Marijuana Law, Policy & Reform

Editor: Douglas A. Berman
Moritz College of Law

Tuesday, July 31, 2018

Noting the enduring challenges for sports leagues with state marijuana reforms in tension with federal prohibition

Download (3)Regular readers know that I find fascinating the intersections between sports and marijuana reform, but I have not blogged on the subject much lately.  This new article, headlined "Leagues being pushed to allow medical marijuana use for pain management," gives me an excuse to return to this topic. Here are excerpts:

Between legalization in states with multiple professional sports franchises (like California), and increasing numbers of studies showing marijuana to be largely benign (and perhaps even beneficial) in comparison to opiates, the tide of public opinion continues to turn.  And for now, certain pro sports leagues are getting around the federal prohibition by essentially embracing a wink-and-nod policy.

The National Hockey League doesn’t list cannabis as a banned substance and doesn’t appear to care much about positive cannabis tests. Major League Baseball lists cannabis as a “drug of abuse,” but only tests if there is reasonable cause (and page 40 of the league’s drug policy specifically states that they don’t issue suspensions for a positive test for marijuana) — though, oddly enough, Minor League Baseball does still test and suspend athletes for marijuana use. In addition, the World Anti-Doping Agency, which oversees Olympic policy, has also loosened its standards on what constitutes a positive test, allowing up to 150 nanograms per milliliter (ng/ml) of blood—which essentially means you’d need to be actively high in order to test positive.

But in the NBA and NFL — two leagues in which former players have estimated that more than 80 percent of their peers used marijuana during their careers—there remains a punitive cost. The NFL’s threshold for a positive test is 35 ng/ml; the NBA’s is 15 ng/ml. Repeated infractions, in both leagues, can result in a suspension.

In large part, the NBA’s policy is based on perception: Former commissioner David Stern, in an interview with ex-NBA player and marijuana advocate Al Harrington, said that the league tightened its rules, in part, because “some of our players came to us and said some of these guys are high coming into the game,” and because of the long-held theory (now largely debunked) that marijuana is a gateway drug to harder substances.  Stern now believes the league’s collective bargaining agreement should be altered so that players should be allowed to do whatever is legal in their individual state.  His successor as commissioner, Adam Silver, has embraced some of the most progressive policies of any major sports league, and has said that he’s open to legalizing medical marijuana (though how that would work in states where marijuana remains illegal is unclear).

And that leaves the NFL, whose players — given the inherently violent nature of their sport — may have the best case of all for embracing medical marijuana.  Yet while the NFL has said it’s open to working with its players association on a study of marijuana, it has continued to suspend a number of players for positive drug tests.  In a 2017 radio interview, NFL commissioner Roger Goodell expressed concerns that marijuana use “can be negative to the health of our players.” In a way, this isn’t surprising, given the NFL’s overarching cautiousness when it comes to both political and social issues.  But that policy will face continued challenges from ex-NFL players like [Eugene] Monroe, who point to mounting evidence that cannabis is a safer alternative to the opiates they took regularly in order to sustain their careers.

July 31, 2018 in Medical Marijuana Commentary and Debate, Sports, Who decides | Permalink | Comments (0)

Monday, July 30, 2018

Notable review of Florida’s "booming" medicial marijuana industry

Florida-medical-marijuana-program-rules

This local Florida article, headlined "Marijuana booming as state nears 2-year mark," reports on (unsurprising?) medical marijuana realities in the Sunshine State.  Here are highlights from the lengthy piece:

More than 100,000 Floridians now can legally take marijuana for medicinal purposes.  This milestone, reached in April, is one of many signs that Florida’s young marijuana industry is booming as the state approaches the two-year anniversary of voters legalizing medical pot.

But issues remain: Some patients complain that the Florida Department of Health’s rules create unfair barriers for patients. They can’t smoke their marijuana or grow their own, for example.  They also gripe about the patient approval process and the cost of medication.  Companies eager to jump into the marijuana business are waiting for the state to issue additional licenses required by law upon passing the 100,000-patient mark....

In November 2016, 71 percent of Florida’s voters gave the green light to medical marijuana.  The state still is issuing guidelines and battling lawsuits over how that should be done.  But the direction is clear.  Already, analysts are projecting a $1 billion medical marijuana market in Florida by 2020. 

Fourteen companies have received licenses from the state.  They’ve opened 43 dispensaries statewide, including offices in Summerfield and Lady Lake, to serve the growing number of approved patients, which has more than doubled since the start of the year.  The coveted licenses are drawing attention from established marijuana businesses.  In June, California-based MedMen paid $53 million to acquire the cultivation and distribution rights from Treadwell Nursery in Eustis....

[T]he process to become a qualifying doctor [initially meant] doctors were required to pay $1,000 for an eight-hour course. That requirement has since decreased to a two-hour course costing $250. More than 1,500 physicians now are able to recommend marijuana to patients, including more than 40 in Sumter, Lake and Marion counties.

Miami-Dade and Palm Beach counties have the most registered physicians, with more than 200 each.  Demand for doctors persists, with 1,500 to 3,500 patients joining the registry every week....

Even as more and more people line up for treatment, criticism of the program continues.  Companies and advocates of Amendment 2, which authorized medical marijuana, are challenging some of the rules laid out by the Department of Health.  Attorney John Morgan sued the department over its rule banning smokeable cannabis, arguing it goes against the will of the voters who approved the amendment.  Vaping is allowed.  Tallahassee Circuit Judge Karen Gievers sided with Morgan, saying the restriction was unconstitutional.  The state immediately appealed the decision, and Morgan tried to get the Florida Supreme Court to consider the case.  He now is focusing on legalizing recreational use.

Morgan criticized Gov. Rick Scott, who had opposed the broad legalization of medical marijuana, for allowing the smoking ban. Scott defended following the law as it is written. He is not alone in voicing smoking opposition. The American Society of Addiction Medicine rejects smoking as a means of drug delivery for medical purposes. The American Cancer Society Cancer Action Network, the ACS’s advocacy group, has not taken a position on legalization of marijuana for medical purposes, citing a need for more scientific research on marijuana’s potential benefits and harms.

July 30, 2018 in Medical Marijuana Commentary and Debate, Medical Marijuana Data and Research, Medical Marijuana State Laws and Reforms, Who decides | Permalink | Comments (0)

Wednesday, July 25, 2018

Disconcerting disconnect between Trumpian rhetoric and health care realities for veterans when medical marijuana involved

Cover.vetsandmarijuana3.12-22Prez Donald Trump yesterday gave a big speech to the VFW, Veterans of Foreign Wars, and he extolled his commitment to ensuring veterans receive first-rate health care: "We’re also committed to ensuring that when our warriors return home as veterans, they receive the best care anywhere on Earth." Unfortunately, as this new New York Times highlights, this rhetoric does not meet reality in at least one notable setting. The lengthy article is headlined "V.A. Shuns Medical Marijuana, Leaving Vets to Improvise," and here are excerpts:

Some of the local growers along the [California] coast here see it as an act of medical compassion: Donating part of their crop of high-potency medical marijuana to ailing veterans, who line up by the dozens each month in the echoing auditorium of the city’s old veterans’ hall to get a ticket they can exchange for a free bag.

