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.
Tuesday, September 23, 2014
The title of this post is the title of this new paper by Julie Andersen Hill now available via SSRN. Here is the abstract:
Although marijuana is illegal under federal law, twenty-three states have legalized some marijuana use. The state-legal marijuana industry is flourishing, but marijuana-related businesses report difficulty accessing banking services. Because financial institutions won’t allow marijuana-related businesses to open accounts, the marijuana industry largely operates on a cash only basis — a situation that attracts thieves and tax cheats.
This article explores the root of the marijuana banking problem as well as possible solutions. It explains that although the United States has a dual banking system comprised of both federal- and state-chartered institutions, when it comes to marijuana banking, federal regulation is pervasive and controlling. Marijuana banking access cannot be solved by the states acting alone for two reasons. First, marijuana is illegal under federal law. Second, federal law enforcement and federal financial regulators have significant power to punish institutions that do not comply with federal law. Unless Congress acts to remove one or both of these barriers, most financial institutions will not provide services to the marijuana industry. But marijuana banking requires more than just Congressional action. It requires that federal financial regulators set clear and achievable due diligence requirements for institutions with marijuana business customers. As long as financial institutions risk federal punishment for any marijuana business customer’s misstep, institutions will not provide marijuana banking.
Friday, August 29, 2014
As Americans continue to embrace pot—as medicine and for recreational use—opponents are turning to a set of academic researchers to claim that policymakers should avoid relaxing restrictions around marijuana. It's too dangerous, risky, and untested, they say. Just as drug company-funded research has become incredibly controversial in recent years, forcing major medical schools and journals to institute strict disclosure requirements, could there be a conflict of interest issue in the pot debate?
VICE has found that many of the researchers who have advocated against legalizing pot have also been on the payroll of leading pharmaceutical firms with products that could be easily replaced by using marijuana. When these individuals have been quoted in the media, their drug-industry ties have not been revealed.
Take, for example, Dr. Herbert Kleber of Columbia University. Kleber has impeccable academic credentials, and has been quoted in the press and in academic publications warning against the use of marijuana, which he stresses may cause wide-ranging addiction and public health issues. But when he's writing anti-pot opinion pieces for CBS News, or being quoted by NPR and CNBC, what's left unsaid is that Kleber has served as a paid consultant to leading prescription drug companies, including Purdue Pharma (the maker of OxyContin), Reckitt Benckiser (the producer of a painkiller called Nurofen), and Alkermes (the producer of a powerful new opioid called Zohydro)....
Other leading academic opponents of pot have ties to the painkiller industry. Dr. A. Eden Evins, an associate professor of psychiatry at Harvard Medical School, is a frequent critic of efforts to legalize marijuana. She is on the board of an anti-marijuana advocacy group, Project SAM, and has been quoted by leading media outlets criticizing the wave of new pot-related reforms. "When people can go to a ‘clinic’ or ‘cafe’ and buy pot, that creates the perception that it’s safe,” she told the Times last year.
Notably, when Evins participated in a commentary on marijuana legalization for the Journal of Clinical Psychiatry, the publication found that her financial relationships required a disclosure statement, which noted that as of November 2012, she was a "consultant for Pfizer and DLA Piper and has received grant/research support from Envivo, GlaxoSmithKline, and Pfizer." Pfizer has moved aggressively into the $7.3 billion painkiller market. In 2011, the company acquired King Pharmaceuticals (the makers of several opioid products) and is currently working to introduce Remoxy, an OxyContin competitor.
Dr. Mark L. Kraus, who runs a private practice and is a board member to the American Society of Addiction Medicine, submitted testimony in 2012 in opposition to a medical marijuana law in Connecticut. According to financial disclosures, Kraus served on the scientific advisory panel for painkiller companies such as Pfizer and Reckitt Benckiser in the year prior to his activism against the medical pot bill. Neither Kraus or Evins responded to a request for comment.
These academic revelations add fodder to the argument that drug firms maintain quiet ties to the marijuana prohibition lobby. In July, I reported for the Nation that many of the largest anti-pot advocacy groups, including the Community Anti-Drug Coalitions for America, which has organized opposition to reform through its network of activists and through handing out advocacy material (sample op-eds against medical pot along with Reefer Madness-style videos, for example), has relied on significant funding from painkiller companies, including Purdue Pharma and Alkermes. Pharmaceutical-funded anti-drug groups like the Partnership for Drug-Free Kids and CADCA use their budget to obsess over weed while paying lip-service to the much bigger drug problem in America of over-prescribed opioids.
