medical marijuana, people ask him how they can learn more about the drug’s medical properties and about legal risks. Those two concerns, he said, likely reduce the number of doctors comfortable with and willing to discuss marijuana’s place in medicine, even if it’s allowed in their states.
August 14, 2016 in Federal Marijuana Laws, Policies and Practices, Medical community perspectives, Medical Marijuana Commentary and Debate, Medical Marijuana Data and Research, Medical Marijuana State Laws and Reforms, Who decides | Permalink | Comments (2)
Saturday, August 13, 2016
As reported in prior posts here and here, the Drug Enforcement Agency this past week made only a modest change to federal marijuana policies. Not surprisingly, the failure of DEA being willing to do a lot more has generated criticisms and various expressions of concern and analytical perspectives. Here are some of these reactions from various traditional and non-traditional media sources:
From Business Insider here, "Here's what the DEA's big decision on marijuana means for users and 'potrepreneurs'"
From Forbes here, "DEA's Hypocritical Marijuana Decision Ignores The Evidence"
From Marijuana.com here, "DEA No, Clinton Yes: As POTUS, Hillary Would Reschedule Marijuana"
From the New York Times here, "Stop Treating Marijuana Like Heroin"
From Quartz here, "The DEA's sop to pot advocates won't boost marijuana research very much at all"
Friday, August 12, 2016
The title of this is the headline of this new Time article that serves as a somewhat fitting follow-up to the (big?) news the DEA delivered this week about marijuana scheduling and research. Here are excerpts:
On Thursday the U.S. government announced that marijuana would continue to be classified as a Schedule 1 drug, meaning it has a high potential for abuse. However, the feds are allowing more research on marijuana’s medicinal uses by making it easier for researchers to grow it.
Many researchers, both those who view marijuana as beneficial and those who are skeptical, argue that the government’s stance still hinders research. “I understand the cautious nature of the government, whose role is basically to protect its citizens, but it is disappointing that marijuana continues to be included on the DEA’s list of the most dangerous drugs,” says Dr. Yasmin Hurd of Mount Sinai, who studies the effects of marijuana on the brain.
Though more than 20 states have legalized marijuana for medicinal uses, there’s still a lot scientists don’t know about it. “It’s actually quite amazing how little we really know about something that has been used for thousands of years,” says Sachin Patel of Vanderbilt University who studies cannabis. “We desperately need well-controlled unbiased large scale research studies into the efficacy of cannabis for treating disease states, which we have very little of right now. Without these studies we are basically flying blind with regard to medical marijuana in my opinion.”
Scientists argue that studying marijuana is safe, and researching it shouldn’t be such a difficult process. “A question that is not on the lips of researchers is whether or not the consumption of cannabis-based medicines is safe,” says Gregory Gerdeman, an Assistant Professor of Biology at Eckerd College. “In the biomedical research community, it is universally understood that cannabis is a very safe, well-tolerated medicine.”
Here’s what researchers tell TIME they want to know about marijuana.
Is marijuana an effective cancer therapy?...
What does it do to the brain?...
What dosage or strains have the best use in medicine?...
Can marijuana help brain and cognitive problems?...
What about anxiety?...
Can pot help end the opioid epidemic?...
Are there long term consequences of using pot?
August 12, 2016 in Federal Marijuana Laws, Policies and Practices, History of Marijuana Laws in the United States, Medical community perspectives, Medical Marijuana Commentary and Debate, Medical Marijuana Data and Research, Who decides | Permalink | Comments (0)
Thursday, August 11, 2016
DEA concludes that there is "no substantial evidence that marijuana should be removed from schedule I"
The language quoted in the title of this post is from the letter, dated July 19, 2016, in which the Drug Enforcement Administration (DEA) announced that it had "formally denied a petition to initiate rulemaking proceedings to reschedule marijuana." This lengthy document makes this letter and related materials publically available with this explanation: "Because the DEA believes that this matter is of particular interest to members of the public, the agency is publishing below the letter sent to the petitioner which denied the petition, along with the supporting documentation that was attached to the letter."
Here are some excerpts from the letter:
In accordance with the CSA scheduling provisions, after gathering the necessary data, DEA requested a scientific and medical evaluation and scheduling recommendation from the Department of Health and Human Services (HHS). HHS concluded that marijuana has a high potential for abuse, has no accepted medical use in the United States, and lacks an acceptable level of safety for use even under medical supervision. Therefore, HHS recommended that marijuana remain in schedule I. The scientific and medical evaluation and scheduling recommendation that HHS submitted to DEA is attached hereto.