One Vietnam veteran in the line said he was using marijuana-infused oil to treat pancreatic cancer. Another said that smoking cannabis eased the pain from a recent hip replacement better than prescription pills did. Several said that a few puffs temper the anxiety and nightmares of post-traumatic stress disorder. “I never touched the stuff in Vietnam,” said William Horne, 76, a retired firefighter. “It was only a few years ago I realized how useful it could be.”

The monthly giveaway bags often contain marijuana lotions, pills, candies and hemp oils, as well as potent strains of smokable flower with names like Combat Cookies and Kosher Kush.  But the veterans do not get any medical guidance on which product might help with which ailment, how much to use, or how marijuana might interact with other medications.

Ordinarily, their first stop for advice like that would be the Department of Veterans Affairs health system, with its thousands of doctors and hundreds of hospitals and clinics across the country dedicated to caring for veterans.  But the department has largely said no to medical marijuana, citing federal law.  It won’t recommend cannabis products for patients, and for the most part it has declined even to study their potential benefits. That puts the department out of step with most of the country, where at least 30 states now have laws that allow the use of medical marijuana in some form.

A department survey suggests that nearly a million veterans may be using medical marijuana anyway. But doctors in the veterans’ health system say the department’s lack of research has left them without much good advice to give veterans.  “We have a disconnect in care,” said Marcel Bonn-Miller, a psychologist who worked for years at the veterans’ hospital in Palo Alto, Calif., and now teaches at the University of Pennsylvania medical school.  “The V.A. has funded lots of marijuana studies, but not of therapeutic potential. All the work has been related to problems of use.”...

A bipartisan bill introduced in the House of Representatives this spring would order the department to study the safety and efficacy of marijuana for treating chronic pain and PTSD. If the bill passes, the department could not only develop expertise about a drug that many veterans have turned to on their own — it may also start down the road toward eventually allowing its doctors and clinics to prescribe cannabis.

“I talk to so many vets who claim they get benefits, but we need research,” said Representative Tim Walz, Democrat of Minnesota, who introduced the bill along with Phil Roe, Republican of Tennessee, who is a physician. “You may be a big advocate of medical marijuana, you may feel it has no value,” Mr. Walz said. “Either way, you should want the evidence to prove it, and there is no better system to do that research than the V.A.”

A spokesman for the Department of Veterans Affairs said Congress would need to do more than pass the current House bill. The spokesman, Curt Cashour, said that because cannabis is classified as a Schedule 1 drug under federal law, researchers would need to secure approval from five separate agencies to conduct studies. “The opportunities for V.A. to conduct marijuana research are limited because of the restrictions imposed by federal law,” Mr. Cashour said. “If Congress wants to facilitate more federal research into Schedule 1 controlled substances such as marijuana, it can always choose to eliminate these restrictions.”

The department does have two small studies in their early stages. One, in San Diego, looks at whether cannabidiol, a nonintoxicating component of cannabis, can help patients during PTSD therapy; it is scheduled to continue through 2023. The other, planned for South Carolina, would examine the palliative effects of cannabis in hospice patients. “In a system as big as ours, that’s not much, certainly not enough,” said Dr. David J. Shulkin, who was President Trump’s first secretary of veterans affairs before being fired in March.

During his tenure as secretary, Dr. Shulkin eased some rules, allowing the department’s doctors to start talking to veterans about medical marijuana. But many veterans faulted him for not going further. Dr. Shulkin said that the tangle of red tape surrounding Schedule 1 drug studies should no longer be an excuse not to conduct them. “We have an opioid crisis, a mental health crisis, and we have limited options with how to address them, so we should be looking at everything possible,” he said.

The push for more research and for access to medical marijuana in the veterans’ health system is not coming just from liberal areas of California. The generally conservative American Legion and Veterans of Foreign Wars both favor expanded research. And some of the most vocal advocates are products of the nation’s strict military academies. “Cannabis is the safe, responsible choice,” said Nick Etten, an Annapolis graduate and former Navy SEAL who runs an advocacy group called the Veterans Cannabis Project. “It helps with the Big Three we struggle with after combat — pain, sleep and anxiety — and it is safer than many medications.”

Lots of recent prior related posts:

July 25, 2018 in Federal Marijuana Laws, Policies and Practices, Medical Marijuana Commentary and Debate, Who decides | Permalink | Comments (0)

Monday, July 23, 2018

Prominent US Representative for Ohio now advocating that "marijuana should be legal in all 50 states"

220px-Rep._Tim_Ryan_Congressional_Head_Shot_2010CNN recently published this recent commentary advocating federal marijuana reform that is particularly notable because of its author: Tim Ryan, a Democrat representing Ohio's 13th congressional district who is co-chair of the House Addiction, Treatment, and Recovery Caucus (and who at least once had aspirations to be a party leader in the House). Here are excerpts from the commentary:

The year Donald Trump was elected President, more Americans were arrested for marijuana possession than for all violent crimes combined.  Moreover, the ACLU found that even though African-Americans use marijuana at similar rates to white Americans, they are almost four times more likely to be arrested for marijuana possession....

As co-chair of the House Addiction, Treatment, and Recovery Caucus, I've been hesitant to support legalizing marijuana in the past.  But after meeting with countless Ohio families and youth whose lives have been irreparably harmed by a marijuana arrest, I find the social and economic injustices of our marijuana policy too big to ignore.  I firmly believe no person should be sentenced to a lifetime of hardship because of a marijuana arrest. It is morally wrong and economically nonsensical.  That is why I am calling for an end to marijuana being used as an excuse to lock up our fellow Americans.

Marijuana should be legal in all 50 states. Across the country, nine states and the District of Columbia have passed laws legalizing marijuana.  Voters in Michigan and Oklahoma will be voting on marijuana initiatives this November, and efforts are underway in Missouri, Arizona, Nebraska and Utah to get legalization initiatives on the ballot. While I support these states for leading by example, this is an issue that affects every corner of our nation.  You should not be able to legally buy a product in one state, just to be arrested for the very same act in another.

Studies have shown that marijuana legalization could save $7.7 billion in averted enforcement costs and add $6 billion in additional tax revenue -- a $13.7 billion net savings.  Not to mention the reported 782,000 jobs it could create on day one.  Think of what our country could do with that money: rebuild our highways, bridges, and railroads; provide our communities with the resources they need to respond effectively to substance abuse and the opioid epidemic; and create jobs....

Congress can change this by passing the Marijuana Justice Act.  This legislation would remove marijuana's designation as a Schedule I drug -- those classified as having no accepted medical use and a high potential for abuse.  It would also eliminate all criminal penalties for an individual who imports, exports, manufacturers, distributes, or processes with intent to distribute marijuana.  To create economic opportunity in communities devastated by mass incarceration, the bill creates a $500 million community reinvestment fund to provide job training for the nascent legal cannabis industry.

The War on Drugs failed the American people. It is time for us to take the necessary steps to right our nation's wrongs.  We cannot afford to leave people behind and money on the table. If we are truly a nation that believes in second chances, our federal marijuana laws must change.  America is speaking. Congress must act.

