Thursday, March 19, 2015
"The Kids Aren't Alright, But Older Adults Are: How Medical Marijuana Market Growth Impacts Adult and Adolescent Substance-Related Outcomes"
The title of this post is the title of this notable new SSRN piece authored by Rosanna Smart providing an empirical reassessment of some data on the impact of medical marijuana reform on drug use and abuse. Here is the abstract:
Public opinion has grown more favorable to legalizing the sale and use of cannabis; many states now have "medical marijuana" laws (MMLs), and a few have legalized commercial production and sale for non-medical purposes. Prior research examining the effects of MML adoption has largely found reassuring evidence on the consequences of such policies -- no impact on adolescent cannabis use, and large decreases in crime rates, motor vehicle fatalities, suicides, and prescription opioid overdoses for adults. However, medical marijuana regimes vary greatly, and simple comparisons of states with such laws to states without them miss that variability.
Reanalysis using a more sensitive measure of MML penetration (per-capita adult medical marijuana registration rates) confirms that growth in medical marijuana market size lowers alcohol and opioid-related poisoning deaths for older adults, and lessens traffic fatalities in accidents involving older drivers. However, larger medical marijuana markets lead to increased cannabis consumption by adolescents, accompanied by increases in traffic fatalities and alcohol poisoning mortality for this age group.
March 19, 2015 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)
Tuesday, March 17, 2015
The question in the title of this post is the headline of this new piece by Miriam Boeri appearing in This Week magazine. Here are excepts (with links preserved):
[R]esearch has shown that marijuana, while still criminalized at the federal level, can be effective as a substitute for treating opioid addicts and preventing overdoses. Massachusetts, which recently legalized medical marijuana — and where heroin overdoses have soared — could be a fertile testing ground for this potentially controversial treatment....
With each state crafting unique medical marijuana regulations, we find ourselves at a crucial turning point in drug policy.... Among drug treatment specialists, marijuana remains controversial. Although some research has shown marijuana to be an alternative treatment for more serious drug addiction, addiction treatment specialists still view marijuana as highly addictive and dangerous. These views handicap policy reform, but despite its status as a Schedule 1 drug, recent research shows marijuana could be part of the solution to the most deadly drug epidemic our country has seen in decades.
In 2012 Massachusetts became the 18th state to legalize medical marijuana, though the first 11 dispensaries are not scheduled to open until sometime in the coming year. This situation presents an opportunity to implement sensible, research-based policy.
Massachusetts, like many states across the US, has seen a dramatic rise in opioid addition fueled by the increase in opiate prescription pills. In Boston, heroin overdoses increased by 80 percent between 2010 and 2012, and four out of five users were addicted to pain pills before turning to heroin.
Meanwhile, the leading cause of death among the Boston's homeless population has shifted from AIDS complications to drug overdoses, with opiates involved in 81 percent of overdose deaths. This is an alarming finding given recent expansion in clinical services for the city's homeless.
Addiction specialists and health care professionals in Boston have been at the forefront of integrating behavioral and medical care. Naloxone and methadone are currently the main solutions to address the growing opiate addiction and overdose problem. But Naloxone is an overdose antidote, not a cure or a form of preventative therapy.
Methadone, like heroin and other opioids, has a very narrow therapeutic index (the ratio between the toxic dose and the therapeutic dose of a drug). This means that a small change in dosage can be lethal to the user. Marijuana, however, has one of the safest (widest) therapeutic ratios of all drugs.
Research shows that marijuana has been used as a form of self-treatment, where users take cannabis in lieu of alcohol, prescription opiates, and illegal drugs. That's one reason why researchers are calling for marijuana to be tested as a substitute for other drugs. In this capacity, marijuana can be thought of as a form of harm reduction. While researchers don't seek to discount some of the drug's potential negative effects, they view it as a less damaging alternative to other, harder drugs. Despite these findings, marijuana is rarely incorporated in formal drug treatment plans.
A recent study might change this policy. Comparing states with and without legalized medical marijuana, it found a substantial decrease in opioid (heroin and prescription pill) overdose death rates in states that had enacted medical marijuana laws. In their conclusions, the researchers suggested that medical marijuana should be part of policy aimed to prevent opioid overdose....
Since Massachusetts has not yet opened its medical marijuana dispensaries, it is too early to see if medical marijuana legislation will help reduce opiate addiction in the Commonwealth. Using recent research findings, Massachusetts policymakers have a unique opportunity to implement medical marijuana policies that address its contemporary opiate overdose. Medical marijuana could be part of drug treatment for heroin and opiates....
Formerly demonized and later legislated as a Schedule 1 substance, marijuana could diminish the damage wrought by harder drugs, like heroin. While opioid use is a nationwide epidemic, Massachusetts — long at the forefront of developing scientifically based public policy — has the opportunity to be at the forefront of cutting-edge, socially-informed drug policy.
Thursday, March 12, 2015
As noted in prior posts here and here, the biggest news this week in the marijuana reform arena has been the introduction of a bipartisan federal medical marijuana reform bill by Senators Rand Paul, Cory Booker and Kirsten Gillibrand, the CARERS Act. The preamble to this bill expressly provides that its purposes are to "extend the principle of federalism to State drug policy, provide access to medical marijuana, and enable research into the medicinal properties of marijuana."
Notably, this statement of purposes and the overall structure of the CARERS Act would seem to be in harmony with the stated goals of the leading figure and group opposing significant marijuana reform, namely Patrick Kennedy and Smart Approaches to Marijuana. Notably, on this page under a picture of Patrick Kennedy, SAM proclaims it is "acting in the best interests of public health and safety." In addition, Kennedy in this recent commentary piece stated that he favors "reforming our drug laws and emphasizing public health" and that we "should indeed reform broken laws that disproportionately harm ethnic and racial minorities and the poor."
