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
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.
In 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"
The 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."
Wednesday, May 11, 2016
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:
Much of the work by AAA in this space can be found at this link.
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.
Tuesday, May 10, 2016
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.
Monday, April 18, 2016
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?"
The 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
As 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
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:
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.
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.
This article states that most Cannabis users, use Cannabis as a way of self-medicating.
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.
This article discusses depression, symptoms of depression, and how it affects cognition. It then discusses how cannabis decreases these symptoms by altering brain chemistry.
This article looks at the Pros and Cons of smoking marijuana.
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.
Tuesday, February 23, 2016
New poll indicates large Ohio majority wants medical marijuana to be a (state?) constitutional right
This new local article, headlined "Ohio voters support medical marijuana amendment, poll finds," reports on a new poll of Ohioans that asked a distinctive — and perhaps distinctively confusing — question about their views on medical marijuana reform. Specifically, here is the question Public Policy Poling asked of Ohioians last week as reported in this "Ohio Survey Results" document:
In thinking about medical marijuana, do you favor or oppose making it a constitutional right for patients with terminal or debilitating medical conditions to possess and consume marijuana if their doctors recommend it?
Here are the basic results of this poll as reported in this press article, along with who sponsored it and the marijuana reform context in Ohio:
Nearly three out of four Ohioans said access to marijuana for certain medical conditions should be a constitutional right, according to a Public Policy Polling survey released Monday. The survey was commissioned by national group Marijuana Policy Project, which plans to put a medical-only amendment on the November ballot in Ohio.
Specifically, the poll asked if voters favor or oppose "making it a constitutional right for patients with terminal or debilitating medical conditions to possess and consume marijuana if their doctors recommend it." The poll did not ask about specific amendment language, which has not been publicly released. Public Policy Polling surveyed 672 Ohio voters Feb. 17-18. The poll has a margin of error of 3.8 percentage points.
Wide support was seen in every demographic group -- race, age, political party, and gender.
- Gender: Women 75 percent, men 73 percent
- Party: Democrat, 85 percent; Republican, 69 percent; independent, 62 percent
- Race: White, 76 percent; African-American, 71 percent; other, 54 percent
- Age: 18-29, 76 percent; 30-45, 71 percent; 46-65, 80 percent; older than 65, 64 percent
Marijuana Policy Project spokesman Mason Tvert said the results weren't surprising. "It's become pretty common knowledge that marijuana can be incredibly beneficial in the treatment of a variety of medical conditions," Tvert said. "There are few laws still on the books that are as unpopular as those that prohibit sick and dying people from accessing medical marijuana."
The D.C.-based organization has had a hand in crafting most state marijuana decriminalization and legalization laws in the past two decades. Tvert said the organization is confident most Ohioans will support its initiative, which he said will be different from Issue 3, last year's failed recreational marijuana measure.
Several independent polls conducted last year showed as many as nine in 10 Ohio voters favored legal medical marijuana use, but only a slim majority of Ohioans supported legalizing recreational use. Support dropped below 50 percent when voters were asked about Issue 3 specifics including the measure's "monopoly" on commercial growers.
I would guess that Marijuana Policy Project sponsored this poll's distinctive question because it is trying to decide whether it should seek to move forward in Ohio with a reform initiative that proposed a change to the Ohio Constitution or instead just sought to change Ohio's statutory provisions. One forceful criticism of the marijuana legalization initiative roundly rejected by voters last year was that, as a proposed constitutional amendment, it would lock a specific business structure for marijuana reform into the state's Constitution and would be hard to modify by the Ohio legislature in the years ahead.
I suspect MPP will look at this poll as evidence that a strong majority of Ohio voters are comfortable with a medical marijuana reform initiative in the form of a state constitutional amendment. But, because a number of members of the Ohio legislatures are busy considering statutory reforms, I also suspect that any coming marijuana reform campaign will also include dispute and debate over whether a state constitutional amendment is the best way to end marijuana prohibition in the state.
February 23, 2016 in Campaigns, elections and public officials concerning reforms, Initiative reforms in states, Medical Marijuana Commentary and Debate, Medical Marijuana Data and Research, Medical Marijuana State Laws and Reforms, Polling data and results | Permalink | Comments (0)
Monday, February 8, 2016
Oregon Health Authority report calls for "the creation of an independent, free‐standing Oregon Institute for Cannabis"
I was intrigued and pleased to see this notable new press story out of Oregon reporting on this notable new public health task force report titled "Researching the medical and public health properties of cannabis." Here are the basics via the press coverage:
Oregon should fund an independent marijuana institute to support and conduct world-class research into the drug's medical and public health benefits, says a task force that includes state officials, scientists and leading physicians.
Tax dollars generated through recreational marijuana sales would supplement private funding to underwrite the quasi-public Oregon Institute for Cannabis Research. The center would hire research scientists, as well as staff to help academic researchers navigate the complexities of federally sanctioned cannabis research.
The recommendation, included in a report submitted Monday to the Legislature by the task force, calls for Oregon to break new ground by providing a sustained source of state money to support marijuana research. Among the proposals: the institute itself would grow and handle marijuana for research purposes. "This institute will position Oregon as a leader in cannabis research and serve as an international hub for what will soon be a rapidly accelerating scientific field," states the report, prepared by the Oregon Health Authority. "No other single initiative could do as much to strengthen the Oregon cannabis industry and to support the needs of Oregon medical marijuana patients."
