Friday, April 4, 2014
If it clearly saved thousands of innocent lives on roadways, would most everyone support medical marijuana reforms?
The question in the title of this post is my sincere inquiry, directed particularly to those most concerned about modern marijuana reform movements, as a follow-up to this extended (data-focused) commentary by Jacob Sollum at Forbes headlined "More Pot, Safer Roads: Marijuana Legalization Could Bring Unexpected Benefits." Here are excerpts (with key research links retained):
The anti-pot group Project SAM claims drug test data show that marijuana legalization in Washington, approved by voters in that state at the end of 2012, already has made the roads more dangerous. The group notes with alarm that the percentage of people arrested for driving under the influence of a drug (DUID) who tested positive for marijuana rose by a third between 2012 and 2013. “Even before the first marijuana store opens in Washington, normalization and acceptance [have] set in,” says Project SAM Chairman Patrick J. Kennedy. “This is a wakeup call for officials and the public about the dangerousness of this drug, especially when driving.”
In truth, these numbers do not tell us anything about the dangerousness of marijuana. They do not even necessarily mean that more people are driving while high. Furthermore, other evidence suggests that legalizing marijuana could make the roads safer, reducing traffic fatalities by encouraging the substitution of marijuana for alcohol....
According to State Toxicologist Fiona Couper, the share of DUID arrestees in Washington whose blood tested positive for THC, marijuana’s main psychoactive ingredient, rose from 18.6 percent in 2012 to 24.9 percent in 2013. That’s an increase of more than 33 percent, as Project SAM emphasizes with a scary-looking bar graph. At the same time, the total number of DUID arrests in Washington rose by just 3 percent, about the same as the increases seen in the previous three years, while DUID arrests by state troopers (see table below) fell 16 percent.
These numbers do not suggest that Washington’s highways are awash with dangerously stoned drivers. So why the substantial increase in positive marijuana tests? Lt. Rob Sharpe, commander of the Washington State Patrol’s Impaired Driving Section, notes that additional officers were trained to recognize drugged drivers in anticipation of marijuana legalization. So even if the number of stoned drivers remained the same, police may have pulled over more of them as a result of that training....
As Columbia University researchers Guohua Li and Joanne E. Brady pointed out a few months ago in the American Journal of Epidemiology, [a recent] increase in marijuana consumption has been accompanied by an increase in the percentage of drivers killed in car crashes who test positive for cannabinol, a marijuana metabolite.
But as with the increase in DUID arrestees who test positive for THC, this trend does not necessarily mean marijuana is causing more crashes. A test for cannabinol, which is not psychoactive and can be detected in blood for up to a week after use, does not show the driver was under the influence of marijuana at the time of the crash, let alone that he was responsible for it. “Thus,” Li and Brady write, “the prevalence of nonalcohol drugs reported in this study should be interpreted as an indicator of drug use, not necessarily a measurement of drug impairment.”
Another reason to doubt the premise that more pot smoking means more deadly crashes: Total traffic fatalities have fallen as marijuana consumption has risen; there were about 20 percent fewer in 2012 than in 2002. Perhaps fatalities would have fallen faster if it weren’t for all those new pot smokers. But there is reason to believe the opposite may be true, that there would have been more fatalities if marijuana consumption had remained level or declined.
While marijuana can impair driving ability, it has a less dramatic impact than alcohol does. A 1993 report from the National Highway Traffic Safety Administration, for example, concluded: “The impairment [from marijuana] manifests itself mainly in the ability to maintain a lateral position on the road, but its magnitude is not exceptional in comparison with changes produced by many medicinal drugs and alcohol. Drivers under the influence of marijuana retain insight in their performance and will compensate when they can, for example, by slowing down or increasing effort. As a consequence, THC’s adverse effects on driving performance appear relatively small.” Similarly, a 2000 report commissioned by the British government found that “the severe effects of alcohol on the higher cognitive processes of driving are likely to make this more of a hazard, particularly at higher blood alcohol levels.”
Given these differences, it stands to reason that if more pot smoking is accompanied by less drinking, the upshot could be fewer traffic fatalities. Consistent with that hypothesis, a study published last year in the Journal of Law and Economics found that legalization of medical marijuana is associated with an 8-to-11-percent drop in traffic fatalities, beyond what would be expected based on national trends. Montana State University economist D. Mark Anderson and his colleagues found that the reduction in alcohol-related accidents was especially clear, as you would expect if loosening restrictions on marijuana led to less drinking. They also cite evidence that alcohol consumption declined in states with medical marijuana laws.
Anderson et al. caution that the drop in deadly crashes might be due to differences in the settings where marijuana and alcohol are consumed. If people are more likely to consume marijuana at home, that could mean less driving under the influence. Hence “the negative relationship between legalization and alcohol-related fatalities does not necessarily imply that driving under the influence of marijuana is safer than driving under the influence of alcohol,” although that is what experiments with both drugs indicate.
Arrest data from Washington are consistent with the idea that marijuana legalization could result in less drunk driving. Last year drunk driving arrests by state troopers fell 11 percent. By comparison, the number of drunk driving arrests fell by 2 percent between 2009 and 2010, stayed about the same between 2010 and 2011, and fell by 6 percent between 2011 and 2012. The drop in drunk driving arrests after marijuana legalization looks unusually large, although it should be interpreted with caution, since the number of arrests is partly a function of enforcement levels, which depend on funding and staffing.
Two authors of the Journal of Law and Economics study, Anderson and University of Colorado at Denver economist Daniel Rees, broadened their analysis in a 2013 article published by the Journal of Policy Analysis and Management. Anderson and Rees argue that marijuana legalization is apt, on balance, to produce “public health benefits,” mainly because of a reduction in alcohol consumption. Their projection hinges on the premise that marijuana and alcohol are substitutes. If marijuana and alcohol are instead complements, meaning that more pot smoking is accompanied by more drinking, the benefits they predict would not materialize. Anderson and Rees say “studies based on clearly defined natural experiments generally support the hypothesis that marijuana and alcohol are substitutes.” But in the same issue of the Journal of Policy Analysis and Management, Rosalie Liccardo Pacula, co-director of the RAND Corporation’s Drug Policy Research Center, and University of South Carolina criminologist Eric Sevigny conclude that the evidence on this point “remains mixed.”
A study published last month by the online journal PLOS One suggests that the substitution of marijuana for alcohol, assuming it happens, could affect crime rates as well as car crashes. Robert G. Morris and three other University of Texas at Dallas criminologists looked at trends in homicide, rape, robbery, assault, burglary, larceny, and auto theft in the 11 states that legalized marijuana for medical use between 1990 and 2006. While crime fell nationwide during this period, it fell more sharply in the medical marijuana states, even after the researchers adjusted for various other differences between states. Morris and his colleagues conclude that legalization of medical marijuana “may be related to reductions in rates of homicide and assault,” possibly because of a decline in drinking, although they caution that the extra drop in crime could be due to a variable they did not consider.