Based on the HHS evaluation and all other relevant data, DEA has concluded that there is no substantial evidence that marijuana should be removed from schedule I. A document prepared by DEA addressing these materials in detail also is attached hereto. In short, marijuana continues to meet the criteria for schedule I control under the CSA because:
1) Marijuana has a high potential for abuse. The HHS evaluation and the additional data gathered by DEA show that marijuana has a high potential for abuse.
2) Marijuana has no currently accepted medical use in treatment in the United States. Based on the established five-part test for making such determination, marijuana has no ‘‘currently accepted medical use’’ because: As detailed in the HHS evaluation, the drug’s chemistry is not known and reproducible; there are no adequate safety studies; there are no adequate and well-controlled studies proving efficacy; the drug is not accepted by qualified experts; and the scientific evidence is not widely available.
3) Marijuana lacks accepted safety for use under medical supervision. At present, there are no U.S. Food and Drug Administration (FDA)-approved marijuana products, nor is marijuana under a New Drug Application (NDA) evaluation at the FDA for any indication. The HHS evaluation states that marijuana does not have a currently accepted medical use in treatment in the United States or a currently accepted medical use with severe restrictions. At this time, the known risks of marijuana use have not been shown to be outweighed by specific benefits in well-controlled clinical trials that scientifically evaluate safety and efficacy....
Although the HHS evaluation and all other relevant data lead to the conclusion that marijuana must remain in schedule I, it should also be noted that, in view of United States obligations under international drug control treaties, marijuana cannot be placed in a schedule less restrictive than schedule II. This is explained in detail in the accompanying document titled "Preliminary Note Regarding Treaty Considerations."
Accordingly, and as set forth in detail in the accompanying HHS and DEA documents, there is no statutory basis under the CSA for DEA to grant your petition to initiate rulemaking proceedings to reschedule marijuana. Your petition is, therefore, hereby denied.
DEA has denied two petitions to reschedule marijuana under the Controlled Substances Act (CSA). In response to the petitions, DEA requested a scientific and medical evaluation and scheduling recommendation from the Department of Health and Human Services (HHS), which was conducted by the U.S. Food and Drug Administration (FDA) in consultation with the National Institute on Drug Abuse (NIDA). Based on the legal standards in the CSA, marijuana remains a schedule I controlled substance because it does not meet the criteria for currently accepted medical use in treatment in the United States, there is a lack of accepted safety for its use under medical supervision, and it has a high potential for abuse
Sunday, August 7, 2016
One reason I have started to consider repeal of blanket marijuana prohibition inevitable is because there are now ever so many monied interests and individuals eager to profit from repeal and now ever fewer such interests and individuals who profit from prohibition. And in a capitalist-driven economy and society, this is a very big deal. Further evidence of these realities comes from this interesting recent Business Insider article about marijuana capital headlined "Private equity is 'seeing more excitement than it can handle' in the marijuana industry." Here are excerpts:
The cannabis industry is starting to see some serious investment activity. Over the last few years, a new wave of cannabis-finance companies have formed to capitalize on the green rush.
Companies like Tuatara Capital, Seventh Point, Poseidon Asset Management, and Privateer Holdings have dived headfirst into the industry. While the first three are brand new, having been founded in the last few years, Privateer started in 2011. The fund bills itself as the first in the US to focus solely on cannabis-related endeavors.
These private-equity firms invest specifically in companies operating in the legal-cannabis industry,as well as providing capital for new startups to generate returns down the road. "It's never a dull day," Al Foreman, the CIO of Tuatara and a 16-year veteran of the private-equity industry, told Business Insider. "It's fascinating to be part of a new and emerging industry."
Retail sales of legal cannabis, including both medical and recreational, are projected to hit $4.3 billion in 2016, according to Marijuana Business Daily's 2016 fact book. And sales will likely skyrocket to $11 billion by 2020, with recreational sales representing an ever larger portion of the market. Some outlets are predicting even higher sales, with estimates ranging as high as $22.8 billion by 2020.
So far, the money's pouring in. Forty-seven percent of active investors in the cannabis space plan on sinking $10 million or more into private cannabis companies in the next year, according to the fact book. On its own, Seventh Point, named for the seven points of a cannabis leaf, is looking at completing $75 million worth of fundraising this year, according to the firm's CEO, Steve Gormley, who has over 15 years of experience in private equity. "It's like a floodgate," Gormley told Business Insider. "We oversubscribed [raising more money than intended] our first two funds. I haven't seen anything like this in my career."
