Marijuana Law, Policy & Reform

Editor: Douglas A. Berman
Moritz College of Law

Tuesday, July 26, 2016

The latest government data on marijuana use and attitudes

This new USA Today article, headlined "Study examines evolving rates, perceptions of marijuana use," reports on some new data on marijuana consumption and related topics in the United States. Here are excerpts from the press report on the marijuana report:

A new study from the Substance Abuse and Mental Health Services Administration provides an in-depth examination of marijuana use in the United States, as well as data regarding the public’s perception of the risks associated with the drug.  Using data collected by the National Survey on Drug Use and Health from 2012 to 2014, SAMHSA analyzed various regions around the country and within states to determine the rates of marijuana use and “perceptions of risks of harm” associated with the drug’s use in different parts of the U.S.

“This report provides a very detailed understanding of marijuana use and perception patterns in communities across the nation,” said Fran Harding, Director of SAMHSA’s Center for Substance Abuse Prevention. “This information can help public health officials and others better gauge the marijuana-related prevention and treatment needs in their communities and fine-tune their programs and services to best address them....

According to the study, 20.3 million people age 12 or older used marijuana in the past month, or approximately 1 in 13 people over the age of 12.

Although the federal government still classifies marijuana as a Schedule I drug, many states have begun to make changes to their cannabis laws. Alaska, Colorado, Oregon, Washington and the District of Columbia are currently the only states with legalized recreational marijuana, but 23 states and the District of Columbia have legalized forms of medical marijuana while an additional 14 have taken measures to decriminalize the drug.

The report comes several months ahead of the November elections, where eight states will have the option to legalize either recreational or medical cannabis. Five states — Arizona, California, Maine, Massachusetts and Nevada — are pursuing recreational marijuana, while three more — Arkansas, Florida and Missouri — could legalize medicinal cannabis.

Breaking their study into several regions — West, Northeast, Midwest and South — SAMHSA identified several states with multiple high use substate regions. Among those identified were Alaska, California, Colorado, Maine, Massachusetts, Oregon, Rhode Island, Vermont, Washington and the District of Columbia. Rhode Island and Vermont are the only two of those states to have either not legalized recreational marijuana or not have it on the ballot in 2016.

In spite of the increasingly relaxed marijuana laws, the SAMHSA study also found that approximately 74.9 million people aged 12 or older “perceived great risk of harm” from using marijuana once a month, or approximately 2 out of every 7 people above the age of 12. The states with the highest percentages of perception of risk were all from the South — Alabama, Arkansas, Florida, Kentucky, Louisiana, Mississippi and Texas. Alabama, Louisiana and Texas were among the states with the lowest use rate. The states with the lowest perception of risk include high marijuana use areas like Oregon, Washington and the District of Columbia.

The SAMHSA 19-page "short report" that is the basis for this article is available at this link under the title "Marijuana Use and Perceived Risk of Harm from Marijuana Use Varies within and across States."  For anyone really interested in marijuana data, especially divided by regions, the particulars and graphics from this report will be really interesting.

July 26, 2016 in Medical Marijuana Data and Research, Recreational Marijuana Data and Research | Permalink | Comments (0)

Friday, July 22, 2016

Illinois judge orders reconsideration of making migraines an eligible condition for medical marijuana in the state

Migraines-spousesAs reported in this Chicago Tribune article, in Illinois "a judge has ordered state officials to reconsider adding migraine headaches to the list of conditions that qualify a patient to buy" marijuana.  Here is more about this significant ruling:

Cook County Circuit Court Associate Judge Rita Novak overturned Illinois Department of Public Health Director Dr. Nirav Shah's denial of a petition to add migraines to that list.  The judge ordered Shah to reconsider evidence presented to the Medical Cannabis Advisory Board before its members voted to recommend approval of marijuana to treat migraines.

The court ruling came in response to a suit filed by a man whose name was kept secret because he already has been using marijuana to treat his headaches, his attorneys said.  Since adolescence, the middle-age man has suffered migraines up to three times a week, lasting from several hours up to three days, attorney Robert Bauerschmidt said.

The man has tried triptans, the most common treatment for migraines, but they didn't work well.  He tried narcotic painkillers but had a bad reaction that keeps him from using them, the attorney said.  "He's been through everything," Bauerschmidt said. "Marijuana doesn't cure it, but he finds the pain less severe and believes the headaches are less frequent when he's using it."

Though federal law still prohibits marijuana possession, state law allows it for patients who have any of about 40 specific medical conditions, including cancer, AIDS or multiple sclerosis.  Patients may buy the pot only from state-approved dispensaries.

The latest ruling comes after another judge last month ordered the state to add post-traumatic stress disorder as a qualifying condition for medical pot.  That ruling has been rendered somewhat moot, since Gov. Bruce Rauner recently signed a law adding PTSD and terminal illness as qualifying conditions.  But taken together, the separate rulings by different judges suggest that judicial review may further expand the program.

Attorney Mike Goldberg, whose firm handled the two prior cases, has pending lawsuits asking to add six other conditions: irritable bowel syndrome, chronic postoperative pain, osteoarthritis, intractable pain, autism and polycystic kidney disease.  "It's a potential game-changer for the industry," Goldberg said.

But Annie Thompson, a spokeswoman for the Illinois attorney general's office, which represents the state in court, emphasized that the ruling does not require adding migraines to the list.  It instead orders the director to reconsider within the parameters of the law and the judge's findings.

Joe Wright, the former director of the state's medical cannabis program, agreed that the case is not a done deal. "I'm not sure that means you'd necessarily have to add it," he said.  "That means they have to look at it again in light of what the advisory board considered."  If migraines and other conditions are added, Wright said, "That would open up the patient population fairly sizably."...

If the director adds migraines as a qualifying condition, that could greatly enlarge the number of patients. Migraines are a widespread condition, occurring in about 16 percent of Americans, according to two surveys cited by the American Headache Society.  Because there is no widely accepted blood test or brain scan to verify migraines, they typically are diagnosed by medical history, symptoms and a physical and neurological examination, according to the Mayo Clinic.  Typically Migraines occur repeatedly to the same patient, involving moderate to severe head pain that last for hours or days, nausea or vomiting and sensitivity to noise and light.

July 22, 2016 in Court Rulings, Medical community perspectives, Medical Marijuana Data and Research, Medical Marijuana State Laws and Reforms, Who decides | Permalink | Comments (0)

Thursday, July 21, 2016

New psychology research suggests why we ought to consider encouraging adults to use more marijuana and less alcohol

15As highlighted by this Washington Post piece, headlined "Researchers got people drunk or high, then made a fascinating discovery about how we respond," some notable new research provide yet another reason why society might be better off encouraging marijuana use rather than alcohol use. Here are the basics from the WaPo piece:

[R]esearch on the link between marijuana and aggression has been mixed. Marijuana seems to make most people relaxed, but it can also cause anxiety and paranoia, conditions which can occasionally manifest themselves in violent ways....

So a recent study from the Netherlands, published in the journal Psychopharmacology, attempts to put this question to bed using the gold standard of scientific research: a random controlled trial. They recruited a group of 20 heavy alcohol users (three-plus drinks a day for men, two-plus for women), 21 heavy marijuana users who smoked at least three times a week, and 20 controls who didn't use either drug heavily at all.... Then they made all three groups complete a number of tests designed to get people riled up....

The researchers measured aggression, before and after the respondents took the test, by asking them how aggressive they felt on a 100-point scale. For good measure, they had the marijuana and alcohol users go through the whole thing again one week later, this time without getting high or drunk, as a kind of separate control. They found, first of all, that "alcohol intoxication increased subjective aggression in the alcohol group." The alcohol users, in other words, acted more aggressive when they were drunk than they did when they were sober. By contrast, the smokers became less aggressive when they were high.

These findings held through both the self-assessments — alcohol users rated themselves as more aggressive when drunk — and through the responses to the tests: The drinkers tried harder to undermine their computer opponents when they were drunk. But the smokers actually acted less aggressive toward their computer opponents when they were high. "The results in the present study support the hypothesis that acute alcohol intoxication increases feelings of aggression and that acute cannabis intoxication reduces feelings of aggression," the researchers conclude.

This is in line with other research. A study in 2014, for instance, found that marijuana use among couples was linked to lower rates of domestic violence. In a fun study from the 1980s, researchers gave undergraduates varying doses of marijuana and then asked them to administer electric shocks to people in another room. The more stoned the undergrads were, the less interested they were in zapping other people.