July 23, 2018 in Campaigns, elections and public officials concerning reforms, Federal Marijuana Laws, Policies and Practices, Medical Marijuana Commentary and Debate, Recreational Marijuana Commentary and Debate, Who decides | Permalink | Comments (3)

Thursday, July 19, 2018

Effective explanation of why it is so hard to explain the exact number of "medical marijuana states"

MarijuanamapOver at Marijuana Moment, Kyle Jaeger has this nice new piece on a bit of head-counting (or should I say state-counting) that always sticks in my craw. His piece is headlined "How Many Medical Marijuana States Are There? Advocates Disagree On The Number," and here are excerpts:

Is it 30? 31? How about 45 or 49?

With marijuana legalization efforts moving forward at full steam in states across the country, it can be understandably difficult to keep track of the total number of states that have legalized cannabis in some form, especially when it comes to counting differing medical programs.

In some cases, even national advocacy groups disagree over the actual tally.  For example, the Marijuana Policy Project (MPP) lists 30 legal medical marijuana states, while NORML says the number is 31.  Americans for Safe Access, meanwhile, has an interactive map that provides information about existing cannabis laws in 45 states. So what is the number, really?

If you ask NORML, it’s a plain and clear 31. Paul Armentano, the organization’s deputy director, told Marijuana Moment that it’s based on simple reasoning: there are currently 31 states in the U.S. that have legalized marijuana for medical or recreational purposes (not including more limited, CBD-focused laws in other states, but we’ll get to those in a minute)....

Unlike NORML, MPP determines what constitutes a legal medical marijuana state based on the fact the state passed a law aimed at medical cannabis in addition to an independent analysis of the efficacy of those laws.  That’s why the organization doesn’t include Louisiana in its list of legal states, for instance, even though NORML and others count it.

“Forty-nine states have adopted some form of medical marijuana law, and we feel that the easiest distinction to draw is between those that are effective and relatively comprehensive and those that are ineffective or highly restrictive,” Mason Tvert, MPP’s media relations director, told Marijuana Moment.  “There are some states, such as Louisiana, that could arguably fall into both categories, but our policy experts currently still consider it to be too limited to be considered one of the states that has adopted an effective and comprehensive medical marijuana law.”...

When you hear numbers in the upper 40s, those generally take into account states that allow certain patients to use CBD extracts with low-THC composition, but licensed programs providing those products are few and far between. Generally speaking, legalization advocates don’t consider CBD-only states “legal,” per se, but it’s another factor that can muddle the math.

What consequence, if any, these varying tallies have on public policy is uncertain. Advocates believe, however, that including the CBD-only states is one key factor that led to the passage in 2014, and subsequent extension, of a congressionally approved rider preventing Justice Department interference in medical marijuana states.  Since the text of the measure itself meticulously lists out all of the affected states — including ones like Texas and Virginia, which only have CBD laws — it is that much harder for lawmakers from those states to vote no....

One thing advocates do agree on is the number of states that allow recreational, or adult-use marijuana. That’s nine, plus Washington, D.C.

July 19, 2018 in History of Marijuana Laws in the United States, Medical Marijuana Commentary and Debate, Medical Marijuana State Laws and Reforms | Permalink | Comments (0)

Friday, July 13, 2018

"Behind Schedule — Reconciling Federal and State Marijuana Policy"

Nejmp1804408_f1The title of this post is the title of this new Perspectives piece appearing in the The New England Journal of Medicine and authored by Rebecca Haffajee, Robert MacCoun and Michelle Mello. I recommend the piece highly in part because of its terrific graphic under the heading "U.S. Marijuana Policy Milestones, 1970–2018." Here is part of its text:

The present state of conflicting laws seems unstable and suboptimal for rational drug control. Federal regulation that accommodates and reinforces state medical marijuana regulatory regimes would result in a safer, more reliable, more accessible supply of marijuana products. Congress, because it answers to the people and represents the states, appears the most likely branch to move on marijuana policy; it could even be encouraged to act by Canada’s recent legalization of recreational marijuana.  Federal courts are increasingly hearing challenges to marijuana’s Schedule I status but have so far been unwilling to deem Congress’s scheduling determination irrational and therefore unconstitutional.

In Congress, rescheduling marijuana by amending the CSA is one attractive option.  The executive branch, too, can reschedule CSA substances, but the mechanisms are time consuming and unlikely to attract interest within the current administration.  Because considerable evidence now supports marijuana’s therapeutic benefits in reducing chronic pain, nausea, and vomiting in patients with cancer, as well as multiple sclerosis–related muscle spasms, there is a compelling argument that marijuana is more appropriately designated as a Schedule II or Schedule III drug.  Rescheduling would facilitate further study of products for FDA approval, but would not automatically change the severity of penalties for marijuana crimes or alter international treaty obligations, enshrined in the CSA, to ensure that all psychoactive substances are used only for legitimate medical and scientific purposes.

Congress could also remove marijuana from the CSA schedules altogether. This dramatic action could be coupled with legislation authorizing FDA oversight of marijuana products. Whether marijuana’s psychoactive effects preclude this move away from regulation as a controlled substance would provoke considerable debate. Subjecting marijuana products to FDA approval would hinder access initially but ultimately foster a robust system for regulation and research. FDA oversight of marketing would also improve product safety and consistent promotion across states.

The [proposed] legislation [sponsored by Senators Gardner and Warren] represents a third option designed to respect states’ rights — codifying the approach articulated in the Cole Memorandum by amending the CSA to exempt marijuana activities that are lawful in the jurisdiction where they occur. This solution would be more permanent than attorney-general guidance or agreements between states and the attorney general regarding enforcement, which shift with the political winds, and would therefore promote stability for medical users and suppliers. But it would not facilitate research into marijuana harms and benefits, bring products within the FDA’s purview to ensure safety and efficacy, alleviate interstate health risks, or address potential conflicts with international treaty obligations.

We think this third option, which addresses some pressing conflict-of-law concerns such as unpredictable criminal enforcement, is preferable to the current blurred vision of the future of marijuana policy.  Ultimately, a more comprehensive federal regime that perhaps resembles Canada’s recent legalization of recreational marijuana could affirmatively promote health and safety through research and regulation.

July 13, 2018 in Campaigns, elections and public officials concerning reforms, Federal Marijuana Laws, Policies and Practices, History of Marijuana Laws in the United States, Medical Marijuana Commentary and Debate, Recreational Marijuana Commentary and Debate, Who decides | Permalink | Comments (2)

Wednesday, July 11, 2018

"Guns N’ Ganja: How Federalism Criminalizes the Lawful Use of Marijuana"

Guns-and-mmjThe title of this post is the title of this notable new article authored by Ira Robbins now available via SSRN.  Here is its abstract:

Federalism is a vital tenet of our Republic.  Although federal law is the supreme law of the land, our Constitution recognizes the integral role that state law plays in the national scheme.  Like any pharmaceutical drug that withstands rounds of clinical testing, state law functions as a laboratory in which Congress can evaluate and potentially adopt novel policies on a nation-wide basis.  Most of the time, federal and state law exist harmoniously, complementing one another; other times, however, the two systems clash, striking a dissonant chord.

In the United States, state marijuana laws are currently on a crash course with federal marijuana law, exemplifying the discordant consequences our dual-system of laws sometimes generates.  Eight states and the District of Columbia have legalized recreational marijuana use, yet under the Controlled Substances Act (“CSA”) marijuana remains illegal in the eyes of federal law. Mere confusion concerning the legality of marijuana is not the only consequence, however.  One notable casualty ensuing from the battle of the mutually exclusive federal and state marijuana laws is the deprivation of rights belonging to the unsuspecting, average citizen.