The proposal represents the latest effort by states to fill gaps in marijuana research created by the federal prohibition of the drug. The government allows research on cannabis, but the approval process is especially complicated and involves marijuana produced at a government-run facility based at the University of Mississippi. The recommendation came out of a law passed last year by the Legislature that called for the creation of a governor-appointed task force to study ways to support a medical marijuana industry geared toward patients. The report doesn't include estimates for what it would cost to fund the center, but makes clear that financial support from the state would be essential. Other states have set aside money for research, but not on an ongoing basis.
Sen. Chris Edwards, D-Eugene, the lawmaker behind the provision that created the task force, said paying for the institute with revenue from the state's marijuana tax is a politically viable idea, but said it isn't likely to gain traction during the Legislature's 35-day session, which began last week. Under current law, marijuana tax revenue goes to the common school fund, mental health, alcoholism and drug services, the Oregon State Police, local and the health authority. "One thing I heard consistently is that people want to understand better the health effects and the health and safety issues -- the potential effects of pesticides and also the potential for medical uses of cannabis," he said. "I think there is broad support for those pieces."...
Colorado and Washington, the first states to legalize marijuana for recreational use, also have plans for research. Colorado lawmakers in 2014 approved a one-time $9 million expenditure for marijuana-related studies, including three that will require federal approval, said Ken Gershman, medical marijuana research grant program manager for the Colorado Department of Public Health and Environment. Six involve "observational studies" of people already consuming marijuana. University researchers in Colorado plan to examine whether young adults and adolescents with inflammatory bowel disease benefit from marijuana, and the effect of cannabidiol, a component of the marijuana plant known as CBD, on Parkinson's-related tremors. Other studies will examine the effect of high-CBD oil extracts on epilepsy, as well as the drug's impact on sleep and post-traumatic stress disorder.
Washington, which offers a marijuana research license, carved out a percentage of its marijuana tax revenue for cannabis research. The law calls for some of that work to look at ways of measuring marijuana intoxication and impairment.
California was the first state to fund research into marijuana's medicinal benefits. In 2000, the state set aside $10 million to fund the Center for Medicinal Cannabis Research at the University of California, San Diego. The center oversaw multiple research projects, most of them looking at marijuana's effect on neuropathic pain. Like Colorado, California's funding was a one-time expenditure.
Dr. J.H. Atkinson, a co-director of the center and a professor of psychiatry at the University of California, San Diego School of Medicine, said the research was "relatively small in scope and duration" but offered a potential model for other states. He said the studies showed a promising connection between cannabis and pain relief. "Without too much chest thumping," he said, "it was the most comprehensive body of research on the potential (of cannabis) ever conducted in this country."...
Research into marijuana is complicated by the drug's longtime status as a Schedule 1 drug. That category of drugs, which includes heroin, is defined as substances that have a "high potential for abuse" and "no currently accepted medical use." Federal research proposals involving involving Schedule 1 drugs must undergo review by the National Institute on Drug Abuse and must use cannabis produced by the University of Mississippi, which holds the lone government contract to grow pot for research purposes. The agency in 2014 said it planned to increase production of marijuana to support more research....
Paul Armentano, deputy director of the National Organization for the Reform of Marijuana Laws, said "ample research" and "an extensive history of human use" provide more than enough evidence to contradict marijuana's status under federal law as a drug that lacks medical benefit. Armentano said he welcomes more research from states like Oregon but is skeptical it will make a difference in the debate about marijuana's Schedule 1 status. "Unfortunately science has never driven marijuana policy," he said. "If it did, the United States would already have a very different policy in place."
February 8, 2016 in Federal Marijuana Laws, Policies and Practices, Medical community perspectives, Medical Marijuana Commentary and Debate, Medical Marijuana Data and Research, Medical Marijuana State Laws and Reforms, Taxation information and issues , Who decides | Permalink | Comments (0)
Sunday, February 7, 2016
The title of this post is the headline of this lengthy super-informative article that seems like a perfect read as we await the latest version of the SuperBowl. Here is how a piece worth reading in full gets started:
With much of the NFL world camped out in the San Francisco Bay Area in the days before Super Bowl 50, researchers released sobering news: late Oakland Raiders quarterback Ken Stabler had a degenerative brain disease associated with repeated blows to the head. Later Wednesday, another late, great QB, Earl Morrall, also was revealed to have had chronic traumatic encephalopathy (CTE), which is associated with memory loss, impaired judgment and progressive dementia. Dozens of former players have been diagnosed, some who died in old age, like Frank Gifford, and a few who took their lives, like Junior Seau.
There is no known treatment for CTE, not least because there's no test that can point it out in the living — it's detected in post-mortem brain scans. But to one former player who's sure his nine-year career gave him the disease, there's an obvious treatment that isn't allowed in the NFL, even though it would be easy to score not far from Levi's Stadium on Super Bowl Sunday for anyone with a doctor's note: medical marijuana. "If cannabis is implemented and (the NFL) can lead the science on this, they can resolve this brain injury situation in a big way," Kyle Turley said.
Turley is at the forefront of a vocal movement arguing that medical marijuana's pain-suppressing and possible neuroprotective benefits make it the only effective treatment for the effects that chronic concussive blows to the head have on football players. As co-founder of the Gridiron Cannabis Coalition, Turley is the movement's most outspoken member, but it also includes other retired players and rapper/marijuana entrepreneur Snoop Dogg.
More players' brains are found to show signs of CTE with each year that passes. Researchers at Boston University have found evidence of CTE in 96 percent of the NFL players' brains they examined. At the same time, more states are allowing doctors to prescribe marijuana as a medicine – 23 so far, according to National Organization for the Reform of Marijuana Laws.
