Marijuana Law, Policy & Reform

Editor: Douglas A. Berman
Moritz College of Law

Saturday, June 16, 2018

"High on Crime? Exploring the Effects of Marijuana Dispensary Laws on Crime in California Counties"

The title of this post is the title of this notable new research now available via SSRN authored by Priscillia Hunt, Rosalie Liccardo Pacula and Gabriel Weinberger. Here is its abstract:

Regulated marijuana markets are more common today than outright prohibitions across the U.S. states.  Advocates for policies that would legalize marijuana recreational markets frequently argue that such laws will eliminate crime associated with the black markets, which many argue is the only link between marijuana use and crime.  Law enforcement, however, has consistently argued that marijuana medical dispensaries (regulated retail sale and a common method of medical marijuana distribution), create crime in neighborhoods with these store-fronts.

This study offers new insight into the question by exploiting newly collected longitudinal data on local marijuana ordinances within California and thoroughly examining the extent to which counties that permit dispensaries experience changes in violent, property and marijuana use crimes using difference-in-difference methods.  The results suggest no relationship between county laws that legally permit dispensaries and reported violent crime.  We find a negative and significant relationship between dispensary allowances and property crime rates, although event studies indicate these effects may be a result of pre-existing trends.  These results are consistent with some recent studies suggesting that dispensaries help reduce crime by reducing vacant buildings and putting more security in these areas.  We also find a positive association between dispensary allowances and DUI arrests, suggesting marijuana use increases in conjunction with impaired driving in counties that adopt these ordinances, but these results are also not corroborated by an event study analysis.

June 16, 2018 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 | Permalink | Comments (0)

Monday, June 4, 2018

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

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

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

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

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

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

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

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

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

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

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

Thursday, May 17, 2018

"Planting the seed for marijuana use: Changes in exposure to medical marijuana advertising and subsequent adolescent marijuana use, cognitions, and consequences over seven years"

Download (14)The title of this post is the title of this notable new research now appearing in the journal Drug and Alcohol Dependence.  Here is its highlights and abstract:

Highlights

• Many adolescents are exposed to medical marijuana (MM) advertising.

• MM advertising exposure may contribute to increased marijuana use and consequences.

• Regulations for marijuana advertising are needed, similar to tobacco and alcohol.

Abstract

Background

Marijuana use during adolescence is associated with neurocognitive deficits and poorer functioning across several domains.  It is likely that more states will pass both medical and recreational marijuana legalization laws in the coming elections; therefore, we must begin to look more closely at the longitudinal effects of medical marijuana (MM) advertising on marijuana use among adolescents so that we can better understand effects that this advertising may have on their subsequent marijuana use and related outcomes.

Methods

We followed two cohorts of 7th and 8th graders (mean age 13) recruited from school districts in Southern California from 2010 until 2017 (mean age 19) to examine effects of MM advertising on adolescents’ marijuana use, cognitions, and consequences over seven years.  Latent growth models examined trajectories of self-reported exposure to medical marijuana ads in the past three months and trajectories of use, cognitions, and consequences.

Results

Higher average exposure to MM advertising was associated with higher average use, intentions to use, positive expectancies, and negative consequences.  Similarly, higher rates of change in MM advertising exposure were associated with higher rates of change in use, intentions, expectancies, and consequences over seven years.

Conclusions

Results suggest that exposure to MM advertising may not only play a significant role in shaping attitudes about marijuana, but may also contribute to increased marijuana use and related negative consequences throughout adolescence.  This highlights the importance of considering regulations for marijuana advertising, similar to regulations in place for the promotion of tobacco and alcohol in the U.S.

This RAND press release provides an account of the research behind this new article, and it begins this way:

Adolescents who view more advertising for medical marijuana are more likely to use marijuana, express intentions to use the drug and have more-positive expectations about the substance, according to a new RAND Corporation study.

The findings—from a study that tracked adolescents' viewing of medical marijuana ads over seven years—provides the best evidence to date that an increasing amount of advertising about marijuana may prompt young people to increase their use of the drug. The study was published by the journal Drug and Alcohol Dependence.

May 17, 2018 in Business laws and regulatory issues, Medical Marijuana Data and Research, Recreational Marijuana Data and Research | Permalink | Comments (0)

Wednesday, May 2, 2018

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

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

Objectives

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

Methods

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

Results

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

Conclusions

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

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

Monday, April 30, 2018

Lots of new medical marijuana coverage via CNN

Last night CNN aired the fourth installment of Chief Medical Correspondent Dr. Sanjay Gupta's programming about marijuana.  This Special Report was titled "Weed 4: Pot vs. Pills," and CNN has has a number of stories in recent days related to its work in this space.  Here are links to just some of its recent coverage:

April 30, 2018 in History of Marijuana Laws in the United States, Medical community perspectives, Medical Marijuana Commentary and Debate, Medical Marijuana Data and Research | Permalink | Comments (0)

Wednesday, April 25, 2018

Does the new Medical Cannabis Research Act now have a real shot at becoming law?

DownloadThe question in the title of this post is prompted by this notable new Bloomberg article headlined "Medical Marijuana Bill Gains Backing of Key Republican in House." Here are the interesting details from the piece:

House Judiciary Chairman Bob Goodlatte has agreed to co-sponsor a Florida Republican’s bipartisan bill to make medical marijuana research easier, his office confirmed on Wednesday.

That backing by the conservative Virginia Republican potentially bolsters the bill’s chances in the House. Representative Matt Gaetz started circulating a handout Tuesday night explaining his Medical Cannabis Research Act, with Goodlatte listed as a co-sponsor. "I can confirm that the chairman will co-sponsor," said Kathryn Rexrode, a spokesman for Goodlatte, who is not running for re-election, in an email.

A spokesman for Gaetz said the measure was to be introduced on Wednesday or Thursday, with its sponsors set to hold a news conference on Thursday.... A draft of the legislation was also obtained Tuesday by Bloomberg News -- as well as a separate summary Gaetz was circulating outside the House chamber.