The CSA establishes a schedule of drugs, and various federal regimes — such as entitlement programs and welfare benefits — impose compliance with the CSA as a necessary antecedent for conferral of those benefits.  For example, although possessing a firearm is a fundamental right under the Second Amendment, citizens who wish to lawfully smoke marijuana can no longer avail themselves of this fundamental right. Section 922(g)(3) of the Gun Control Act prevents users of Schedule I drugs pursuant to the CSA — irrespective of state law — from possessing or owning a firearm. Marijuana, despite its lack of potential for addiction, plethora of medical benefits, and disconnect from violence, has always been a Schedule I drug — essentially deemed more addictive and dangerous than methamphetamine, a Schedule II drug. Unknowing, ordinary citizens are consequently caught in this legal black hole, contemplating how conduct can be both lawful and unlawful.

This Article proposes a simple solution to a complex problem: deschedule marijuana.  The Article first surveys the past, observing that the Nixon Administration’s placement of marijuana in Schedule I rang of racial undertones, and then examines the present, noting the majority of states that have legalized medicinal marijuana and the numerous anecdotal reports of its alleviating properties.  Further, enforcing § 922(g)(3) against individuals who consume marijuana lawfully pursuant to state law simultaneously overreaches and under-reaches, failing to target the violent criminals that Congress initially sought to apprehend.  Thus, the federal government’s insistence on maintaining marijuana in Schedule I undermines principles of federalism and prevents law-abiding citizens from fully exercising their constitutional right to own a firearm.

July 11, 2018 in Business laws and regulatory issues, Federal Marijuana Laws, Policies and Practices, Medical Marijuana Commentary and Debate, Recreational Marijuana Commentary and Debate | Permalink | Comments (0)

Saturday, July 7, 2018

"Defying Congress, Jeff Sessions Keeps Blocking Medical Marijuana Research"

The title of this post is the headline of this recent Reason piece by Mike Riggs, which gets started this way:

It's been almost two years since the Drug Enforcement Administration (DEA) began accepting applications for new growers of research cannabis, and two dozen applicants are still in regulatory limbo.

Since the DEA announced in August 2016 that it would end the federal monopoly on producing cannabis for scientific research in the United States, growers, investors, researchers, applicants, and even members of Congress have sought to understand why a relatively simple licensing review process has stretched on for nearly two years. The answer is pretty straightforward: Attorney General Jeff Sessions, for reasons he has not publicly disclosed, decided to intervene in a process that has historically not involved the attorney general in order to stop the DEA from issuing licenses to growers.

While the Controlled Substances Act gives the attorney general regulatory authority over scheduled drugs, that authority has historically been delegated to the DEA, which is part of the Justice Department. The DEA has a whole division, in fact, dedicated to "investigat[ing] the diversion of controlled pharmaceuticals and listed chemicals from legitimate sources while ensuring an adequate and uninterrupted supply for legitimate medical, commercial, and scientific needs."

Members of Congress are not happy with Sessions' obstruction of the licensing process.  In April, Sens. Orrin Hatch (R–Utah) and Kamala Harris (D–Calif.) sent the attorney general a letter in which they asked him to provide the Senate with a timeline for processing applications from potential manufacturers of research marijuana. They also asked the DOJ to update applicants on the review process.  Both actions, Hatch and Harris suggested, should be completed by May 15, 2018.  Not only did the DOJ miss that deadline, but it doesn't seem interested in playing catch-up.

Four license applicants I interviewed in late June told me they've received no official updates from either the DEA or the DOJ in months.  Applicants who have spoken to congressional offices working on this issue say their contacts are equally frustrated by Sessions' obstruction of the DEA's licensing process.

July 7, 2018 in Federal Marijuana Laws, Policies and Practices, Medical Marijuana Commentary and Debate, Medical Marijuana Data and Research, Who decides | Permalink | Comments (0)

Thursday, June 28, 2018

Highlighting how extraordinary the approval of medical marijuana was in Oklahoma

OK-Yes-788Over at Marijuana Moment, Kyle Jaeger has this terrific new piece reflecting on the extraordinary dynamics surrounding the vote on Tuesday in Oklahoma approving a medical marijuana initiative. I recommend the piece in full, and here are excerpts:

Voters in one of the reddest states in the nation approved one of the most far-reaching marijuana ballot measures on Tuesday, making Oklahoma the 30th state to legalize medical cannabis.

And while advocates and pro-legalization organizers in the state will tell you they weren’t necessarily surprised by the results — with polls consistently showing majority support in the lead-up to Tuesday’s vote, for example — the initiative’s passage by a wide margin (57 percent to 43 percent) is still extraordinary.

In part, that’s because of the political landscape of Oklahoma. The state hasn’t voted for a Democratic presidential candidate since 1964, and its marijuana laws have historically reflected a staunch, prohibitionist mindset. Just four years ago, getting caught consuming cannabis in public twice could land you in prison for up to a decade.

But perhaps even more impressively, the initiative was decisively approved—during a midterm primary election—in spite of the fact that committees in support of State Question 788 were outspent by committees opposed to the measure six-to-one. According to the latest campaign finance records, Oklahomans for Health, which played a leading role in support of the initiative, and Yes On 788 spent a total of about $155,000 during their campaigns based on the latest campaign finance disclosure statements submitted June 26.

Committees opposed to the initiative, Oklahomans Against 788 and SQ Is NOT Medical spent a total of about $920,500 on their anti-legalization campaigns, some of which was used for television advertising against the measure. Supporters, on the other hand, did not have enough funds to go on the air with their message.

Chip Paul, chairman of Oklahomans for Health, told Marijuana Moment that the group’s minimal spending “speaks volume for liberty, freedom, unity… because Oklahoma united around this and made it happen.”...

Unlike pro-legalization campaign committees advancing reform bids in many past state-level elections, Oklahomans for Health did not receive financial contributions from national advocacy groups such as Marijuana Policy Project or the Drug Policy Alliance. Paul said it was better that way because “it means more if we do this for $0 or $10,000.”

Another element of the group’s campaign efforts involved strategically avoiding divisive, partisan politics. While the initiative itself has been characterized as “liberal” because it doesn’t include a list of limited medical conditions that qualify individuals for cannabis, the issue at hand is increasingly bipartisan. A recent survey from the progressive think tank Center for American Progress found a record 68 percent of Americans favor recreational legalization, including 57 percent of Republicans. Support for medical marijuana legalization is even higher, with 93 percent of Americans in agreement that patients should be able to legally access the plant. “For the most, we’ve managed to rise above things that would divide us,” Paul said.