A small body of research suggests marijuana can heal head trauma, yet Turley wonders why the league isn't investigating the drug as a medicine. To advocates, hosting the Super Bowl in the region is almost hypocritical, given what they see happening to the heads of NFL players and the spiraling lives of some former players. "The NFL's policy against medical marijuana is stupid and counterproductive," said Dale Gieringer, director of the California chapter of NORML, in an email calling the NFL out of touch with the laws of the state. "There's no doubt NFL players would be better off with medical access to marijuana."
Turley is a former defensive lineman who has been extremely outspoken about his medical struggles after playing for three NFL teams in nine years. A New Yorker article from 2009 describes him blacking out at a Nashville concert, feeling much the same way he did when he was kneed in the head during a game years earlier. The former lineman had recently retired and was taking painkillers. He wound up in the hospital, where he said he briefly lost nearly all control of his body. "Before quitting all the pills and committing to cannabis ... my life was a train wreck, plain and simple," Turley told NBC Owned Television Stations.
Today, Turley has eliminated all other chemicals from his system, from Aleve to Zoloft, he said. The San Diego resident has found strains of marijuana that relieve pain and other strains with effects comparable to the psychiatric pill Vicodin, but without the narcotic effects.
Medical marijuana has fairly well known, though not conclusively proven, pain relieving benefits. But to Turley, the drug also treats mental anguish he believes comes from CTE. There is very little research on that front, but the 40-year-old father insists marijuana has given him stability after recently feeling despondent and suicidal. "The reality is I don't think about those things anymore. And if it wasn't for cannabis, I wouldn't be where I am mentally," Turley said.
Turley swears that marijuana use is rampant in the NFL – "from players to coaches to owners, marijuana is in the National Football League" – but only a handful of players have spoken out about using it. They emphasize the mental clarity it offers as much as the pain relief.
"I always healed fast, ahead of schedule; was never really very swollen; my mind was very sharp, and after concussions medicated with it," Nate Jackson told marijuana magazine High Times this week, discussing how marijuana helped him in his days with the Broncos in the 2000s.
It's not just young players who swear by pot, either. Jim McMahon, one of the heroes of the Chicago Bears' 1985 championship, revealed last month that he weaned himself off pharmaceutical drugs that left his head feeling fuzzy. "This medical marijuana has been a godsend. It relieves me of the pain – or thinking about it, anyway," he told The Chicago Tribune.
February 7, 2016 in History of Marijuana Laws in the United States, Medical Marijuana Commentary and Debate, Medical Marijuana Data and Research, Medical Marijuana State Laws and Reforms | Permalink | Comments (0)
Saturday, January 23, 2016
The question in the title of this post is prompted by this local article from Maine, headlined "Sales of medical marijuana jumped 46 percent in Maine last year: The state's pot dispensaries took in $23.6 million as the social stigma faded and more patients seeking relief from chronic pain tried the drug." Here are excerpts:
Mainers spent $23.6 million on medical marijuana from dispensaries last year, a 46 percent increase driven by multiple factors, including patients seeking alternatives to prescription painkillers and more doctors certifying people to use the drug, according to dispensary operators.
Operators say the increase in sales illustrates the growing willingness of patients and doctors to consider alternatives to traditional medicine, and a reduction in the social stigma surrounding the use of medical marijuana.
But an official for the Maine Medical Association said Wednesday the big jump also shows why the medical community has resisted opening the program to more patients with different medical conditions, citing a lack of research that demonstrates medical marijuana is effective in treating them.
The $23.6 million in 2015 dispensary sales generated $1.29 million in sales tax, according to Maine Revenue Services. In 2014, the dispensaries sold $16.2 million worth of medical marijuana products and collected more than $892,000 in sales tax, a 40 percent increase over the previous year and more than triple the tax revenue collected in 2013. The sales figures from Maine Revenue Services do not include numbers from the state’s 2,255 caregivers, who are small-scale growers authorized to sell marijuana to up to five patients.
“There are a number of factors at play here. The first would be that Mainers are becoming more used to the idea of therapeutic cannabis,” said Becky DeKeuster, director of education for Wellness Connection, which operates four of Maine’s eight dispensaries. “We’ve had a very successful dispensary program for five years now and people are becoming used to this option.”
Maine is one of 34 states that allow some form of medical cannabis. Maine legalized medical uses in 1999, and the state’s first dispensaries opened in 2011. Last year, Maine’s program was voted the best medical marijuana program in the country by Americans for Safe Access, a national group that advocates for legal access to the drug.
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, said Samantha Edwards, spokeswoman for the state Department of Health and Human Services, which oversees the medical marijuana program.
About 340 medical providers certified patients to obtain medical marijuana. Patients qualify for certification if they have one of a dozen specific conditions, including cancer, glaucoma, chronic pain and Crohn’s disease. Tim Smale, operator of the Remedy Compassion Center in Auburn and president of the Maine Dispensary Operators Association, believes there has been about a three-fold increase in the number of doctors certifying patients in the past couple of years. Maine law has been amended so that nurse practitioners and physician’s assistants also can certify patients....
Gordon Smith, spokesman for the state medical association, said the large increase in sales illustrates why the association has lobbied against efforts to expand the medical marijuana program to include more qualifying conditions or eliminate them altogether. “We don’t want to put Maine’s medical community in a position where it’s being asked to be a front for recreational use of marijuana,” Smith said. “We acknowledge marijuana helps a small number of medical conditions and there is good evidence of that, but for many of the (conditions) on the list, there’s not scientific data to establish marijuana is helpful.”
One condition that has been debated is post-traumatic stress disorder, which Maine added to the list of qualifying conditions in 2013. The Mayo Clinic defines post-traumatic stress disorder as a mental health condition that’s brought on when a person sees or experiences a severely traumatic event. A person suffering from PTSD may have uncontrollable thoughts about the event and also experience flashbacks, nightmares and severe anxiety.