This multi-author research can be examined at this link and under the title "Subjective aggression during alcohol and cannabis intoxication before and after aggression exposure." And here is how the abstract of the article describes the results anf findings:

Results: Subjective aggression significantly increased following aggression exposure in all groups while being sober. Alcohol intoxication increased subjective aggression whereas cannabis decreased the subjective aggression following aggression exposure. Aggressive responses during the PSAP increased following alcohol and decreased following cannabis relative to placebo. Changes in aggressive feeling or response were not correlated to the neuroendocrine response to treatments.

Conclusions: It is concluded that alcohol facilitates feelings of aggression whereas cannabis diminishes aggressive feelings in heavy alcohol and regular cannabis users, respectively.

July 21, 2016 in Medical Marijuana Data and Research, Recreational Marijuana Data and Research | Permalink | Comments (1)

Wednesday, July 6, 2016

New study suggests medical marijuana is already saving millions in Medicare costs

Medicare-and-uncle-samThis new Boston Globe article, headlined "Medical marijuana changing prescription practices, study finds," reports on fascinating new research seeming to document another financial benefit from marijuana reform. Here are the interesting details:

The arrival of medical marijuana in Massachusetts and other states is changing the way doctors prescribe conventional medications, a study published Wednesday reports.

The study, one of the first to investigate whether medical marijuana laws alter prescribing patterns, analyzed data from 17 states and Washington, D.C. It found that after medical marijuana laws were adopted, doctors wrote fewer prescriptions for Medicare patients diagnosed with anxiety, pain, nausea, depression, and other conditions thought to respond to marijuana treatment.

That translated to about $165 million less spent on prescription drugs in just one year in the Medicare program, which provides health insurance for older adults, according to the study published in the journal Health Affairs. Analysts said the findings are especially significant coming amid the nation’s opioid crisis and campaigns to reduce the prescribing of potentially addictive painkillers.

W. David Bradford, a health economist at the University of Georgia and the study’s senior researcher, said an ongoing review of the government’s Medicaid database, which includes a younger population more likely to use marijuana, suggests an even stronger correlation between prescribing trends and medical marijuana laws. Medicaid insures mostly younger patients who are poor and disabled. “This research says there is evidence that physicians are responding as if marijuana is medicine, and as if there is clinical benefit,” Bradford said.

The researchers analyzed millions of drugs prescribed by physicians from 2010 through 2013 in the Medicare Part D database. They focused their analysis on drugs that treat conditions for which marijuana might be an alternative treatment, including anxiety, depression, glaucoma, nausea, pain, psychosis, seizures, sleep disorders, and a muscle control disorder known as spasticity. They found that for all conditions, except glaucoma and spasticity, fewer prescriptions were written when a medical marijuana law was in effect.

To confirm the link to marijuana laws, and not other factors, the researchers compared results from the states with medical marijuana to states that had not legalized it. They did not see a similar decline in prescribing in states without marijuana laws. As a further test, the researchers selected four drugs prescribed for conditions for which there are no studies suggesting benefit from marijuana treatment. Those drugs included blood-thinners, antibiotics, antivirals to treat the flu, and a drug used in dialysis. They found no decline in prescriptions for these drugs....

Avi Dor, a health economist and professor of health policy and management at George Washington University’s Milken Institute, called the study “impressive and timely,” given concerns about prescription opioid abuse. Opioids are often prescribed for many of the conditions the researchers studied. “We can’t be sure about the causality [in the study], but the evidence is strong in favor of the marijuana laws leading to the substitution away from certain drugs,” said Dor, who was not involved in the research. “We just don’t know if, over time, the effects they find will wash out or become amplified,” Dor said. “Physicians and their patients are only beginning to experiment with the new therapeutic alternative of medical marijuana.”

The Health Affairs study estimated that if medical marijuana had been available in all states in 2013, the Medicare prescription program would have saved about $468 million because of fewer prescriptions for just that year -- an amount equal to one-half of 1 percent of Medicare prescription spending that year. But the researchers acknowledged that savings for Medicare might translate into more costs for patients who pay for medical marijuana out of their own pockets, because insurance doesn’t cover the drug.

Dr. Kevin Hill, an assistant professor of psychiatry at McLean Hospital and Harvard Medical School who studies marijuana, said the Medicare savings are important. But he noted physicians remain reluctant to recommend marijuana to their patients because they feel the evidence supporting its use is insufficient, or they are concerned about legal ramifications if they suggest a drug the federal government classifies as dangerous. “Medical marijuana may reduce prescription costs in some cases, but there is a risk that medical marijuana may be used for conditions that are not supported by evidence,” Hill said.

July 6, 2016 in Federal Marijuana Laws, Policies and Practices, Medical community perspectives, Medical Marijuana Commentary and Debate, Medical Marijuana Data and Research, Who decides | Permalink | Comments (0)

Saturday, July 2, 2016

"Could Marijuana Help Treat Alzheimer's Disease?"

The question in the title of this post is the headline of this local article reporting on new research that could be a profound "game-changer" if confirmed by additional future findings.  Here are the basics and why:

Researchers said Thursday marijuana may help treat Alzheimer's disease after discovering a new connection with an active ingredient.  Researchers at the The Salk Institute for Biological Studies in La Jolla said the connection has to do with THC, which is found in marijuana.

Five million Americans suffer with Alzheimer's disease, and it is a number that is expected to grow substantially as baby boomers move into what were supposed to be their golden years.

July 2, 2016 in Medical community perspectives, Medical Marijuana Commentary and Debate, Medical Marijuana Data and Research | Permalink | Comments (0)

Monday, June 20, 2016

Bipartisan Medical Marijuana Research Act of 2016 gets support from most vocal opponents and supporters of reform

Capitolpot-largeAs reported in this WonkBlog posting via the Washington Post, two members of Congress known to marijuana reformers for different reasons are now teaming up to support new federal laws to advance marijuana research.  The piece is headlined "Marijuana’s biggest adversary on Capitol Hill is sponsoring a bill to research … marijuana," and here are excerpts:

Rep. Andy Harris (R-Md.) is Congress's most vocal opponent of legal marijuana, having single-handedly spearheaded a provision blocking legal pot shops in the District of Columbia in 2014. Rep. Earl Blumenauer (D-Ore.), on the other hand, was recently named Congress's "top legal pot advocate" by Rolling Stone.

The two lawmakers couldn't be farther apart on marijuana policy, but they're teaming up this week to introduce a significant overhaul of federal marijuana policy that would make it much easier for scientists to conduct research into the medical uses of marijuana.

As Harris described it in an interview, the bipartisan Medical Marijuana Research Act of 2016 would "cut through the red tape" that currently makes it exceedingly difficult for researchers to obtain and use marijuana in clinical trials. As federal law currently stands, only one facility in Mississippi is allowed to produce marijuana used for research. "Because of this monopoly, research-grade drugs that meet researchers’ specifications often take years to acquire, if they are produced at all," Brookings Institution researchers wrote last year.

Beyond those difficulties, researchers wanting to work with the drug need to have their work approved by the Drug Enforcement Administration, the Food and Drug Administration and, in some cases, the National Institutes on Health. Those hurdles, and the amount of time it takes to jump over all of them, deter many researchers from doing work on marijuana. In one typical case, it took a team of scientists seven years to get full approval to conduct research into using marijuana to treat post-traumatic stress disorder among veterans.

But the bill sponsored by Harris, Blumenauer, Rep. Sam Farr (D-Calif.) and Rep. H. Morgan Griffith (R-Va.) would allow many more growers to produce marijuana for research. It would also remove levels of federal review for marijuana research projects and specify shorter windows for federal approval of the projects.

Crucially, it would also change the criteria by which the federal government allows marijuana research to proceed. "The federal government must grant an application for [approval] unless it's not in the public interest, rather than assuming it's not," Blumenauer said in an interview. "Reversing that presumption is huge."

Marijuana is currently listed under Schedule 1 of the federal Controlled Substances Act, the most stringent category of regulation. This bill would not change the schedule status of marijuana, but it would essentially create a "carve-out" within Schedule 1 for marijuana research, according to Harris. "Marijuana's actually different from other things in Schedule 1, which are all discrete chemicals," he said in an interview. "The plant is a combination of hundreds of compounds, so it needs to be treated separately from the other drugs in Schedule 1."