June 28, 2018 in Campaigns, elections and public officials concerning reforms, History of Marijuana Laws in the United States, Initiative reforms in states, Medical Marijuana Commentary and Debate, Medical Marijuana State Laws and Reforms, Who decides | Permalink | Comments (0)

Tuesday, June 26, 2018

SCOTUS provides a good new First Amendment precedent for doctors interested in recommending marijuana

Supreme-court-marijuanaThe modern state medical marijuana laws owe part of their structure to critical lower federal court rulings about the First Amendment's protection of doctors who wish to discuss marijuana use with patients.  In the late 1990s after California voters passed the nation's first medical marijuana law, the federal government threatened physicians who recommended or prescribed a Schedule I drug with possible revocation of DEA registration and exclusion from Medicare and Medicaid reimbursements.   But this threat was thwarted through litigation which culminated in a ruling by the U.S. Court of Appeals for the Ninth Circuit holding that physicians’ First Amendment freedom of speech rights under the privileged doctor-patient relationship permitted them to issue medical marijuana recommendations.  The Ninth Circuit's ruling in Conant v. Walters, 309 F.3d 629 (9th Cir. 2002), has provided a key foundation for modern medical marijuana regimes, but the firmness of that foundation could be questioned because the US Supreme Court has never addressed this issue directly.

As of this morning, the Supreme Court still has not addressed this issue directly, but it has now ruled in National Institute of Family and Life Advocates v. Becerra, available here, that the First Amendment limits what states can tell doctors and other health professional to say or not say.  Here is part of a fascinating passage (which even mentions medical marijuana, with my emphasis added) extolling the importance of broad constitutional protections in this realm:

As with other kinds of speech, regulating the content of professionals’ speech “pose[s] the inherent risk that the Government seeks not to advance a legitimate regulatory goal, but to suppress unpopular ideas or information.” Turner Broadcasting, 512 U. S., at 641.  Take medicine, for example. “Doctors help patients make deeply personal decisions, and their candor is crucial.” Wollschlaeger v. Governor of Florida, 848 F.3d 1293, 1328 (CA11 2017) (en banc) (W. Pryor, J. concurring).  Throughout history, governments have “manipulat[ed] the content of doctor-patient discourse” to increase state power and suppress minorities:

“For example, during the Cultural Revolution, Chinese physicians were dispatched to the countryside to convince peasants to use contraception. In the 1930s, the Soviet government expedited completion of a construction project on the Siberian railroad by ordering doctors to both reject requests for medical leave from work and conceal this government order from their patients.  In Nazi Germany, the Third Reich systematically violated the separation between state ideology and medical discourse. German physicians were taught that they owed a higher duty to the ‘health of the Volk’ than to the health of individual patients.  Recently, Nicolae Ceausescu’s strategy to increase the Romanian birth rate included prohibitions against giving advice to patients about the use of birth control devices and disseminating information about the use of condoms as a means of preventing the transmission of AIDS.” Berg, Toward a First Amendment Theory of Doctor-Patient Discourse and the Right To Receive Unbiased Medical Advice, 74 B. U. L. Rev. 201, 201– 202 (1994) (footnotes omitted).

Further, when the government polices the content of professional speech, it can fail to “‘preserve an uninhibited marketplace of ideas in which truth will ultimately prevail.’” McCullen v. Coakley, 573 U. S. ___, ___–___ (2014) (slip op., at 8–9).  Professionals might have a host of good-faith disagreements, both with each other and with the government, on many topics in their respective fields.  Doctors and nurses might disagree about the ethics of assisted suicide or the benefits of medical marijuana; lawyers and marriage counselors might disagree about the prudence of prenuptial agreements or the wisdom of divorce; bankers and accountants might disagree about the amount of money that should be devoted to savings or the benefits of tax reform.  “[T]he best test of truth is the power of the thought to get itself accepted in the competition of the market,” Abrams v. United States, 250 U. S. 616, 630 (1919) (Holmes, J., dissenting), and the people lose when the government is the one deciding which ideas should prevail.

Given the modern politics of marijuana reform, I was not that worried that the Ninth Circuit's work in Conant v. Walters would be undermined anytime soon. But it would not be too hard to imagine Attorney General Jeff Sessions or other state or federal officials resistant to marijuana reform trying to heavily regulate how medical professionals can talk to patients about marijuana. This new SCOTUS precedent would seem to limit such efforts.

June 26, 2018 in Court Rulings, History of Marijuana Laws in the United States, Medical community perspectives, Medical Marijuana Commentary and Debate, Who decides | Permalink | Comments (0)

Monday, June 25, 2018

Formal FDA approval for Epidiolex means some part of the federal government finds some part of cannabis plant has "accepted medical use"

Download (1)This new CNN piece, headlined "FDA approves first cannabis-based drug," reports on the big news from the federal government concerning a very specific form of medical marijuana. Here are the details:

The US Food and Drug Administration approved a cannabis-based drug for the first time, the agency said Monday. Epidiolex was recommended for approval by an advisory committee in April, and the agency had until this week to make a decision.

The twice-daily oral solution is approved for use in patients 2 and older to treat two types of epileptic syndromes: Dravet syndrome, a rare genetic dysfunction of the brain that begins in the first year of life, and Lennox-Gastaut syndrome, a form of epilepsy with multiple types of seizures that begin in early childhood, usually between 3 and 5.

"This is an important medical advance," FDA Commissioner Dr. Scott Gottlieb said in a statement Monday. "Because of the adequate and well-controlled clinical studies that supported this approval, prescribers can have confidence in the drug's uniform strength and consistent delivery."

The drug is the "first pharmaceutical formulation of highly-purified, plant-based cannabidiol (CBD), a cannabinoid lacking the high associated with marijuana, and the first in a new category of anti-epileptic drugs," according to a statement Monday from GW Pharmaceuticals, the UK-based biopharmaceutical company that makes Epidiolex....

The FDA has approved synthetic versions of some cannabinoid chemicals found in the marijuana plant for other purposes, including cancer pain relief. Justin Gover, chief executive officer of GW Pharmaceuticals, described the approval in the statement as "a historic milestone." He added that the drug offers families "the first and only FDA-approved cannabidiol medicine to treat two severe, childhood-onset epilepsies."

"These patients deserve and will soon have access to a cannabinoid medicine that has been thoroughly studied in clinical trials, manufactured to assure quality and consistency, and available by prescription under a physician's care," Gover said. Epidiolex will become available in the fall, Gover told CNN.  He would not give any information on cost, saying only that it will be discussed with insurance companies and announced later....

It's an option for those patients who have not responded to other treatments to control seizures.  According to the Epilepsy Foundation, up to one-third of Americans who have epilepsy have found no therapies that will control their seizures. Shauna Garris, a pharmacist, pharmacy clinical specialist and adjunct assistant professor at the University of North Carolina's Eshelman School of Pharmacy, said the drug is effective and works somewhere between "fairly" and "very well." She has not used Epidiolex in her own clinical practice and was not involved in the development of the drug but said she's not sure it will live up to "all of the hype" that has surrounded it....

As part of the FDA's review of the medication, the potential for abuse was assessed and found to be low to negative, according to Gover. Still, this approval comes as the White House is said to be reconsidering federal prohibition of marijuana and as more and more states approve it for recreational and medicinal use. Gover said the approval signals "validation of the science of cannabinoid medication."

As the title of this post highlights, this news serves as still further proof of the misguided placement of marijuana as a Schedule I drug under the Controlled Substances Act defined as having "no currently accepted medical use in treatment in the United States." But, it should also be realize that this news serves as proof that the federal government, even without any reform to the CSA, can and will approve a cannabis-based medicine which has been "thoroughly studied in clinical trials [and] manufactured to assure quality and consistency."  Thus, the catch-22 comes from the fact that marijuana's placement on Schedule I precludes US-based companies from doing the types of clinical trials that the FDA demands.  (If we had a well-functioning federal government, marijuana surely would have been at least re-scheduled to Schedule II or III under the CSA many years ago.  But I digress....)