Although several other states have authorized medical marijuana sales to people with PTSD, the U.S. Department of Veterans Affairs describes the practice as a growing concern because some veterans are using the drug to relieve symptoms of PTSD, yet there is a lack of medical evidence of its effectiveness.
DeKeuster said Wellness Connection, which serves about 11,000 patients across the state, is seeing more patients who want to use medical cannabis as a first option for treatment instead of as a last resort. The top three qualifying conditions among Wellness Connection patients are chronic pain, post-traumatic stress disorder and cancer. “Physicians and patients both are looking for a pain relief solution that is natural,” DeKeuster said....
Another factor contributing to the rise in the use of medical marijuana is that dispensaries have dozens of strains, as well as pills, tinctures and edible forms that make taking the drug easier, DeKeuster said. Smale said dispensary operators across the state report similar trends among all their patients, including seeing more elderly people who want to use medical cannabis for treatment of chronic pain. The Remedy Compassion Center, which Smale owns and operates in Auburn, now primarily serves patients between ages 50 and 70, he said. “The other things we’re finding is folks are looking for an alternative to their opiates,” he said. “We hear many anecdotal reports of people reducing or eliminating opiate use through medical cannabis.”
In addition to anecdotally answering some questions about what is going on with medical marijuana in Maine, it raised for me a bunch of questions about whether these developments in the Pine Tree State are also playing out in a bunch of other medical marijuana states. In particular, I would love to know if dispensary sales are up similarly in a number of other states and also whether there is any reliable data about "people reducing or eliminating opiate use through medical cannabis."
Monday, October 19, 2015
The title of this post is the title of this effective piece from Stateline, the news service of the Pew Charitable Trusts that provides reporting and analysis on trends in state policy. Here is an excerpt:
Montana is among several vanguard states whose voters eagerly legalized medical cannabis by passing broad ballot initiatives as many as 19 years ago, but left lawmakers struggling to regulate an industry that grew quickly with few rules.
Today, states like California, Montana and Michigan are still attempting to clean up their laws with bills that would develop licensing systems for growers, create a fee structure for providers and product, or legalize all marijuana use.
It’s a legislative and regulatory pitfall that lawmakers warn other states they could face as public demand for legal medical and recreational marijuana grows, and more states allow it.
Maryland opened the door to medical use last year, and Georgia, Oklahoma, Texas and Wyoming passed laws legalizing access to less-potent medical cannabis products for certain patients this year. At least 20 initiatives to legalize medical or recreational marijuana could be on the ballot in 16 states next year. And in November, voters in Ohio will decide whether recreational marijuana should be legal in that state.
Proponents of using marijuana as medicine say ingesting the drug can ease chronic pain, stimulate appetites for the very ill, soothe nausea caused by cancer treatments and prevent seizures in children with epilepsy. Detractors say the research surrounding medical marijuana isn’t conclusive, the drug poses significant public health risks and those who advocate for it use medical marijuana to trick voters into sanctioning an illegal drug for recreational use....
And unless state lawmakers get ahead of their constituents on legalization, they face a potential regulatory nightmare, said Washington state Sen. Ann Rivers. Rivers, a Republican, should know. Medical marijuana was legalized in Washington by voter initiative in 1998, leaving gaping regulatory holes and hazards that lawmakers like her have spent years trying to fix.
Sunday, October 18, 2015
The question in the title of this post is prompted by this provocative new Forbes commentary headlined "The NFL Should Be Investing In Marijuana If It Wants To Survive." Authored by Blake Yagman and Jason Belzer, here are excerpts:
The National Football League has survived more public relations crises in the past year than most multi-billion dollar organizations endure in a decade. Yet the greatest existential threat to the NFL, if not to the existence of football itself, still remains Chronic Traumatic Encephalopathy, or “CTE.”...
Terrifyingly, the vast prevalence of the disease may not have been known until fairly recently. Just this year, Boston University found the existence of CTE in the brains of 96% of 91 tested subjects, all of whom played football at some organized level. When the disease was first discovered in 2002 in the brain of former Pittsburgh Steeler Mike Webster by Dr. Bennet Omalu, the NFL initially tried to limit the fallout from the discovery. According to Omalu, “NFL doctors told me that if 10% of mothers in this country would begin to perceive football as a dangerous sport, that is the end of football.”
Last year, Harvard Medical School Professor Dr. Lester Grinspoon called attention to a neuro-protective agent that has the potential to render concussions obsolete – Marijuana. According to Grinspoon, a National Institute of Health study from 1998 revealed the neuro-protective qualities of Marijuana’s two main psycho-active ingredients, Cannabidiol and Delta-9 Tetrahudrocannabidol (THC). In 2008, a similar study in Spain revealed that the THC-receptors in the brain are involved in the healing process upon sustaining brain injury. Most recently, the National Institute of Health showed that THC significantly decreases the death rate of patients with physically sustained brain trauma. In 2013, a team of researchers in Brazil were able to prove that Cannabidiol has the ability to regenerate brain cells in mice. The study specifically showed a capacity to promote the growth of brain cells in the areas of the brain attributed to depression, anxiety, and chronic stress—the symptoms of CTE.
If components of Marijuana have been proven beneficial to patients with neurological injury, the natural conclusion would be to study the drug and develop a medication that could help prevent terrible effects of concussions and CTE. That being said, the barriers to begin this sort of endeavor — research that nevertheless could save the game of football — are high (no pun intended). Perhaps most obviously, the biggest issue is one of funding....