Similarly, this About page on the SAM website states that the organization is comprised of "medical doctors, lawmakers, treatment providers, preventionists, teachers, law enforcement officers and others who seek a middle road between incarceration and legalization [to provide a] commonsense, third-way approach to marijuana policy is based on reputable science and sound principles of public health and safety" (emphasis added). In addition, this SAM information page about cannabis-based medicines states that SAM advocates for "rapid expansion of research into the components of the marijuana plant for delivery via non-smoked forms" and a special FDA reform that "allows seriously ill patients to obtain non-smoked components of marijuana."
Based on these various stated commitments by Patrick Kennedy and SAM, I certainty think it would be quite consistent with their advocacy or them to support expressly and vocally the CARERS Act. As I read the CARERS Act, it seeks to cautiously reform federal marijuana laws that are obviously "broken" because they fully preclude state lawmakers and administrators, researchers and doctors from being seriously involved and invested in reforms to state marijuana laws "based on reputable science and sound principles of public health and safety." In addition, something like the CARERS Act is absolutely essential for rapid expansion of medical research in this arena. Indeed, the powerful press conference introducing the CARERS Act had lawmakers, parents and patients all powerfully explaining why federal medical marijuana reform is essential to ensuring more needed medical research, and in order to fully ensure a serious and enduring commitment in both federal and state laws to marijuana policy "based on reputable science and sound principles of public health and safety."
Notably, there is not yet any mention of the CARERS Act on the SAM website, and I am inclined to guess that Patrick Kennedy and other SAM leaders are working on a formal response. For the reasons outlined above, I sincerely hope that Patrick Kennedy and other SAM leaders soon become vocal proponents of the CARERS Act. Historically, a problematic mix of politics and fear, not reputable science and sound principles of public health and safety, has dominated federal federal drug laws. I hope that SAM will, through support of the CARERS Act, help ensure public that we start turning the corner and head on a sounder scientific and public health path in the months and years to come.
Prior related posts:
March 12, 2015 in Federal Marijuana Laws, Policies and Practices, History of Marijuana Laws in the United States, Medical community perspectives, Medical Marijuana Commentary and Debate, Medical Marijuana Data and Research, Medical Marijuana State Laws and Reforms, Who decides | Permalink | Comments (0)
Tuesday, March 10, 2015
I am watching the press conference (streamed here) with presentations by Senators Rand Paul, Cory Booker and Kirsten Gillibrand introducing their new federal medical marijuana reform bill, the CARERS Act. Fascinating stuff.
Senator Booker started by noting veterans' interest in using medical marijuana, Senator Paul spoke of the need for more research and banking problems for state-legal marijuana business, and Senator Gillibrand was the closer by stressing the need for families to have access to high-CBC medicines for children suffering from seizure disorders.
Adding to the power of the press conference is a set of testimonials from a mom eager to have CBC treatments for her daughter (who had a small seizure during the press conference!), and an older woman with MS eager to have access to marijuana to help her sleep. Senator Paul followed up by introducing a father of one of his staffers with MS, who testified from a wheelchair. Senator Booker then introduced a 35-year-old veteran who complained about been deemed a criminal for his medical marijuana use by a country he fought for over six years. Notably, after all the white users/patients advocated for reform, Senator Booker introduced an African-American business owner talking about the problems with having to run a medical marijuana business without access to banking services.
This Drug Policy Alliance press release summarizes what is in the CARERS Act:
The Compassionate Access, Research Expansion and Respect States - CARERS - Act is the first-ever bill in the U.S. Senate to legalize marijuana for medical use and the most comprehensive medical marijuana bill ever introduced in Congress. The CARERS Act will do the following:
Allow states to legalize marijuana for medical use without federal interference
Permit interstate commerce in cannabidiol (CBD) oils
Reschedule marijuana to schedule II
Allow banks to provide checking accounts and other financial services to marijuana dispensaries
Allow Veterans Administration physicians to recommend medical marijuana to veterans
Eliminate barriers to medical marijuana research.
March 10, 2015 in Criminal justice developments and reforms, 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)
Monday, March 9, 2015
As reported in this new Washington Post entry, headlined "In a first, senators plan to introduce federal medical marijuana bill," a trio of notable Senators have interesting plans for mid-day Tuesday:
In what advocates describe as an historic first, a trio of senators plan to unveil a federal medical marijuana bill Tuesday. The bill, to be introduced by Senators Rand Paul (R-Ky.), Cory Booker (D-N.J.), and Kirsten Gillibrand (D-N.Y.), would end the federal ban on medical marijuana.
The Compassionate Access, Research Expansion and Respect States (CARERS) Act would “allow patients, doctors and businesses in states that have already passed medical marijuana laws to participate in those programs without fear of federal prosecution,” according to a joint statement from the senators’ offices. The bill will also “make overdue reforms to ensure patients – including veterans receiving care from VA facilities in states with medical marijuana programs – access the care they need.” The proposal will be unveiled at a 12:30 p.m. press conference on Tuesday, which will be streamed live here. Patients, their families and advocates will join the senators at the press conference.
The announcement was met with praise by advocates. “This is a significant step forward when it comes to reforming marijuana laws at the federal level,” Dan Riffle, director of federal policies for the Marijuana Policy Project, said in a statement. “It’s long past time to end the federal ban,” said Michael Collins, policy manager for the Drug Policy Alliance, said in a statement. Both describe the introduction of the bill as a first for the Senate....
In December, Congress for the first time in roughly a decade of trying approved an amendment that bars the Justice Department from using its funds to prevent states from implementing their medical marijuana laws — a significant victory for proponents of the practice.
Potential Republican presidential candidates Rand, Sen. Ted Cruz (R-Texas) and former Florida Gov. Jeb Bush (R) have all said they support states’ rights to legalize pot, though they themselves disagree with the policy.