While most of the money in the industry is still coming from family offices and people's personal bank accounts, 18% of entrepreneurs who have started cannabis companies in the past year have landed funding from venture-capital and private-equity investors, according to the fact book. "We're getting more excitement than we can handle," Gormley continued. "I cut my teeth in the dot-com era. I lived through the housing bubble. This is something completely unto itself."
Founders Fund, the legendary Silicon Valley venture-capital firm, sank $75 million into Privateer Holdings in 2015, according to PitchBook. Even Roger Mcnamee, an early Facebook investor, sank a chunk of his personal fortune into a series B round for MJ Freeway, a cannabis software and compliance firm based in Colorado, the company's cofounder, Jessica Billingsley, told Business Insider.
But he industry still faces numerous regulatory challenges. Though states like Colorado and Washington have set up markets for recreational marijuana, the plant is still a Schedule I drug at the federal level, and most banks refuse to deal with cannabis companies for fear of federal repercussions. Firms that invest in the cannabis space need to be particularly careful about where their money goes. They only invest in states that have specific rules allowing for the commercialization of recreational or medicinal marijuana.
Companies registered with the Securities and Exchange Commission cite ongoing federal prohibition, banking issues, as well as potential civil and criminal penalties as the top risks to investing in the cannabis sector, according to Law360. But there are ways to get around these risks: Some companies, like Cannakorp, build products used for the consumption of marijuana — but don't actually touch the plant themselves. This exposes investors to far less legal risk as opposed to dealing with, say, a dispensary.
Because of this often confusing regulation, where different rules exist in each state, Foreman says that investing in cannabis requires "professional, full-time focus" to successfully navigate the industry. "The market is so fragmented," Foreman said. "Each individual state is a separate market. If you're an investor who's accustomed to looking at companies or sectors that are national or global — to retrain that mindset to focus on an individual state market is an obstacle that needs to be overcome."
While neither Gormley nor Foreman could say who specifically invested in their funds, both mentioned that private investors, rather than institutional, provided the bulk of their fundraising. Foreman added that he thinks institutional investors — who have largely steered clear of the marijuana industry so far — have been warming up to the industry as recently as the past few months as more markets open....
Initially, mostly cultivators and producers who had been successful were taking their profits and reinvesting, according to Gormley. Then, high-net worth individuals, who have a much higher risk tolerance than institutional investors, started getting into the space. Once these individuals started taking the industry seriously, the basket of investors started to broaden.
Roughly nine months ago, a proliferation of family offices jumped into the space, Gormley found. "Now, we've got venture capitalists and hedge fund operators and private-equity senior managers coming in as individuals," he said.
These firms, specifically focused on the cannabis industry, are trying to bring a level of financial maturity to a complex industry. "We launched Tuatara to create an entry point for sophisticated investors," Foreman said. "That's the next phase of evolution for the capital-raising and the capital-accumulation process." Foreman thinks that because so many new markets are expected to open up as states like California vote on legalization in November, the "argument around market fragmentation" will start to go away, he said. "The overall landscape will have reached a point of critical mass, and the industry will be too big to ignore," Foreman added.
Gormley, for his part, was much more direct. "I'm seeing the profile of the cannabis-industry investor thawing," Gormley said. "Whereas it was only cowboys, I'm seeing people who are more traditionally bottom-line driven and conservative coming off the sidelines." He even likens attitudes he's seen about cannabis in the US to marriage equality. "When I was growing up, it was inconceivable," Gormley said, regarding marriage equality. "And then it started to happen at the state level, and then there was just this massive cultural shift."
Wednesday, August 3, 2016
The title of this post is the title of this notable forthcoming paper authored by Ryan Boudin Stoa available via SSRN. Here is the abstract:
Marijuana legalization is sweeping the nation. As many as thirty marijuana legalization initiatives may appear on election ballots in 2016, legalizing the recreational or medicinal use of marijuana in as many as 17 states and adding to the growing number of states that have already legalized marijuana. Many of these legalization initiatives propose to regulate marijuana in a manner similar to alcohol, and many titles are variations of “the regulate marijuana like alcohol act.” For political and public health reasons the analogy makes sense, but it also reveals a regulatory blind spot. States may be using alcohol as a model for regulating the distribution, retail, and consumption of marijuana, but marijuana is much more than a retail product. It is also an agricultural product, and by some measures, the largest cash crop in the United States. Since marijuana prohibition laws were passed long before any regulations for cultivation were developed, states are facing an unprecedented challenge: regulate, for the first time ever, one of the country’s largest agricultural industries.