If the league were to finance this research, they would face an avalanche of cries of hypocrisy, as the league has a strict no-drug policy. Realistically, the program is often taken as seriously by its players as the league’s selection of the policy’s mandated testing date of April 20th (the unofficial holiday of recreational users of Marijuana).... Quite notoriously, players simply pass the annual test and continue to use the drug therapeutically for injuries during the season. Medical Marijuana is legal in 23 states, recreational use is legal in three states, and the drug has been decriminalized in many of the United States’major cities, yet the drug remains “illegal”for use by players.
Although the initial publicity for the NFL might be negative, the potential impact reaching into future generations is tremendous. Not only would the league attempt to cure a major medical question that plagues modern sports, but it could potentially set a precedent for major corporations to push Marijuana research forward to fully discover the drug’s potential. The looseness of the NFL’s current Marijuana policy, as well as Commissioner Goodell’s recent statement that the league is willing to support research into Marijuana’s medical uses specific to football, suggest that this partnership is a more than viable option.
Some prior related posts on NFL players and marijuana use:
Wednesday, September 30, 2015
The title of this post is the headline of this must-read New Republic article, which is mostly about the current crazy "wild west" world of CBD medicines. There are many parts of the article that make it must-read in full, and here are passages that I especially wanted to highlight for commentary:
Today, dozens of companies produce CBD in an array of forms. CBD can be inhaled through vape pens, applied in topical salves, ingested in edibles, or swallowed in oil-based tinctures. Oil has become the dominant CBD delivery method for kids with epilepsy, since it is easy to administer and ingest, and there is no shortage of it available for sale online. There are dozens of companies boasting names like Healthy Hemp Oil, Dose of Nature, and Natural Organic Solutions, each of them selling CBD products at prices ranging from trivial to dizzyingly steep. You don’t have to look hard to find them. If you have a PayPal account and $100 to spare, you could have a vial of hemp oil delivered to your doorstep....
In February, as part of an investigation into the marketing claims of six hemp oil companies, the FDA analyzed 18 CBD products. What it found was disturbing: Many of these supposed CBD products were entirely lacking in CBD. Of the products tested, six contained no cannabinoids whatsoever. Another 11 contained less than 1 percent CBD. The product that tested highest in CBD, at 2.6 percent, was a capsule for dogs. In states that have legalized CBD, regulations can require CBD products to contain at least 5 percent CBD, more often 10 or 15 percent....
In the end, companies like HempMedsPx are asking consumers simply to trust them. CBD oils are never subjected to systematic testing by any U.S. regulatory body. The FDA regulates all pharmaceutical labs in the country. But cannabis labs like the ones that HempMedsPx and others use are not, because cannabis is not federally recognized as a legal drug.
All of this makes CBD remarkably difficult for even the most dedicated health care providers to manage safely. Dr. Kelly Knupp, an associate professor of pediatrics and neurology at the University of Colorado, and the director of the Dravet Syndrome program at Children’s Hospital Colorado, said families of epileptic children have tried to bring CBD oils to the hospital for testing. “They’re just concerned that they don’t know exactly who’s growing [the hemp],” Knupp said. “They know it’s not being regulated.” But because CBD is a Schedule I controlled substance, high-tech, regulated laboratories, like those at the University of Colorado, can’t accept, store, or test CBD oils, lest they risk prosecution. “There is no such lab that can take that product,” Knupp said, which leaves any testing up to the unregulated testing centers that cater to the cannabis industry....
To this point, CBD oil has existed in a kind of liminal space — at once an illegal drug, a legal medication, and some kind of “dietary” supplement. It’s possible this could change in the coming years, however. GW Pharmaceuticals, a U.K.-based firm, has developed a “pure CBD” medication called Epidiolex that has shown promising test results. It is currently on a fast-track to receive FDA clearance. For some patients, Epidiolex could be a miracle cure. This summer, in Wired magazine, writer Fred Vogelstein chronicled his family’s own struggles to find an effective treatment for his son’s epilepsy — including experiments with hemp oil — and the immense hurdles they overcame to gain access to Epidiolex prior to its FDA approval. The drug could be for sale on pharmacy shelves in the near future, though exactly how near is hard to say.
For the sake of all the individuals and families struggling with seizure disorders, I sincerely hope that all the emerging CBD treatments being promoted by private industry are much more than snake oil. But I find especially remarkable the sad reality that the blanket prohibition of marijuana in any form at the federal level means that it is near impossible for a person to even have access to a credible lab in order to try to research whether a CBD oil marketed to suffering persons is even what it claims to be. What a sad mess, and one that I hope will get cleared up before too long at the federal level by efforts to move marijuana off Schedule I of the Controlled Substances Act.
September 30, 2015 in Federal Marijuana Laws, Policies and Practices, Medical community perspectives, Medical Marijuana Commentary and Debate, Medical Marijuana Data and Research, Medical Marijuana State Laws and Reforms, Who decides | Permalink | Comments (0)
Tuesday, September 15, 2015
High Intensity Drug Trafficking Area Programs (HIDTAs) are, as explained here, a special kind of drug-enforcement task force that was "created by Congress with the Anti-Drug Abuse Act of 1988 [and] provides assistance to Federal, state, local, and tribal law enforcement agencies operating in areas determined to be critical drug-trafficking regions of the United States." Usefully, the Rocky Mountain HIDTA has been especially focused on marijuana reform, and the last three years it has produced a annual report around this time under the title "The Legalization of Marijuana in Colorado: The Impact." Volume Three of that report, which runs nearly 200 pages and was just release, can be accessed at this link.