March 9, 2015 in Criminal justice developments and reforms, 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)
Wednesday, March 4, 2015
This week in my marijuana seminar we will be watching and discussing the terrific (though already dated) documentary "Code of the West" about medical marijuana reforms in Montana. Among the many stories effectively documented by this movie is the important reality that, while Montana enacted via voter initiative medical marijuana reforms in 2004, the medical marijuana industry in the state only became active and prominent after the issuance of the 2009 Ogden Memo. This memo from the Obama Administration's Justice Department stated that the federal government would not prosecute "individuals whose actions are in clear and unambiguous compliance with existing state laws providing for the medical use of marijuana."
In addition to the coverage of this story in Montana in this great documentary, I have seen a number of anecdotal reports about how the medical marijuana industry kicked into high gear in many western states as a result of the 2009 Ogden Memo, especially states like California, Colorado and Washington. But, to my knowledge, nobody has yet done any systematic research on the impact of the Ogden Memo, in individual states or nationwide, on the number of state-compliant medical marijuana dispensaries or the number of persons working in and around the medical marijuana industry or the number of persons registered for or regularly obtaining marijuana in conjunction with a doctor's recommendation.
I am busy trying to finish an article complaining about the lack of rigorous social science research surrounding the real impact of state-level marijuana reforms, and I am especially intrigued and troubled by how little systematic data I can find concerning the medical marijuana industry and users. If anyone knows of any significant recent data collections or other research on these fronts, please let me know.
March 4, 2015 in Federal Marijuana Laws, Policies and Practices, History of Marijuana Laws in the United States, Medical Marijuana Data and Research, Medical Marijuana State Laws and Reforms, Who decides | Permalink | Comments (1)
Friday, February 27, 2015
As detailed in this local article, headlined "Colorado releases trove of marijuana data," the Colorado Department of Revenue today released this 40-page "Annual Update" report that "may very well be largest collection of data about marijuana use ever released in human history." Here is a partial summary of some of the data cite the press report:
74 tons of marijuana flower were sold in the state, of which only 19 tons were sold as "recreational," telling us medical patients used more than twice as much marijuana flower (buds) as did recreational customers....
Conversely, recreational users consumed vastly more edible marijuana products in 2014 than did medical marijuana patients. 1.96 million units of medical edibles were sold. 2.8 million of them were sold to recreational buyers.
That means a total of 4.8 million edible marijuana products like cookies, candy bars and drinks sold in 2014. That's equal to almost one edible to every resident of Colorado....
The state of Colorado was cranking out almost 17,000 new plants each day at the end of 2014.... At year's end, Colorado recreational pot growers were cultivating more than 200,000 new plants each month to support their businesses, compared to just 25,000 in January, the first month of legal sales.
Plants need to be designated as either "retail" or "medical" when they are potted. By contrast, growers cranked out more than 300,000 new medical plants in all but two months of the year.
Each plant is tagged with an RFID chip, which is tracked through each step of cultivation and preparation for sale. The state tracking system logged 37 million "events," including new cutting planted and plants processed into various products.
Denver is the undisputed capitol of the marijuana trade in Colorado. 60 percent of all the recreational buds sold in the state were sold in Denver, 11.5 tons. The next nearest competitor, Boulder County, looked paltry by comparison with 2.5 tons.
Denver is also tops in medical pot with 31 tons sold compared to just 11 tons in El Paso County. By a 5-1 margin, the Denver County's recreational sales of infused products outpaced its next nearest competitor with 1.3 million units sold. About 2.6 million edibles sold in Denver. A half million sold in Boulder....
The data reveal that 9,400 jobs were created above-board in Colorado's marijuana sector with the dawn of recreational sales. There were 6,600 state badges issued to workers in the medical pot industry as 2014 began. By year's end, the figure mushroomed to 16,000.
833 brand-new recreational marijuana facilities opened in Colorado in 2014, including 322 retail stores. At year's end there were 1,416 medical marijuana facilities, a slight increase over 2013. State regulators suspended 30 licenses for violations over the course of the year. An additional 153 agreed to corrections or shut-downs.
Though there is a lot of data to take in and assess, the economic development story in the form of jobs created strikes me as a hugely significant factors for the future of marijuana reform. This other official Colorado document seems to indicate that total job growth in Colorado numbered 80,000, which suggests that perhaps as much as 25% (if not more) of the job growth in Colorado can and should be fairly attributed to Colorado's marijuana sector.
Tuesday, February 17, 2015
What do we know about the success and failings of modern medical marijuana reform in the United States?
Thanks in large part to the enactment of full recreation legalization reform in Colorado and Washington in 2012, much of the most intense political and social debate over marijuana reform has focused on recreational reforms. But, as serious students of modern state reforms know, medical marijuana reform is where the real action is nationwide because there have now been state-level medical marijuana reform in dozens of states over the last decade and Congress recently told the Department of Justice that it could not use fund to interfere with implementation of these state-level medical marijuana reforms.
Problematically, while lots of advocates and research are already investing lots of time looking at the impact and import of full recreation legalization reform in Colorado and elsewhere, a lot less energy has been invested seeking to better understand the impact and import of medical marijuana reform in so many jurisdictions. Helpfully, the advocacy group Americans for Safe Access has produced a few reports that take stock, at least at the legal level, of all the state-activity in this space. And ASA's most recently-update report on state laws makes this important point in its preface:
How many medical cannabis states are there? The answer depends. What medical condition do you have? Can you afford to purchase it? Are you a minor?
The national dialogue on medical cannabis is complicated because the solutions remain controversial. Individual states have adopted differing policies as part of an ongoing experiment that will one day lead federal policy into alignment with the overwhelming public support for legal access. These parallel experiments are a normal part of our federalist system.
Until recently, counting medical cannabis states boiled down to a ”yes or no” analysis – either a state had some kind of medical cannabis law, or it did not. That simple analysis is no longer enough to understand the evolving landscape for medical cannabis in the United States. The laws are simply too different, and not all function as intended. At Americans for Safe Access (ASA), the nation’s leading medical cannabis patients’ advocacy organization, we have more than a dozen years of experience in state policy development and implementation. Our experience shows that not all medical cannabis laws are working equally for the patients they were designed to serve. We need a new way to talk about and evaluate state medical cannabis laws.