One needs to be very cautious, of course, drawing any firm conclusions based on any early research about impaired driving, car crashes, and marijuana reform. But let's imagine it does turn out generally true that legalizing medical marijuana helps produce a 10% drop in a jurisdiction's traffic fatalities. If extended nationwide throughout the US, where we have well over 30,000 traffic fatalities each and every year, this would mean we could potentially save more than 3000 innocent lives each year from nationwide medical marijuana reform. (One might contrast this number with debated research and claims made about the number of lives possibly saved by the death penalty: I do not believe I have seen any research from even ardent death penalty supporters to support the assertion that even much more robust use of the death penalty in the US would be likely to save even 1000 innocent lives each year.)
Obviously, many people can and many people surely would question and contest a claim that we could or would potentially save more than 3000 innocent lives each year from nationwide medical marijuana reform. But, for purposes of debate and discussion (and to know just how important additional research in this arena might be to on-going pot reform debates), I sincerely wonder if anyone would still actively oppose medical marijuana reform if (and when?) we continue to see compelling data that such reform might save over 50 innocent lives each and every week throughout the United States.
Cross-posted at Marijuana Law, Policy and Reform
April 4, 2014 in Criminal justice developments and reforms, Medical Marijuana Commentary and Debate, Medical Marijuana Data and Research, Medical Marijuana State Laws and Reforms | Permalink | Comments (0)
Tuesday, March 18, 2014
Via Nicole Flatow at ThinkProgress, researchers are one step closer to studying the use of medical marijuana to treat PTSD.
On Friday, the federal government took a potentially momentous step back from this position, granting researchers who have for years borne the brunt of this policy access to a legal supply of marijuana. The decision means a psychiatry professor at the University of Arizona who specializes in treating veterans may for the first time be able to perform a triple-blind study on marijuana and post-traumatic stress disorder.
The Multidisciplinary Association for Psychedelic Studies (MAPS) was granted permission to purchase marijuana fro the National Institute on Drug Abuse. The DEA still needs to sign off but it seems likely that it will given this development.
As I discuss in more detail in this law review article, I find the Controlled Substances Act's research restrictions for Schedule I substances especially hard to defend (or, really, to make any sense of at all).
The CSA places substances into Schedule I if they have no currently accepted medical use. Importantly, this category includes both (1) substances we are fairly certain have no medical value and (2) substances that we think may have promise as medicines even if we aren't yet sure either way. (Marijuana is, of course, the most high profile of the latter sort of substance.)
It seems to me that the two categories should be treated very differently as far as research goes. If we know a substance has no medicinal value, then we arguably lose very little by making it hard to study the substance. But if preliminary studies indicate the substance has medicinal value--as, for example, with marijuana--then I'd think we'd want to encourage further study, not make it more difficult.
The CSA, however, puts up the same roadblocks for studying all Schedule I substances, including those that we think hold medical promise. The only conceivable reasons for doing this are leakage concerns (ie, that substances approved for research will leak into the black market) or that the substance is so very dangerous that we need to be extra cautious when studying its medical value.
Certainly neither of these are legitimate concerns when it comes to marijuana. The only people in the United States who have any trouble getting their hands on marijuana are researchers. And the health risks of marijuana are certainly no worse than many FDA approved drugs.
All this is to say this while the news that the federal government may be easing up when it comes to studying marijuana is worth cheering, the core of the problem remains: a regulatory scheme that makes the study of Schedule I substances difficult, even for substances that have shown promise as medicines.
Thursday, March 6, 2014
As reported in this lengthy local article, headlined "Conservative committee opens door to medical marijuana for Florida," a notable swing/southern state now has a number of notable legislators talking in notable ways about marijuana reform. Here are excerpts:
One conservative Republican who has suffered from brain cancer talked about the deceit of the federal government in hiding the health benefits of marijuana for his cancer. Another legislator reluctantly met with a South Florida family, only to be persuaded to support legalizing the drug.
Then there was Rep. Charles Van Zant, the surly Republican from Palatka who is considered the most conservative in the House. He not only voted with his colleagues Wednesday to pass out the bill to legalize a strain of marijuana for medical purposes, he filed the amendment to raise the amount of psychoactive ingredients allowed by law — to make it more likely the drug will be effective.
The 11-1 vote by the House Subcommittee on Criminal Justice, was a historic moment for the conservatives in the GOP-dominated House. It was the first time in modern history that the Florida Legislature voted to approve any marijuana-related product. “That’s because people here in Tallahassee have realized that we can’t just have a bumper-sticker approach to marijuana where you’re either for it or against it,” said Rep. Matt Gaetz, R-Shalimar, the committee chairman and sponsor of the bill after the emotional hearing. “Not all marijuana is created equally.”
The committee embraced the proposal, HB 843, by Gaetz and Rep. Katie Edwards, D-Plantation, after hearing heart-wrenching testimony from families whose children suffer from chronic epilepsy. A similar bill is awaiting a hearing in the Senate, where Senate president Don Gaetz, a Niceville Republican and Matt’s father, has said he has heard the testimony from the families and he wants the bill to pass as a first step. “Here I am, a conservative Republican but I have to try to be humble about my dogma,” Senate President Don Gaetz told the Herald/Times....
For a committee known for its dense, often tedious scrutiny of legal text, the debate was remarkable. Rep. Dave Hood, a Republican trial lawyer from Daytona Beach who has been diagnosed with brain cancer, talked about how the federal government knew in 1975 of the health benefits of cannabis in stopping the growth of “brain cancer, of lung cancer, glaucoma and 17 diseases including Lou Gehrig’s disease” but continued to ban the substance. “Frankly, we need to be a state where guys like me, who are cancer victims, aren’t criminals in seeking treatment I’m entitled too,” Hood said.
Rep. Dane Eagle, R-Cape Coral, said he had his mind made up in opposition to the bill, then changed his mind after meeting the Hyman family of Weston. Their daughter, Rebecca, suffers from Dravet’s Syndrome. “We’ve got a plant here on God’s green earth that’s got a stigma to it — but it’s got a medical value,” Eagle said, “I don’t want to look into their eyes and say I’m sorry we can’t help you,” he said. “We need to put the politics aside today and help these families in need.”
The Florida Sheriff’s Association, which adamantly opposes a constitutional amendment to legalize marijuana for medical use in Florida, surprised many when it chose not to speak up. Its lobbyist simply announced the group was “in support.” The bi-partisan support for the bill was summed up by Rep. Dave Kerner, a Democrat and lawyer from Lake Worth. “We sit here, we put words on a piece of paper and they become law,” he said. “It’s very rare as a legislator that we have an opportunity with our words to save a life.”
The only opposing vote came from Rep. Gayle Harrell, R-Stuart, an advocate for the Florida Medical Association. Her husband is a doctor. She looked at the families in the audience and, as tears welled in her eyes, she told them: “I can’t imagine how desperate you must be and I want to solve this problem for you.” But, she said the bill had “serious problems.” It allowed for a drug to be dispensed without clinical trials and absent the kind of research that is needed to protect patients from harm. “I really think we need to address this using science,” Harrell said, suggesting legislators should launch a pilot program to study and test the effectiveness of the marijuana strain. “This bill takes a step in the right direction … but it’s not quite there.”