That summary listed current co-sponsors as Goodlatte and fellow Republicans Dana Rohrabacher of California and Karen Handel of Georgia; as well as Democrats Alcee Hastings and Darren Soto of Florida; Steve Cohen of Tennessee and Earl Blumenauer of Oregon.

The measure, as described would increase the number of federally approved manufacturers of cannabis for research purposes, and it would also provide a "safe harbor" for researchers and patients in clinical trials so that institutions such as universities would not risk losing federal funding.  The bill makes it clear that the Department of Veterans Affairs could refer patients for clinical trials, and eligible researchers at the VA could perform research on medical cannabis.

Clear standards on federally approved growers would be imposed.  At the same time, the measure was described as fostering innovation, making it easier for industry leaders to work with researchers to develop new scientific breakthroughs.

Even so, the chances that most of Gaetz’s Republican colleagues will help him pass the bill in an election year are slim.  And the odds of Sessions reversing course are also long....

Asked if he’s talked to the attorney general about his new bill, Gaetz said he has not. He joked of Sessions, "doesn’t call or visit me anymore." Gaetz is among House conservatives who have been criticizing the Justice Department in unrelated battles over providing Congress documents tied to the FBI’s handing of its investigations of Hillary Clinton’s emails, and the Russia inquiry led by Special Counsel Robert Mueller.

Trump offered qualified support for legalization while on the presidential campaign trail, saying that medical marijuana “should happen” and that laws regarding recreational usage should be left in the hands of the states. Trump made his assurances this month after Republican Senator Cory Gardner of Colorado, a state that has legalized marijuana, had held up Justice Department nominees.

This article is right to suggest that the odds of any marijuana reform making it through Congress these days are slim. But because the Medical Cannabis Research Act sounds like a very modest proposal that has the backing of a key Committee Chair, this bill would seems to at least have some chance. Indeed, because there are a number of other more robust federal marijuana reform proposals gaining attention and sponsors, it strikes me as even possible that AG Jeff Sessions might not oppose this proposal as actively as he may be inclined to oppose others making the rounds.  That all said, I still think the most likely answer to the question in the title of this post is "no."

UPDATE: Over here at Marijuana Moment, Tom Angell has more details on the provisions of the Medical Cannabis Research Act.

April 25, 2018 in Federal Marijuana Laws, Policies and Practices, History of Marijuana Laws in the United States, Medical Marijuana Data and Research, Who decides | Permalink | Comments (0)

Friday, April 20, 2018

"Does medical marijuana decrease opioid use or boost it?"

The title of this post is the title of this effective new WonkBlog piece by Keith Humphreys, which makes these important points:

Studies conducted at the state level show that expanding access to medical marijuana is correlated with lower rates of opioid misuse and overdose.  Yet studies of individuals show that using medical cannabis is correlated with higher rates of using and misusing opioids.  This set of conflicting research has revealed less about the relationship between marijuana and opioids than it has about how science is misunderstood and misused in political debates....

The math underlying why many such apparent contradictions exist across scientific research areas is complicated, but the underlying point is simple: We can’t know what’s happening to individuals by looking just at state data (or county or city data), and we can’t know what is happening to states just by looking at individuals. Thus there isn’t any logical contradiction between marijuana and opioid use having opposite relationships at the state and individual level.

The other statistical point of relevance here is more widely understood: Just because two things are correlated doesn’t prove there’s a causal relationship between them. However, in this particular domain, people tend to apply that rule only to the subset of studies that conflict with their views on marijuana.  Sometimes this is a conscious decision by people who want to spin the evidence, but more often it reflects unconscious, built-in flaws in human reasoning that make us more prone to attend to and trust evidence that confirms what we already believe or deeply want to believe.  That is, people who hold anti-marijuana views will be more likely to accept the individual correlational studies as proving that medical cannabis is harmful and dismiss the state-level studies as “merely correlational.”  Those with positive views of marijuana will do the reverse.  (If you want to see this phenomenon in action, watch how this article is discussed on Twitter today!)

Being human, scientists also sometimes fall prey to the same problem, being too critical of marijuana studies that don’t accord with their beliefs and not critical enough of those that do.  But at their best, scientists design rigorous studies of important questions and then accept the answers whether they (or anyone else) likes them or not.

Solving the puzzle of whether and how medical cannabis and opioids interact will require laboratory experiments and randomized clinical trials in which researchers can control exposure to both drugs rather than relying on correlational data. In one recent such study, Ziva Cooper of Columbia University found initial evidence that marijuana may modify both the pain-relieving effects and abuse liability of oxycodone.

More studies like Cooper’s are needed and should become more common if Congress is wise enough to loosen restrictions on medical marijuana research. In the meantime, the medical marijuana debate will rage on, with many people on each side citing as authoritative whichever study suits their purposes.

April 20, 2018 in Medical community perspectives, Medical Marijuana Commentary and Debate, Medical Marijuana Data and Research | Permalink | Comments (0)

Thursday, April 12, 2018

Senators Orrin Hatch and Kamala Harris write to AG Jeff Sessions to push for more medical marijuana research

53352_lgAs reported in this new press release, "US Senators Orrin Hatch (R-UT) and Kamala Harris (D-CA), both members of the Senate Judiciary Committee, sent a letter today to US Attorney General Jeff Sessions urging the Drug Enforcement Administration (DEA) to cease efforts to slow medical marijuana research, following reports that the Department of Justice was blocking medical marijuana research efforts by delaying approvals for manufacturers growing research-grade medical marijuana."  Here is more from the text of the letter:

Dear Attorney General Sessions:

We write to request that you enable the Drug Enforcement Administration (DEA) to fulfill its charter of lawfully registering manufacturers of the controlled substance of marijuana for research without delay. Research on marijuana is necessary to resolve critical questions of public health and safety, such as learning the impacts of marijuana on developing brains and formulating methods to test marijuana impairment in drivers.

To date, it has been federal practice that only one manufacturer — the University of Mississippi — is licensed to produce marijuana for federally-sanctioned research. Historically, as the DEA has noted, that single manufacturer could meet the minimal demand for research. However, the DEA changed its policy nearly two years ago because, as it explained, “There is growing public interest in exploring the possibility that marijuana or its chemical constituents may be used as potential treatments for certain medical conditions,” and the DEA — along with the Food and Drug Administration (FDA) and the National Institutes of Health (NIH) — “fully supports expanding research into the potential medical utility of marijuana and its chemical constituents.”