In a separate action, the DEA is currently considering whether to keep marijuana in Schedule 1, move it to a lower schedule, or de-schedule it entirely. But Harris says that process doesn't affect his thinking on this bill. "I'm not going to wait for the DEA to figure out what's going on," he said.

John Hudak, who studies marijuana policy at the Brookings Institution, calls the bill "a really creative approach by Congressman Blumenauer and his colleagues to effectively reschedule marijuana without having to reschedule it." He added, "It forces the government to make it easier for qualified legitimate researchers to get access to product and conduct that research."

Marijuana advocates used to tussling with Harris over his opposition to legal weed may be surprised to see him coming out forcefully in support of improved research. But as a doctor himself, Harris says researchers tell him that they can't do their jobs on account of federal red tape. "It's a Catch-22 that the research is difficult because of the strict rules, and the rules are strict because of the lack of research," he said. His thinking on the drug hasn't changed, he says: "I think medical marijuana should be much more strictly controlled than it is now." But, he adds, "as a physician I would never want to deny a medicine to a patient that has been shown, with scientific rigor, to help them."

June 20, 2016 in Federal Marijuana Laws, Policies and Practices, Medical community perspectives, Medical Marijuana Commentary and Debate, Medical Marijuana Data and Research, Who decides | Permalink | Comments (0)

Thursday, June 16, 2016

New Drug Policy Alliance report highlights problems with access and data in New York medical marijuana program

DownloadEarlier this week the Drug Policy Alliance this notable new report detailing and lamenting that New York's medical marijuana program is too restrictive and that information about the program is not readily available.  This DPA press release reports on some of the report's findings, and here are excerpts from the press release:

The Drug Policy Alliance issued a report assessing the first four months on the state’s medical marijuana program.  The report is in response to demand for information in the face of the absence of all but the most limited public information from the New York State Department of Health.  The report, the first systematic assessment of the program so far and its impact on patient access, found patients and caregivers face significant barriers to accessing medical marijuana.

On January 7th 2016, New York became the 23rd state to rollout its medical marijuana program. The law, which was passed in June of 2014, took eighteen months to implement and has been criticized as being one of the most restrictive and burdensome programs in the country.  Since the program was launched, patients and advocates have been frustrated by numerous barriers to accessing the program, including difficulty finding participating physicians, trouble accessing dispensaries and medication, and affordability.

The Department of Health has released only limited data about how the program is performing, offering little more than updates on the number of patients and doctors who have completed registration applications. Working with Compassionate Care NY, the state’s largest grassroots organization of patients and caregivers, the Drug Policy Alliance surveyed 255 people who had sought to access the state’s medical marijuana program.

According to the report, one of most pressing problems is that patients are struggling to find health care providers who are participating in the program.  According to DOH, as of June 9th, only 593 physicians New York physicians registered to certify patients for medical marijuana – less than 1% of all physicians in New York. Because there is no publicly available list of participating physicians, patients are forced to cold-call doctors in hopes of finding one or go through social media or other potentially unreliable sources.

More than half of patients and caregivers surveyed in the DPA report had not yet found a doctor to certify them, and among those, 3 out of 5 have been trying for 3 to 4 months to locate a registered physician.

Geographic inaccessibility is another barrier compounding problems of patient access to medicine.  Under the law, only five producers are licensed to grow medical marijuana in New York, and each can only operate 4 dispensaries.  This means that for a state of almost 20 million people and 54,000 square miles, there are only 20 dispensaries allowed (of which only 17 dispensaries have opened, to date). Patients, many of whom are very sick and disabled, must travel hours in some cases to get to a dispensary.  According to findings from the survey, 27% of registered patients/caregivers travelled for 1 to 5 hours to access a dispensary, while nearly 2 out of 5 reported that the dispensary they visited did not carry the specific kind of medical marijuana that was recommended to them by their physician.

Another major finding of the report is the unaffordability of medicine.  For respondents who had obtained medicine, 70% indicated that their monthly cost would be $300 and above, and more than 3 in 4 patients and caregivers who purchased medicine from a dispensary, stated that they would not be able to afford the monthly cost of medicine.

DPA’s report calls on the New York State legislature to pass bills currently pending in Albany that would amend the Compassionate Care Act, New York’s medical marijuana law, and improve access to medicine for those in need....  “New Yorkers deserve more transparency and information about how the state’s medical marijuana program is performing,” said Julie Netherland, PhD, of the Drug Policy Alliance and Compassionate Care NY. “Our data confirms what we have heard from patients and caregivers for months – New York’s program is not easily accessible, and even for patients who manage access the program, most cannot afford the medication.  We urge the legislature to act quickly and pass these bills to improve the program so patients in need can get relief.”

June 16, 2016 in Medical Marijuana Commentary and Debate, Medical Marijuana Data and Research, Medical Marijuana State Laws and Reforms | Permalink | Comments (0)

Thursday, June 9, 2016

Notable CDC survey data showing no changes in youth marijuana use despite massive state changes in marijuana law and policy

Via Tom Angell, the founder of Marijuana Majority, I just saw this interesting data report from the Center For Desease Control under the heading "Trends in the Prevalence of Marijuana, Cocaine, and Other Illegal Drug Use, National YRBS: 1991—2015." For those who do not know, the YRBS refers to the nation Youth Risk Behavior Survey which "monitors priority health risk behaviors and "is conducted every two years during the spring semester and provides data representative of 9th through 12th grade students in public and private schools throughout the United States."

The first three lines of data from this link will be of greatest interest to marijuana reform advocate, as it reports from the last 25 years the survey results on the issues of how many high-schoolers have "Ever used marijuana (one or more times during their life)" and have "Tried marijuana before age 13 years (for the first time)" and "Currently used marijuana (one or more times during the 30 days before the survey)."  Though I am simplifying the particulars, for all these survey questions, it appears that teen use of marijuana as reported via these surveys generally increased some in the 1990s and generally decreased over the last 15 years. And, of particular note, the CDC report that from 2013 to 2015, these was essentially and statistically speaking "No change." (Also, encouragingly, it appears that use of harder drugs by teens is also either not changing or even "decreasing" in recent years.)

Long story short, while adult use of marijuana is being legalize recreationally in a few states and medically in many more, it appears that so far we are seeing no obvious impact on teen use of marijuana.   I am not confident that these trends will persist over a long period of time if marijuana is legalized for recreational use by adults nationwide, but for now there is preliminary data to contradict assertions by opponents that marijuana reform that reform will be leading to significant increases in use by underage populations.

June 9, 2016 in History of Marijuana Laws in the United States, Medical Marijuana Data and Research, Recreational Marijuana Data and Research | Permalink | Comments (0)

Tuesday, June 7, 2016

Minnesota Dept of Health survey shows patients and health-care providers report benefits from medical marijauna including reduced opioid use

Download (20)This local article, headlined "Most Minnesota medical marijuana patients, and their practitioners, find treatment beneficial," reports on some positive results from early surveys of participants in Minnesota's medical marijuana program. Here are basics from the press report (with links from the original, and my emphasis added):

Almost all patients participating in Minnesota’s medical marijuana program say they are benefiting from the treatment, according to the results of a Minnesota Department of Health (MDH) survey released Monday.  Most of the patients’ health-care providers agree, although they tend to be more modest with their assessment of the treatment’s therapeutic benefits, the survey also found.

“This was certainly not a clinical trial.  It can’t answer questions about effectiveness,” said Dr. Thomas Arneson, research manager for the MDH’s Office of Medical Cannabis, in a phone interview with MinnPost.  “But I was impressed by the high level of benefit reported,” he added.  “We heard from 55 percent of the patients, which is pretty good. So even if it was a lower presumption of benefit among the others who didn’t respond, it was still pretty substantial.”

In Minnesota, marijuana (cannabis) in liquid or oil form can be prescribed by certified health-care practitioners to patients with nine qualifying medical conditions: cancer (to help treat the disease’s symptoms or the side effects of cancer therapies), glaucoma, HIV/AIDS, Tourette syndrome, amyotrophic lateral sclerosis (ALS), seizures (such as those characteristic of epilepsy), severe and persistent muscle spasms (such as those characteristic of multiple sclerosis), Crohn’s disease and terminal illness.   Starting July 1, patients with intractable pain will also be able to participate in the state’s medical marijuana program....

MDH sent the survey to the 435 patients who purchased medical marijuana during the first three months of the state’s program (July 1 to Sept. 30, 2015) and to the 345 health-care practitioners, including physicians, physician assistants and nurse practitioners, who certified them as being eligible for the treatment. The survey asked the patients and the practitioners to rate the level of benefit received from the use of medical marijuana on a scale of 1 (no benefit) to 7 (a great deal of benefit). 