Thursday, August 28, 2014
As reported in this notable new FoxNews piece, headlined "Marijuana compound may slow, halt progression of Alzheimer's," some more interesting marijuana research has produced some more reason to hope that marijuana reform could be a real boon for public health. Here are the details:
Neuroscientists found that extremely low doses of a compound found in marijuana may slow or halt the progression of Alzheimer’s disease. A study published in the Journal of Alzheimer’s Disease reported that neuroscientists using a cellular model of Alzheimer's found low doses of delta-9-tetrahydrocannabinol (THC) reduced the production of amyloid beta, and prevented abnormal accumulation, which is one of the early signs of the memory-loss disease.
“Decreased levels of amyloid beta means less aggregation, which may protect against the progression of Alzheimer’s disease. Since THC is a natural and relatively safe amyloid inhibitor, THC or its analogs may help us develop an effective treatment in the future,” said lead author Chuanhai Cao, a neuroscientist and PhD at the Byrd Alzheimer’s Institute and the University of South Florida College of Pharmacy.
Neuroscientists also found THC enhanced mitochondrial function which is needed to supply energy, transmit signals and maintain a healthy brain. “THC is known to be a potent antioxidant with neuroprotective properties, but this is the first report that the compound directly affects Alzheimer’s pathology by decreasing amyloid beta levels, inhibiting its aggregation, and enhancing mitochondrial function,” Cao said.
The research noted that the therapeutic benefits of THC at low doses appear greater than the associated risks of toxicity and memory impairment....
As many as 5 million Americans suffer from Alzheimer’s disease, with the numbers projected to reach 14 million by 2050, according to the Centers for Disease Control and Prevention (CDC).
Thursday, August 14, 2014
The title of this post is the headline of this notable new AP article. Alex has done a terrific job on this blog keeping track of the intersection of America's favorite sport and America's favorite prohibited substance, and this AP article help highlight how dynamic that intersection can be. Here are excerpts:
Marijuana is casting an ever-thickening haze across NFL locker rooms, and it's not simply because more players are using it. As attitudes toward the drug soften, and science slowly teases out marijuana's possible benefits for concussions and other injuries, the NFL is reaching a critical point in navigating its tenuous relationship with what is recognized as the analgesic of choice for many of its players.
"It's not, let's go smoke a joint," retired NFL defensive lineman Marvin Washington said. "It's, what if you could take something that helps you heal faster from a concussion, that prevents your equilibrium from being off for two weeks and your eyesight for being off for four weeks?"
One challenge the NFL faces is how to bring marijuana into the game as a pain reliever without condoning its use as a recreational drug. And facing a lawsuit filed on behalf of hundreds of former players complaining about the effects of prescription painkillers they say were pushed on them by team trainers and doctors, the NFL is looking for other ways to help players deal with the pain from a violent game....
There are no hard numbers on how many NFL players are using marijuana, but anecdotal evidence, including the arrest or league discipline of no fewer than a dozen players for pot over the past 18 months, suggests use is becoming more common. Redskins offensive lineman Ryan Clark didn't want to pinpoint the number of current NFL players who smoke pot but said, "I know a lot of guys who don't regularly smoke marijuana who would use it during the season."...
Another longtime defensive lineman, Marcellus Wiley, estimates half the players in the average NFL locker room were using it by the time he shut down his career in 2006. "They are leaning on it to cope with the pain," said Wiley, who played defensive line in the league for 10 seasons. "They are leaning on it to cope with the anxiety of the game."
The NFL is fighting lawsuits on two fronts — concussions and painkillers — both of which, some argue, could be positively influenced if marijuana were better tolerated by the league.
The science, however, is slow-moving and expensive and might not ever be conclusive, says behavioral psychologist Ryan Vandrey, who studies marijuana use at John Hopkins. Marijuana may work better for some people, while narcotics and other painkillers might be better for others. "Different medicines work differently from person to person," Vandrey said. "There's pretty good science that shows marijuana does have pain relieving properties. Whether it's a better pain reliever than the other things available has never been evaluated."...