There are major regulatory challenges ahead, and how states respond to those challenges will shape the course of the marijuana industry. At present there is a gap in understanding the regulatory challenges presented by marijuana agriculture, and the options states have to address them. This Article identifies those challenges and the regulatory approaches most capable of addressing them. The study begins by describing the existing state of marijuana agriculture regulations. States are likely to find that the marijuana industry’s unique characteristics justify a tailored regulatory approach; relying on existing agricultural policies may be ineffectual or lead to perverse outcomes.
Next, fundamental questions about the “marijuana fragmentation spectrum” are explored. Will the industry come to be dominated by agricultural conglomerates mass-producing a marijuana commodity, as many have feared? Or will governments and the industry adopt the appellation model favored by the wine industry, to protect local farmers and differentiate between products? The major environmental impacts of marijuana agriculture are analyzed as well, including regulations that address water allocation, water quality, energy, organic certification, and crop insurance. Finally, the study addresses power distribution trade-offs within marijuana agriculture regulation frameworks, including local vs. state, and consolidated vs. fragmented, regulatory authority dilemmas. The findings suggest that responsible and sustainable marijuana agriculture can be fostered at the state level, but only if regulations are responsive to the unique and unprecedented challenges that marijuana agriculture presents.
August 3, 2016 in Business laws and regulatory issues, Medical Marijuana Commentary and Debate, Medical Marijuana State Laws and Reforms, Recreational Marijuana Commentary and Debate, Recreational Marijuana State Laws and Reforms, Who decides | Permalink | Comments (0)
Friday, July 22, 2016
The title of this post is the headline of this notable recent commentary from The Hill authored by Ike Brannon. Here are excerpts:
It seems as if everyone has woken up to the problem of opioid abuse at once and wants to do something about it. In March, Politico assembled a working group to “confront the opioid epidemic.” In May, New York Gov. Andrew Cuomo (D) announced the creation of a statewide heroin task force that he charged with ending the heroin and opioid crisis in the state. And in June, a Senate Appropriations Subcommittee approved a 93 percent increase in funding to combat opioid addiction nationwide.
The problem of opiate abuse is growing. There were an estimated 16,000 deaths caused by prescription opioid overdoses in 2010, the last year for which we have reliable data, three timesas many who died in 1999. More people die from drug overdose each year as are killed by firearms.
As deaths from opioid abuse grow, the proposals to address this crisis have remained the same: Doctors should be more judicious about prescribing painkillers, governments should invest more in treatment facilities, and the courts should mete out stricter punishments for those who illegally sell these drugs. All of this, of course, is more or less what we’ve been doing the last five decades, with little success.
However, the data tell us that there is a possible deterrent to growing opioid addiction that has shown real promise: the wholesale legalization of marijuana.
Several states have made the drug legal in some form for over a decade — whether via medical marijuana or, more recently, the outright legalization of the drug — and the data generated from these state-level experiments suggests that the easier it is to acquire marijuana, the less opioid abuse there is. For instance, in 2014, researchers from the Johns Hopkins Bloomberg School of Public Health and the Philadelphia Veterans Affairs Medical Center found that opioid overdose deaths decreased by nearly 25 percent in a state following the passage of medical marijuana laws.
A recently published study by the RAND Corporation also found a decrease in opioid addiction and overdoses in states with medical marijuana dispensaries. And last month, investigators at the University of Michigan published a retrospective survey of 244 patients suffering from chronic pain who frequented medical marijuana dispensaries and discovered that they frequently substituted medical marijuana for opiates, with many of them judging medical marijuana as being more effective at treating chronic pain. Medical marijuana use was associated with a 64 percent decrease in opioid use, as well as a reduction in the amount and severity of the side effects of medications and an improved quality of life....
It’s hard to dispute that legalizing marijuana would reduce opiate abuse and save lives. There are other reasons to end its prohibition, but its role in solving what appears to be an otherwise intractable problem claiming thousands of lives a year seems like a compelling one.
Thursday, July 14, 2016
The title of this post is the headline of this new Huffington Post commentary authored by Steph Sherer, who serves as the Executive Director of Americans for Safe Access. Here are excerpts from the start and end of this piece along with the author's accounting of the 10 "smoke signals" showing how the winds of change are blowing with respect to federal marijuana policies:
Putting this article together gave me an opportunity step back and observe the landscape that medical cannabis policy has created. The work of medical cannabis advocates and brave legislators is truly saving lives. Positive outcomes from medical cannabis policies are driving more states to create and improve programs. With more than 300 million Americans living in the 42 states, along with D.C., Guam, and Puerto Rico, where some kind of medical cannabis law has been passed, there is a strong platform for politicians to move forward on this issue.