Cross-posted at Marijuana Law, Policy and Reform
ProFootballTalk continues its coverage of medical marijuana use and the NFL. The latest: Harvard Professor (emeritus) and longtime medical marijuana advocate, Dr. Lester Grinspoon, has penned an open letter to NFL Commissioner Roger Goodell, calling on the NFL to fund studies on whether marijuana might help treat brain injuries (CTE).
“The extensive research required to definitively determine cannabis’s ability to prevent CTE will require millions of dollars in upfront investment,” Dr. Lester Grinspoon wrote in an open letter to Goodell, via LeafScience.com. “[I]t’s highly unlikely that a pharmaceutical company will get involved in studying cannabis as a treatment for CTE, because the plant [and its natural components] can’t be patented.”
Grinspoon’s letter speaks to the fundamental question of whether the NFL will sit and wait for someone else to figure out whether medical marijuana can help treat or prevent CTE, or whether the NFL is sufficiently committed to the health of players to fully explore this and any other possibility.
Here’s hoping the league adopts the spirit of Dr. Grinspoon’s letter, objectively assessing any possible treatment for CTE and spending money as warranted to explore potential vehicles for helping players reverse or prevent its development.
I think Mike Florio's (of ProFootballTalk) comments at the end of the post (and his continued interest in this story) may be as noteworthy as Grinspoon's letter, at least as far as the future of medical marijuana and the NFL. Florio is among the most prominent NFL reporters right now. His blog is part of the NBC network and he appears on NBC's flagship Sunday Night Football program. If Florio continues covering the story of medical marijuana and the NFL the way he has, I think it will go a long way in terms of keeping it in the mind of football fans (and the league.)
Wednesday, March 5, 2014
"I am more convinced than ever that it is irresponsible to not provide the best care we can, care that often may involve marijuana."
The title of this post is the central and essential thesis of this notable new CNN commentary by Dr. Sanjay Gupta. Here are more excerpts from the lengthy piece:
This scientific journey is about a growing number of patients who want the cannabis plant as a genuine medicine, not to get high.
It is about emerging science that not only shows and proves what marijuana can do for the body but provides better insights into the mechanisms of marijuana in the brain, helping us better understand a plant whose benefits have been documented for thousands of years. This journey is also about a Draconian system where politics override science and patients are caught in the middle.
Since our documentary "Weed" aired in August, I have continued to travel the world, investigating and asking tough questions about marijuana. I have met with hundreds of patients, dozens of scientists and the curious majority who simply want a deeper understanding of this ancient plant. I have sat in labs and personally analyzed the molecules in marijuana that have such potential but are also a source of intense controversy. I have seen those molecules turned into medicine that has quelled epilepsy in a child and pain in a grown adult. I've seen it help a woman at the peak of her life to overcome the ravages of multiple sclerosis.
I am more convinced than ever that it is irresponsible to not provide the best care we can, care that often may involve marijuana.
I am not backing down on medical marijuana; I am doubling down.
I should add that, although I've taken some heat for my reporting on marijuana, it hasn't been as lonely a position as I expected. Legislators from several states have reached out to me, eager to inform their own positions and asking to show the documentary to their fellow lawmakers.
I've avoided any lobbying, but of course it is gratifying to know that people with influence are paying attention to the film. One place where lawmakers saw a long clip was Georgia, where the state House just passed a medical marijuana bill by a vote of 171-4. Before the legislative session started, most people didn't think this bill had a chance.
More remarkable, many doctors and scientists, worried about being ostracized for even discussing the potential of marijuana, called me confidentially to share their own stories of the drug and the benefit it has provided to their patients. I will honor my promise not to name them, but I hope this next documentary will enable a more open discussion and advance science in the process.
Marijuana is classified as a Schedule I substance, defined as "the most dangerous" drugs "with no currently accepted medical use." Neither of those statements has ever been factual. Even many of the most ardent critics of medical marijuana don't agree with the Schedule I classification, knowing how it's impeded the ability to conduct needed research on the plant.
Even the head of the National Institute on Drug Abuse, Dr. Nora Volkow, seems to have softened her stance; she told me she believes we need to loosen restrictions for researchers....
I've tried to pull together these latest developments in our new documentary, "Cannabis Madness." Although the 1936 film "Reefer Madness" was propaganda made to advance an agenda with dramatic falsehoods and hyperbole, I hope you will find "Cannabis Madness" an accurate reflection of what is happening today, injected with the best current science.
You will meet families all across the country -- a stay-at-home mom from Ohio, a nurse practitioner from Florida, an insurance salesman from Alabama -- more than 100 families who have all left jobs, homes, friends and family behind and moved to Colorado to get the medicine that relieves their suffering.
As things stand now, many of these good people don't ever get to return home. Why? Because transporting their medicine, even if it is a non-psychoactive cannabis oil, could get them arrested for drug trafficking. And so they are stuck, cannabis refugees. You will meet them, and if you're like me, you'll be heartbroken to hear their stories, but you'll also have a lump in your throat when you see the raw, true love these parents have for their sick children....
I know the discussion around this topic will no doubt get heated. I have felt that heat. But I feel a greater responsibility than ever to make sure those heated discussions are also well-informed by science. And, with that: I hope you get a chance to watch on March 11 at 10 p.m. Eastern.
Saturday, March 1, 2014
This recent article in USA Today reporting on some recent comments by a notable government scientist confirms yet again that the marijuana reform movement is going to help facilitate research on the drug. Here are excerpts from this article to that end:
One of the nation's top scientists raised concerns about the nationwide move to legalize marijuana, saying regular use of the drug by adolescents had been tied to a drop in IQ and that a possible link to lung cancer hasn't been seriously studied.
"I'm afraid I'm sounding like this is an evil drug that's going to ruin our civilization and I don't really think that," Francis Collins, director of the National Institutes of Health, said Thursday. "But there are aspects of this that probably should be looked at more closely than some of the legalization experts are willing to admit."
He said the National Institute on Drug Abuse, which he oversees, was interested in pursuing such studies now that legalization has made them more feasible to do. But the process will take time, he cautioned. "We don't know a lot about the things we wish we did," he said at a small dinner with journalists hosted by USA TODAY and National Geographic. "I've been asked repeatedly, does regular marijuana smoking, because you inhale deeply, increase your risk of lung cancer? We don't know. Nobody's done that study."
Collins, 63, is a geneticist who led the project to map the human genome. Since 2009, he has headed the NIH, the nation's leading agency for biomedical research....
"There's a lot we don't know because it's been an illegal drug ...," he said. "I think one of the things we'll need to do is take advantage of legalization now to try to mount studies that were impossible before, if people are willing to participate."