Surveys were completed by 241 (55 percent) of the patients and by 94 (27 percent) of the health-care practitioners.  The perception of benefit was high in both groups. Almost 88 percent of the patients and 68 percent of the health-care practitioners reported at least some benefit to the patient (a score of 4 or higher) from the treatment.  A “significant” level of benefit (a score of 6 or 7) was reported by 66 percent of the patients and 46 percent of the practitioners.

The top three conditions for which the patients surveyed had been prescribed medical marijuana were severe muscle spasms, seizures and cancer. Although benefits were reported for all of those conditions, patients with cancer reported the highest scores, while the practitioners indicated that they had observed the greatest benefit from the treatments among their patients with muscle spasms.

The practitioners’ reports of benefit for all the conditions were generally more conservative than those of the patients.   “The patients were a little bit higher on the more subjective quality-of-life benefits than the healthcare practitioners were,” said Arneson. “The clinicians tended to respond more with things that were measurable, that were objective,” he added.

One interesting benefit reported by the practitioners was a reduction in the need for other pain medications.  Twelve said their patients were able to reduce their pain medication dosage as a result of the marijuana, including at least six who were able to decrease their use of prescription opioids.

About 20 percent of the surveyed patients and 16 percent of the surveyed practitioners reported patient side effects from the marijuana treatment — a finding that mirrors what has been observed in research conducted elsewhere, said Arneson.  In the MDH survey, the side effects included hives, stomach pains, dizziness, fatigue, a burning sensation in the mouth and paranoia. None of the side effects were life-threatening, although four patients (2 percent) reported an increase in seizures.

Despite the survey's overall positive results, not everybody who receives medical marijuana treatment for one of the qualifying conditions is going to benefit from it, Arneson emphasized.  “How much of this is the placebo factor, we don’t know, although it’s probably quite a bit of it,” he said.  “Cannabis is not a miracle drug,” he added.

Still, the survey suggests that whether or not the placebo effect is in play, many patients believe medical marijuana is helping to ease their symptoms.   “These are individual persons, individual lives, many of whom are having great difficulties in their lives because of their medical conditions,” said Arneson. ... 

FMI:  The MDH’s report on the survey was published online in the June issue of Minnesota Medicine magazine, where it can be read in full.  The complete survey results — including specific comments from patients about the effects of the treatment on their medical condition — can be found on MDH’s Office of Medical Cannabis website.

June 7, 2016 in Medical community perspectives, Medical Marijuana Commentary and Debate, Medical Marijuana Data and Research, Medical Marijuana State Laws and Reforms | Permalink | Comments (0)

Monday, June 6, 2016

Louisiana universities and businesses now clearly think the Bayou State is a serious medical marijuana reform jurisdiction

Medical-marijuana-mms-titlepng-a8616304bffdd15cThere has been some enduring debate and uncertainty as to whether Louisiana should "count" as one of the two-dozen-plus states that have enacted significant medical marijuana reforms.  For a number of reasons, and especially since recent legislative reforms to the state's medical marijuana rules, I think Louisiana should count in any accounting of such states.  And this recent local article, headlined "Louisiana gearing up for marijuana business: How much might LSU, Southern, companies profit? How will it be distributed?," suggests that now shortage of Louisiana officials and institutions are now considering the state's work in this space very seriously. Here are highlights from the interesting article:

Growing up on a cotton farm in Missouri in the 1950s, Bill Richardson didn’t know a thing about marijuana. Nobody talked about it, he never saw it and he certainly never smoked it. “I didn’t inhale,” Richardson, LSU’s 71-year-old vice president for agriculture and dean of the College of Agriculture, said with a smile in a recent interview.

Richardson has become the unlikely leader of an effort to get LSU into the pot business. Last month, the Louisiana Legislature approved a bill that legalizes the use of marijuana for people suffering from a specific list of debilitating diseases. The so-called medical marijuana legislation authorizes LSU and Southern University to grow and produce cannabis to be consumed in a liquid form. (Hold the “Cheech and Chong” jokes — it cannot be smoked, and no, they won’t be offering samples.)

The boards of both universities appear likely to give the go-ahead for pot cultivation. It’s not clear yet, however, who will provide the $10 million to $20 million needed to produce the drug, which will be sold at 10 standalone pharmacies designated by a state agency. None of the people wanting to be treated by pot will have access to it for at least 18 months.

When the Legislature legalized marijuana for patients suffering from 10 specific diseases, lawmakers told emotional stories about the children and loved ones who stood to benefit. Opponents, meanwhile, warned darkly that Louisiana was heading down a slippery slope toward legalizing a dangerous drug. Lost in the debate is what the measure will mean for LSU and Southern — and the private companies that are now emerging to try to profit from the new industry by partnering with the universities.

The legislation by state Sen. Fred Mills, R-Parks, gave LSU and Southern no money to launch this new venture, meaning they will have to rely on private companies to buy the seeds, hire scientists, rent or build growing facilities and pay for all the other costs. “All of the money would have to come from venture capitalists, or you’d have to sell bonds,” said Adell Brown, the point person at Southern as the university’s interim chancellor for its Agricultural Research and Extension Center. Neither Brown nor Richardson can say yet how much it will cost to get the business running at full speed, but both agree that it probably will take at least $10 million.

Brown and Richardson both report getting calls from representatives of companies that want to rent or sell land or provide a growing facility. Others are inquiring about financing the entire venture with the expectation of earning a profit. “It’s a money-making venture,” Brown said.

Neither he nor Richardson knows yet where they might grow the pot, but the universities are not likely to do it together. (The Legislature has authorized them to cultivate the marijuana because of federal laws prohibiting the transport of marijuana across state lines.) The University of Mississippi grows marijuana for research under a special federal license on the edge of its campus, in a field surrounded by two fences and armed guards, said an Ole Miss spokesman. “My recommendation is that it not be grown on campus, for the PR,” Richardson said.

He expects that LSU’s Board of Supervisors will authorize the growing of marijuana at its June 24 meeting. “It’s something we can do,” Richardson said, adding that he sees this as an opportunity for the university to duplicate its pioneering work with rice and other crops. Besides, “over the past year, I’ve heard enough testimonials of the medicinal effects to believe that the benefits outweigh the negatives. Plus, there may be some opportunities to create an income stream to help us balance our budget.”

Brown said he expects Southern’s board to approve the venture at either its June or July meeting. “It will be a highly sophisticated and self-controlled facility with the proper protocols for security,” he said. “We have faculty members who have done work with a lot of different crops that are of the same family.”...

While LSU and Southern are gearing up, several state entities are working to provide the regulatory framework for everyone who wants to be involved. The Louisiana State Board of Medical Examiners already has drafted its rules for doctors who want to apply to treat patients suffering from cancer, multiple sclerosis, epilepsy and seven other diseases, including HIV and AIDS. No doctor can treat more than 100 patients, said Eric Torres, the executive director of the medical board. Mills’ legislation, Senate Bill 271, requires doctors to “recommend,” not “prescribe,” the drug, to get around federal laws.

The state Department of Agriculture and Forestry is drafting rules that will govern the growing and production of the medical marijuana. The Legislature has authorized money for the agency to hire outside labs to make sure the marijuana is free of pesticides and heavy metals and has the least possible THC — the active ingredient that makes people high — and to hire staff to regulate the new business. “We have to make sure that end product is safe,” Agriculture Commissioner Mike Strain said in an interview.

The end product is what the patients actually will buy. “The marijuana cannot be inhaled,” said Jesse McCormick, of the Louisiana Cannabis Association, who lobbied to pass SB271. “It could be a cream. It could be in liquid form — tincture. It could be a gel cap. It could be a vitamin gummy. If you’re going to a dispensary to find ‘bud’ — well, you won’t.” The Louisiana Board of Pharmacy will decide on the drug’s final form and is leaning in favor of allowing LSU and Southern to make that decision. “Let the producers be as creative as they wish,” said Malcolm Broussard, the executive director of the board.

The 17 members of this Baton Rouge-based board — who are appointed by the governor to six-year terms — also will decide who will operate the 10 pharmacies throughout Louisiana that will sell the medical marijuana. Under state law, they cannot be part of a normal drugstore, although Broussard said it’s possible that the therapeutic drug could be sold in a convenience store. That store could not also sell prescription drugs, but it could offer over-the-counter drugs, he said.