This ASA report goes on, not surprisingly, to provide a patient-centric analysis of how to "talk about and evaluate state medical cannabis laws." But, of course, that is not the only way policy-makers may want to examine this issue, especially because there is considerable skepticism about whether many persons who seek out medical marijuana are trule "patients."
Wednesday, February 11, 2015
This new AP article, headlined "Colorado collected about $76 million in recreational and marijuana pot revenue in 2014," reports on the latest official reporting of tax revenues collected on legal marijuana sales in Colorado for last year. Here are some of the details and some context for what they mean:
Marijuana makes money. But legalizing it doesn't eliminate the black market or solve a state's budget problems. Those are the lessons from Colorado's first full year of tax collections on recreational pot. The year-end report, released Tuesday, tallied about $44 million in new sales taxes and excise taxes from recreational pot.
Add fees and pre-existing taxes from medical pot, which has been legal since 2000, and Colorado's total 2014 pot haul was about $76 million....
Colorado started selling recreational weed on Jan. 1, 2014. But its first month of sales resulted in only $1.6 million for the state. By December, that figure was $5.4 million. The reason for the increase? Regulatory delays. Red tape meant stores opened slowly, with many municipalities waiting months before allowing pot shops to open....
But legal weed isn't an overnight flood of tax money. "Everyone who thinks Colorado's rollin' in the dough because of marijuana? That's not true," said state Sen. Pat Steadman, a Denver Democrat and one of the Legislature's main budget-writers....
Colorado's pot regulators have struggled to establish a wholesale pot price to collect excise taxes. "Taxing a percentage of price may simply not work," said Pat Oglesby, a former congressional tax staffer who now studies marijuana's tax potential at the Chapel Hill, N.C., Center for New Revenue. He pointed out that the two latest legal weed states -- Alaska and Oregon, both still working on retail regulations -- will tax marijuana by weight, similar to how tobacco is taxed.
Every state in the union, liberal to conservative, has a market for marijuana. And making pot legal doesn't guarantee those consumers will leave the black market and happily sign up to start paying taxes. In Washington state, medical marijuana isn't taxed. It is in Colorado, but all adults are allowed to grow up to six plants on their own. That means the states' new marijuana markets had legal competition from Day One. And that doesn't account for the black market, which of course is completely free of taxes and regulations.
Lawmakers in both Colorado and Washington are looking for ways to drive pot smokers out of the lower-taxed medical pot market and into the recreational one. But obstacles are stiff. "If there is untaxed medical pot, the taxes are voluntary. When you make it voluntary, people won't necessarily pay," Oglesby said.
The marijuana market is far from settled. Colorado benefited from first-in-the-nation curiosity and marijuana tourism. As more states legalize, Colorado and Washington will face competition. "Colorado is probably kind of a best-case scenario" for pot tax collections, said Jeffrey Miron, a Harvard University economist who studies the drug market. "If a number of other states legalize -- and two of them already have -- then bit by bit, Colorado revenue is likely to decline."
There's an even bigger uncertainty looming for states considering legal weed -- a new president in 2016. "The huge unknown is still federal policy," Miron said. "A new president can radically change state policies toward legalization."
I believe that Colorado's official year-end accounting can be found in this link/document, and I notice that there appears to be no column for state (or federal) income taxes paid by persons now working legally in the state-legalized marijuana market. Though certainly direct taxes on marijuana manufacturing and sales is the most tangible and measurable consequences of marijuana reform, I tend to think the biggest long-term economic impact for a state comes from creating a (huge?) industry with collateral businesses all of which will provide lots of jobs for individuals who will pay (lots of?) income tax on what they make in this new industry.
February 11, 2015 in Medical Marijuana Data and Research, Medical Marijuana State Laws and Reforms, Recreational Marijuana Data and Research, Recreational Marijuana State Laws and Reforms, Taxation information and issues | Permalink | Comments (2)
Friday, February 6, 2015
This new Huffington Post article, headlined "New Study Finds Marijuana To Be Effective Against Depression," provides a report on new research suggesting marijuana may be helpful in treating a wide-spread mental health disease. Here are the encouraging details:
Research has suggested that cannabis may be a promising treatment option for a number of different physical and mental health conditions, from post-traumatic stress disorder to chronic pain. A study released this week suggests that depression can be added to that list.
Neuroscientists from the University of Buffalo's Research Institute on Addictions found that endocannabinoids -- chemical compounds in the brain that activate the same receptors as THC, an active compound in marijuana -- may be helpful in treating depression that results from chronic stress.
In studies on rats, the researchers found that chronic stress reduced the production of endocannabinoids, which affect our cognition, emotion and behavior, and have been linked to reduced feelings of pain and anxiety, increases in appetite and overall feelings of well-being. The body naturally produces these compounds, which are similar to the chemicals in cannabis. Reduction of endocannabinoid production may be one reason that chronic stress is a major risk factor in the development of depression.
Then, the research team administered marijuana cannabinoids to the rats, finding it to be an effective way to restore endocannabinoid levels in their brains -- possibly, thereby, alleviating some symptoms of depression. "Using compounds derived from cannabis -- marijuana -- to restore normal endocannabinoid function could potentially help stabilize moods and ease depression," lead researcher Dr. Samir Haj-Dahmane said in a university press release.
Recent research around marijuana's effect on symptoms of post-traumatic stress disorder further bolsters the Buffalo neuroscientists' findings, since both disorders involve the way the brain responds to stress. A study published last year in the journal Neuropsychopharmacology, for instance, found synthetic cannabinoids triggered changes in brain centers associated with traumatic memories in rats, preventing some of the behavioral and physiological symptoms of PTSD. Another study published last year found that patients who smoked cannabis experienced a 75 percent reduction in PTSD symptoms.
However, it's important to note that the relationship between marijuana and depression is complex. Some research has suggested that regular and heavy marijuana smokers are at a higher risk for depression, although a causal link between cannabis use and depression has not been established. More studies are needed in order to determine whether, and how, marijuana might be used in a clinical context for patients with depression.