Tuesday, February 18, 2014
A helpful colleague alerted me to this interesting article discussing why one Colorado doctor has become a vocal opponent of modern marijuana reforms:
A Libertarian pot advocate turned opponent, Dr. Christian Thurstone, is at ground zero in the marijuana legalization battle. The medical director of a large Colorado youth drug treatment clinic; an associate professor of psychiatry at the University of Colorado, Denver; and one of a small number of doctors board certified in general, child and adolescent and addictions psychiatry, he has unique insight into the marijuana momentum sweeping the nation.
Thurstone believes that marijuana legalization is a disaster in the making. He is not shy about saying so. His experience with Colorado toe-in-the-water legalization of marijuana for medical purposes was his epiphany.
He noticed back in 2009, when Colorado began providing "medical" marijuana for its residents, that his clinic's clientele tripled: 95% of his patients came for marijuana addiction. He learned from his teenage clients that "medical" marijuana was easy to score on the streets. But the potency was increasing from medical grade. Soon his young clients would tell him how marijuana was their preferred medicine for relieving stress and anxiety.
Eventually, these young addicts came in with "medical" marijuana licenses. It was at this point Thurstone felt he needed to act. He wrote a piece for the Denver Post criticizing medical marijuana laws in January 2010 titled "Smoke and Mirrors: Colorado Teenagers and Marijuana." Thurstone made some fighting points. "What Colorado has created is a backdoor way to legalize marijuana, and it has done so in a manner that makes a mockery of responsible medicine," he wrote....
Five years later Thurstone continues his crusade. During an interview on Denver's KUSA television station in January, Thurstone was quoted as saying, "We're seeing a lot more patients, a lot more youth coming to treatment for marijuana addiction....If somebody tries marijuana before the age of 18, one in six develops an addiction to the drug. If someone waits until after 18, the number is more like one in nine."
"We have good reason to believe from both animal and human studies that exposure to marijuana during this important time of brain development can permanently change the way the brain develops," he added. "We have good evidence showing that marijuana exposure in adolescents confers up to an eight-point drop in IQ from age 13 to 38. We know that youth who use marijuana are two times more likely to develop psychosis as young adults."
Predictably, the pro-pot people have skewered him. They have questioned his knowledge, his competence and just about everything else. But Thurstone's critics do make some salient points when they refer to studies by the CDC in 2012 and another by economists at the University of Colorado, Denver and Montana State University in 2011 that indicate marijuana use among teens declined in Colorado after the passage of the comprehensive medical marijuana laws.
Thurstone criticized the studies. Still they are strong evidence in opposition to him. The debate will continue to rage on, and Thurstone will continue his campaign. He is, after all, a convert who went from being in favor of legalizing pot to opposing it.
I find this article and Dr. Thurstone's perspective quite interesting for a number of reasons, especially because it highlights how one's distinct type of involvement with marijuana use and abuse can (unduly?) influence one's views on the benefits and costs of legal reform. I do not doubt Dr. Thurstone's representation that he has a lot more teenage clients seeking help for marijuana addiction, but I do wonder if that reality is evidence of greater teen use of marijuana or just greater willingness of teens (and their parents) to seek treatment for marijuana problems now that involvement with marijuana is not longer treated as a serious criminal justice concern by the state.
Relatedly, though I am not surprised to hear a doctor express concern about hearing teens say that marijuana has become a "preferred medicine for relieving stress and anxiety," I still wonder if there is obviously a better "medicine" for this purpose. Most adults use alcohol to relieve stress and anxiety, but I doubt society wants most kids to instead try that form of self-medication. In addition, big Pharma makes big money marketing to doctors and patients a bunch of prescription drugs to deal with stress and anxiety, but I am not aware of any strong evidence that the solutions to stress and anxiety peddled by big Pharma are ideal for teens, either.
I make these points not to assert that Dr. Thurstone is misguided to be concerns about teenage marijuana use, but rather just to encourage broader reflection on whether the problems and concerns he identifies have been made worse by marijuana reform or rather have just become more visible to him.
Thursday, February 13, 2014
Orrin Devinsky and Daniel Friedman, two physicians at the NYU Comprehensive Epilepsy Center, provide an informative and sober discussion of medical marijuana issues and research problems in this New York Times op-ed headlined "We Need Proof on Marijuana." Here are excerpts:
Many people have heard the story of Charlotte Figi, a young girl from Colorado with severe epilepsy. After her parents began giving her a marijuana strain rich in cannabidiol (CBD), the major nonpsychoactive ingredient in marijuana, Charlotte reportedly went from having hundreds of seizures per week to only two or three per month. Previously, her illness, Dravet Syndrome, was a daily torture despite multiple high doses of powerful anti-seizure drugs.
As news of Charlotte’s story moved from the Internet to a CNN story by Dr. Sanjay Gupta to Facebook pages, some families of children with similar disorders moved to Colorado, which recently legalized marijuana, to reap what they believe are the benefits of the drug.
Dozens of other anecdotes of miraculous responses to marijuana treatments in children with severe epilepsy are rife on Facebook and other social media, and these reports have aroused outsize hopes and urgent demands. Based on such reports, patients and parents are finding official and backdoor ways to give marijuana to their children.
But scientific studies have yet to bear out the hopes of these desperate families. The truth is we lack evidence not only for the efficacy of marijuana, but also for its safety. This concern is especially relevant in children, for whom there is good evidence that marijuana use can increase the risk of serious psychiatric disorders and long-term cognitive problems.
The recent wave of state legislatures considering and often approvingmedical marijuana raises significant concerns. By allowing marijuana therapy for patients with diseases such as difficult-to-control epilepsy, are state legislatures endorsing the medical benefits and safety of a broad range of marijuana species and strains before they have been carefully tested and vetted? Marijuana contains around 80 cannabinoids (THC is the major psychoactive cannabinoid, largely responsible for the high) and more than 400 other compounds. The chemical composition of two genetically identical plants can vary based on growing conditions, soil content, parasites and many other factors.
While the language of the legislation may be cautious, there is an implied endorsement of medical benefit for marijuana when a legislature passes a bill and a governor signs it into law, and the tremendous gaps in our knowledge are not effectively conveyed to the public....
Before more children are exposed to potential risks, before more desperate families uproot themselves and spend their life savings on unproven miracle marijuana cures, we need objective data from randomized placebo-controlled trials....
Paradoxically, however, as state governments increasingly make “medical” marijuana available to parents to give to their children, the federal government continues to label the nonpsychoactive CBD — as well as THC — as Schedule 1 drugs. Such drugs are said to have “no currently accepted medical use in the United States, a lack of accepted safety for use under medical supervision, and a high potential for abuse.” This designation hamstrings doctors from performing controlled studies. While it is possible to study Schedule 1 drugs in a controlled laboratory setting, it is extremely difficult to study these substances in patients. For our study, we keep the CBD in a 1,200-pound safe in a locked room, in a building with an alarm system.
To foster research, we need to change compounds derived from marijuana from Schedule 1 to a less restrictive category. It is troubling that while few barriers exist for parents to give their children marijuana in Colorado, there are significant federal roadblocks preventing doctors from studying it in a rigorous scientific manner.