As of August 11, 2016, 354 individuals and institutions were approved by the DEA to conduct expansive research on marijuana and its related components. Those researchers needed access to a federally compliant expanded product line—they needed to study different types of marijuana and across various delivery mechanisms. Accordingly, a diverse, DEA-vetted market of suppliers of research-grade marijuana would be critical. Since the DEA’s Federal Register Notice on August 12, 2016, at least 25 manufacturers have formally applied to produce federally-approved research-grade marijuana....

We write this letter because research on marijuana is necessary for evidence-based decision making, and expanded research has been called for by President Trump’s Surgeon General, the Secretary of Veterans Affairs, the FDA, the CDC, the National Highway Safety Administration, the National Institute of Health, the National Cancer Institute, the National Academies of Sciences, and the National Institute on Drug Abuse. In order to facilitate such research, scientists and lawmakers must have timely guidance on whether, when, and how these manufacturers’ applications will be resolved.

The benefits of research are unquestionable. Research will give law enforcement guidance to do their jobs:protecting drivers on the roads, protecting kids in schools, and maintaining law and order. Ninety-two percent of veterans support federal research on marijuana, and the Department of Veterans’ Affairs is aware that many veterans have been using marijuana to manage the pain of their wartime wounds. America’s heroes deserve scientifically-based assessments of the substance many of them are already self-administering.

By allowing expanded research, the Department of Justice will aid legislators in making sound decisions, help law enforcement in developing critical public safety guidance, and ensure that citizens have the benefit of informed, evidence-based policy.

April 12, 2018 in Federal Marijuana Laws, Policies and Practices, Medical Marijuana Commentary and Debate, Medical Marijuana Data and Research, Who decides | Permalink | Comments (0)

Tuesday, April 3, 2018

"Marijuana use is associated with intimate partner violence perpetration among men arrested for domestic violence"

Tps-150The title of this post is the title of this notable new research published in Translational Issues in Psychological Science. Here is the article's abstract:

Intimate partner violence (IPV) is a serious public health problem. Substance use, particularly alcohol, is a robust risk factor for IPV.  There is a small but growing body of research demonstrating that marijuana use is positively associated with IPV perpetration.  However, research on marijuana use and IPV has failed to control for other known predictors of IPV that may account for the positive association between marijuana use and IPV perpetration.  Therefore, the current study examined whether marijuana use was associated with IPV perpetration after controlling for alcohol use and problems, antisocial personality symptoms, and relationship satisfaction, all known risk factors for IPV.

Participants were men arrested for domestic violence and court-referred to batterer intervention programs (N = 269). Findings demonstrated that marijuana use was positively and significantly associated with psychological, physical, and sexual IPV perpetration, even after controlling for alcohol use and problems, antisocial personality symptoms, and relationship satisfaction.  Moreover, marijuana use and alcohol use and problems interacted to predict sexual IPV, such that marijuana use was associated with sexual IPV at high, but not low, levels of alcohol use and problems.  These findings lend additional support to the body of research demonstrating that marijuana use is positively associated with IPV perpetration in a variety of samples.  Results suggest that additional, rigorous research is needed to further explore why and under what conditions marijuana is associated with IPV perpetration.

April 3, 2018 in Criminal justice developments and reforms, Medical Marijuana Data and Research, Recreational Marijuana Data and Research | Permalink | Comments (0)

Monday, April 2, 2018

Two new papers provide further evidence of marijuana reform aiding with opioid crisis

180402-imd-ec-800As reported via this CNN article, headlined "Marijuana legalization could help offset opioid epidemic, studies find," this weeks bring the publication of notable new research suggesting a link between marijuana access and reduced use of opioids. Here are the basics:

Experts have proposed using medical marijuana to help Americans struggling with opioid addiction. Now, two studies suggest that there is merit to that strategy. The studies, published Monday in the journal JAMA Internal Medicine, compared opioid prescription patterns in states that have enacted medical cannabis laws with those that have not. One of the studies looked at opioid prescriptions covered by Medicare Part D between 2010 and 2015, while the other looked at opioid prescriptions covered by Medicaid between 2011 and 2016.

The researchers found that states that allow the use of cannabis for medical purposes had 2.21 million fewer daily doses of opioids prescribed per year under Medicare Part D, compared with those states without medical cannabis laws. Opioid prescriptions under Medicaid also dropped by 5.88% in states with medical cannabis laws compared with states without such laws, according to the studies....

In order to evaluate whether medical marijuana could function as an effective and safe alternative to opioids, the two teams of researchers looked at whether opioid prescriptions were lower in states that had active medical cannabis laws and whether those states that enacted these laws during the study period saw reductions in opioid prescriptions.

Both teams, in fact, did find that opioid prescriptions were significantly lower in states that had enacted medical cannabis laws. The team that looked at Medicaid patients also found that the four states that switched from medical use only to recreational use -- Alaska, Colorado, Oregon and Washington -- saw further reductions in opioid prescriptions, according to Hefei Wen, assistant professor of health management and policy at the University of Kentucky and a lead author on the Medicaid study. "We saw a 9% or 10% reduction (in opioid prescriptions) in Colorado and Oregon," Wen said. "And in Alaska and Washington, the magnitude was a little bit smaller but still significant."...

The details of the medical cannabis laws were found to have a significant impact on opioid prescription patterns, the researchers found. States that permitted recreational use, for example, saw an additional 6.38% reduction in opioid prescriptions under Medicaid compared with those states that permitted marijuana only for medical use, according to Wen.

The method of procurement also had a significant impact on opioid prescription patterns. States that permitted medical dispensaries -- regulated shops that people can visit to purchase cannabis products -- had 3.742 million fewer opioid prescriptions filled per year under Medicare Part D, while those that allowed only home cultivation had 1.792 million fewer opioid prescriptions per year.