Wednesday, February 4, 2015
This Huffington Post piece, headlined "U.S. Surgeon General Vivek Murthy Says Marijuana 'Can Be Helpful' For Some Medical Conditions," reports on some significant comments today by America's top doc. Here are the details:
Dr. Vivek Murthy, the nation's new surgeon general, says that marijuana "can be helpful" for some medical conditions, and wants science to dictate policy on the federally banned substance.
"We have some preliminary data that for certain medical conditions and symptoms, that marijuana can be helpful," Murthy said during a Wednesday interview on "CBS This Morning" in response to a question about his stance on marijuana legalization.
While Murthy didn't take the opportunity to endorse legalization of marijuana for medical or recreational purposes, he did add that he believes U.S. marijuana policy should be driven by science and what it reveals about the efficacy of using the plant for medical purposes. "I think we're going to get a lot more data about that," Murthy said. "I'm very interested to see where that takes us."...
In January, the American Academy of Pediatrics called on the Drug Enforcement Administration to reclassify marijuana as a less-harmful substance in order to facilitate research for its potential medical use.
Under the Controlled Substances Act, the U.S. has five "schedules" for drugs and chemicals that can be used to make drugs. Schedule I is reserved for drugs that the DEA considers to have the highest potential for abuse and no "currently accepted medical use." Marijuana has been classified as Schedule I for decades, along with other substances like heroin and LSD. While a lower schedule for marijuana would not make it legal, it could ease restrictions on researching the drug....
"Dr. Murthy's comments add to a growing consensus in the medical community that marijuana can help people suffering from painful conditions," Tom Angell, chairman of drug policy reform group Marijuana Majority, told The Huffington Post. "It's crazy that federal law still considers marijuana a Schedule I drug, a category that's supposed to be reserved for substances with no medical value. In light of these comments from his top medical adviser, the president should direct the attorney general to immediately begin the process of rescheduling marijuana."
Monday, January 26, 2015
The title of this post is the title of this notable new report coming from the American Academy of Pediatrics. Here is its abstract:
This technical report updates the 2004 American Academy of Pediatrics abstract technical report on the legalization of marijuana. Current epidemiology of marijuana use is presented, as are definitions and biology of marijuana compounds, side effects of marijuana use, and effects of use on adolescent brain development. Issues concerning medical marijuana specifically are also addressed. Concerning legalization of marijuana, 4 different approaches in the United States are discussed: legalization of marijuana solely for medical purposes, decriminalization of recreational use of marijuana, legalization of recreational use of marijuana, and criminal prosecution of recreational (and medical) use of marijuana. These approaches are compared, and the latest available data are presented to aid in forming public policy. The effects on youth of criminal penalties for marijuana use and possession are also addressed, as are the effects or potential effects of the other 3 policy approaches on adolescent marijuana use. Recommendations are included in the accompanying policy statement.
The AAP's updated policy statement referenced at the end of this abstract is available at this link, and here are three of the most notable of the ten recommendations appearing at the end of the policy statement:
The AAP opposes “medical marijuana” outside the regulatory process of the US Food and Drug Administration. Notwithstanding this opposition to use, the AAP recognizes that marijuana may currently be an option for cannabinoid administration for children with life-limiting or severely debilitating conditions and for whom current therapies are inadequate.
The AAP opposes legalization of marijuana because of the potential harms to children and adolescents. The AAP supports studying the effects of recent laws legalizing the use of marijuana to better understand the impact and define best policies to reduce adolescent marijuana use.
The AAP strongly supports research and development of pharmaceutical cannabinoids and supports a review of policies promoting research on the medical use of these compounds. The AAP recommends changing marijuana from a Drug Enforcement Administration schedule I to a schedule II drug to facilitate this research.
January 26, 2015 in Federal Marijuana Laws, Policies and Practices, Medical community perspectives, Medical Marijuana Commentary and Debate, Medical Marijuana Data and Research, Who decides | Permalink | Comments (0)
Friday, January 23, 2015
The title of this post is the headline of this notable new piece via Quartz. Here are excerpts (with links from the original):
By 1970, legislation codified cannabis as one of the nation’s most dangerous drugs: the Controlled Substance Act classified marijuana as a Schedule 1 drug, meaning it possessed high potential for abuse and had no acceptable medical use. Over 40 years later, the classification remains.But research has shown that marijuana, while still criminalized at the federal level, can be effective as a substitute for treating opioid addictsand preventing overdoses. Massachusetts, which recently legalized medical marijuana — and where heroin overdoses have soared — could be a fertile testing ground for this potentially controversial treatment.Before being criminalized, marijuana was used in the US to cure depression and a variety of other mental health ailments. Many studies have supported the therapeutic benefits of cannabinoids, along with the ability of marijuana’s psychoactive ingredients to treat nausea, help with weight loss, alleviate chronic pain, and mitigate symptoms of neurological diseases.Other research, however, contradicts claims regarding the benefits of cannabidiol treatment. Some say marijuana actually poses a risk for psychosis and schizophrenia. Although the FDA has approved some synthetic cannabinoids for medical treatment, federal agencies do not support marijuana as a legitimate medicine until more clinical studies have been conducted....Among drug treatment specialists, marijuana remains controversial. Although some research has shown marijuana to be an alternative treatment for more serious drug addiction, addiction treatment specialists still view marijuana as highly addictive and dangerous. These views handicap policy reform, but despite its status as a Schedule 1 drug, recent research shows marijuana could be part of the solution to the most deadly drug epidemic our country has seen in decades.In 2012 Massachusetts became the 18th state to legalize medical marijuana, though the first 11 dispensaries are not scheduled to open until sometime in the coming year. This situation presents an opportunity to implement sensible, research-based policy.Massachusetts, like