After putting this list together, it is mind-blowing to me that Senator Grassley will not allow the Compassionate Access, Research Expansion, and Respect States (CARERS) Act (S. 683/H.R. 1538) a vote in the Senate Judiciary Committee, especially considering that 78% of people in his own state of Iowa support medical cannabis. Maybe this is one of the reasons he is struggling with his campaign for re-election. This important bill would remedy the state-federal conflict over medical marijuana law; allowing (not requiring) states that want to participate in medical cannabis programs to do so without breaking federal law.
Maybe Grassley just needs to see this list too…
1. CARERS has Growing Support from Mainstream Republicans, such as Senator Graham (R-NC) and Congressman Young (R-IA)...
2. National Patient Organizations Are Calling for Change in Federal Law...
3. States Keep Passing Medical Cannabis Laws...
4. States Continue to Improve Medical Cannabis Laws...
5. New CDC Guidelines Instruct Pain Doctors Not to Test for THC...
6. Largest Pharmaceutical Retailer Acknowledges Medical Benefits of Cannabis...
7. Politicians Breaking Political Boundaries for Medical Cannabis...
8. Studies Continue to Show Public Health Benefits in States with Medical Cannabis...
9. Both Presidential Candidates Support Medical Cannabis...
10. Opponents Know they are Losing this Fight
In June, a new bill, the bipartisan Medical Marijuana Research Act of 2016, was introduced. Surprisingly, this bill was sponsored by several known medical cannabis opponents, including Representative Andy Harris (R-Md.), one of Congress’s most vocal opponent of legal marijuana. Other sponsors included, Earl Blumenauer (D-OR), Sam Farr (D-CA), and Morgan Griffith (R-VA), and in the Senate; Brian Schatz, (D-HI), Orrin Hatch (R-UT), Chris Coons, (D-DE), and Thom Tillis (R-NC). While it should be commended that they are making a step towards removing federal barriers to medical cannabis research, this bill does nothing to protect state programs and patients. It is their way of saying, we are losing this fight, so we must give something in return.
Ending the conflict between state and federal medical cannabis laws is the most important goal for keeping patients safe, and for that reason, it is important to remain focused on passing the CARERS Act, which would protect existing state programs and patients. While more research is certainly desirable, patients cannot wait for the years or decades it may take for the results of this research to drive further Federal policy changes.
And there you have it! 10 reasons that clearly show the end of Federal Medical Marijuana Prohibition is near, and that also show how out of touch Senator Grassley is on this issue. ASA and many other advocates have worked hard to make the changes mentioned above possible. If just a small portion of the 89% of Americans who support medical cannabis let their members of Congress know, then this may be the last year for federal prohibition of medical cannabis.
July 14, 2016 in Campaigns, elections and public officials concerning reforms, Federal Marijuana Laws, Policies and Practices, Medical Marijuana Commentary and Debate, Who decides | Permalink | Comments (0)
Tuesday, July 12, 2016
This new Huffington Post piece, headlined "Medical Marijuana Fails To Make GOP Platform After Vigorous Debate," reports on the unsuccessful efforts by some Republican delegate to get the Grand Old Party to take a grand new approach to marijuana reform in the party platform. Here are some of the details:
Republican delegates meeting on Monday voted not to endorse medical cannabis in their party’s official platform. In the process, however, they managed to air some of the wildest unproven theories about marijuana. Maine legislator and delegate Eric Brakey introduced the measure before the full GOP Platform Committee, prompting a vigorous debate over whether to support states that allow nonsmokable cannabis for medicinal purposes.
Medical cannabis has greatly improved the lives of patients with debilitating conditions, noted delegates in favor of the measure. They also said children “are being saved” by hemp products because their conditions often can’t be controlled with any other substance.
But a number of delegates rose in opposition to the measure. A member from Utah claimed scientists have a “long way to go with research” on marijuana and argued that studies, which she did not provide, showed a link between it and mental health issues.
Another delegate absurdly claimed that people who commit mass murders are “young boys from divorced families, and they’re all smoking pot.” Yet another delegate claimed marijuana triggered schizophrenia, and is funded nationally by Democrat and New York financier George Soros. “Let’s think a little bit what happens with Percocet, with OxyContin,” claimed a third delegate, who drew a connection between the ongoing heroin epidemic and teenagers smoking marijuana.
Pro-medical cannabis delegates pushed back, complaining their fellow committee members misunderstood the scope of the proposal. “We’re not talking about Cheech and Chong being encouraged here,” Brakey said, referencing the comedy duo who support marijuana.