"We found that there was about a 14.5% reduction in any opiate use when dispensaries were turned on -- and that was statistically significant -- and about a 7% reduction in any opiate use when home cultivation only was turned on," Bradford said. "So dispensaries are much more powerful in terms of shifting people away from the use of opiates."...

This is not the first time researchers have found a link between marijuana legalization and decreased opioid use. A 2014 study showed that states with medical cannabis laws had 24.8% fewer opioid overdose deaths between 1999 and 2010. A study in 2017 also found that the legalization of recreational marijuana in Colorado in 2012 reversed the state's upward trend in opioid-related deaths.

Here are links to the JAMA Internal Medicine articles referenced here, as well as a companion commentary:

Medical and Adult-Use Marijuana Laws and Opioid Prescribing for Medicaid Enrollees by Hefei Wen & Jason Hockenberry

Association Between US State Medical Cannabis Laws and Opioid Prescribing in the Medicare Part D Population by Ashley C. Bradford et al

The Role of Cannabis Legalization in the Opioid Crisis by Kevin Hill & Andrew Saxon

 

Some (of many) prior related posts:

April 2, 2018 in Medical community perspectives, Medical Marijuana Commentary and Debate, Medical Marijuana Data and Research, Medical Marijuana State Laws and Reforms, Recreational Marijuana Data and Research | Permalink | Comments (0)

Wednesday, March 28, 2018

Notable efforts to expand reach and application of New Jersey's medical marijuana program

Nj-mmj-e1522187420449The great state of New Jersey has been the focal point for a lot of interesting debate over recreational marijuana reform this year.  But as that debate continues, the state's new Governor has announced here a new effort to "expands patient access to medical marijuana."  Here are some details:

Governor Phil Murphy [Tuesday] announced major reforms to New Jersey’s Medicinal Marijuana Program. Reforms include the addition of medical conditions, lowered patient and caregiver fees, allowing dispensaries to add satellite locations, and proposed legislative changes that would increase the monthly product limit for patients, and allow an unlimited supply for those receiving hospice care.

“We are changing the restrictive culture of our medical marijuana program to make it more patient-friendly,” Governor Murphy said. “We are adding five new categories of medical conditions, reducing patient and caregiver fees, and recommending changes in law so patients will be able to obtain the amount of product that they need. Some of these changes will take time, but we are committed to getting it done for all New Jersey residents who can be helped by access to medical marijuana.”

More than 20 recommendations are outlined in a report that New Jersey Department of Health Commissioner Dr. Shereef Elnahal submitted to Governor Murphy in response to Executive Order 6, which directed a comprehensive review of the program within 60 days. “As a physician, I have seen the therapeutic benefits of marijuana for patients with cancer and other difficult conditions,” said Dr. Elnahal. “These recommendations are informed by discussions with patients and their families, advocates, dispensary owners, clinicians, and other health professionals on the Medicinal Marijuana Review Panel. We are reducing the barriers for all of these stakeholders in order to allow many more patients to benefit from this effective treatment option."

In the report, the Department submitted three categories of recommendations: those that are effective today, regulatory changes that will go through the rulemaking process, and proposals that require legislation. In addition, there are recommendations for important future initiatives to allow home delivery, develop a provider education curriculum, and expedite the permitting process. Effective today, five new categories of medical conditions (anxiety, migraines, Tourette’s syndrome, chronic pain related to musculoskeletal disorders, and chronic visceral pain) will be eligible for marijuana prescription. Currently, 18,574 patients, 536 physicians, and 869 caregivers participate in the program – a far smaller number than comparably populated states. The Commissioner will also be able to add additional conditions at his discretion.

Other immediate changes include lowering the biennial patient registration fee from $200 to $100 and adding veterans and seniors -- 65 and older -- to the list of those who qualify for the $20 discounted registration fee. Those on government assistance, including federal disability, already receive the reduced fee.

The report prepared by the New Jersey Department of Health is available at this link.

March 28, 2018 in Medical community perspectives, Medical Marijuana Commentary and Debate, Medical Marijuana Data and Research, Medical Marijuana State Laws and Reforms | Permalink | Comments (0)

Sunday, March 25, 2018

"Unique treatment potential of cannabidiol for the prevention of relapse to drug use: preclinical proof of principle"

Npp201754f1The title of this post is the title of this notable new research just published on-line from the journal Neuropsychopharmacology.  Here is the abstract:

Cannabidiol (CBD), the major non-psychoactive constituent of Cannabis sativa, has received attention for therapeutic potential in treating neurologic and psychiatric disorders. Recently, CBD has also been explored for potential in treating drug addiction.  Substance use disorders are chronically relapsing conditions and relapse risk persists for multiple reasons including craving induced by drug contexts, susceptibility to stress, elevated anxiety, and impaired impulse control.  Here, we evaluated the “anti-relapse” potential of a transdermal CBD preparation in animal models of drug seeking, anxiety and impulsivity.  Rats with alcohol or cocaine self-administration histories received transdermal CBD at 24 h intervals for 7 days and were tested for context and stress-induced reinstatement, as well as experimental anxiety on the elevated plus maze.

Effects on impulsive behavior were established using a delay-discounting task following recovery from a 7-day dependence-inducing alcohol intoxication regimen.  CBD attenuated context-induced and stress-induced drug seeking without tolerance, sedative effects, or interference with normal motivated behavior.  Following treatment termination, reinstatement remained attenuated up to ≈5 months although plasma and brain CBD levels remained detectable only for 3 days.  CBD also reduced experimental anxiety and prevented the development of high impulsivity in rats with an alcohol dependence history.  The results provide proof of principle supporting potential of CBD in relapse prevention along two dimensions CBD: beneficial actions across several vulnerability states, and long-lasting effects with only brief treatment. The findings also inform the ongoing medical marijuana debate concerning medical benefits of non-psychoactive cannabinoids and their promise for development and use as therapeutics.

I found this research via this press article with a headline that provides a crisp accounting of what this research means: "Cannabis drug may help alcohol and cocaine addicts overcome their cravings, study finds." Here is how one of the researchers explained the findings in the press account:

Speaking of the findings, lead author Dr Friedbert Weiss said: 'The efficacy of the CBD to reduce reinstatement in rats with both alcohol and cocaine -- and, as previously reported, heroin -- histories predicts therapeutic potential for addiction treatment across several classes of abused drugs.