NFL Commissioner Roger Goodell has treaded gingerly around the subject. Before last season's Super Bowl he said the league would "follow the medicine" and not rule out allowing players to use marijuana for medical purposes. An NFL spokesman reiterated that this month, saying if medical advisers inform the league it should consider modifying the policy, it would explore possible changes.
A spokesman for the players union declined comment on marijuana, beyond saying the union is always looking for ways to improve the drug-testing policy. But earlier this year, NFLPA executive director DeMaurice Smith said the marijuana policy is secondary when set against the failure to bring Human Growth Hormone testing into the game. Some believe relaxing the marijuana rules could be linked to a deal that would bring in HGH testing....
The NFL drug policy has come under even more scrutiny this summer, after the NFL handed down a season-long suspension of Browns receiver Josh Gordon for multiple violations of the NFL substance-abuse policy. That suspension, especially when juxtaposed against the two-game ban Ray Rice received for domestic violence, has led some to say the league's priorities are out of whack.
In June, Harvard Medical School professor emeritus Lester Grinspoon, one of the forefathers of marijuana research, published an open letter to Goodell, urging him to drop urine testing for weed altogether and, more importantly, fund a crash research project for a marijuana-based drug that can alleviate the consequences of concussions. "As much as I love to watch professional football, I'm beginning to feel like a Roman in the days when they would send Christians to the lions," Grinspoon said. "I don't want to be part of an audience that sees kids ruin their future with this game, and then the league doesn't give them any recourse to try to protect themselves."
The league does, in fact, fund sports-health research at the NIH, to the tune of a $30 million donation it made in 2012. But the science moves slowly no matter where it's conducted and, as Vandrey says, "the NFL is in business for playing football, not doing scientific research."
Monday, August 11, 2014
The title of this post is the headline of this new commentary by Jacob Sullum at Forbes. Here are excerpts:
Two consequences that pot prohibitionists attribute to marijuana legalization—more underage consumption and more traffic fatalities—so far do not seem to be materializing in Colorado, which has allowed medical use since 2001 and recreational use since the end of 2012.
Survey data released last week by the Colorado Department of Public Health and Environment (CDPHE) indicate that marijuana use among high school students continues to decline, despite warnings that legalization would make pot more appealing to teenagers. In the 2013 Healthy Kids Colorado survey, 37 percent of high school students reported that they had ever tried marijuana, down from 39 percent in 2011. The percentage who reported using marijuana in the previous month (a.k.a. “current” use) also fell, from 22 percent in 2011 to 20 percent in 2013. The CDPHE says those drops are not statistically significant. But they are part of a general downward trend in Colorado that has persisted despite the legalization of medical marijuana in 2001, the commercialization of medical marijuana in 2009 (when the industry took off after its legal status became more secure), and the legalization of recreational use (along with home cultivation and sharing among adults) at the end of 2012.... Traffic fatalities also have generally declined since Colorado began loosening its marijuana laws. Fatalities rose in 2001, the year that Colorado’s medical marijuana law took effect, but by 2003 had fallen below the 2000 level. Since peaking in 2002, fatalities have fallen by more than a third. Legal sales of recreational marijuana began in January, and so far this year traffic fatalities are down. According to to the Colorado Department of Transportation, there were 258 fatalities from January through July, compared to 263 during the same period last year. In short, Colorado’s experience does not provide much evidence that less repressive marijuana laws make the roads more dangerous (and they might even make the roads safer by encouraging the substitution of cannabis for alcohol).
August 11, 2014 in Medical Marijuana Commentary and Debate, Medical Marijuana Data and Research, Recreational Marijuana Commentary and Debate, Recreational Marijuana Data and Research | Permalink | Comments (0)
Sunday, August 10, 2014
The title of this post is the headline of this front-page New York Times article. Here are excerpts:
Nearly four years ago, Dr. Sue Sisley, a psychiatrist at the University of Arizona, sought federal approval to study marijuana’s effectiveness in treating military veterans with post-traumatic stress disorder. She had no idea how difficult it would be.
The proposal, which has the support of veterans groups, was hung up at several regulatory stages, requiring the research’s private sponsor to resubmit multiple times. After the proposed study received final approval in March from federal health officials, the lone federal supplier of research marijuana said it did not have the strains the study needed and would have to grow more — potentially delaying the project until at least early next year.
Then, in June, the university fired Dr. Sisley, later citing funding and reorganization issues. But Dr. Sisley is convinced the real reason was her outspoken support for marijuana research. “They could never get comfortable with the idea of this controversial, high-profile research happening on campus,” she said.