Next year’s licensing decision will put a spotlight on a board so obscure that Broussard said he had never before been interviewed by an Advocate reporter during 17 years as executive director.

June 6, 2016 in Business laws and regulatory issues, Medical community perspectives, Medical Marijuana Commentary and Debate, Medical Marijuana Data and Research, Medical Marijuana State Laws and Reforms | Permalink | Comments (0)

Wednesday, June 1, 2016

Seeking any new quantitative or qualitative research on physician engagement with state medical marijuana programs

Image_doctor-marijuana-leaf-001Among the many issues that seem to me to be woefully under-explored in discussions of marijuana reform and policies is the role being played (or not played) by doctors in states with functioning medical marijuana programs.  Ergo, I am seeking, as the title of this post reveals, information from anyone who can help me determine if any new (and rigorous) research is being done in this arena these days. 

I have seen press reports that relatively few doctors are signing up to be a part of formal programming in a number of states.  Those kinds of reports give credence  to complaints I hear from advocates in Ohio that the new bill for medical marijuana in the state will not function well because of the regulatory rules and burdens it will be placing on doctors in order to be able to make a medical marijuana recommendation.  

But I suspect various reports of physician disaffinity for medical marijuana programming may reflect long-enduring beliefs and concerns, especially among old and more "traditional" physicians, that many past claims about marijuana as a wonder drug are based in "snake-oil" type promotion.  Now though, especially with so many states and studies starting to take seriously the potential medical benefits of marijuana (especially in non-smoked forms), I am wondering if doctors, especially younger ones, are becoming more open to considering being involved in medical marijuana programs.

I would be grateful is anyone can point me to any new significant research in this space.

June 1, 2016 in Medical Marijuana Commentary and Debate, Medical Marijuana Data and Research, Who decides | Permalink | Comments (0)

Saturday, May 28, 2016

Calling out Leg/Reg, Ad Law scholars to start looking seriously at pros/cons of structures of state (and eventually federal) medical marijuana reforms

Download (19)As explained in this prior post, this past week the Ohio General Assembly passed a massive medical marijuana bill that creates a remarkable regulatory structure for the development and application of rules and regulations for medical marijuana in the Buckeye State.  Specifically,  the 126-page(!) Ohio medical marijuana bill (available here; detailed summary/analysis here), creates three enduring regulatory bodies in charge of various parts the state's marijuana programming: the Department of Commerce, the board of pharmacy, and the medical board.

In addition, the bill also creates for, a five-year period, a multi-member "medical marijuana advisory committee" which "may develop and submit to the department of commerce, state board of pharmacy, and the state medical board any recommendations related to the medical marijuana control program."  In my prior post, I suggested that Ohio-based lobbyists would surely love this regulatory structure; this post is my effort to encourage fellow LawProfs who follow closely the work of legislators and adminstrative regulators to love looking closely not only this Ohio legislation, but also the broader set of fascinating "leg/reg" and administrative law issues that are swiftly emerging at the local, state and federal level concerning medical marijuana reform.

For a range of understandable reasons, the traditional press and most marijuana/drug policy advocates spend a lot more time talking and thinking about recreational marijuana reforms than about (much more prevalent) medical marijuana reforms.  Serious followers of the work of state legislatures and thoughtful legal scholars should realize, however, that medical marijuana reform efforts at the local, state and federal level is where the most significant (and diverse) action is now to be found and observed.   Only five jurisdictions have enacted recreational marijuana reforms and all of those were the result of voter initiatives.  But more than two dozen states have now enacted major medical marijuana reforms, and another dozen-and-half  states have enacted limited-CBD-oil type reforms.  

Moreover, and perhaps even more importantly, state legislatures have played a significant role in all of the most recent medical marijuana reform efforts in a number of big diverse states ranging from California to Louisiana to New York to Illinois to Pennsylvania to Ohio.   In addition, even at the federal level where blanket prohibition is the law of the land, we have seen lots of notable bills proposed (and some provisions passed) that directly impacts how federal agencies and agents are to engage with state medical marijuana reforms.  And, of course, there is ever-growing discussions of whether, when and how marijuana's placement on Schedule 1 of the Controlled Substantive Act might get changed.

Snip20151020_1In addition to seeing a whole lots of legislative and regulatory action at all levels, there is an extraordinary diversity in regulatory structures being put in place and starting to operate in various ways in various states.  The Ohio legislation, for good of for bad, highlights the problematic reality that still nobody is yet sure at all what could or should be the best structure for developing sound on-going medical marijuana rules and regulations: is sound reform really about "medical/patient" issues for agencies like pharmacy/medical boards; is it really about "business/consumer" issues for agencies like a Department of Commerce or Taxation; or is medical marijuana its own special, strange, unique space that call for its own special, strange, unique regulatory body.

For the record, especially right now when blanket federal marijuana prohibition is still the basic law of the land, I consider medical marijuana reform and regulation to occupy its own special, strange, unique space calling for its own special, strange, unique regulatory body.  For that reason and others, I am encouraged that the new Ohio law has created a diverse, multi-member "medical marijuana advisory committee," and I am hopeful that this body ends up staffed with a motivated and informed group of quasi-policy-makers who will take a leadership role in the months and years ahead as Ohio moves forward with its marijuana reform efforts.  

That all said, and as this post is meant to highlight, my perspectives on these critical legislative/regulatory issues would be greatly informed and enhanced by having legal scholars who study these issues actively providing their informed perspective on the good, the bad and the ugly of sound regulatory reforms.  I know these folks know a lot about topics relating to regulatory (in)efficiency and agency capture and all sort of other important topics, and I want to start better understanding what I know that I now do not know on these next forteirs for marijuana reform.

Long story short:  I am putting you on notice Chris Walker, and I am eager to see some comments!

Some prior related posts about Ohio's recent legislative and regulatory medical marijuana activity:

May 28, 2016 in Business laws and regulatory issues, Federal Marijuana Laws, Policies and Practices, Medical Marijuana Commentary and Debate, Medical Marijuana Data and Research, Medical Marijuana State Laws and Reforms | Permalink | Comments (0)

Tuesday, May 24, 2016

"As more states legalize marijuana, adolescents' problems with pot decline: Fewer adolescents also report using marijuana"

Journal-american-academy-childThe title of this post is the headline of this notable Science Daily release that reports on this notable newly published research in the Journal of the American Academy of Child & Adolescent Psychiatry that surely should be getting lots and lots of attention from marijuana reform advocates.  Here are the basics via the Science Daily:

A survey of more than 216,000 adolescents from all 50 states indicates the number of teens with marijuana-related problems is declining. Similarly, the rates of marijuana use by young people are falling despite the fact more U.S. states are legalizing or decriminalizing marijuana use and the number of adults using the drug has increased.

Researchers at Washington University School of Medicine in St. Louis examined data on drug use collected from young people, ages 12 to 17, over a 12-year span. They found that the number of adolescents who had problems related to marijuana -- such as becoming dependent on the drug or having trouble in school and in relationships -- declined by 24 percent from 2002 to 2013.

Over the same period, kids, when asked whether they had used pot in the previous 12 months, reported fewer instances of marijuana use in 2013 than their peers had reported in 2002. In all, the rate fell by 10 percent. Those drops were accompanied by reductions in behavioral problems, including fighting, property crimes and selling drugs. The researchers found that the two trends are connected. As kids became less likely to engage in problem behaviors, they also became less likely to have problems with marijuana.

The study's first author, Richard A. Grucza, PhD, an associate professor of psychiatry, explained that those behavioral problems often are signs of childhood psychiatric disorders. "We were surprised to see substantial declines in marijuana use and abuse," he said. "We don't know how legalization is affecting young marijuana users, but it could be that many kids with behavioral problems are more likely to get treatment earlier in childhood, making them less likely to turn to pot during adolescence. But whatever is happening with these behavioral issues, it seems to be outweighing any effects of marijuana decriminalization."

The new study is published in the June issue of the Journal of the American Academy of Child & Adolescent Psychiatry. The data was gathered as part of a confidential, computerized study called the National Survey on Drug Use and Health. It surveys young people from different racial, ethnic and income groups in all 50 states about their drug use, abuse and dependence.

In 2002, just over 16 percent of those 12 to 17 reported using marijuana during the previous year. That number fell to below 14 percent by 2013. Meanwhile, the percentage of young people with marijuana-use disorders declined from around 4 percent to about 3 percent.