'The results provide proof of principle supporting the potential of CBD in relapse prevention along two dimensions: beneficial actions across several vulnerability states and long-lasting effects with only brief treatment.

'Drug addicts enter relapse vulnerability states for multiple reasons. Therefore, effects such as these observed with CBD that concurrently ameliorate several of these are likely to be more effective in preventing relapse than treatments targeting only a single state.'

Results further suggest CBD is completely cleared from such rats' brains just three days after the treatment ends.

March 25, 2018 in Medical community perspectives, Medical Marijuana Commentary and Debate, Medical Marijuana Data and Research | Permalink | Comments (0)

Friday, March 23, 2018

Estimates of extraordinary health-care savings in research paper on medical marijuana laws and tobacco use

I just saw this notable research paper authored by Anna Choi, Dhaval Dave and Joseph Sabia under the title "Smoke Gets in Your Eyes: Medical Marijuana Laws and Tobacco Use." The last line of the abstract merits placement in bold because it is such a bold finding:

The public health costs of tobacco consumption have been documented to be substantially larger than those of marijuana use.  This study is the first to investigate the impact of medical marijuana laws (MMLs) on tobacco cigarette consumption . First, using data from the National Survey of Drug Use and Health (NSDUH), we establish that MMLs induce a 2 to 3 percentage-point increase in adult marijuana consumption, likely for both recreational and medicinal purposes.  Then, using data from the NSDUH, the Behavioral Risk Factor Surveillance System (BRFSS), and the Current Population Survey Tobacco Use Supplements (CPS-TUS), we find that the enactment of MMLs leads to a 1 to 1.5 percentage-point reduction in adult cigarette smoking.  We also find that MMLs reduce the number of cigarettes consumed by smokers, suggesting effects on both the cessation and intensive margins of cigarette use.  Our estimated effect sizes imply substantial MML-induced tobacco-related healthcare cost savings, ranging from $4.6 to $6.9 billion per year.

March 23, 2018 in Medical community perspectives, Medical Marijuana Commentary and Debate, Medical Marijuana Data and Research | Permalink | Comments (0)

Wednesday, March 7, 2018

"America Is Giving Away the $30 Billion Medical Marijuana Industry"

800x-1The title of this post is the headline of this notable lengthy new Bloomberg Businessweek article.  I am tempted to politicize this post by saying that a true "America First" President ought to be quite concerned about the sub-headline of this piece: "Why? Because the feds are bogarting the weed, while Israel and Canada are grabbing market share."  I recommend the piece in full, and here are excerpts:

Lyle Craker is an unlikely advocate for any political cause, let alone one as touchy as marijuana law, and that’s precisely why Rick Doblin sought him out almost two decades ago. Craker, Doblin likes to say, is the perfect flag bearer for the cause of medical marijuana production—not remotely controversial and thus the ideal partner in a long and frustrating effort to loosen the Drug Enforcement Administration’s chokehold on cannabis research. There are no counterculture skeletons in Craker’s closet; only dirty boots and botany books. He’s never smoked pot in his life, nor has he tasted liquor. “I have Coca-Cola every once in a while,” says the quiet, white-haired Craker, from a rolling chair in his basement office at the University of Massachusetts at Amherst, where he’s served as a professor in the Stockbridge School of Agriculture since 1967, specializing in medicinal and aromatic plants. He and his students do things such as subject basil plants to high temperatures to study the effects of climate change on what plant people call the constituents, or active elements....

In June 2001, Craker filed an application for a license to cultivate “research-grade” marijuana at UMass, with the goal of staging FDA-approved studies. Six months later he was told his application had been lost. He reapplied in 2002 and then, after an additional two years of no action, sued the DEA, backed by MAPS. By this point, both U.S. senators from Massachusetts had publicly supported his application, and a federal court of appeals ordered the DEA to respond, which it finally did, denying the application in 2004.

Craker appealed that decision with backing from a powerful bench of allies, including 40 members of Congress, and finally, in February 2007, a DEA administrative law judge ruled that his application for a license should be granted. The decision was not binding, however; it was merely a recommendation to the DEA leadership. Almost two years later, in the last week of the Bush administration, the application was rejected. Craker threw up his hands. He firmly believed marijuana should be more widely grown and studied, but he’d lost any hope that it would happen in his lifetime. And he had basil to attend to.

Then, in August 2016, during the final months of the Obama presidency, the DEA reversed course. It announced that, for the first time in a half-century, it would grant new licenses. Doblin, who has seemingly endless supplies of optimism and enthusiasm, convinced the professor there was hope—again. So Craker submitted paperwork, again, along with 25 other groups. The university’s provost co-signed his application, and Senator Elizabeth Warren (D–Mass.) wrote a letter to the DEA in support of his effort. He’s still waiting to hear back. “I’m never gonna get the license,” Craker says.

Pessimism isn’t surprising from a man who’s been making a reasonable case for 17 years to no avail. Studies around the world have shown that marijuana has considerable promise as a medicine. Craker says he spoke late last year at a hospital in New Hampshire where certain cannabinoids were shown to facilitate healing in brain-damaged mice. “And I thought, ‘If cannabinoids could do that, let’s put them in medicines!’ ” He sighs. “We can’t do the research.”

Another sigh. “I’m naive about a lot about things,” he says. “But it seems to me that we should be looking at cannabis. I mean, if it’s going to kill people, let’s know that and get rid of it. If it’s going to help people, let’s know that and expand on it. … But there’s just something wrong with the DEA. I don’t know what else to say. … Somehow, marijuana’s got a bad name. And it’s tough to let go of.”....

Many people expect the Republican-controlled Congress to follow its recent tax overhaul by looking for ways to slash costs in Medicaid and Medicare. Legitimate research into the medicinal properties of marijuana could help. Studies show that opioid use drops significantly in states where marijuana has been legalized; this suggests people are consuming the plant for pain, something they could be doing more effectively if physicians and the FDA controlled chemical makeup and potency. A study published in July 2016 in Health Affairs showed that the use of prescription drugs for which marijuana could serve as a clinical alternative “fell significantly,” saving hundreds of millions of dollars among users of Medicare Part D....