The attempt at clarification may have swayed some votes. Wyoming Sen. John Barasso, chair of the Platform Committee, couldn’t determine at the first attempt whether the measure passed by voice vote. The proposal was voted down on the second vote, however.
Monday, July 11, 2016
The title of this post is the title of this new paper by Carrie Lynn Rosenbaum now available via SSRN. Here is the abstract:
This paper asserts that state and local marijuana reforms that relax criminal penalties should, but will likely not, benefit Latino/a noncitizens. Because of the intricate relationship between criminal and immigration enforcement, state and local police engagement in racial profiling will not only fail to be eliminated by state-level marijuana reforms but may be exacerbated. As a result, in spite of marijuana law reforms intended to lessen overly punitive penalties stemming from minor marijuana conduct, noncitizen Latino/as will continue to be disproportionately criminally policed and deported.
Scholarly literature addressing the intersection of criminal and immigration law has considered ways in which racial profiling in criminal law enforcement infects the immigration removal process. However, the literature has yet to explore the way in which sub-federal drug law reforms, and specifically, recent marijuana law reforms, will fall short for noncitizen Latino/as because of the way in which racial profiling in criminal law enforcement infects the immigration removal process.
After decades of excessive, punitive, and ineffective policies, particularly in the area of drug law enforcement, states have initiated reforms, including marijuana decriminalization. At the same time that decriminalization measures are being implemented, in the field of immigration law, resources for apprehension, detention and deportation have skyrocketed, with a focus on “criminal aliens.” The criminal-immigration removal system has resulted in local and state law enforcement agents playing a critical, and problematic role in the detection, apprehension, and removal of “criminal aliens.”
The plight of noncitizens deported or found inadmissible based on marijuana-related conduct highlights a deeper, systemic problem. Not only do extremely harsh immigration consequences serve as a double-penalty for potentially minor marijuana offenses, particularly in light of criminal law reforms, but enforcement of remaining marijuana laws will likely fall disproportionately on Latina/o noncitizens. Over ninety percent of deportations arising out of criminal law enforcement are to Central American and Mexico, yet Mexican and Central American immigrants make up less than half of the United States immigrant population.
While decriminalization of marijuana may be more than a symbolic move away from the failed “tough on crime” policies of the past, it not only fails to take into consideration the impact of marijuana laws on noncitizens but also may exacerbate the racially biased aspects of drug law enforcement on noncitizens, particularly Latinos. This Article discusses the ways in which criminal-immigration law enforcement has impacted noncitizens, primarily Latino/as, to demonstrate why sub-federal marijuana reforms will fail to alleviate racially disparate outcomes, perpetually leaving Latino/a noncitizens in the shadows.
July 11, 2016 in Criminal justice developments and reforms, Federal Marijuana Laws, Policies and Practices, Medical Marijuana Commentary and Debate, Recreational Marijuana Commentary and Debate, Who decides | Permalink | Comments (1)
Sunday, July 10, 2016
As reported in this Washington Post piece, the Democratic National Committee had a close and notable vote over the terms of the party platform. Here are the details:
The Democratic Party endorsed a "reasoned pathway to future legalization" of marijuana and called for the drug to be downgraded in the Controlled Substances Act, in a tense and unexpected victory for supporters of Sen. Bernie Sanders.
Going into the platform committee meeting, Sanders's campaign had no new language about marijuana. The senator from Vermont had favored state-to-state legalization efforts, and the language approved by the drafting committee called for "policies that will allow more research on marijuana, as well as reforming our laws to allow legal marijuana businesses to exist without uncertainty."
But on Saturday afternoon, the committee brought up an amendment that would have removed marijuana from the Controlled Substances Act. David King, a lawyer and Sanders delegate from Tennessee, argued that marijuana was added to the act — giving the drug the same legal classification as heroin — during a "craze" to hurt "hippies and blacks." The amendment, however, was headed for defeat, with some committee members worrying that it went too far and undermined state-by-state efforts to study decriminalization.
Arguments stopped when committee members proposed swapping in the language of a rival amendment — one that merely downgraded marijuana from Schedule 1 of the Controlled Substance Act and included the undefined "pathway" to legal status.
When the vote was called, 81 of the 187 committee members backed the downgrade amendment — and just 80 opposed it. A roar of applause went up from the seats where people not on the committee were watching the votes. For the next 10 minutes, that victory was thrown into jeopardy. Former Atlanta mayor Shirley Franklin, the co-chair of the platform committee, entertained a complaint that at least one member might not have been able to vote, lacking the "clicker" that recorded electronic ballots.... Finally, former senator Mark Pryor (Ark.), a Clinton delegate, walked up to a microphone to announce that opponents of the amendment were unhappy that the compromise language had been replaced — but not unhappy enough to fight about it. "We withdraw the objection," he said.