June 25, 2018 in Business laws and regulatory issues, 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)

Thursday, June 14, 2018

"The Politics of Passing and Implementing Medical Marijuana in Ohio"

The title of this post is the title of this notable new paper just posted to SSRN authored by A. Lee Hannah.  Here is its abstract:

Why did the state of Ohio adopt a medical marijuana policy? And why did it do so in 2016?  This article addresses these questions by examining the diffusion of medical cannabis policy across the U.S., by describing the evolution of images related to the policy, and by exploring the content of the law.

Using evidence from legislators’ remarks on the floor of the Ohio General Assembly and interviews with activists and analysts, I show that the direct initiative helped push members of the Ohio General Assembly to write and adopt a medical marijuana law (MML) when they were unlikely to do so. Next, I analyze trends in media coverage of medical marijuana to demonstrate that the spread of the policy has also been aided by shifting images related to the beneficiaries of medical cannabis programs.  Turning to the content of the law, I find that Ohio’s MML is written similarly to later adopters in the Midwest – where laws are more restrictive and medicalized. Finally, I assess how the characteristics of the law and looming elections will affect the implementation of Ohio’s Medical Marijuana Control Program.

June 14, 2018 in History of Marijuana Laws in the United States, Medical Marijuana Commentary and Debate, Medical Marijuana State Laws and Reforms | Permalink | Comments (0)

Saturday, June 9, 2018

Mapping out Oklahoma positions with approaching medical marijuana reform initiative vote

OK-Yes-788

This recent article from Religion News Service, headlined "In red-state Oklahoma, marijuana ballot question splits people of faith," provides a great look at the range of perspectives on marijuana reform in Oklahoma with only weeks before a big initiative vote. Here are snippets from an article worth reading in full:

As Presbyterian minister Bobby Griffith sees it, legalizing medical marijuana in Oklahoma could help arthritis sufferers with chronic pain and veterans with post-traumatic stress disorder.

The 41-year-old husband and father has a personal reason, too, for supporting State Question 788 — a pro-marijuana initiative that the Bible Belt state’s voters will decide June 26. “For myself, I would be interested in a prescription for it to see if it works better than my anxiety and depression medications,” said Griffith, co-pastor of a Presbyterian church near downtown Oklahoma City and a member of the national group Clergy for a New Drug Policy.

As Griffith characterizes it, the Oklahoma ballot measure’s potential to improve health outcomes and reduce dependence on addictive opioid painkillers makes it a “moral issue.”

Religious opponents counter that backing the issue would be immoral. Sen. James Lankford, R-Okla., an ordained Southern Baptist pastor, blasts the ballot measure as a “recreational marijuana vote disguised as medical marijuana.”

“The moral issue to me is really a family issue,” Lankford, who directed a Baptist youth camp before his 2010 election to Congress, told Religion News Service. “The best thing for our state is not to get more parents and grandparents to smoke marijuana,” added the senator, who filmed a commercial urging voters to reject State Question 788. “To have our communities more drug-addicted and distracted, that doesn’t help our families. It doesn’t make us more prosperous. It doesn’t make our schools more successful.”...

[F]aith arguments are prominent in a state where three out of four residents describe themselves in Gallup polling as “moderately religious” or “very religious.” The vote — which will take place on the state’s primary day for governor and other state and federal offices — resulted from a petition signed by nearly 68,000 voters and presented to state officials two years ago.

If State Question 788 passes, Abner warns, Oklahoma could follow the nine states that have authorized recreational use of marijuana. “The key thing is that it’s not medical,” he said. “This is something that’s hiding behind that (terminology) to bring recreational marijuana to Oklahoma. And from a spiritual standpoint, none of us can sustain the sound minds and healthy bodies God desires us to have when we place ourselves under the controlling influence of something other than the Holy Spirit.”

Other religious opponents include top officials of the Baptist General Convention of Oklahoma — representing the state’s roughly 577,000 Southern Baptists — and the Catholic Conference of Oklahoma, the public policy arm of the state’s Roman Catholic dioceses, comprising roughly 288,000 parishioners. “My hope is that Oklahoma will vote down marijuana legalization and continue to put legal barriers between addiction and the communities it devastates,” Russell Moore, president of the Southern Baptist Convention’s Ethics and Religious Liberty Commission, said in a statement published by The Baptist Messenger, an Oklahoma newspaper.

But Jon Middendorf, senior pastor of Oklahoma City First Church of the Nazarene, said he favors “whatever can bring relief to folks who are in chronic pain.”

“I’m just exhausted of conspiracy theories that always seem to emanate from the Christian right,” said Middendorf, who stressed that he was speaking personally and not on behalf of his congregation. “There’s always some sinister story behind it all,” he added. “It really might be that somebody who’s in pain just needs something that hasn’t been tried just yet, that offers some help for relief and quality of life, that they would not have had otherwise.”...

Typically, Oklahomans rank among the most conservative voters in the nation.... But on the medical marijuana issue, recent polling shows State Question 788 enjoying support from 57.5 percent of voters and seeming likely to pass, reported Bill Shapard, CEO of SoonerPoll.com.

“We’ve polled this issue multiple times over the last five years, and we continue to see that certain groups, who one might think would be opposed to SQ788, continue to support it,” Shapard said in a statement. “Thirty years ago, these groups would have opposed it, but roughly half have changed their minds since then.”

Griffith, whose congregation is affiliated with the Presbyterian Church in America, said some of his most conservative friends support State Question 788. “A very conservative person I know — I mean, she loves President Trump but she also wants medical marijuana,” he said. “She has rheumatoid arthritis and wants to have something that helps relieve the pain and has some healing qualities about it without the addiction.”

Notably, this article was published before Prez Trump's comments this past Friday suggesting he would support a federal marijuana reform bill that would formally respect state marijuana reform laws.   I suggested in this post a few months ago that proponents of Question 788 likely could benefit greatly, given that 65% of the state voted for Prez Trump, if they could claim he was supportive of state marijuana reform efforts.   interesting times.