many states across the US, has seen a dramatic rise in opioid addition fueled by the increase in opiate prescription pills. In Boston, heroin overdoses increased by 80% between 2010 and 2012, and four out of five users were addicted to pain pills before turning to heroin.Meanwhile, the leading cause of death among the Boston’s homeless population has shifted from AIDS complications to drug overdoses, with opiates involved in 81% of overdose deaths. This is an alarming finding given recent expansion in clinical services for the city’s homeless.Addiction specialists and health care professionals in Boston have been at the forefront of integrating behavioral and medical care. Naloxone and methadone are currently the main solutions to address the growing opiate addiction and overdose problem. But Naloxone is an overdose antidote, not a cure or a form of preventative therapy.Methadone, like heroin and other opioids, has a very narrow therapeutic index (the ratio between the toxic dose and the therapeutic dose of a drug). This means that a small change in dosage can be lethal to the user. Marijuana, however, has one of the safest (widest) therapeutic ratios of all drugs.Research shows that marijuana has been used as a form of self-treatment, where users take cannabis in lieu of alcohol, prescription opiates, and illegal drugs. That’s one reason why researchers are calling for marijuana to be tested as a substitute for other drugs. In this capacity, marijuana can be thought of as a form of harm reduction. While researchers don’t seek to discount some of the drug’s potential negative effects, they view it as a less damaging alternative to other, harder drugs. Despite these findings, marijuana is rarely incorporated in formal drug treatment plans.A recent study might change this policy. Comparing states with and without legalized medical marijuana, it found a substantial decrease in opioid (heroin and prescription pill) overdose death rates in states that had enacted medical marijuana laws. In their conclusions, the researchers suggested that medical marijuana should be part of policy aimed to prevent opioid overdose....Since Massachusetts has not yet opened its medical marijuana dispensaries, it is too early to see if medical marijuana legislation will help reduce opiate addiction in the Commonwealth. Using recent research findings, Massachusetts policymakers have a unique opportunity to implement medical marijuana policies that address its contemporary opiate overdose. Medical marijuana could be part of drug treatment for heroin and opiates.For homeless people, however, getting a marijuana card is expensive and buying medical marijuana from a dispensary is beyond their economic means. Street drugs are more prevalent in their social setting, easier to obtain, and can be much cheaper. From a policy perspective, addressing the alarming rates of overdose deaths among the homeless in Boston could mean distributing medical marijuana cards to homeless addicts for free and providing reduced cost medical marijuana.Formerly demonized and later legislated as a Schedule 1 substance, marijuana could diminish the damage wrought by harder drugs, like heroin. While opioid use is a nationwide epidemic, Massachusetts — long at the forefront of developing scientifically based public policy — has the opportunity to be at the forefront of cutting-edge, socially-informed drug policy.
Monday, January 19, 2015
This lengthy local article, headlined "Social-conservative lawmaker fights for legalizing medical marijuana," notes that a notable Republican Senator in the Keystone state has become noted for his "pot proselytizing." Here are excerpts from the piece:
Standing amid the lunchtime crush at the Pennsylvania Farm Show last week was a gray-haired man in deck shoes and a fleece vest, animatedly pitching an unusual - and illegal - product. Like a street-corner preacher, Sen. Mike Folmer (R., Lebanon) was bringing his message to the people - in his case thousands of voters he hopes will pressure their representatives to support his bill to legalize medical marijuana.
Folmer stops anyone who will listen, alternately delivering a rant against Big Pharma - which he blames for holding up federal approval of medical cannabis - and smiling at wise-cracking visitors who ask, "Any free samples?"
"I feel like a missionary," he said Friday, pausing to pop in a throat lozenge before beginning his pot proselytizing again. "I'm a Bible-believing Presbyterian. I don't even drink."
But Folmer, a 59-year-old grandfather of seven and a social conservative from a largely rural district northeast of Harrisburg, was moved by two mothers who stopped in his office 18 months ago. They told him they believed medical marijuana could ease their children's epileptic seizures without the damaging side effects of the narcotics that doctors had been prescribing. Skeptical, he hit his computer to find out and soon became a convert to the cannabis cause.
"It was very compelling," he said. "I learned that it is nontoxic, no one's going to die. So I figured, no harm, no foul. There are too many sick people." He teamed up with one of the state's most liberal lawmakers, Sen. Daylin Leach (D., Montgomery). Their original bill cleared the Senate by a wide margin (43-7) before dying in the House last fall.
When the new legislative session opened in December, Folmer immediately reintroduced the bill. It calls for letting patients purchase medical cannabis with a doctor's recommendation from centers licensed by a newly created board. Medical cannabis growers, processors, and dispensers would be licensed and regulated. Users would pay an access fee and would be barred from operating vehicles while taking the medication....
Folmer said neither parents of sick children nor adults with chronic conditions want to wait - or should wait - any longer. In his view, patients suffering from a range of illnesses are being prescribed narcotic cocktails of highly addictive and dangerous drugs that have little effect on these disorders.
On Friday, when a brisk but sunny afternoon drew a steady crowd to the show, Patti Bach breezed past Folmer's booth. She didn't need information. She already knew about the bill and voted against lawmakers who did not support it. "I eat Vicodin like candy," said Bach, 56, of Carlisle, who said she suffers from debilitating chronic pain. "Cannabis could reduce the pain and allow me to function."
Bach, who said her 30-year-old daughter has severe epilepsy, said she had researched the issue extensively and discussed it with her doctor. "He said as soon as it's legal he would prescribe it for me," she said.
Monica Kline, a Harrisburg lobbyist who raises alpacas in Folmer's district with her husband, a former Army pilot, donated the booth space at the farm show. Kline said her husband, a Vietnam veteran, hated to see returning veterans with post-traumatic stress disorder unable to find relief. Nor could she, who helps a mothers' advocacy group, bear to see another child suffer needlessly. "We knew we had to change our booth," said Kline, daughter of former Lt. Gov. Ernest Kline. "Parents were losing children."...