There was more celebration in the back of the room. Later, after the unanimous adoption of a tough criminal justice reform plank, the grumbling that ended some sessions was replaced by Sanders voters saying: "Thank you! Thank you!"
The text of the marijuana amendment: "Because of conflicting laws concerning marijuana, both on the federal and state levels, we encourage the federal government to remove marijuana from its list as a Class 1 Federal Controlled Substance, providing a reasoned pathway for future legalization."
July 10, 2016 in Campaigns, elections and public officials concerning reforms, Medical Marijuana Commentary and Debate, Recreational Marijuana Commentary and Debate, Who decides | Permalink | Comments (0)
Thursday, July 7, 2016
This AP article, headlined "It’s official: Arkansas will vote on medical marijuana in November," provides the interesting details on another state now sure to be considering marijuana reform through initiative this fall. Here are the dynamic details:
A proposal to legalize medical marijuana in Arkansas qualified for the November ballot on Thursday, putting the issue before the state’s voters for the second time in four years. The secretary of state’s office said it had verified at least 77,516 of the more than 117,000 signatures submitted for the proposed initiated act by Arkansans for Compassionate Care were from registered voters.
Initiated acts need at least 67,887 signatures, while constitutional amendments need at least 84,859. Friday is the deadline for groups to turn in signatures for their ballot measures.
Arkansas voters narrowly rejected a similar medical marijuana proposal in 2012, and this fall could face two competing legalization measures. Melissa Fults, campaign director for Arkansans for Compassionate Care, repeated her call for the sponsor of the competing proposal to abandon his efforts.
“It does complicate it tremendously if he does turn in because it’s going to greatly decrease our chances of either one passing,” Fults said. The measure from Fults’ group would allow patients with a range of medical conditions and a doctor’s recommendation to buy marijuana from dispensaries. Unlike the competing proposal, it would allow patients to grow their own marijuana if they don’t live near a dispensary.
David Couch, the sponsor of the competing measure, said he planned to submit petitions for his proposed constitutional amendment Friday morning and said he didn’t believe having two marijuana proposals on the ballot would doom either. “If you support medical marijuana and you believe that sick people should have this medicine, you should say vote for both,” Couch said. “That’s what I’m going to say.”
The conservative Family Council Action Committee, which campaigned against the marijuana proposal in 2012, said it would review the petitions for a potential legal challenge and was also considering challenging the proposal’s language in court. “This same issue was defeated in the election of 2012, and I believe the people of Arkansas are wise enough to see through this sham and vote it down again,” Jerry Cox, the committee’s executive director, said in a statement.
Republican Gov. Asa Hutchinson, a former head of the federal Drug Enforcement Administration, said he opposed the measure and urged members of the medical community to share concerns they may have about the legalization efforts. “I believe that while we want to provide medicine to anyone who needs it, this opens a lot of doors that causes more problems than it solves,” Hutchinson told reporters.
Wednesday, July 6, 2016
The title of this post is the headline of this lengthy new local article which gets started this way:
The rules for Ohio's medical marijuana growers and dispensaries are months away from being written, but entrepreneurs are already eyeing the future market here.
Dozens of marijuana and cannabis-related business names have been registered with the state since the legislature passed Ohio's medical marijuana law in late May. Existing Ohio companies are considering how they can service the marijuana industry. Companies working in legal marijuana states are planning to expand.
The coming months will likely be filled with medical marijuana conferences, workshops and panels for would-be marijuana business owners. But much of the preparation will be speculative, as crucial details -- such as the number of business licenses available and the criteria used to award them -- are unknown.
Ohio's medical marijuana law goes into effect Sept. 8 and requires the system to be fully operational by September 2018. The commerce department has until May 6, 2017, to issue rules and regulations for cultivators, and the rest of the rules must be set by October 2017.
But that's not stopping aspiring "potpreneurs" from getting a head start.
This new Boston Globe article, headlined "Medical marijuana changing prescription practices, study finds," reports on fascinating new research seeming to document another financial benefit from marijuana reform. Here are the interesting details:
The arrival of medical marijuana in Massachusetts and other states is changing the way doctors prescribe conventional medications, a study published Wednesday reports.