Among those who’ve advised Craker is Tony Coulson, a former DEA agent who retired in 2010 and works as a consultant for companies developing drugs. Coulson was vehemently antimarijuana until his son, a combat soldier, came home from the Middle East with post-traumatic stress disorder and needed help. “For years I was of the belief that the science doesn’t say that this is medicine,” he says. “But when you get into this curious history, you find the science doesn’t show it primarily because we’re standing in the way. The NIDA monopoly prevents anyone from getting into further studies.”

Coulson blames the Obama administration for not acting sooner, creating a situation in which the decision on granting new growing licenses was passed down to Attorney General Jeff Sessions, who has publicly declared his belief in the dangers of marijuana. The NIDA monopoly is now his to change. “Sessions has a 1930s Reefer Madness view of the marijuana world,” Coulson says. “It’s not realistic, and it’s not what rank-and-file DEA really are concerned about. DEA folks have moved beyond this.”

“I guess I take a nationalist approach here,” says Rick Kimball, a former investment banker who’s raising money for a marijuana-related private equity fund and is a trustee for marijuana policy at the Brookings Institution. “We have a huge opportunity in the U.S.,” he says, “and we ought to get our act together. I’m worried that we’re ceding this whole market to the Israelis.”

March 7, 2018 in Business laws and regulatory issues, Federal Marijuana Laws, Policies and Practices, Medical community perspectives, Medical Marijuana Commentary and Debate, Medical Marijuana Data and Research, Who decides | Permalink | Comments (0)

Monday, March 5, 2018

Encouraging research from Minnesota on success of medical marijuana in the treatment of "intractable pain"

Download (9)This recent press release from the Minnesota Department of Health, headlined "Medical cannabis study shows significant number of patients saw pain reduction of 30 percent or more," provides a summary of this encouraging lengthy report titled "Intractable Pain Patients in the Minnesota Medical Cannabis Program: Experience of Enrollees During the First Five Months." Here is the start of the press release:

Forty-two percent of Minnesota’s patients taking medical cannabis for intractable pain reported a pain reduction of thirty percent or more, according to a new study conducted by the Minnesota Department of Health. “This study helps improve our understanding of the potential of medical cannabis for treating pain,” said Minnesota Health Commissioner Jan Malcolm. “We need additional and more rigorous study, but these results are clinically significant and promising for both pain treatment and reducing opioid dependence.”

The first-of-its-kind research study is based on the experiences of the initial 2,245 people enrolled for intractable pain in Minnesota’s medical cannabis program from August 1, 2016 to December 31, 2016. Of this initial group, 2,174 patients purchased medical cannabis within the study’s observation period and completed a required self-evaluation before each purchase.

As part of the self-evaluation, patients completed the PEG (pain, enjoyment and general activity) screening tool. On a scale of 0 to 10 (with 0 being no pain and 10 being the highest pain), patients rated their level of pain, how pain interfered with their enjoyment of life and how pain interfered with their general activity.

Using the PEG scale data, 42 percent of the patients who scored moderate to high pain levels at the beginning of the measurement achieved a reduction in pain scores of 30 percent or more, and 22 percent of patients both achieved and maintained a reduction of 30 percent or more over four months. The 30 percent reduction threshold is often used in pain studies to define clinically meaningful improvement. Health care practitioners caring for program-enrolled patients suffering from intractable pain reported similar reductions in pain scores, saying 41 percent of patients achieved at least a reduction of 30 percent or more.

The study also found that of the 353 patients who self-reported taking opioid medications when they started using medical cannabis, 63 percent or 221 reduced or eliminated opioid use after six months. Likewise, the health care practitioner survey found that 58 percent of patients who were on other pain medications were able to reduce their use of these medications when they started taking medical cannabis. Thirty-eight percent of patients reduced opioid medication (nearly 60 percent of these cut use of at least one opioid by half or more), 3 percent of patients reduced benzodiazepines and 22 percent of patients reduced other pain medications.

The safety profile of medical cannabis products available through the Minnesota program continues to appear favorable. No serious adverse events (life threatening or requiring hospitalization) were reported for this group of patients during the observation period. 

Here is a portion of the executive summary from the full report:

Among respondents to the patient (54% response rate) and health care practitioner (40% response rate) surveys, a high level of benefit was reported by 61% and 43%, respectively (score of 6 or 7 on a seven-point scale). Little or no benefit (score of 1, 2, or 3) was reported by 10% of patients and 24% of health care practitioners.

The benefits extended beyond reduction in pain severity, though that was the benefit mentioned most often (64%). The benefit described second most often was improved sleep (27%), which likely has a synergistic relationship with reduction in pain severity. In some cases improved sleep, reduction of other pain medications and their side effects, decreased anxiety, improved mobility and function, and other quality of life factors were cited as being the most important benefit. The pattern of described benefits was similar in the patient and the health care practitioner survey results....

A large proportion (58%) of patients on other pain medications when they started taking medical cannabis were able to reduce their use of these meds according to health care practitioner survey results. Opioid medications were reduced for 38% of patients (nearly 60% of these reduced at least one opioid by ≥50%), benzodiazepines were reduced for 3%, and other pain medications were reduced for 22%. If only the 353 patients (60.2%, based on medication list in first Patient Self-Evaluation) known to be taking opioid medications at baseline are included, 62.6% (221/353) were able to reduce or eliminate opioid usage after six months.