When patients have not been able to get successful medical treatment, and they live in a state where the law allows medical marijuana for children — we are not suggesting they smoke the drug — compassionate use is reasonable. But for the long-term health of Charlotte and other patients like her, we urgently need valid data.
Tuesday, February 11, 2014
I've always thought one of the strangest things about the DEA's insistence that marijuana has no currently accepted medical use is that one of the claimed medical uses is as an appetite stimulant. When I cover CSA scheduling of marijuana in my Controlled Substances class, I sometimes joke about whether we really need scientific studies to know that marijuana can make people hungry.
The DEA's position, of course, is that there isn't enough evidence to say that marijuana can stimulate the appetites of cancer and AIDS patients. (The synthetic-THC drug Marinol, on the other hand, has been officially determined to make people hungry.)
Though I don't think it will be enough to satisfy the DEA, today brings some new scientific evidence of (and explanation for) marijuana's effect as an appetite stimulant. The blog Toke of the Town reports:
In a new study published this week in Nature Neuroscience, European researchers claim to have proven that smoking weed does, in fact, give you the munchies. Beyond that, they appear to have isolated the specific region of the brain that is affected by THC consumption, and identified the process through which that desire to eat an entire box of Lucky Charms at 2am comes from.
Friday, January 31, 2014
The title of this post is the headline of this notable new New York Times editorial. Here are excerpts:
In the lead-up to the Super Bowl, in which it so happens both teams hail from states that recently legalized marijuana for recreational purposes, pressure is mounting on the [NFL] to reconsider its ban. A group called the Marijuana Policy Project has even bought space on five billboards in New Jersey, where the game will take place on Sunday, asking why the league disallows a substance that, the group says, is less harmful than alcohol.
It’s a fair question. Marijuana isn’t a performance-enhancing drug, for starters, and more than 20 states have legalized it for medical purposes. The league would merely be catching up to contemporary practice by creating a medical exception.
At a news conference on Jan. 7, the league commissioner, Roger Goodell, did not rule out a change in policy. “I don’t know what’s going to develop as far as the next opportunity for medicine to evolve and to help either deal with pain or help deal with injuries,” he said, “but we will continue to support the evolution of medicine.” On Jan. 23, he said the league would “follow medicine and if they determine this could be a proper usage in any context, we will consider that.” There is, in fact, a body of evidence indicating a “proper usage”: one of particular relevance to a hard-hitting, injury-riddled sport.
“Cannabinoids,” the Institute of Medicine reported in 1999, “can have a substantial analgesic effect.” N.F.L. medical experts obviously aren’t convinced, but N.F.L. players seem to be. HBO’s “Real Sports With Bryant Gumbel” estimated in January that 50 to 60 percent of players smoked marijuana, many to manage pain.
Players, of course, have access to other painkillers, including prescription drugs. Yet as former Surgeon General Joycelyn Elders has argued, “marijuana is less toxic than many of the drugs that physicians prescribe every day.” As public opinion and state laws move away from strict prohibition, it’s reasonable for the N.F.L. to do the same and let its players deal with their injuries as they — and their private doctors — see fit.
Monday, November 25, 2013
New report (by reform advocacy group) praises state regulation of medical marijuana in wake of DOJ enforcement memo
As reported in this press release,"[m]edical marijuana advocates Americans for Safe Access (ASA) issued a report today that analyzes the Obama Administration's latest enforcement guidelines for federal prosecutors in states that regulate medical marijuana distribution." Here are basics concerning the 88-page report (which is available in full here):
The report, "Third Time the Charm? State Laws on Medical Cannabis Distribution and Department of Justice Guidance on Enforcement," shows that states have already enacted regulations that meet federal concerns, and some would have stronger regulations if it were not for federal threats that disrupted the legislative process. The report concludes with recommendations for how federal and state legislators can protect patients and harmonize state and federal policies.
Medical marijuana patients greeted the Department of Justice (DOJ) memo issued August 31st by U.S. Deputy Attorney General James Cole with cautious optimism. The memo is the third from the Obama Administration that attempts to rein in federal prosecutors in states that allow for regulated distribution of marijuana. The first memo, issued in October 2009 by Cole's predecessor, then-Deputy Attorney General David Ogden, did not stop various federal prosecutors from attempting to thwart the implementation of several state medical marijuana laws. A report issued by ASA earlier this year put the cost of federal interference with state medical marijuana programs at more than $300 million.
“We hope the latest federal policy on marijuana will compel the Obama Administration to make good on its promises to stop wasting taxpayer money on undermining duly enacted state laws,” said ASA Executive Director Steph Sherer. “With almost 40 percent of Americans living in states that permit medical marijuana, it's time for the federal government to resolve the conflict between its outdated policies and the growing number of compassionate state laws.”...
The ASA report recommends that state legislators use the 2013 Cole memo as a guide when developing production and distribution regulations, while avoiding unnecessarily restrictive policies that fail to meet the needs of patients. The report also urges lawmakers to recognize that all three DOJ directives maintain that cultivation by individual patients is not a federal enforcement concern, giving the green light for state legislators to preserve or adopt patient cultivation rules.
The report also recommends that Congress make short and long-term policy changes to ensure respect for state laws and protection for patients and their providers. The report urges federal legislators to restrict how DOJ funds are spent on enforcement in medical marijuana states until the DOJ can determine what "metrics" to use in evaluating compliance with their enforcement priorities. As a long-term solution, the report asks Congress to adopt HR 689, which would reclassify marijuana for medical use.
Tuesday, November 19, 2013
The title of this post is the headline of this new commentary by Jacob Sollum. Here are excerpts:
Possessing up to an ounce of marijuana in California is an “infraction” punishable by a $100 fine. In other words, state law treats pot smoking as a transgression akin to jaywalking or fishing without a license. Yet growing and selling marijuana are felonies that can send you to prison for years.
If consuming marijuana is not a crime, how can it be a crime merely to help someone consume marijuana? That is a question voters will confront next fall if the California Cannabis Hemp Initiative qualifies for the ballot.
The initiative, which would eliminate all state and local penalties for producing, possessing, and distributing marijuana, instructs the legislature to regulate cannabis “in a manner analogous to, and no more onerous than, California’s beer and wine model.” That is similar to the policies approved last fall by voters in Colorado, where the legalization initiative was known as the Regulate Marijuana Like Alcohol Act, and Washington, where the state liquor control board will license pot shops that are scheduled to open next year.
The Colorado and Washington initiatives both received about 55 percent of the vote, and recent polling in California indicates a similar level of support. All three states have had medical marijuana dispensaries for years, and that experience on the whole appears to have been reassuring.
The main criticism of the dispensaries — that they cater largely to recreational consumers who fake or exaggerate symptoms to get the requisite doctor’s notes — actually counts in favor of broader legalization. If medical marijuana is a charade that amounts to de facto legalization, what is there to fear from making it official?