The bill stands a solid chance of becoming law if it reaches the desk of the incoming governor. "Gov.-elect Wolf supports the legalization of medical marijuana because he believes we should not deny doctor-recommended treatment that could help people suffering from seizures or cancer patients affected by chemotherapy," said his spokesman, Jeff Sheridan. House Speaker Mike Turzai (R., Allegheny) opposed the measure as GOP leader last year, but new House Majority Leader David Reed (R., Indiana) was a cosponsor of a House version of the bill....
Folmer says he thinks he can win passage of his bill in the Senate by spring. Still, he said he feels every day he's in a race against the clock. "My greatest fear is that I am going to get a call from one of the moms that one of the children has died," he said. "I'm not saying marijuana is a cure, but people ought to have the opportunity for help."
It bears noting in the context of this story that Pennsylvania's state motto is "Virtue, liberty, and independence." Kudos to this social-conservative lawmaker for showing such a commitment to these values in his work on this front.
January 19, 2015 in Medical Marijuana Commentary and Debate, Medical Marijuana Data and Research, Medical Marijuana State Laws and Reforms, Political perspective on reforms, Who decides | Permalink | Comments (0)
Thursday, January 15, 2015
The Cato Institute has posted this short research brief in which a group of social scientists summarize this study recently published in the American Journal of Public Health titled "Medical Marijuana Laws and Suicides by Gender and Age." Here are excerpts from the research brief (with references removed and my emphasis added):
Our research examines the relationship between medical marijuana laws (hereafter MMLs) and suicides. While the majority of people who suffer from mental illness do not commit suicide, over 90 percent of those who do commit suicide have a diagnosable mental or substanceuse disorder. The relationship between marijuana use and suicide-related outcomes (e.g., depression, suicidal ideation, and suicide attempts) has been studied extensively, but there have been no previous attempts to estimate the relationship between medical marijuana laws and completed suicides, the tenth leading cause of death in the United States....
Our empirical analysis draws on data from the Centers for Disease Control from 1990 through 2007 to examine the relationship between legalizing medical marijuana and suicide rates. This empirical approach can be thought of as exploiting a “natural experiment” unrelated to comorbidities or personality. Our results suggest that the passage of a MML is associated with an almost 5 percent reduction in the total suicide rate.
When we examine the relationship between legalization and suicides by gender and age, we find evidence that MMLs are associated with decreased suicides among 20- through 29-year-old males and among 30- through 39-year-old males. This result is consistent with registry data from Arizona, Colorado, and Montana showing that most medical marijuana patients are male, and that roughly half are under the age of 40....
We conclude that the legalization of medical marijuana leads to fewer suicides among young adult males. This result is consistent with the oft-voiced, but controversial, claim that marijuana can be used to cope with depression and anxiety caused by stressful life events. However, the result may, at least in part, be attributable to the reduction in alcohol consumption among young adults that appears to accompany the legalization of medical marijuana.
Our study is relevant to the ongoing debate surrounding marijuana legalization for medical or recreational purposes. Opponents of these policy changes contend that any increase in marijuana use is undesirable. Yet our research suggests the public-health benefits of legalization may outweigh the costs.
Thursday, November 20, 2014
A helpful reader helpfully alerted me to this notable new Congressional Research Service report titled "Federal Proposals to Tax Marijuana: An Economic Analysis." Here is the detailed report's summary:
The combination of state policy and general public opinion favoring the legalizing of marijuana has led some in Congress to advocate for legalization and taxation of marijuana at the federal level. The Marijuana Tax Equity Act of 2013 (H.R. 501) would impose a federal excise tax of 50% on the producer and importer price of marijuana. The National Commission on Federal Marijuana Policy Act of 2013 (H.R. 1635) proposes establishing a National Commission on Federal Marijuana Policy that would review the potential revenue generated by taxing marijuana, among other things.
This report focuses solely on issues surrounding a potential federal marijuana tax. First, it provides a brief overview of marijuana production. Second, it presents possible justifications for taxes and, in some cases, estimates the level of tax suggested by that rationale. Third, it analyzes possible marijuana tax designs. The report also discusses various tax administration and enforcement issues, such as labeling and tracking.
Economic theory suggests the efficient level of taxation is equal to marijuana’s external cost to society. Studies conducted in the United Kingdom (UK) and Canada suggest that the costs of individual marijuana consumption to society are between 12% and 28% of the costs of an individual alcohol user, and total social costs are even lower after accounting for the smaller number of marijuana users in society. Based on an economic estimate of $30 billion of net external costs for alcohol, the result is an external cost of $0.5 billion to $1.6 billion annually for marijuana. These calculations imply that an upper limit to the economically efficient tax rate could be $0.30 per marijuana cigarette (containing an average of one half of a gram of marijuana) or $16.80 per ounce. An increased number of users in a legal market would raise total costs, but not necessarily costs per unit.
Some could also view excise taxes as a means to curtail demand, particularly as the price of marijuana can be expected to drop from current retail prices of up $200-$300 per ounce to prices closer to the cost of production at $5-$18 per ounce, if broadly legalized. The demand for marijuana is estimated to be relatively price inelastic, meaning that consumer demand is relatively insensitive to price changes. Although previous studies of marijuana demand largely examine consumers willing to engage in illegal activities, it appears that higher tax rates would have a minor effect on reducing demand. With this said, tax policy, coupled with adequate law enforcement, could be an effective tool to limit marijuana consumption among youth, as empirical studies indicate that their demand is more sensitive to price than non-youth.
Excise taxes on marijuana could also be levied primarily to raise revenue, as has been historically the case with tobacco and alcohol. As an illustration, assuming a total market size of $40 billion, a federal tax of $50 per ounce is estimated to raise about $6.8 billion annually, after accounting for behavioral effects associated with price decreases following legalization.
The choices in administrative design could affect consumer behavior, production methods, evasion rates, or the tax base of a federal marijuana excise tax. Some of the more significant choices include whether to exempt medicinal uses or homegrown marijuana from tax.