March 5, 2018 in Medical community perspectives, Medical Marijuana Commentary and Debate, Medical Marijuana Data and Research, Medical Marijuana State Laws and Reforms | Permalink | Comments (0)

Wednesday, February 28, 2018

Americans for Safe Access releases its latest analysis and report card on medical marijuana programs across United States

Asa_default_social_thumbnail2The advocacy group Americans for Safe Access regularly produces reports on the state of state medical marijuana laws, and this latest 2018 version of ASA's “Medical Marijuana Access in the United States: A Patient-Focused Analysis of the Patchwork of State Laws” now runs almost 200 pages.  I recommend the report in full for everyone interested in medical marijuana information, and here is part of the report's preface:

For over fifteen years, Americans for Safe Access (ASA) has engaged state and federal governments, courts, and regulators to improve the development and implementation of state medical cannabis laws and regulations.  This experience has taught us how to assess whether or not state laws meet the practical needs of patients. It has also provided us with the tools to advocate for programs that will better meet those needs. Passing a medical cannabis law is only the first step in a lengthy implementation process, and the level of forethought and advance input from patients can make the difference between a well-designed program and one that is seriously flawed.  One of the most important markers of a well-designed program is whether or not all patients who would benefit from medical cannabis will have safe and legal access to their medicine without fear of losing any of the civil rights and protections afforded to them as American citizens....

Today, we have a patchwork of medical cannabis laws across the United States.  Thirty states, the District of Columbia, Guam, and Puerto Rico have adopted laws that created programs that allow at least some patients legal access to medical cannabis.  Most of those thirty states provide patients with protections from arrest and prosecution as well as incorporate a regulated production and distribution program.  Several programs also allow patients and their caregivers to cultivate a certain amount of medical cannabis themselves.  While it took a long time for states to recognize the importance of protecting patients from civil discrimination (employment, parental rights, education, access to health care, etc.), more and more laws now include these explicit protections.

However, as of 2017, none of the state laws adopted thus far can be considered ideal from a patient’s standpoint.  Only a minority of states currently include the entire range of protections and rights that should be afforded to patients under the law, with some lagging far behind others.  Because of these differences and deficiencies, patients have argued that the laws do not function equitably and are often poorly designed, implemented, or both.  As production and distribution models are implemented, hostile local governments have found ways to ban such activity, leaving thousands of patients without the access state law was intended to create. Minnesota, for example, despite setting up a regulatory system for the production, manufacturing, and distribution of cannabis oil extracts, prohibits qualified patients from using the actual plant.  These laws include sanctions for qualified patients who seek to use their medicine in whole plant form, unnecessarily eliminating clinically validated routes of administration used by hundreds of thousands of patients.  Some states have taken years to implement their medical cannabis laws leaving patients waiting years before their medicine is available. 

February 28, 2018 in 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 | Permalink | Comments (0)

Friday, February 23, 2018

"Medical marijuana laws and adolescent marijuana use in the United States: A systematic review and meta-analysis"

CoverThe title of this post is the title of this notable new article by multiple authored in the journal Addiction.  Here is the abstract:

Aims

To conduct a systematic review and meta-analysis of studies in order to estimate the effect of US medical marijuana laws (MMLs) on past-month marijuana use prevalence among adolescents.

Methods

A total of 2999 papers from 17 literature sources were screened systematically.  Eleven studies, developed from four ongoing large national surveys, were meta-analyzed.  Estimates of MML effects on any past-month marijuana use prevalence from included studies were obtained from comparisons of pre–post MML changes in MML states to changes in non-MML states over comparable time-periods.  These estimates were standardized and entered into a meta-analysis model with fixed-effects for each study.  Heterogeneity among the study estimates by national data survey was tested with an omnibus F-test.  Estimates of effects on additional marijuana outcomes, of MML provisions (e.g. dispensaries) and among demographic subgroups were abstracted and summarized.  Key methodological and modeling characteristics were also described. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed.

Results

None of the 11 studies found significant estimates of pre–post MML changes compared with contemporaneous changes in non-MML states for marijuana use prevalence among adolescents. The meta-analysis yielded a non-significant pooled estimate (standardized mean difference) of −0.003 (95% confidence interval = −0.012, +0.007). Four studies compared MML with non-MML states on pre-MML differences and all found higher rates of past-month marijuana use in MML states pre-MML passage. Additional tests of specific MML provisions, of MML effects on additional marijuana outcomes and among subgroups generally yielded non-significant results, although limited heterogeneity may warrant further study.

Conclusions

Synthesis of the current evidence does not support the hypothesis that US medical marijuana laws (MMLs) until 2014 have led to increases in adolescent marijuana use prevalence. Limited heterogeneity exists among estimates of effects of MMLs on other patterns of marijuana use, of effects within particular population subgroups and of effects of specific MML provisions.

February 23, 2018 in Medical Marijuana Commentary and Debate, Medical Marijuana Data and Research, Medical Marijuana State Laws and Reforms | Permalink | Comments (0)

Tuesday, February 13, 2018

"How will cannabis legalization affect alcohol consumption?"

UntitledThe question in the title of this post is the headline of this notable new commentary authored by Beau Kilmer and Rosanna Smart.  Like many thoughtful commentaries in this arena, the authored highlight that a seemingly simple question does not have a simple answer.  Here are excerpts:

How will legalization affect alcohol consumption?  Will drinking go down because people substitute cannabis for alcohol, or will drinking go up because cannabis and alcohol complement each other?  These questions have important implications for the health consequences of legalization, and for tax revenues.  Unfortunately, we don’t have the answers, yet.

A 2015 RAND Corporation study about cannabis legalization for the state of Vermont concluded that the evidence was mixed about whether cannabis and alcohol were substitutes or complemented each other.  A 2016 University of Washington literature review about changing cannabis polices and alcohol use concluded the relationship was complex.

Much research has relied on evidence of how laws that increase access to medical cannabis affect alcohol use.  The findings are mixed, possibly because the studies examine different age groups, measures of alcohol consumption and time periods.  The alcohol-cannabis relationship may differ across population subgroups — teens may treat these substances differently than adults. Also, some studies consider only effects on whether people drink, but not effects on how often or how much they drink.

Different studies also examine different time periods, and the laws have been changing over time.  Early state laws (such as the medical cannabis legislation California passed in 1996) tend to allow broader qualifying patient conditions, legal home cultivation and less oversight of dispensaries.  Differences in policies may lead to different effects on cannabis use, and possibly alcohol use. And the laws’ impact may evolve over time as the market expands or as federal enforcement shifts.