States that allow medical use do not seem to have suffered as a result. In fact, Montana State University economist D. Mark Anderson and University of Colorado economist Daniel Rees find that enacting medical marijuana laws is associated with a 13 percent drop in traffic fatalities, possibly because more cannabis consumption means less alcohol consumption, which has a much more dramatic effect on driving ability.
Anderson and Rees also consider the impact of legalization on pot smoking by teenagers. Looking at data from the Youth Risk Behavior Survey from 1993 through 2011, they see “little evidence of a relationship between legalizing medical marijuana and the use of marijuana among high school students.” Narrowing the focus to California after medical marijuana dispensaries began proliferating, they find “little evidence that marijuana use among Los Angeles high school students increased in the mid-2000s.”
Monday, November 11, 2013
In America, the relationship between doctors and the hegemonic pharmaceutical industry is fraught with painful, mind-numbing contradiction. There’s no better example of this than in the treatment of Post-Traumatic Stress Disorder (PTSD) among US veterans and others around the country. Drugs like Risperdal, an antipsychotic, are said to be no more effective in the treatment of PTSD than a placebo. These drugs are widely distributed to treat the symptoms of PTSD, despite allegations that they’re ineffectual in treatment of the condition.
PTSD is a disorder, characterized by extreme emotional or mental anxiety, often the result of a physical or psychological injury. When confronted with a potentially deadly situation, it’s natural for humans to feel afraid — we’ve developed pretty sophisticated fight-or-flight responses to deal with real or perceived danger. PTSD arises when that response is damaged, and the patient feels stressed or frightened even when he or she is no longer in danger. The disease disproportionately affects soldiers deployed in war zones. Very often they are in situations so dangerous that they develop the condition, and return home as shell-shocked emotional cripples. Veteran’s Affairs claims that today, almost 300,000 veterans have been diagnosed with PTSD, although the number is likely much higher due to lack of diagnosis.
According to Dr. Raphael Mechoulam, marijuana could be the answer. Mechoulam is a respected Israeli neuroscientist who studies the use of medical cannabis and its role in “memory extinction.” Memory extinction happens slowly to everyone, but it’s clear that in regular pot smokers, the process may be exacerbated, to say the least. According to Mechoulam, increased memory extinction could be helpful for sufferers of PTSD, reducing the mind’s associative link between external stimuli and traumatic events. Instead of connecting a loud noise with a bomb going off, cannabis can help destroy that link completely.
Despite this research, many states still do not count PTSD as a disorder that warrants a medical marijuana card. Because of this, veterans are seeking other legal and non-legal ways to procure weed. I recently spoke with two young ex-marines who self-medicate their PTSD with copious amounts of marijuana. Jeremiah Civil and Christian Slater are veterans of the Iraq War. These men saw things that would make the average citizen cringe in horror, and they left the war with deep emotional scars. Both Jeremiah and Christian were diagnosed with PTSD shortly before returning home, thrown into the wild world of a society that doesn’t understand their condition.
Tuesday, October 29, 2013
The title of this post is the student-selected topic for discussion this week in my Marijuana Law, Policy and Reform seminar. Here is the outline of issues and resources the students prepared to foster and facilitate discussion:
My Experience Working at a Marijuana Dispensary – One girl's first-hand account of her experience working at a dispensary in California for one year
14 Kinds of Jobs Sustained by Marijuana – According to Indeed.com, which tracks job listings, in 2011 there was over a 3,000 percent increase in the medical marijuana industry since 2005. This is a list of 14 types of jobs available in medical cannabis.
Your Genius Idea for a 420-Friendly Lazer Tag Arena Could Soon Become Reality in Colorado – Colorado’s Marijuana Enforcement Division (MED) is accepting applications for business proposals, but only existing medical marijuana shop owners are allowed to apply for the recreational marijuana licenses for the first nine months. Investors have committed “well over $1 million” to Colorado marijuana companies.
High-Paying Jobs Available in New Medical Marijuana Industry? – Dixie Elixirs, Denver-based company that manufactures medicated edibles, employed directly in excess of 10,000 employees, including high-salary executive jobs, scientists, and attorneys.
Cannabis Career Institute Hits Chicago to Help Residents Cash in on ‘The New Gold Rush’– CCI is continuing its educational tour in Chicago, teaching students the ins and outs of owing a dispensary or grow operation through their “pot college.”
Marijuana Entrepreneurs, Seminars, and Finance
These are all resources that pertain to creating your own marijuana business. They are comprised of seminar services, RSS feeds regarding important marijuana entrepreneur news, and derivative sources of some economics that marijuana creates.
Comparison to Casino and Alcohol
Links with state-by state jobs numbers for the wine and spirits industry (not including the beer industry). No need to read through all of them, just click on a few links to get a sense of the alcohol industry's job impacts. http://www.wswa.org/search_results.php?search=repeal%20prohibition&type=news
A PDF fact sheet of the total number of jobs the alcohol industry supports: http://www.discus.org/assets/1/7/ContributionFactSheet.pdf
A brief survey of casino jobs across America: http://www.americangaming.org/industry-resources/research/fact-sheets/casino-employment
An employment study from "The Journal of Gambling Business and Economics." Apparently that's a thing. It's a technical read, so they should read the descriptive parts and skip the technical parts. http://www.walkerd.people.cofc.edu/360/AcademicArticles/Cotti2008.pdf
Another employment study, done by the St. Louis Federal Reserve. The gaming has had a positive impact on employment in localities across the country. http://research.stlouisfed.org/publications/review/04/01/garrett.pdf
1) In addition to the educational aspects of the store, weGrow provides anywhere between 15 and 20 full- and part-time jobs. But Mann says it’s the ancillary jobs created that make a difference, including hiring a doctor on site for medical marijuana evaluations; professors to teach classes, including technicians and experienced growers; design and construction positions; security positions, and distributors. About 75 indirect jobs are created with the opening of each weGrow store. http://aznow.biz/small-biz/wegrow-phoenix-opens-cultivates-opportunities-arizona%29
2) By recognizing the potential for medical marijuana business advertisements, the Sacramento News and Review is expanding its distribution and hiring more staff. http://www.today.com/id/43641235/ns/business-us_business/#.Um8iJiRieiY
3) Interesting stats — apparently only a quarter of people think legalized pot would lead to more jobs in their community, while 57% believe there would be no effect. Makes you wonder if this is a (mis)perception that should be hit harder by legalization reformers. If the benefits can be demonstrated to those in the 57% camp maybe you pull in some new supporters. http://www.huffingtonpost.com/2010/04/20/legalizing-pot-will-not-b_n_544526.html?
4) Mr. McPherson said the city stood to reap more of what he called the “secondary benefits.” “You’ve got accountants that are working for them, you’ve got all the security companies that are working for them, you have labs that are working for them, you have bakeries that are baking all the edibles, you have union employees that are getting great benefits, you have delivery services, hydroponic stores, doctors get some benefit,” he said. “It’s the secondary market that gains from this, and all of those pay business taxes to us.” http://www.nytimes.com/2012/02/12/us/cities-turn-to-a-crop-for-cash-medical-marijuana.html?_r=2&
Saturday, October 26, 2013
But at a time when polls show widening public support for legalization — recreational marijuana is about to become legal in Colorado and Washington, and voter initiatives are in the pipeline in at least three other states — California’s 17-year experience as the first state to legalize medical marijuana offers surprising lessons, experts say.