Some prior related posts:

June 9, 2018 in Campaigns, elections and public officials concerning reforms, Initiative reforms in states, Medical Marijuana Commentary and Debate, Medical Marijuana State Laws and Reforms, Religion, Who decides | Permalink | Comments (0)

Friday, June 8, 2018

Rounding-up some notable and thoughtful reactions to the new STATES Act approach to federal marijuana reform

As noted in this prior post, President Donald Trump this morning seemingly indicated support for the new marijuana reform law proposed yesterday by Senators Cory Gardner (R-Colo.) and Elizabeth Warren (D-Mass.) and Representatives David Joyce (R-Ohio) and Earl Blumenauer (D-Ore.).  The proposal, knows as Strengthening the Tenth Amendment Through Entrusting States Act (STATES Act), has already drawn reactions both political and academic.  Here is a round up:

Tom Angell has collected a lot of notable reactions at Marijuana Moment under the heading, "Lawmakers And Advocates React To Bipartisan Trump-Supported Marijuana Bill"

For more detailed and academic perspectives, I highly recommend:

Prior related posts:

June 8, 2018 in Federal Marijuana Laws, Policies and Practices, History of Marijuana Laws in the United States, Medical Marijuana Commentary and Debate, Recreational Marijuana Commentary and Debate, Who decides | Permalink | Comments (0)

Monday, June 4, 2018

Medical marijuana news nationwide, in states large and small, developing and debated

There are so many interesting developments, some small and some big, in medical marijuana states that I cannot come close to keeping track of it all.  Having seen a lot of notable stories in a lot of states in recent days, I figured it might be time to do a round-up of stories that caught my eye.  So, though this is not in any sense comprehensive, here goes in alphabetical order:

From Arkansas here, "Arkansas Supreme Court to hear dispute over medical marijuana rollout"

From Connecticut here, "With booming medical marijuana program, some fear shortages"

From Georgia here, "Georgia couple loses custody of son after giving him marijuana to treat seizures"

From Florida here, "As marijuana dispensaries open their doors, Florida registers 5,400 new users per week"

From Maryland here, "Overwhelmed computer system stalls medical marijuana sales over weekend in Maryland

From Ohio here, "Ohio announces 56 sites where medical marijuana will be sold"

From Oklahoma here, "Oklahoma's medical marijuana law would be unique"

From Utah here, "Unofficially, many Utah law enforcement groups are lining up to oppose the medical marijuana initiative"

June 4, 2018 in Medical community perspectives, Medical Marijuana Commentary and Debate, Medical Marijuana Data and Research, Medical Marijuana State Laws and Reforms | Permalink | Comments (1)

Friday, June 1, 2018

Brookings debuts short documentary: "The Life She Deserves: Medical Marijuana in the United States"

Regular readers have often seen me use this space to sing the praises of various writings from various folks at Brookings on various marijuana reform topics.  This Brookings feature highlights that their work in this space has taken on a new dimension:

For 100 years, Brookings has been known for its in-depth public policy research, primarily shared through reports, books, and events. This year, the Institution has added a new medium to its canon of work: narrative film.

On May 29, Brookings and Variety co-hosted the Washington, D.C. premiere of the Institution’s first documentary-short film, “The Life She Deserves.” The film is an intimate portrait of Virginia teenager Jennifer Collins and her family’s struggle to find a treatment to control her debilitating epilepsy and their fight to change medical marijuana laws. Following the screening of the film—a culmination of more than two years of work between Senior Fellow John Hudak and the Institution’s creative video team — John Hudak, Jennifer Collins, her mother and medical cannabis advocate Beth Collins, and George Burroughs, the film’s director, discussed the role of film in influencing policy and the current picture of state-level marijuana legalization and federal restrictions on the use and clinical research into medical cannabis. Ted Johnson, a senior editor at Variety, moderated the conversation....

“The Life She Deserves” is available to watch online at www.lifeshedeserves.com.

June 1, 2018 in Federal Marijuana Laws, Policies and Practices, Medical Marijuana Commentary and Debate, Medical Marijuana State Laws and Reforms | Permalink | Comments (0)

Monday, May 28, 2018

"PTSD & Pot: Veterans making Memorial Day push for legal marijuana"

The title of this post is the title of this lengthy new Fox News article. Regular readers know I have, since starting this blog more nearly five years ago, regularly blogged about a range of issues relating to veterans and their access to marijuana (a dozen of recent posts on this topic are linked below). As I have said before and will say again, I feel a genuine and deep debt to anyone and everyone who serves this nation through the armed forces, and I feel especially strongly on a day like Memorial Day that veterans should be able to have safe and legal access to any and every form of medicine that they and their doctors reasonably believe could help them with any ailments or conditions. Here is part of the start of the Fox News piece:

Veterans from across the country will be gathering in our nation's capital on Memorial Day this year to not only honor those who made the ultimate sacrifice, but to advocate for a cause that isn't typically associated with our nation's heroes -- the legalization of marijuana.

The veterans and advocates taking part in the Memorial Day Veterans Rally DC hope to change the stigma that surrounds cannabis, the preferred term for marijuana among advocates, by arguing that this alternative medicine is already helping some vets treat issues like PTSD, chronic pain and depression -- all without the use of dangerous & addictive prescription drugs like opioids. One of their rallying cries is "plants over pills," and they're not just coming from the usual legal pot hot-spots like Colorado....

Beyond a lack of access in all 50 states, advocates say one of the biggest problems is that veterans are forced to pay for this alternative treatment out of pocket, despite what they say are life-saving results. That's due to Department of Veterans Affairs regulations which stipulate VA doctors still cannot prescribe medicinal marijuana to patients, despite the fact that they are allowed to "discuss marijuana use with veterans as part of comprehensive care planning."

Some recent prior related posts:

May 28, 2018 in Medical Marijuana Commentary and Debate, Medical Marijuana State Laws and Reforms, Who decides | Permalink | Comments (0)

Sunday, May 27, 2018

"Could medical marijuana help fight opioid abuse? It’s complicated"

MarijuanavopioidsThe title of this post is the thoughtful headline of this article from Illinois thoughtfully discussing the issues surrounding the relationship between opioid use and marijuana access.  Here are excerpts:

Tom Utley says medical marijuana allowed him to reduce his use of prescription painkillers by 98 percent over the past year and a half. “It has given me control of my life,” said Utley, 42, a Mason County resident whose chronic pain after a car crash 27 years ago used to require him to swallow Vicodin and OxyContin pills four times a day.  Now he takes prescription opioids only a few times each month.

Utley, who works part time running a gymnastics tumbling program, has found relief in marijuana-infused topical lotions and patches, as well as smokable cannabis, from Springfield’s HCI Alternatives dispensary. Unlike prescription opioids, marijuana doesn’t come with the unwanted side-effects of constipation, cravings and cloudy thinking, he said....

Utley is among those who see expanded access to medical marijuana for people in pain as one solution for the nationwide epidemic of addiction to legal opioid painkillers and illegal opioids such as heroin and fentanyl.  There were about 2,000 fatal and 14,000 nonfatal opioid overdoses in Illinois last year. “I think it would be a way-better alternative,” Utley said of medical cannabis....

The Illinois General Assembly is considering a bill that could vastly expand the number of people qualifying for the state’s medical marijuana pilot program.  Senate Bill 336 would allow people who have been or could be prescribed opioids to apply for acceptance into the program.  The science surrounding the therapeutic benefits of marijuana is far from conclusive. But those shades of gray are missing from descriptions of both the benefits of cannabis from supporters of SB 336, and the drawbacks cited by opponents.

“Public policy is light years ahead of the science right now,” said Ziva Cooper, a research scientist who is associate professor of clinical neurobiology in psychiatry at Columbia University in New York. “There seems to be this nationwide experiment on the effects of cannabis that is happening in the absence of rigorous studies.”

SB 336 passed the Illinois Senate on a 44-6 vote April 26.  The bill is expected to receive a vote from the full House by the end of the week....  A spokeswoman for Gov. Bruce Rauner, a Republican, didn’t respond when asked the likelihood that Rauner would sign the bill into law if it reaches his desk.