The study, one of the first to investigate whether medical marijuana laws alter prescribing patterns, analyzed data from 17 states and Washington, D.C. It found that after medical marijuana laws were adopted, doctors wrote fewer prescriptions for Medicare patients diagnosed with anxiety, pain, nausea, depression, and other conditions thought to respond to marijuana treatment.
That translated to about $165 million less spent on prescription drugs in just one year in the Medicare program, which provides health insurance for older adults, according to the study published in the journal Health Affairs. Analysts said the findings are especially significant coming amid the nation’s opioid crisis and campaigns to reduce the prescribing of potentially addictive painkillers.
W. David Bradford, a health economist at the University of Georgia and the study’s senior researcher, said an ongoing review of the government’s Medicaid database, which includes a younger population more likely to use marijuana, suggests an even stronger correlation between prescribing trends and medical marijuana laws. Medicaid insures mostly younger patients who are poor and disabled. “This research says there is evidence that physicians are responding as if marijuana is medicine, and as if there is clinical benefit,” Bradford said.
The researchers analyzed millions of drugs prescribed by physicians from 2010 through 2013 in the Medicare Part D database. They focused their analysis on drugs that treat conditions for which marijuana might be an alternative treatment, including anxiety, depression, glaucoma, nausea, pain, psychosis, seizures, sleep disorders, and a muscle control disorder known as spasticity. They found that for all conditions, except glaucoma and spasticity, fewer prescriptions were written when a medical marijuana law was in effect.
To confirm the link to marijuana laws, and not other factors, the researchers compared results from the states with medical marijuana to states that had not legalized it. They did not see a similar decline in prescribing in states without marijuana laws. As a further test, the researchers selected four drugs prescribed for conditions for which there are no studies suggesting benefit from marijuana treatment. Those drugs included blood-thinners, antibiotics, antivirals to treat the flu, and a drug used in dialysis. They found no decline in prescriptions for these drugs....
Avi Dor, a health economist and professor of health policy and management at George Washington University’s Milken Institute, called the study “impressive and timely,” given concerns about prescription opioid abuse. Opioids are often prescribed for many of the conditions the researchers studied. “We can’t be sure about the causality [in the study], but the evidence is strong in favor of the marijuana laws leading to the substitution away from certain drugs,” said Dor, who was not involved in the research. “We just don’t know if, over time, the effects they find will wash out or become amplified,” Dor said. “Physicians and their patients are only beginning to experiment with the new therapeutic alternative of medical marijuana.”
The Health Affairs study estimated that if medical marijuana had been available in all states in 2013, the Medicare prescription program would have saved about $468 million because of fewer prescriptions for just that year -- an amount equal to one-half of 1 percent of Medicare prescription spending that year. But the researchers acknowledged that savings for Medicare might translate into more costs for patients who pay for medical marijuana out of their own pockets, because insurance doesn’t cover the drug.
Dr. Kevin Hill, an assistant professor of psychiatry at McLean Hospital and Harvard Medical School who studies marijuana, said the Medicare savings are important. But he noted physicians remain reluctant to recommend marijuana to their patients because they feel the evidence supporting its use is insufficient, or they are concerned about legal ramifications if they suggest a drug the federal government classifies as dangerous. “Medical marijuana may reduce prescription costs in some cases, but there is a risk that medical marijuana may be used for conditions that are not supported by evidence,” Hill said.
July 6, 2016 in Federal Marijuana Laws, Policies and Practices, Medical community perspectives, Medical Marijuana Commentary and Debate, Medical Marijuana Data and Research, Who decides | Permalink | Comments (0)
Tuesday, July 5, 2016
The title of this post is the name of this timely event scheduled for tomorrow afternoon on the campus of The Ohio State University. I will be one of a number of speakers at an event being sponsored by the Ohio Cannabis Association. Here is the planned schedule for the event:
Wednesday, July 6th; 5:00pm – 8:00pm (Networking from 5-6. Program Begins Promptly at 6.)
The Ohio State University - Student Union - Great Hall Meeting Room 1739 N. High St, Columbus, OH 43210
Featuring leading experts on all aspects of the new industry…
State: State Sen. Kenny Yuko; State Rep. Kirk Schuring
National: John Hudak, Brookings Institute
Business: Andy Joseph, Apeks Supercritical; Jimmy Gould, Ohio House Medicinal Marijuana Task Force and GLA; Roberto Ryan, QC Infusion
Medical: Dr. Brian Santin, Ohio House Medicinal Marijuana Task Force; Janet Brenneman, Ohio Cannabis Nurses Association
Legal: Deb Tongren, Esq.; Douglas A. Berman, OSU Professor of Law