November 20, 2014 in Federal Marijuana Laws, Policies and Practices, Medical Marijuana Data and Research, Recreational Marijuana Data and Research, Taxation information and issues , Who decides | Permalink | Comments (0)
Tuesday, October 7, 2014
This new monograph, which has just been published via the peer-reviewed journal Addiction, has a title that perfectly describes the piece's research and discussion, "What has research over the past two decades revealed about the adverse health effects of recreational cannabis use?". Here are all the parts of the piece's abstract:
Aims: To examine changes in the evidence on the adverse health effects of cannabis since 1993.
Methods: A comparison of the evidence in 1993 with the evidence and interpretation of the same health outcomes in 2013.
Results: Research in the past 20 years has shown that driving while cannabis-impaired approximately doubles car crash risk and that around one in 10 regular cannabis users develop dependence. Regular cannabis use in adolescence approximately doubles the risks of early school-leaving and of cognitive impairment and psychoses in adulthood. Regular cannabis use in adolescence is also associated strongly with the use of other illicit drugs. These associations persist after controlling for plausible confounding variables in longitudinal studies. This suggests that cannabis use is a contributory cause of these outcomes but some researchers still argue that these relationships are explained by shared causes or risk factors. Cannabis smoking probably increases cardiovascular disease risk in middle-aged adults but its effects on respiratory function and respiratory cancer remain unclear, because most cannabis smokers have smoked or still smoke tobacco.
Conclusions: The epidemiological literature in the past 20 years shows that cannabis use increases the risk of accidents and can produce dependence, and that there are consistent associations between regular cannabis use and poor psychosocial outcomes and mental health in adulthood.
Monday, October 6, 2014
The title of this post is the headline of this notable media report on a notable new study suggesting marijuana use can have a positive impact on those who suffer brain injuries. Here are the details:
Researchers found that patients with traumatic brain injuries using marijuana were more likely to survive. The study, led by researchers at Los Angeles Biomedical Research Institute, surveyed emergency patients for levels of tetrahydrocannabinol (THC), an active ingredient present in marijuana. They found that those tested positive for THC had a lower mortality compared to people who tested negative for the illicit substance.
According to the researchers THC plays a key role in protecting the brain in case of a traumatic brain injury. The researchers looked at 446 patients with a traumatic brain injury. Urine samples were collected to test the presence of THC in their body. It was observed that 82 of the total patients had THC in their system and out of these 2.4 percent patients had died compared to 11.5 percent deaths of patients who had tested negative for the illicit substance.
"Previous studies conducted by other researchers had found certain compounds in marijuana helped protect the brain in animals after a trauma," said David Plurad, MD, an LA BioMed researcher and the study's lead author. "This study was one of the first in a clinical setting to specifically associate THC use as an independent predictor of survival after traumatic brain injury."...
Other researchers conducted have highlighted how THC helps boosts appetite, lowers ocular pressure, reduces muscle spasms, relieves pain and alleviates symptoms linked with irritable bowel disease. However, this new study has certain significant limitations. "While most - but not all - the deaths in the study can be attributed to the traumatic brain injury itself, it appears that both groups were similarly injured," Dr. Plurad said. "The similarities in the injuries between the two groups led to the conclusion that testing positive for THC in the system is associated with a decreased mortality in adult patients who have sustained traumatic brain injuries."
The finding is published in the edition of The American Surgeon.
Thursday, October 2, 2014
The title of this post is the headline of this new Wasington Post summary of some notable recent research concerning California marijuana users. Here is how the piece starts (with links from the original):
A 2013 survey in the New England Journal of Medicine found that nearly 8-in-10 doctors approved the use of medical marijuana. Now, a wide-ranging survey in California finds that medical marijuana patients agree: 92 percent said that medical marijuana alleviated symptoms of their serious medical conditions, including chronic pain, arthritis, migraine, and cancer.
The data come from the California Behavioral Risk Factor Surveillance System, a representative health survey of 7,525 California adults produced by the Public Health Institute in partnership with the CDC. Researchers found that in total, five percent of California adults said they had used medical marijuana for a "serious medical condition."
"Our study’s results lend support to the idea that medical marijuana is used equally by many groups of people and is not exclusively used by any one specific group," the authors write. There were similar usage rates among both men and women. Adults of all ages reported medical marijuana use, although young adults were the most likely to use it.
There were some small differences in medical marijuana use across members of different races, although the authors stress that "the absolute difference in prevalence between the racial/ethnic groups is less than three percentage points, which may not have much importance in practical terms."
Sunday, September 28, 2014
As reported in this local AP piece, headlined "Illinois Banks $5 Million in Medical Marijuana Applications: More than 350 groups apply to run cultivation centers and dispensaries," the Prairie State is already seeing an economic benefit from its new medical marijuana laws. Here are the details:
Illinois is already seeing a lot of "green" thanks to medical marijuana. A preliminary count showed 158 applications for cultivation centers and 211 applications for dispensaries beat the Monday afternoon deadline. That means that nonrefundable fees collected by the state from the applicants topped $5 million.
"There's a ton of excitement and enthusiasm from the industry," said one applicant, Ben Kovler, founding partner and CEO of Chicago-based Green Thumb Industries. "This shows there is trust in the system the state has set up."
Green Thumb submitted applications for cultivation centers in Normal, Rock Island, Oglesby and Dixon and dispensaries in Mundelein, Chicago and Chicago Heights, Kovler said. Applications were so extensive that they filled many boxes and required the company to rent a truck, he said.
Bob Morgan, coordinator of the state's medical cannabis program, said the volume of applications "will allow us to pick the most qualified applicants." Applicants weren't deterred by stringent qualifications, fees and cash requirements, Morgan added. For cultivation centers, there was a non-refundable application fee of $25,000 and a first-year registration fee of $200,000....
Illinois expects to grant up to 21 permits for cultivation centers and up to 60 permits for dispensaries before the end of the year. The first legal marijuana would be available to registered patients in the spring of 2015.