Supporters of the legislation cite studies that have documented a correlation between a reduction in opioid-related fatalities and opioid prescriptions in states that allow the use of marijuana for medical or recreational purposes.  “The science is generally supportive of the concept,” said state Sen. Don Harmon, D-Oak Park, the bill’s chief Senate sponsor. “People don’t die from cannabis. I don’t feel like we’re doing much harm.”

But those studies, as well as numerous anecdotal reports from patients, don’t necessarily prove that expanding medical marijuana use leads to positive outcomes for the general population, Cooper said.  Results also aren’t conclusive when it comes to the negative implications of cannabis use reported in other legitimate but non-definitive studies, she said.  Those studies, publicized by Springfield-based Illinois Church Action on Alcohol and Addiction Problems, suggest marijuana is associated with an increased risk of prescription opioid misuse and addiction, and actually may contribute to the opioid epidemic....

Cooper said, “There is correlational evidence on both sides of the argument.” ...  The studies do make a compelling argument that more and more-rigorous follow-up studies are needed, she said while declining to comment on SB 336. “It’s just going to take time for us to do the studies that will yield the actual data that support some of these things we’re hearing about in the media,” she said.

Cooper was a member of a committee convened by the National Academies of Sciences, Engineering and Medicine that issued a report in January 2017 on the current state of evidence surrounding the health effects from cannabis and chemicals in cannabis known as cannabinoids.  The report said there is “conclusive” or “substantial” evidence that cannabis or cannabinoids are effective for the treatment of chronic pain in adults. “But there are a couple of caveats,” she said.  For example, she said, the report didn’t say there’s conclusive evidence that cannabis is more effective than opioids in helping patients deal with pain....

Data from the state indicate that 3 million Illinoisans obtained an opioid prescription in 2016, according to Chris Stone, chief executive officer of HCI Alternatives.  Even if just 10 percent of those patients sought temporary access to the state’s medical marijuana program under the provisions of SB 336, up to 300,000 people would join a program currently serving 36,800 people, he said....

Illinois, unlike most states with medical marijuana programs, doesn’t allow a general diagnosis of pain to qualify patients for the program, Cassidy said.  The Illinois Department of Public Health is appealing a Cook County judge’s January ruling ordering the department to add “intractable pain” to the list of qualifying conditions for medical marijuana.

IDPH director Dr. Nirav Shah has said there was a lack of “high-quality data” to justify adding pain to the list of more than 30 conditions, which include cancer, AIDS, spinal cord injury, seizures and fibromyalgia. SB 336 isn’t designed to add pain patients to the program for the rest of their lives. “This is really about folks who are looking at a six-month period of time of needing these medications or a three-month time period — for those folks who are very much at risk of addiction,” Cassidy said.

Some (of many) prior related posts:

May 27, 2018 in Medical community perspectives, Medical Marijuana Commentary and Debate | Permalink | Comments (0)

Tuesday, May 22, 2018

"Cities should restrict marijuana businesses to the same areas as junkyards and strip clubs"

The title of this post is the (catchy?) subheadline of this new provocative Bloomberg commentary authored by economist Tyler Cowen under the main headline "Legalize Pot, But Don’t Normalize It." Here are excerpts:

I think it is the proper province of government to regulate the use of public spaces in ways that encourage order and utility.  Private shopping malls won’t let you walk through the halls snorting heroin or smoking marijuana, and there is nothing outrageous about that decision.  The property owners have decided that they want a particular kind of experience and image for their venue, and they regulate its use and access accordingly.  Municipal governments should make and enforce comparable decisions.

Cities and towns already face these trade-offs when it comes to zoning.  Even if you believe, as I do, that most zoning regulations are far too restrictive, it’s legitimate for a local government to decide that a waste dump, an auto junkyard or a strip club cannot simply set up shop anywhere in a city, hang out a sign and attract attention.  We ought to treat marijuana the same way.

I propose that cities and suburbs restrict the sale and usage of marijuana to the same areas we use for garbage disposal and other “zoned out of sight” enterprises.  We needn’t throw anyone in jail: If people or businesses violate these strictures, keep hitting them with the equivalent of parking tickets or injunctions, much as you would for an out-of-place repair shop.  It should be possible to visit Colorado without knowing that marijuana is legal there.  If someone is determined to ingest it, they can either drive to an industrial zone or order it online, and smoke it at home or up away in the mountains.

You might wonder why we should be so worried about public marijuana use.  To put it bluntly, I see intelligence as one of the ultimate scarcities when it comes to making the world a better place, and smoking marijuana does not make people smarter.  Even if you think there is no long-term damage, right after smoking a person is less able to perform most IQ-intensive tasks (with improvisational jazz as a possible exception).  By having city streets filled with pot, pot stores and the odor of pot, we are sending a signal that our society isn’t so oriented toward the intellect or bourgeois values.  Even if that signal is reflecting a good bit of truth, it would be better not to acknowledge it too openly, just as most advocates of legalized prostitution don’t want to allow brothels on Main Street....

Marijuana advocates commonly counter that the drug is no worse or more dangerous than alcohol.  I agree, but you nonetheless might still believe that alcohol has acquired too prominent a place in the American public sphere, even if that state of affairs is no longer reversible.  There is no reason we should compound that mistake with marijuana.

May 22, 2018 in Business laws and regulatory issues, Medical Marijuana Commentary and Debate, Recreational Marijuana Commentary and Debate | Permalink | Comments (0)

Wednesday, May 2, 2018

"Medical Marijuana Users are More Likely to Use Prescription Drugs Medically and Nonmedically"

Download (10)The title of this post is the title of this notable new research authored by Theodore Caputi and Keith Humphreys being published in the Journal of Addiction Medicine. Here is its abstract:

Objectives

Previous studies have found a negative population-level correlation between medical marijuana availability in US states, and trends in medical and nonmedical prescription drug use. These studies have been interpreted as evidence that use of medical marijuana reduces medical and nonmedical prescription drug use. This study evaluates whether medical marijuana use is a risk or protective factor for medical and nonmedical prescription drug use.

Methods

Simulations based upon logistic regression analyses of data from the 2015 National Survey on Drug Use and Health were used to compute associations between medical marijuana use, and medical and nonmedical prescription drug use. Adjusted risk ratios (RRs) were computed with controls added for age, sex, race, health status, family income, and living in a state with legalized medical marijuana.

Results

Medical marijuana users were significantly more likely (RR 1.62, 95% confidence interval [CI] 1.50–1.74) to report medical use of prescription drugs in the past 12 months. Individuals who used medical marijuana were also significantly more likely to report nonmedical use in the past 12 months of any prescription drug (RR 2.12, 95% CI 1.67–2.62), with elevated risks for pain relievers (RR 1.95, 95% CI 1.41–2.62), stimulants (RR 1.86, 95% CI 1.09–3.02), and tranquilizers (RR 2.18, 95% CI 1.45–3.16).

Conclusions

Our findings disconfirm the hypothesis that a population-level negative correlation between medical marijuana use and prescription drug harms occurs because medical marijuana users are less likely to use prescription drugs, either medically or nonmedically. Medical marijuana users should be a target population in efforts to combat nonmedical prescription drug use.

May 2, 2018 in Medical Marijuana Commentary and Debate, Medical Marijuana Data and Research | Permalink | Comments (0)