At the same time, the number of kids in the study who reported having serious behavior problems -- such as getting into fights, shoplifting, bringing weapons to school or selling drugs -- also declined over the 12-year study period. "Other research shows that psychiatric disorders earlier in childhood are strong predictors of marijuana use later on," Grucza said. "So it's likely that if these disruptive behaviors are recognized earlier in life, we may be able to deliver therapies that will help prevent marijuana problems -- and possibly problems with alcohol and other drugs, too."

May 24, 2016 in History of Marijuana Laws in the United States, Medical Marijuana Data and Research, Recreational Marijuana Data and Research, Science | Permalink | Comments (0)

Wednesday, May 11, 2016

AAA study properly highlights challenge of assessing marijuana impairment for highway safety laws

As reported in this press piece, headlined "Legal limits for driving on pot not backed by science, study shows," the folks at AAA have released a valuable new report on marijuana impairment and driving. Here are the basics via the press report:

Legal blood limits for marijuana are not an accurate way to measure whether someone was driving while impaired, and can lead to unsafe drivers going free while others are wrongfully convicted, according to a new study.

The study released Tuesday by the AAA Foundation for Traffic Safety found that drivers can have a low level of THC, the active ingredient in marijuana, in their blood and be unsafe behind the wheel, while others with relatively high levels may not be a hazard.

Marijuana is not metabolized in the system in the same way as alcohol. So while a person with a blood-alcohol level of .08 or higher is considered too drunk to drive, it's not possible to say the same thing absent other evidence about a person testing at 5 nanograms per milliliter of blood of THC — the level used to find impairment by Colorado, Montana and Washington, the study found.

The difference matters, because Illinois and 11 other states have laws that forbid any level of marijuana in the system while driving. A pot decriminalization bill being considered in the Illinois legislature would raise the level to 5 ng/ml. The bill faces opposition from law enforcement and anti-pot advocates.

Efforts to legally measure marijuana impairment have become a major concern for lawmakers as more states move to legalize cannabis, either for medical use or adult recreational use. Four states have legalized pot for recreational use by adults, and 24 states — including Illinois, plus Washington, D.C. — allow medical use, according to the Marijuana Policy Project, a D.C.-based advocacy group.

"It's an attempt to try to do an apples-to-apples comparison with blood alcohol concentration," said Chris Lindsey, senior legislative analyst for the Marijuana Policy Project. He noted that the AAA findings echo earlier research. "They found out that these things can't really be compared."

Another problem is that high THC levels may drop before a test is administered, because the average time to collect blood from a suspect driver is often two hours, the AAA study found. Frequent pot users can exhibit high levels of the drug long after use, while levels can decline rapidly among occasional users, so it is difficult to develop fair guidelines, the study found.

Because of the problem in measuring whether someone is impaired with a blood test, AAA urged states to also look at behavioral and physiological evidence through field sobriety tests, such as seeing whether a driver has bloodshot eyes or is able to stand on one leg. "That kind of testing has proved effective in court," said J.T. Griffin, chief government affairs officer for Mothers Against Drunk Driving, or MADD.

He pointed to a 2015 study by the National Highway Traffic Safety Administration that found no big crash risk associated with people driving with marijuana in their system but says more study is needed. Alcohol remains the biggest drug problem on the highways, he said. "We know that almost one-third of all traffic deaths are caused by alcohol," Griffin said.

AAA released a second study Tuesday that showed fatal crashes involving drivers who recently used marijuana had doubled in Washington after that state legalized the drug in December 2012 — the percentage of drivers involved in fatal crashes who had used marijuana jumped to 17 percent from 8 percent between 2013 and 2014. Most drivers who had THC in their systems also had alcohol or other drugs in their blood at the time of the crash, the study found. The study noted that the drivers who had THC in their blood were not necessarily impaired nor were they necessarily at fault in the crashes.

Much of the work by AAA in this space can be found at this link.

May 11, 2016 in Criminal justice developments and reforms, Medical Marijuana Data and Research, Recreational Marijuana Data and Research | Permalink | Comments (1)

Tuesday, May 10, 2016

"Could medical marijuana solve Ohio's opioid problem?"

The question in the title of this post is the headline of this new lengthy cleveland.com article.  Here are excerpts: 

Ohio lawmakers have spent the last five years tackling the state's opioid epidemic, making it harder to obtain addictive painkillers and easier for people to receive treatment for their addiction. The same lawmakers have rebuffed efforts to legalize marijuana. One representative said last year that legalization would "be like pouring gasoline on the fire."

But the number of overdose deaths continues to climb -- nearly 2,000 people died from opioid overdoses in Ohio in 2014. And medical marijuana advocates point to a growing body of research that supports marijuana as a safer, less addictive alternative to those drugs.

Rep. Ryan Smith, a Gallia County Republican, said that point was raised several times during House GOP discussions about a bill legalizing medical marijuana. "The thought is we're treating pain right now with various addictive opiates so if there's an opportunity to treat them with something else that's less addictive, why not?" Smith said.

The House will vote Tuesday on House Bill 523, which would establish a tightly regulated medical marijuana program where patients could buy and use marijuana with a doctor's recommendation. Smoking and growing at home would not be permitted. Lawmakers hope the bill will halt two ballot measure efforts. Ohio would be the 25th state to legalize medical marijuana.

Clinical research doesn't support marijuana for most of the conditions states' laws allow, a study published last year in the Journal of the American Medical Association journal concluded. But the study did find sufficient evidence that marijuana can alleviate chronic and neuropathic pain and muscle spasticity associated with Multiple Sclerosis and preliminary evidence that it can benefit patients with seizure disorders.

Harvard Medical School's Dr. Kevin Hill, who authored the study, said there's no question cannabis is safer than opioids. "You may end up in the emergency room, but you're not going have a fatal overdose from marijuana," Hill said.

Greg Gerdeman, a pharmacologist and professor at Eckerd College in Florida, said the science is there, but federal laws placing marijuana in the same drug category as heroin has stifled research on American soil....

A handful of separate studies show pain patients who use marijuana decrease their opioid use. A 2014 study found states with medical marijuana laws had nearly 25 percent fewer opioid-related overdose deaths than those without.

A Canadian study of medical marijuana patients found 80 percent substituted marijuana for prescription drugs. And a University of Michigan study released in March showed a 64 percent reduction in opioid use among pain patients who also used marijuana.

Researchers in each study warned cannabis should not be an automatic replacement for opioids. Hill said the idea needs to be studied further and it's premature to recommend marijuana to treat opioid addiction. But patients say otherwise. Retired nurse Rhonda Agard of Toledo weaned herself off a pain pump, anxiety medication, and sleeping pills by switching to marijuana.

Agard had been on pain meds for 13 years after breaking her back. She overdosed at least 20 times by her count, including one time when her children found her on the floor, her heart beating only 15 beats per minute. "I was no better than people on heroin except mine was legal -- head nodding, falling asleep, drooling -- thank God I'm not like that today," Agard said.

The idea of using marijuana to treat opioid addiction has become a hot topic in Maine. Medical marijuana advocates there are pushing state regulators to add opioid addiction to the list of qualifying medical marijuana conditions.

Massachusetts Democrat Sen. Elizabeth Warren asked the Centers for Disease Control and Prevention earlier this year to examine the effectiveness of medical marijuana as an alternative to opioids and the impact of marijuana legalization on overdose deaths....

If Ohio decides to legalize marijuana for medical use, it won't be covered by health insurance plans and might be more expensive than prescription medications. And critics of the proposed bill say it creates too much red tape and few doctors will register to recommend marijuana.

Dr. Amol Soin, a pain management doctor in Dayton, said the research is promising, but he and other physicians want to be able to prescribe compounds known to work instead of the whole plant. "Given the scenario we have a compound vetted by the FDA and backed by studies, I think it will hold promise," Soin said.

May 10, 2016 in Medical community perspectives, Medical Marijuana Commentary and Debate, Medical Marijuana Data and Research | Permalink | Comments (0)

Monday, April 18, 2016

Colorado Department of Public Safety releases "Marijuana Legalization in Colorado: Early Findings"

This new Denver Post piece, headlined "Fewer Coloradans seek treatment for pot use, but heavier use seen," reports on this notable new official state government report from Colorado (which I believe was just released today, but bears a cover date of March 2016). Here is a basic summary via the Denver Post piece:

Colorado's treatment centers have seen a trend toward heavier marijuana use among patients in the years after the state legalized the drug, according to a new report from the Colorado Department of Public Safety.  The 143-page report released Monday is the state's first comprehensive attempt at measuring and tracking the consequences of legalization.