Here is an excerpt from the report's executive summary highlighting its coverage:
Rocky Mountain High Intensity Drug Trafficking Area (RMHIDTA) is tracking the impact of marijuana legalization in the state of Colorado. This report will utilize, whenever possible, a comparison of three different eras in Colorado’s legalization history:
• 2006 – 2008: Early medical marijuana era
• 2009 – Present: Medical marijuana commercialization and expansion era
• 2013 – Present: Recreational marijuana era
Rocky Mountain HIDTA will collect and report comparative data in a variety of areas, including but not limited to:
• Impaired driving
• Youth marijuana use
• Adult marijuana use
• Emergency room admissions
• Marijuana-related exposure cases • Diversion of Colorado marijuana
This is the third annual report on the impact of legalized marijuana in Colorado. It is divided into eleven sections, each providing information on the impact of marijuana legalization. The sections are as follows:
Section 1 – Impaired Driving...
Section 2 – Youth Marijuana Use...
Section 3 – Adult Marijuana Use...
Section 4 – Emergency Room Marijuana and Hospital Marijuana-Related Admissions...
Section 5 – Marijuana-Related Exposure...
Section 6 – Treatment...
Section 7 – Diversion of Colorado Marijuana...
Section 8 – Diversion by Parcel...
Section 9 – THC Extraction Labs...
Section 10 – Related Data...
Section 11 – Related Material...
The nature and order of the sections in this big RMHIDTA "Impact" report help highlight that RMHIDTA is almost exclusively interested in emphasizing and lamenting any and all potential negative impacts from marijuana reform in Colorado and deemphasizing and mariginalizing any and all potential positive impacts.
This bias toward emphasizing the negative and ignoring positive impacts is most obvious in terms of the report's (almost non-existant) discussion of the economic development and tax revenues resulting from legalization. Jobs created by marijuana reform are not mentioned anywhere in the report, and a short discussion of tax revenues in the final sections of the report starts with this warning: "It will take years of data collection to complete an analysis of whether marijuana legalization is economically positive or an economic disaster."
Similarly, changes in overall crime rates are only briefly discussed in the final "related data" section of the report, probably because the news seems pretty positive: property crime rates seem to be going down since marijuana reform throughout Colorado while violent crimes rates seem flat. Of particular note, as this semi-official chart reveals, it appears Denver (which is sort-of ground-zero for marijuana reform relalities and likely impact) experienced a significant decrease in reported homicides, rapes and robbery in 2014 relative to 2013. I suspect that this RMHIDTA report would have made much of Colorado and/or Denver homicide rates if they had gone up, but instead this "impact" goes undiscussed.
Reporting biases notwithstanding, this is still an important report that assembles lots of data. And, perhaps in part because of its biases, this report now stands as the latest, greatest effort by the law enforcement community to make the case that marijuana reform in Colorado is a failed experiment. Any and all serious students of marijuana law and policy should take the time to review what this report says and how it is saying what it is saying.
September 15, 2015 in Criminal justice developments and reforms, Medical Marijuana Data and Research, Medical Marijuana State Laws and Reforms, Recreational Marijuana Data and Research, Recreational Marijuana State Laws and Reforms, Who decides | Permalink | Comments (0)
Tuesday, September 1, 2015
Latest survey data shows marijuana use up, while other drug and alcohol use down, on college campuses
This news release from the University of Michigan, which reports on new data from its Monitoring the Future study, provides some evidence to support the notion that marijuana reform movements and other social factor may be lead college students to use more marijuana while also using less other illicit and licit drugs. Here is some of the interesting new data via the press release:
Daily marijuana use among the nation's college students is on the rise, surpassing daily cigarette smoking for the first time in 2014. A series of national surveys of U.S. college students, as part of the University of Michigan's Monitoring the Future study, shows that marijuana use has been growing slowly on the nation's campuses since 2006.
Daily or near-daily marijuana use was reported by 5.9 percent of college students in 2014 — the highest rate since 1980, the first year that complete college data were available in the study. This rate of use is up from 3.5 percent in 2007. In other words, one in every 17 college students is smoking marijuana on a daily or near-daily basis, defined as use on 20 or more occasions in the prior 30 days....
In sum, quite a number of drugs have been fading in popularity on U.S. college campuses in recent years, and a similar pattern is found among youth who do not attend college. Two of the newer drugs, synthetic marijuana and salvia, have shown steep declines in use. Other drugs are showing more gradual declines, including narcotic drugs other than heroin, sedatives and tranquilizers — all used non-medically — as well as inhalants and hallucinogens....
While 63 percent of college students in 2014 said that they have had an alcoholic beverage at least once in the prior 30 days, that figure is down a bit from 67 percent in 2000 and down considerably from 82 percent in 1981. The proportion of the nation's college students saying they have been drunk in the past 30 days was 43 percent in 2014, down some from 48 percent in 2006.
Occasions of heavy or binge drinking — here defined as having five or more drinks in a row on at least one occasion in the prior two weeks — have consistently had a higher prevalence among college students than among their fellow high school classmates who are not in college.
Still, between 1980 and 2014, college students' rates of such drinking declined 9 percentage points from 44 percent to 35 percent, while their non-college peers declined 12 percentage points from 41 percent to 29 percent, and high school seniors' rates declined 22 percentage points from 41 percent to 19 percent....
Cigarette smoking continued to decline among the nation's college students in 2014, when 13 percent said they had smoked one or more cigarettes in the prior 30 days, down from 14 percent in 2013 and from the recent high of 31 percent in 1999—a decline of more than half. As for daily smoking, only 5 percent indicated smoking at that level, compared with 19 percent in 1999 — a drop of nearly three fourths in the number of college students smoking daily.