A recent working paper out of the University of Connecticut and Georgia State University has received a fair bit of attention as the latest in this series of attempts to shed light on the issue of whether alcohol and cannabis are substitutes or complements based on evidence from medical cannabis laws.  The authors examined changes in alcohol sales at grocery and convenience stores and other outlets.  They found that cannabis and alcohol are strong substitutes, with medical cannabis implementation being associated with a 15 percent reduction in monthly alcohol sales.

That is a surprisingly large effect, equivalent to what we would predict if the price of alcohol increased on the order of 30 percent.  The effect seems especially large considering that during the study period of 2006 to 2015, the newer state medical cannabis programs that drive the main result were more restrictive and had low participation rates, typically involving less than 1 percent of the population.  Of course, these medical laws could have effects that reach beyond the registered patient population if they made it easier and cheaper for non-patients to access cannabis, or if the laws caused the public to change its attitudes about cannabis and alcohol use more broadly.  Much more needs to be learned about what’s driving the results in this working paper.

Even if a consensus developed about the effect of medical cannabis laws on alcohol use, it would be unwise to simply assume that the same relationship applies to legalizing cannabis sales and advertising for recreational purposes....

These questions about legalization and alcohol consumption will not be resolved anytime soon.  In the meantime, California’s policymakers are making decisions about whether to license stores and lounges, and if so, where and how many.  They would be wise to build flexibility into their regulatory systems and not lock into decisions they may regret as they gain more information.

February 13, 2018 in History of Alcohol Prohibition and Temperance Movements, History of Marijuana Laws in the United States, Medical Marijuana Data and Research, Recreational Marijuana Data and Research | Permalink | Comments (2)

Monday, February 5, 2018

Still more research "suggesting broader access to medical marijuana facilitates substitution of marijuana for powerful and addictive opioids"

S01676296The March 2018 issue of the Journal of Health Economics includes this new research article that provides still further support for a claim that greater access to marijuana may be able to play a role in reducing use and abuse of opioids.  The new article is authored by David Powell, Rosalie Liccardo Pacula and Mireille Jacobson under the title "Do medical marijuana laws reduce addictions and deaths related to pain killers?".  Here is its abstract:

Recent work finds that medical marijuana laws reduce the daily doses filled for opioid analgesics among Medicare Part-D and Medicaid enrollees, as well as population-wide opioid overdose deaths.  We replicate the result for opioid overdose deaths and explore the potential mechanism.  The key feature of a medical marijuana law that facilitates a reduction in overdose death rates is a relatively liberal allowance for dispensaries.  As states have become more stringent in their regulation of dispensaries, the protective value generally has fallen.  These findings suggest that broader access to medical marijuana facilitates substitution of marijuana for powerful and addictive opioids.

Some (of many) prior related posts:

February 5, 2018 in Medical community perspectives, Medical Marijuana Data and Research | Permalink | Comments (0)

Thursday, January 18, 2018

New Maryland report details basis for marijuana measures to "remediate discrimination affecting minority- and women-owned businesses"

Maryland-Medical-Marijuana_thumbnailAs reported in this local article, headlined "State consultant finds grounds to consider race in awarding medical marijuana licenses," a notable report focused on the Maryland business arena was released yesterday. Here are the basics and context:

A state consultant has determined that there are grounds to conclude that minorities are at a disadvantage in Maryland's fledgling medical marijuana industry.

The state’s medical marijuana commission has awarded 15 licenses to growers, but none of them to a minority-owned business.  The General Assembly is considering a bill that would create five new licenses and require the commission to consider the race of applicants.

The consultant’s finding, released by Gov. Larry Hogan’s office Wednesday, is a key legal step toward allowing officials to weigh race when awarding any new licenses. Hogan ordered the study in April.  “Today’s findings are clear and unequivocal evidence that there is a disparity in the medical cannabis industry,” said Shareese Churchill, a spokeswoman for the Republican governor.  “This study is an important part of the process to allow for increased minority participation in our state.”

Del. Cheryl D. Glenn, the chairwoman of the Legislative Black Caucus and a leading advocate for more minority participation in the state’s new marijuana industry, said the finding will help whatever legislation the General Assembly passes withstand a court challenge.  “I’m ecstatic Maryland can move forward and be a beacon of light and show it is a serious issue, that everyone should be concerned about having diversity in a multibillion-dollar industry,” the Baltimore Democrat said....

Such disparity studies are commonly used in government contracting to provide a justification for considering the race or gender of bidders for jobs.  Civil rights advocates found the commission’s failure to award any licenses to black-owned businesses especially galling because African-Americans have disproportionately faced consequences from marijuana being criminalized.

The full consultant report is available at this link, and here are key passages from its conclusion:

After reviewing and analyzing the information received from the State, and bearing in mind the 2017 Disparity Study’s finding that discrimination continues to adversely impact minority-owned and women-owned firms throughout the Maryland economy, I conclude, based upon the information available to me at this time, that the 2017 Disparity Study provides a strong basis in evidence, consisting of both quantitative and qualitative findings, that supports the use of race- and gender-based measures to remediate discrimination affecting minority- and women-owned businesses in the types of industries relevant to the medical cannabis business.

Moreover, the 2017 Disparity Study details a range of race- and gender-neutral activities that the State has already undertaken to address existing disparities. The 2017 Disparity Study found that, notwithstanding these race- and gender-neutral activities, many of which have been in place for a number of years, disparities continue to exist in both public and private contracting in the same geographic and industry markets in which medical cannabis licensees and independent testing laboratories are likely to operate. These disparities, in general, are large, adverse, and statistically significant. In addition, the 2017 Disparity Study contains both qualitative and quantitative evidence to suggest that economy-wide contracting disparities in Maryland’s relevant markets are even greater than disparities in the public sector. This difference may be due to the fact that the State has, for a number of years, operated an assertive MBE program in an attempt to remedy discrimination, which would tend to reduce, though it has not yet eliminated, the effects of discrimination in public procurement. Absent such affirmative remedial efforts by the State, I would expect to see evidence in the relevant markets in which the medical cannabis licensees will operate that is consistent with the continued presence of business discrimination.

January 18, 2018 in Medical Marijuana Data and Research, Medical Marijuana State Laws and Reforms, Race, Gender and Class Issues, Who decides | Permalink | Comments (0)