In 2014, more than a third of patients in treatment reported near-daily use of marijuana, according to the report. In 2007, less than a quarter of patients reported such frequency of use.  Overall, though, the number of people seeking treatment for marijuana has dropped since Colorado voters made it legal to use and possess small amounts of marijuana.  The decrease is likely due to fewer people being court ordered to undergo treatment as part of a conviction for a marijuana-related crime.

The finding is among a growing body of evidence that marijuana legalization has led to a shift in use patterns for at least some marijuana consumers. And that is just one insight from the new report, which looks at everything from tax revenue to impacts on public health to effects on youth.  Among its findings is a steady increase in marijuana use in Colorado since 2006, well before the late-2000s boom in medical marijuana dispensaries.  The report documents a sharp rise in emergency room visits related to marijuana. It notes a dramatic decline in arrests or citations for marijuana-related crimes, though there remains a racial disparity in arrest rates.

But the report, which was written by statistical analyst Jack Reed, also isn't meant as a final statement on legalization's impact. Because Colorado's data-tracking efforts have been so haphazard in the past, the report is more of a starting point.  "[I]t is too early to draw any conclusions about the potential effects of marijuana legalization or commercialization on public safety, public health, or youth outcomes," Reed writes, "and this may always be difficult due to the lack of historical data."

It's not just the lack of data from past years that complicates the report.  Reed also notes that legalization may have changed people's willingness to admit to marijuana use — leading to what appear to be jumps in use or hospital visits that are really just increases in truth-telling.  State and local agencies are also still struggling to standardize their marijuana data-collection systems.  For instance, Reed's original report noted an explosive increase in marijuana arrests and citations in Denver, up 404 percent from 2012 to 2014.  That increase, however, was due to inconsistent data reporting by Denver in the official numbers given to the state.

Intriguingly, though this lengthy report comes from the Colorado Department of Public Safety, not very much of the report discusses general crimes rates at much length. But what is reported in this report is generally encouraging:

  • Colorado’s property crime rate decreased 3%, from 2,580 (per 100,000 population) in 2009 to 2,503 in 2014.

  • Colorado’s violent crime rate decreased 6%, from 327 (per 100,000 population) in 2009 to 306 in 2014. 

April 18, 2016 in History of Marijuana Laws in the United States, Initiative reforms in states, Medical Marijuana Data and Research, Recreational Marijuana Data and Research, Taxation information and issues | Permalink | Comments (0)

Friday, April 15, 2016

"Marijuana Could Soon Be Rescheduled As A Less Dangerous Drug By The DEA, So Why Aren’t Cannabis Proponents Excited?"

DEA_rescheduling2The title of this post is the headline of this astute new International Business Times article, and here are exerpts:

After decades of intransigence on the issue, the Drug Enforcement Administration may finally recommend removing marijuana from the list of the country’s most dangerous drugs. That list was created as part of the Controlled Substances Act (CSA) of 1970, which consolidated all federal drug laws into a single comprehensive measure and defined marijuana as a Schedule I controlled substance, alongside heroin, LSD and other drugs that the government says have no medical value and the highest potential for abuse. That meant marijuana was saddled with the strictest possible restrictions and penalties.

Ever since then, marijuana activists have been fighting to remove cannabis from that category. In 1972, the National Organization for the Reform of Marijuana Laws (NORML) petitioned the DEA to instead place marijuana in Schedule II of the CSA, alongside cocaine, meth and other drugs considered dangerous but with medical potential. Twenty-two years and multiple courtroom battles later, the DEA had a final decision: Marijuana would remain a Schedule I substance.

The DEA has rejected two other marijuana rescheduling petitions since then, but now there’s a glimmer of hope among activists that change could finally be in the works. As first reported last week by the Huffington Post, in a recent letter to a group of Democratic senators, the DEA referenced a 2011 petition to reschedule cannabis to Schedule II, noting, “DEA understands the widespread interest in the prompt resolution to these petitions and hopes to release its determination in the first half of 2016.” While there’s a good chance this determination will be no different than in the past, the country’s rapidly shifting cannabis landscape — with 23 states plus Washington, D.C., having legalized medical marijuana (and Pennsylvania poised to do so) — makes some people think the DEA could be ready to concede that cannabis has medicinal value.

But instead of being cause for celebration, the news has met with largely subdued reaction from marijuana activists and business owners. “Symbolically, one could say that would be a victory because you’d have for the first time the federal government acknowledging that cannabis does in fact have some therapeutic utility,” said NORML deputy director Paul Armentano. “But that by and large would be the extent of it. By moving marijuana from Schedule I to II, the federal government would still be putting forward the intellectual dishonesty that cannabis has a high potential for abuse and needs to be regulated accordingly.”

Such responses suggest it’s not just the DEA that’s shifting its position on federal marijuana laws. Marijuana proponents’ stance on federal cannabis rules are evolving, too. As the movement racks up one legal victory after another with little federal acknowledgement, there’s a growing belief that the cannabis crusade doesn’t have to settle for marijuana's move to Schedule II, for which it has long lobbied. Some even worry that such a rescheduling could in fact limit or derail a thriving industry.

A handful of drugs have been rescheduled like this before. Marinol, a synthetic version of marijuana’s psychoactive components, was moved from Schedule I to Schedule II, and then to Schedule III in the 1980s and '90s. But rescheduling is rare. According to John Hudak, deputy director of the Brookings Institution’s Center for Effective Public Management, the DEA has rescheduled substances 39 times since the CSA was ratified 46 years ago, and only five of those instances involved moving a drug from Schedule I to II. Many drug policy experts aren’t optimistic that marijuana will soon be the sixth instance of this happening. After all, the DEA bases such decisions on existing marijuana research — research that has long been severely limited thanks in part to restrictions related to marijuana’s Schedule I status. Even if the DEA recommends rescheduling marijuana in the next few months, the change wouldn’t happen overnight; it would instead trigger a lengthy rulemaking process. “Even if the DEA comes out in July and says, ‘We are moving from I to II,’ it would still take about a year for that to happen,” said Hudak.

But if rescheduling does occur, some marijuana activists say there would be major repercussions. By acknowledging marijuana has medical use and placing it in the same category not just as cocaine but also Vicodin and Ritalin, the government would be signaling that times have changed. “This stands to be a legacy-defining move for Obama if his administration makes the right decision here,” said Tom Angell, founder of the cannabis advocacy group Marijuana Majority. “It would send a strong message to states that do not yet have medical marijuana laws on the books and a strong message to governments around the world that the U.S. government is now on board [with marijuana policy reform].”

The move wouldn’t just be symbolic. Moving marijuana to Schedule II would remove some of the logistical hurdles and academic taboos limiting cannabis research. It would also eliminate several of the bureaucratic hassles plaguing marijuana markets around the country because of the drug’s Schedule I status, such as confusion over whether publications with marijuana ads can be sent through the mail.

But as many marijuana supporters point out, shifting cannabis to Schedule II would not solve the biggest problems facing the nascent marijuana industry. Many unique barriers for marijuana research would still remain, such as the fact that all cannabis for such studies has to be obtained, via a lengthy and complicated approval process, from a single marijuana grow at the University of Mississippi that’s administered by the National Institute on Drug Abuse (NIDA). “The big issue is Ole Miss’ marijuana monopoly, and this wouldn’t fix that at all,” said drug-policy expert Mark Kleiman, a professor of public policy at the New York University Marron Institute of Urban Management.

Then there’s the fact that the biggest headaches afflicting marijuana businesses, such as a lack of banking services and sky-high tax rates thanks to IRS section 280E, which prohibits drug dealers from deducting the costs of selling illicit substances, are due to laws that cover drugs in both Schedules I and II of the CSA. “Moving it to Schedule II really doesn’t accomplish a lot, and frankly it is not scientifically supportable,” said Taylor West, deputy director of the National Cannabis Industry Association. “From a business perspective, it is unclear [if] it would have any impact on the banking situation, and it is specifically clear it would not have any impact on the 280E situation.”