Warnings voiced against partial legalization — of civic disorder, increased lawlessness and a drastic rise in other drug use — have proved unfounded. Instead, research suggests both that marijuana has become an alcohol substitute for younger people here and in other states that have legalized medical marijuana, and that while driving under the influence of any intoxicant is dangerous, driving after smoking marijuana is less dangerous than after drinking alcohol.
Although marijuana is legal here only for medical use, it is widely available. There is no evidence that its use by teenagers has risen since the 1996 legalization, though it is an open question whether outright legalization would make the drug that much easier for young people to get, and thus contribute to increased use.
And though Los Angeles has struggled to regulate marijuana dispensaries, with neighborhoods upset at their sheer number, the threat of unsavory street traffic and the stigma of marijuana shops on the corner, communities that imposed early and strict regulations on their operations have not experienced such disruption.
Imposing a local tax on medical marijuana, as Oakland, San Jose and other communities have done, has not pushed consumers to drug dealers as some analysts expected. Presumably that is because it is so easy to get reliable and high-quality marijuana legally.
Finally, for consumers, the era of legalized medical marijuana has meant an expanded market and often cheaper prices. Buyers here gaze over showcases offering a rich assortment of marijuana, promising different potencies and different kinds of highs. Cannabis sativa produces a pronounced psychological high, a “head buzz,” while cannabis indica delivers a more relaxed, lethargic effect, a “body buzz.”...
Still, even as public opinion in support of legalizing marijuana has grown, opposition remains strong among many, including some law enforcement organizations, which warn that the use of the drug leads to marijuana dependence, endangers the health of users and encourages the use of other drugs....
In a broad study on the ramifications of legalizing recreational marijuana about to be published in The Journal of Policy Analysis and Management, two economics professors said a survey of evidence showed a correlation between increased marijuana use and less alcohol use for people ages 18 to 29.
The researchers, D. Mark Anderson of Montana State University and Daniel I. Rees of the University of Colorado, said that based on their study, they expected younger people in Colorado and Washington to use marijuana more and alcohol less. “These states will experience a reduction in the social harms resulting from alcohol use: Reducing traffic injuries and fatalities is potentially one of the most important,” the professors said.
Mark A. R. Kleiman, a professor at the University of California, Los Angeles, and an expert on marijuana policy who was the chief adviser to Washington on its marijuana law, said the connection between alcohol and marijuana use, if borne out, would be a powerful argument in favor of decriminalization. “If it turns out that cannabis and alcohol are substitutes, then by my scoring system, legalizing cannabis is obviously a good idea,” Mr. Kleiman said. “Alcohol is so much more of a problem than cannabis ever has been.”
Still, he said, it will take time before long-term judgments can be made. “Does it cause problems?” he said. “Certainly. Is it on balance a good or bad thing? Ask me 10 years from now.”
Thursday, September 19, 2013
Minnesota sheriff asserts "approximately 54 percent of males arrested for violent crime test positive for marijuana in Hennepin County." Really?
The U.S. Department of Justice (DOJ) recently announced that it does not intend to challenge policies in Colorado and Washington state that legalized the sale and recreational use of marijuana to adults — despite the fact that these state laws are in opposition to federal law.
As president of the Major County Sheriffs’ Association, I have joined a broad coalition of law enforcement officers from across the country to express our extreme disappointment with this unprecedented decision.
As law enforcement officials with decades of experience, we know that keeping neighborhoods safe will become more difficult for our men and women on the front lines because of the DOJ’s decision.....
Marijuana is an addictive gateway drug that harms Minnesota’s children and public safety in every community in our state. As sheriff of Hennepin County, I am concerned that legalization of marijuana in other states and reduced federal prosecution will increase the availability of marijuana in Minnesota.
I have seen firsthand in Hennepin County that there is a direct connection between marijuana and violent crime. Drug task forces here have linked marijuana to assaults and homicides. In the Hennepin County Adult Detention Center, marijuana is the most commonly detected drug among the 36,000 inmates who are booked into the facility each year. According to our most recent data, approximately 54 percent of males arrested for violent crime test positive for marijuana in Hennepin County.
The student who sent me the link to this claim by Hennepin County sheriff Rich Stanek remarked that this number seems very high. I share this reaction, in part because I think advocates against modern marijuana reforms would be frequently stressing a link between marijuana and violent crime if it was common to find in more than a few justidictions that over half of all males arrested for violent crimes tested positive for marijuana. (Of course, we all know that correlation does not prove causation and that prohibition rather than legalization might be the reason marijuana users turn to crime, but such a statistic still struck me as potentially quite valuable for the anti-reform forces in the broader debate.)
Intrigued by the data claim made here by Sheriff Stanek, I have now written via e-mail directly to the Hennepin County Sheriff's Office seeking more information about the basis for these claims linking marijuana use and violent crime. (I quickly got this automated response to the e-inquiry: "Emails are answered when staff is available to view them and respond. It may take several days before your email is viewed. Thank you for your patience.")
While patiently waiting for more information concerning these violent crime data claims from the Hennepin County Sheriff's Office, I did a little digging about drug testing of arrestees and found that the Office of National Drug Control Policy released this 2012 Annual Report on arrestee drug abuse. With a focus on five major US cities (none in Minnesota), this report found that in 2012, "the proportion of [big city] arrestees testing positive for marijuana ranged from 37 percent in Atlanta to 58 percent in Chicago," but it also reported that only "17 percent (Atlanta) to 27 percent (Chicago) of [these] arrestees in 2012 had a violent crime as one of the charges recorded for the current arrest."
In other words, though there appears to be extant (and seemingly rigorous) data from the ONDCP report to support a claim that a majority of total arrestees in some urban areas may test positive for marijuana, there is still reason to suspect that nonviolent drug arrestee (particularly those arrested for marijuana offenses) will be disproportionately among those testing positive for marijuana, as opposed to those who are arrested for violent crimes. (And there are other interaction and intersectionality concerns with the data here too, as a significant percentage of arrestees in the ONDCP groups tested positive for multiple drugs in their system and reported alcohol and prescription drug abuse, too.)
Interestingly, two of the five cities that are the focus of the ONDCP report are in medicial marijuana states (Denver and Sacremento), while the three others are in prohibition states (Atlanta, Chicago and New York). It might be interesting (though surely challenging) for a sophisticated empiricist to use the ONDCP data to explore whether big-city arrestee drug use data is potentially impacted by marijuana laws in a particular state.