Thursday, August 20, 2015
The title of this post is drawn from the headline of this Newsweek piece from last month that I just came across. Though it seems from this new news article that former President Jimmy Carter may not be getting a chemotherapy-based cancer treatment, this Newsweek article seemed worth spotlighting on a day when a former US Prez is talking about his cancer diagnosis and coming treatments. (In a coming post, I will highlight another newer Newsweek story on marijuana reform that I think merits even more attention.) Here in a notable excerpt from the lengthy chemo piece:
A growing number of cancer patients and oncologists view the drug as a viable alternative for managing chemotherapy’s effects, as well as some of the physical and emotional health consequences of cancer, such as bone pain, anxiety and depression. State legislatures are following suit; medical cannabis is legal in 23 states and the District of Columbia, and more than a dozen other states allow some patients access to certain potency levels of the drug if a physician documents that it’s medically necessary, or if the sick person has exhausted other options. A large number of these patients have cancer, and many who gain access to medical marijuana report that it works.
“A day doesn’t go by where I don’t see a cancer patient who has nausea, vomiting, loss of appetite, pain, depression and insomnia,” says Dr. Donald Abrams, chief of hematology-oncology at San Francisco General Hospital and a professor of clinical medicine at the University of California, San Francisco. Marijuana, he says, “is the only anti-nausea medicine that increases appetite.”
It also helps patients sleep and elevates their mood — no easy feat when someone is facing a life-threatening illness. “I could write six different prescriptions, all of which may interact with each other or the chemotherapy that the patient has been prescribed. Or I could just recommend trying one medicine,” Abrams says.
A 2014 poll conducted by Medscape and WebMD found that more than three-quarters of U.S. physicians think cannabis provides real therapeutic benefits. And those working with cancer patients were the strongest supporters: 82 percent of oncologists agreed that cannabis should be offered as a treatment option.
Dr. Benjamin Kligler, associate professor of family and social medicine at Albert Einstein College of Medicine, says there has been enough research to prove that at a bare minimum cannabis won’t actually harm a person. In addition, “given what we've seen anecdotally in practice I think there's no reason we shouldn't see more integration of cannabis in the long run as a strategy,” he says. “We have this extremely safe, extremely useful medicine that could potentially benefits a huge population.”
The science journal Nature has this effective new feature article discussing the notable challenges in doing good science in the marijuana reform space. The lengthy article is headlined "The cannabis experiment: As marijuana use becomes more acceptable, researchers are scrambling to answer key questions about the drug." Here are excerpts:
In 2013, Beau Kilmer took on a pretty audacious head count. Citizens in the state of Washington had just voted to legalize marijuana for recreational use, and the state's liquor control board, which would regulate the nascent industry, was anxious to understand how many people were using the drug — and importantly, how much they were consuming.
The task was never going to be straightforward. Users of an illicit substance, particularly heavy users, often under-report the amounts they take. So Kilmer, co-director of the RAND Drug Policy Research Center in Santa Monica, California, led a team to develop a web-based survey that would ask people how often they had used cannabis in the past month and year. To help them gauge the amounts, the surveys included scaled pictures showing different quantities of weed. The survey, along with other data the team had collected, revealed a rift between perception and reality. Based on prior data, state officials had estimated use at about 85 tonnes per year; Kilmer's research suggested that it was actually double that, about 175 tonnes. The take-home message, says Kilmer, was “we're going to have to start collecting more data”.
Scientists around the world would echo that statement. Laws designed to legalize cannabis or lessen the penalties associated with it are taking effect around the world. They are sweeping the sale of the drug out of stairwells and shady alleys and into modern shopfronts under full view of the authorities. In 2013, Uruguay became the first nation to legalize marijuana trade. And several countries in Europe — Spain and Italy among them — have moved away from tough penalties for use and possession. Thirty-nine US states plus Washington DC have at least some provisions for medicinal use of the drug. Washington, Colorado, Alaska and Oregon have gone further, legalizing the drug for recreational consumption. A handful of other states including California and Massachusetts are expected to vote on similar recreational-use measures by the end of 2016.
But the rapid shift has caught researchers on the back foot. “Broadly speaking, there's about 100 times as many studies on tobacco or alcohol as there are on illegal substances,” says Christian Hopfer, a psychiatry researcher at the University of Colorado School of Medicine in Denver. “I don't think it's the priority it should be.”
Despite claims that range from its being a treatment for seizures to a cause of schizophrenia, the evidence for marijuana's effects on health and behaviour is limited and at times conflicting. Researchers struggle to answer even the most basic questions about cannabis use, its risks, its benefits and the effect that legalization will have.
The quick shifts in policies should provide a plethora of natural experiments, but the window will not be open for long. “There's an opportunity here. Some of the most informative research we can do is right at the moment the market changes,” says Robert MacCoun, a social psychologist and public-policy researcher at Stanford Law School in California who worked with Kilmer on the research done in Washington....
As cannabis use becomes legal, the data may become easier to collect. But the drug's use is still low compared with alcohol and tobacco, says Wayne Hall, an addiction researcher at the University of Queensland in Brisbane, Australia, so it is hard to draw firm conclusions. Marijuana may be the most popular illegal drug, he says — about 44% of US adults have used it at some point in their lives according to one source — but only about one in ten have used it in the past year. By contrast, around 70% drank alcohol in that time. “The number of people who use it with any regularity for a long time is pretty small. The longer-term consequences are really understudied,” says Hall.