Some marijuana advocates go further, worrying moving marijuana to Schedule II could actually make things worse. Could rescheduling open the door to Big Pharma moving in and taking over the industry? Or could it force all marijuana to be sold by prescription in pharmacies, doing away with the dispensary and recreational marijuana shop markets spreading across the country? “I think a risk that this creates is that it enables DEA to become more directly involved in the control of the current medical cannabis industry,” said Eric Sterling, executive director of the Criminal Justice Policy Foundation. “And that many of the features of the current medical cannabis industry that the public appreciates and values could be lost or destroyed. The DEA would be able to write regulations of the production and processing and distribution of medical cannabis, and they could be quite onerous.”

Others believe such fears are unfounded. “I think if Big Pharma really wanted marijuana to be a huge part of its product line, you would have seen it push the government long ago to consider rescheduling,” said Hudak at the Brookings Institution. Hudak also doesn’t expect to see the federal government dismantling the current marijuana industry: “The state systems are so large, economically and in terms of the people who are served, and they have become entrenched. And frankly, it would be a tremendous enforcement action by the U.S. government to shut them all down, and it would likely be beyond the enforcement resources of the U.S. government right now.”

April 15, 2016 in Federal Marijuana Laws, Policies and Practices, History of Marijuana Laws in the United States, Medical Marijuana Commentary and Debate, Medical Marijuana Data and Research, Who decides | Permalink | Comments (0)

Sunday, March 20, 2016

Assembling disconcerting data showing crime spikes after marijuana reform

At-logoAs regular readers of my Sentencing Law and Policy blog should know, careful and responsible researchers and advocates should be careful and cautious about making any bold assertion about which kinds of laws and legal reforms may or may not impact crime rates.  Just about every pundit who ever asserts boldly that this reform or that reform certainly will (or certainly won't) reduce or increase crime is proven wrong at some point in some way.  For that reason, I am generally disinclined to put too much stock in any assertions that marijuana reform definitely will or definitely won't lead to a change in serious crime rates in a jurisdiction.

That all said, I think it is very important to keep an eye on any notable corrections between reported crime rates is jurisdictions that have reformed its marijuana laws. And, I just came across a few recent postings by Sierra Rayne at the American Thinker website that present data showing significant crime spikes in key marijuana reform jurisdictions.  Going through the author's posting archive, I found this array of posts  that ought to be of interest to everyone following the impact of marijuana reforms:

As these post headlines perhaps reveal, the author of all these pieces seems quite interested in making the case that there is a causal link between marijuana reform and increases in crime. But even if these posts involve an effort to spin crime data to serve a particular agenda, the data assembled in these posts are disconcerting (and perhaps help explain why we are not hearing from marijuana reform advocates the claim that reform contributes to a decrease in crime).

Critically, lots of crime rates were up in lots of urban and suburban US regions throughout the end of 2014 and through all of 2015; spikes in crime rates in marijuana reform cities might ultimately reflect some broader national trends that have no direct link to marijuana laws and related practicalities.  In addition, especially because marijuana reformers reasonably assert that legalization enables law enforcement to refocus energies on more serious crimes, I wonder if any crime spikes in reform cities might reflect, at least in part, the ability for cops on the beat to discover a greater percentage of serious crimes that we already happening but were going unreported before marijuana reform.

I am hopeful (though not all that optimistic) that over time we will see more and more careful analyses of patterns of crime in the wake of local, state and national marijuana reforms.  In the meantime, though, I want to complement Sierra Rayne for keeping an eye on this important issue, and I robustly encourage everyone else interested in marijuana reform to look closely at all the emerging data in this space.

March 20, 2016 in Assembled readings on specific topics, Criminal justice developments and reforms, Medical Marijuana Commentary and Debate, Medical Marijuana Data and Research, Recreational Marijuana Commentary and Debate, Recreational Marijuana Data and Research | Permalink | Comments (0)

Tuesday, March 8, 2016

Examining and assessing research on marijuana as a treatment for mental disorders

As I mentioned in this prior post, the students in my semester-long OSU Moritz College of Law seminar on marijuana laws and reform are now assembling readings on particular topics in preparation for an in-class presentation/discussion.  The last of three presentations scheduled for this week is going to focus on marijuana as a treatment for mental disorders, and here are the readings (with brief summaries) that my student has assembled on this front:

"The Best Cannabis Strains for Depression"

This article discusses many popular strains of Cannabis and explains how these strains stabilize the mood of the smoker.  According to this article, not all Cannabis is created equal.  Certain strains can be smoked to treat different elements of certain mood disorders.

 

"New Study Finds Marijuana to be Affective Against Depression and PTSD"

Cannabis is used to treat PTSD.  It is also used to treat Depression.  Research on rats found that stress reduces the production of endocannabinoids, which affect cognition, emotion, and behavior.  Since Cannabis contains cannabinoids, it replenishes the stressed smoker’s depleting endocannabinoids.  This helps treat the smoker’s mood disorders.

 

"Cure for Anxiety and Depression in Self-Medicating Marijuana Users Could Be on the Horizon"

This article states that most Cannabis users, use Cannabis as a way of self-medicating.

 

"Medical Marijuana as a Treatment for Depression"

This article states the same conclusion as the other three articles.  It also discusses Israel’s decision to provide its soldiers with marijuana to help combat PTSD and Depression.

 

"Cannabis as a Treatment for Depression"

This article discusses depression, symptoms of depression, and how it affects cognition.  It then discusses how cannabis decreases these symptoms by altering brain chemistry.

 

"Is Medical Marijuana an Effective Treatment for Depression, Bipolar Disorders, Anxiety, and Similar Mood Disorders?"

This article looks at the Pros and Cons of smoking marijuana.

March 8, 2016 in Assembled readings on specific topics, Medical community perspectives, Medical Marijuana Commentary and Debate, Medical Marijuana Data and Research | Permalink | Comments (0)

Wednesday, March 2, 2016

Looks like Maine may no longer be a state to watch on the marijuana legalization initiative front in 2016

This local article, headlined "Maine marijuana legalization bid fails to qualify for ballot," reports that the folks seeking to put a marijuana legalization initiative on the ballot in the Pine Tree state seemed to have come up short in their efforts. Here is why and some context:

An effort to legalize recreational use of marijuana in Maine did not qualify for the November ballot, accoridng to state election officials. Secretary of State Matt Dunlap said in a statement that the proposal did not have enough valid signatures of Maine voters. The campaign needed 61,123 signatures. According to Dunlap’s office, the campaign only provided 51,543 valid signatures.

The Campaign to Regulate Marijuana Like Alcohol now has 10 days to appeal the decision. An appeal would be reviewed in Maine Superior Court. Campaign leader David Boyer said they were “very disappointed” with the Secretary of State office’s determination that 17,000 signatures apparently from a single notary did not match the signatures on file. “We will be exploring all legal avenues that are available to appeal this decision and sincerely hope that more than 17,000 Maine citizens will not be disenfranchised because of a handwriting technicality,” Boyer said.

The campaign turned in 99,229 signatures on Feb. 1. According to Maine election officials, over 31,000 signatures were deemed invalid because signatures on petitions swearing that the circulator witnessed signature collection did not match his or her signature on file. One circulator was listed as the public notary on 5,099 petitions containing 26,779 signatures. Other irregularities included 13,525 signatures that were invalid because they did not belong to a registered voter in the municipality where they were submitted.

The Campaign to Regulate Marijuana Like Alcohol backed the initiative, which would allow adults 21 and older to possess small amounts of marijuana for recreational use. The push for legalization began with two competing measures, including one backed by a group called Legalize Maine. But the campaigns united behind one proposal in October, after advocates became concerned that having two similar proposals on the ballot would create confusion among voters and split the vote.

The campaign faced opposition from a group formed to prevent legalization, and from parts of the medical marijuana community in Maine. When campaign supporters delivered petitions to the Secretary of State’s Office in Augusta in February, they were met by protesters who said that local medical marijuana growers and patients could be hurt if the referendum passed....

Maine has allowed medical marijuana since 1999 and the program has become increasingly popular in recent years. Last year, Mainers spent $23.6 million on medical marijuana from the state’s eight dispensaries, a 46 percent jump from the previous year. Those numbers don’t include sales to patients from the more than 2,200 caregivers licensed to grow and sell marijuana to patients.

The state cannot provide an exact number of patients because it does not keep a registry, but doctors have printed more than 35,000 certificates required under state regulations to certify patients. That number could include duplicates and replacement certificates and is likely higher than the actual number of patients, according to the Department of Health and Human Services, which oversees the medical marijuana program.

March 2, 2016 in Initiative reforms in states, Medical Marijuana Data and Research, Recreational Marijuana State Laws and Reforms, Who decides | Permalink | Comments (0)