September 19, 2013 in Medical Marijuana Commentary and Debate, Medical Marijuana Data and Research, Medical Marijuana State Laws and Reforms, Recreational Marijuana Commentary and Debate, Recreational Marijuana Data and Research | Permalink | Comments (3)
As I continue to think about pros and cons of various possible state regulatory regimes for the legalization of marijuana, I continue to notice the significant differences between the rules and regulations that control medical use of marijuana in the 20+ jurisdictions that have legalized this use. (This list of state Medical Marijuana Laws assembled by NCSL provides an effective summary of these realities.) And especially because there are so many rankings of various states on so many different kinds of metrics --- on topics ranging from business climate to freedom to happiness to inovation to government mismanagement --- I am not wondering whether it would be a good idea to try to develop a ranking of the "best" and "worst" medical marijuana states.
I was unable to find such a ranking and this is surely understandable given the views of partisan advocacy groups focused on marijuana law and policy: advocates for marijuana reform are, in most respects, happy and eager to praise any and every state to have any kind of medical marijuana law; while advocates against marijuana reform are, in most respects, unhappy and eager to criticize any and every state that moves away from blanket marijuana prohibition. But, of course, voters and their elected representatives (not to mention academic researchers) are not partisan advocates, and it would likely be a significant contribution to the reform discourse to have some kind of ranking(s) of those states that have already adopted various medicial marijuana regulatory regimes.
Of course, as the title of this post highlights, any such ranking of medical marijuana states would need to develop some metrics for deciding what are the "best" and "worst" regulatory regimes, and this in turn would require a bunch of contestable normative judgments about what makes for good and bad impacts from medical marijuana laws. But that very challenge --- i.e., deciding whether and how to measure and consider in a cumulative ranking factors like ease of access for ill patients, a state's collected tax revenues, drugged driving statistics, teen marijuana use and abuse --- would both help illuminate what might be considered most important in reform debates and might allow deeper and more informative analysis of state-level impacts from diverse regulatory regimes.
Recent related posts:
- Are there undisputed benefits from prohibition regimes and/or undisputed harms from legalization/regulation regimes?
- Two decades into experimentation, what is really known about medical marijuana practices?
- Do any studies explore increased (or decreased) violent crime or unemployment (or other undisputed social ills) in medicial marijuana states?
Sunday, September 15, 2013
Will Big Pharma, and "the Impact of Marijuana Pharmaceuticals," determine the future of marijuana reform?
The FDA will soon approve Sativex, the first marijuana-based pharmaceutical. Sativex is a tipping point in the marijuana law and the politics of strict prohibition. The reclassification of marijuana under the Controlled Substances Act is in the financial interests of the American pharmaceutical industry. The availability of marijuana-based, or synthetic cannabinoid-based, pharmaceuticals will change the politics of marijuana prohibition.
Friday, September 13, 2013
Do any studies explore increased (or decreased) violent crime or unemployment (or other undisputed social ills) in medicial marijuana states?
Perhaps to the chagrin and annoyance to students in my "Marijuana Law, Policy & Reform" seminar, I keep pushing our class discussion to try to figure out and precisely specify what could be considered undisputed and undisputable harms from any drug legalization regime --- especially if one views simply increased drug use alone, even by young people, to be a social good or at least not clearly a social harm. (This prior post raised some of these issues and ideas.) The question in the title of this post is prompted in part by our most recent class discussion, where a rough consensus emerged that increases in violent crime and/or unemployment might be undisputed metrics of a failed social policy.
Thus the question in the title of this post, which also builds a bit off a prior post which asked "Two decades into experimentation, what is really known about medical marijuana practices?". Specifically, I am wondering if anyone has yet tried (or if it really would even be feasable) to develop effective and sophisticated empirical studies to explore if there have been any statistically significant changes in violent crime rates or unemployement rates in states that have legalized medical marijuana.
As a relative agnostic (with libertarian leanings) on lots of marijuana reform issues, I believe I would be moved significantly by serious data showing (or even just suggesting) causal links between medical marijuana legalization and violent crime rates or unemployment rates. Of course, like research on incarceration and crime rates, the results of any such empirical study linking medical marijuana to an increase or decrease in social ills could be disputable and would be disputed by partisan advocates in the reform policy debate. But for those without a predetermined perspective on various marijuana law, policy and reform issues (which likely describes a majority of Americans), even tentative or partial data showing the positive or negative impact of medicial marijuana and violent crime or other undisputed social harms could and would likely "move the needle" considerably.
This post is intended not only to inquire as to whether anyone is aware of any modern studies exploring these issues in states with medical marijuana laws, but also to ponder whether there are other clear empirical metrics of undisputed social ills that ought to be a central part of the medicial marijuana reform discussion and debate.
Cross-posted at PrawfsBlawg
Recent related posts:
- Are there undisputed benefits from prohibition regimes and/or undisputed harms from legalization/regulation regimes?
- Two decades into experimentation, what is really known about medical marijuana practices?
Thursday, September 12, 2013
The website ProCon.org has via this web portal with lots and lots of helpful information and links on the topic of medical marijuana, and the site lives up to its claim of presenting "facts, studies, and pro and con statements on questions related to whether or not marijuana should be a medical option." But notably absent from this site (or really any others I could find) was any serious and balanced "on the ground" research concerning the practical realities of "medical" marijuana use and abuse in any particular jurisdiction or across the United States.
This ProCon.org webpage, titled "How Many People in the United States Use Medical Marijuana?," has a very interesting state-by-state accounting of "the actual number of patients holding identification cards in the states (and District of Columbia) with mandatory registration" which reports that there are over 1 million registered medical marijuana patients. But this data, of course, does not tell us anything about who are these registered patients and for what purposes and how often they use marijuana as medicine.Similarly, a lot of pro-reform organizations like Americans for Safe Access (ASA) and Marijuana Policy Project (MPP) and National Organization for the Reform of Marijuana Laws (NORML) have lots of information about medical marijuana laws and lots of resources and arguments for would-be advocates. But hard data on medical marijuana patients and their practices do not leap off the page at these locales.
As noted in this prior post, a prominent opponent of modern marijuana reforms called medical marijuana "a laughable fiction" noting that in California, a the typical user is a 32-year-old white man with no life-threatening illness but a long record of substance abuse; in Colorado, 94% of medical marijuana patients just pain as the justification for their pot prescription; and in Oregon, only 10 practitioners write the majority of all marijuana prescriptions in the state. And yet, many prominent doctors have come to acknowledge, as stated by the reknown Dr. Sanjay Gupta in this pro-pot CNN piece, that there are many "legitimate patients who depend on marijuana as a medicine, oftentimes as their only good option."
Because the medical and scientific communities are still vigorously debating the potential health benefits and harms of marijuana and its chemical compounds, and especially because all marijuana distribution and use remains illegal under federal law, I suppose I should not be too surprised that it is hard to find much "on the ground" research concerning the practical realities of "medical" marijuana use and abuse in any particular jurisdiction or across the United States. But I find this reality disappointing, and I know that I would sure like to know a whole lot more about medical marijuana patients and their practices. (And, in class today in my "Marijuana Law, Policy & Reform" seminar, I hope to steer our discussion of medical marijuana to the question of what students think the average likely voter would want to know about the practical realities of "medical" marijuana before supporting any reform to the legal status quo.)