A major question for researchers — and a complication in interpreting the evidence — is dosing. There are more than 85 cannabinoid chemicals in pot. The one of most interest to researchers — and users — is tetrahydrocannabinol (THC). Growers have been able to breed high concentrations of the chemical into strains of the plant meant for recreational and medicinal use. A potency- monitoring programme run by the University of Mississippi for the US National Institute on Drug Abuse (NIDA) found that THC levels have steadily increased in the United States11, from 2–3% in 1985–95 to 4.9% in 2010. The increase is even starker for imported cannabis seized by law-enforcement officials. For these drugs, potency has gone from less than 4% in the late 1980s and early 1990s to more than 12% in 2013.
But it is hard to determine the amounts of THC being consumed by the average customer. It is unclear, for example, whether users 'titrate' their doses, adjusting their intake according to the potency. Nicotine users are known to do this with cigarettes, but nicotine does not impair judgement in the same way that cannabis does. And the effects of THC are less immediate, especially for edible forms.
The escalating potency raises questions about previous research because users in older studies may have been consuming lower-potency cannabis, and the effects may be different. A study published earlier this year, for example, linked high-potency cannabis to a threefold-increased risk of psychosis versus non-use but found no association with lower-potency forms. And many researchers have complained that the pot approved for study in experiments funded by NIDA is a poor match for what is used recreationally or medicinally....
Although states are starting to ease restrictions on recreational use of marijuana, what got the ball rolling in changing public perceptions and the legal landscape for pot were the arguments for its medical use.
Colorado introduced its rules allowing medical marijuana more than a decade before it allowed recreational use. The amendment to the state's constitution listed eight conditions for which marijuana was approved: cancer, glaucoma, HIV/AIDS, cachexia (a progressive wasting syndrome), persistent muscle spasms, seizures, severe nausea and severe pain. But, says Larry Wolk, executive director and chief medical officer of the CDPHE, “those are dictated by the constitution and not necessarily by medical research”.
Although there is a huge amount of anecdotal evidence — and well-organized advocacy groups that campaign for easier access to medical marijuana — there is little conclusive scientific evidence for many of the claimed medical benefits. One of the reasons for this dearth of evidence is that money generally has been obtainable only for research on the negative effects of cannabis. That is beginning to change.
When Colorado first legalized the drug, its public-health department began collecting fees from patients who applied to purchase pot at medical dispensaries. By 2014, the state had amassed more than US$9 million, most of which was ploughed back into a medical marijuana research programme selected by the CDPHE. Among the projects funded by the Colorado millions, there are two investigating whether cannabinoids can help to mitigate seizures in childhood epilepsy. Similar research is being pursued in the United Kingdom and elsewhere in the United States....
One of the biggest questions is how legalization will change usage patterns. One place in which researchers are looking for answers is Europe, where cannabis regulation tends to be much lighter than it is in the United States (see 'Reefer madness'). In the United Kingdom, some police forces overlook cannabis use and small-scale growing operations. Spain allows private consumption, but still has restrictions on sales.
The most extreme and long-standing example is the Netherlands, which decriminalized the possession and sale of small quantities of cannabis in 1976. But although some streets of Amsterdam have been transformed into pungent tourism hotspots, the country as a whole has not changed its habits much.
Although hard data on cannabis use in Europe is patchy, the Netherlands does not have hugely more users than other nations. Data aggregated by the United Nations Office on Drugs and Crime put use in the Netherlands at about 7%. That is more than in Germany (5%) and Norway (5%), about the same as in the United Kingdom and less than in the United States (15%). Nor has the Netherlands seen a huge spike in use of harder drugs, dampening fears that marijuana serves as a gateway to more-dangerous substances such as heroin and cocaine. The message from the Netherlands, says Franz Trautmann, a drugs-policy researcher at the Trimbos Institute in Utrecht, the Netherlands, is that “a very liberal policy doesn't lead to a skyrocketing prevalence”. Rather, cannabis is endemic, he says. “We can't control this through prohibition. This is something which more and more is recognized.”
But the lesson from the Netherlands may be limited because the drug is still illegal, and growing and selling large quantities is still punishable by law. Colorado has gone further by legalizing not merely the drug's use, but the whole production chain, and that could have fundamentally different effects on the economics of pot. “Legalized production really raises the prospect of a dramatic drop in price,” says MacCoun. “It's conceivable marijuana prices could drop 75–80% in a fully legalized model.” (Although Uruguay legalized the drug in 2013, it reportedly has struggled to regulate production and to set up working dispensaries.)
The effects of a sharp drop in cost are unknown. Taxation may also have unintended consequences. If states tax by weight, users might look to higher-potency strains to save money. And once cannabis is a business, it gains a business lobby. Cannabis researchers already talk of being bombarded with e-mails from pro-cannabis groups if they make negative comments about the drug. “Marijuana research is like tobacco research in the '60s,” says Hopfer. “Any study about harms is challenged. It's really something.” Many fear that the big money now to be found in cannabis will drive attempts to obfuscate the risks. “If the commercial interests are too big, then the profit interest is prevailing above the health interest. This is what I'm afraid of,” says Trautmann.
Legalization provides an opportunity to answer some important questions. In a few years, Colorado, Washington and others will know (if only roughly) how legalization affects usage patterns, the number of car crashes and the number of people seeking help for drug dependency. The CDPHE-funded programmes will have added to the knowledge of beneficial effects. And continuing long-term studies of large groups of users will provide more evidence for statisticians who are attempting to disentangle correlation and causation on the negative impacts.
“When a jurisdiction changes its marijuana laws, that provides an opportunity for greater leverage on the questions of cause and effect,” says MacCoun. But, he adds, the signals will only really be clear if the laws result in a dramatic increase in use — something that is neither a given, nor necessarily desirable. “Obviously, we don't want marijuana use to rise just to allow us to answer our questions, but if it does, we'll be poring over all the data.”