Dr. Sisley’s case is an extreme example of the obstacles and frustrations scientists face in trying to study the medical uses of marijuana. Dating back to 1999, the Department of Health and Human Services has indicated it does not see much potential for developing marijuana in smoked form into an approved prescription drug....
Scientists say this position has had a chilling effect on marijuana research. Though more than one million people are thought to use the drug to treat ailments ranging from cancer to seizures to hepatitis C and chronic pain, there are few rigorous studies showing whether the drug is a fruitful treatment for those or any other conditions. A major reason is this: The federal government categorizes marijuana as a Schedule 1 drug, the most restrictive of five groups established by the Controlled Substances Act of 1970. Drugs in this category — including heroin, LSD, peyote and Ecstasy — are considered to have no accepted medical use in the United States and a high potential for abuse, and are subject to tight restrictions on scientific study.
In the case of marijuana, those restrictions are even greater than for other controlled substances.... To obtain the drug legally, researchers like Dr. Sisley must apply to the Food and Drug Administration, the Drug Enforcement Administration and the National Institute on Drug Abuse — which, citing a 1961 treaty obligation, administers the only legal source of the drug for federally sanctioned research, at the University of Mississippi. Dr. Sisley’s proposed study also had to undergo an additional layer of review from the Public Health Service that is not required for other controlled substances in such research.
The process is so cumbersome that a growing number of elected state officials, medical experts and members of Congress have started calling for loosening the restrictions. In June, a letter signed by 30 members of Congress, including four Republicans, called the extra scrutiny of marijuana projects “unnecessary,” saying that research “has often been hampered by federal barriers.”
“It defies logic in this day and age that marijuana is still in Schedule 1 alongside heroin and LSD when there is so much testimony to what relief medical marijuana can bring,” Gov. Lincoln Chafee of Rhode Island said in an interview. In late 2011, he and the governor of Washington at the time, Christine O. Gregoire, filed a petition asking the federal government to place the drug in a lower category. The petition is still pending with the D.E.A.
Despite the mounting push, there is little evidence that either Congress or the Obama administration will change marijuana’s status soon. In public statements, D.E.A. officials have made their displeasure known about states’ legalizing medical and recreational marijuana.
August 10, 2014 in Federal Marijuana Laws, Policies and Practices, History of Marijuana Laws in the United States, Medical Marijuana Commentary and Debate, Medical Marijuana Data and Research | Permalink | Comments (0)
Sunday, August 3, 2014
The title of this post is the title of this notable new Working Paper coming from the non-profit National Bureau of Economic Research authored by D. Mark Anderson, Benjamin Hansen and Daniel Rees. Here is the abstract:
While at least a dozen state legislatures in the United States have recently considered bills to allow the consumption of marijuana for medicinal purposes, the federal government is intensifying its efforts to close medical marijuana dispensaries. Federal officials contend that the legalization of medical marijuana encourages teenagers to use marijuana and have targeted dispensaries operating within 1,000 feet of schools, parks and playgrounds. Using data from the national and state Youth Risk Behavior Surveys, the National Longitudinal Survey of Youth 1997 and the Treatment Episode Data Set, we estimate the relationship between medical marijuana laws and marijuana use. Our results are not consistent with the hypothesis that legalization leads to increased use of marijuana by teenagers.
Thursday, July 31, 2014
The title of this post is drawn in part from the headline of this latest editorial in the New York Times series explaining its editorial judgment that marijuana prohibition should be ended (first noted here). Here is an excerpt from this editorial:
As with other recreational substances, marijuana’s health effects depend on the frequency of use, the potency and amount of marijuana consumed, and the age of the consumer. Casual use by adults poses little or no risk for healthy people. Its effects are mostly euphoric and mild, whereas alcohol turns some drinkers into barroom brawlers, domestic abusers or maniacs behind the wheel.
An independent scientific committee in Britain compared 20 drugs in 2010 for the harms they caused to individual users and to society as a whole through crime, family breakdown, absenteeism, and other social ills. Adding up all the damage, the panel estimated that alcohol was the most harmful drug, followed by heroin and crack cocaine. Marijuana ranked eighth, having slightly more than one-fourth the harm of alcohol.
Federal scientists say that the damage caused by alcohol and tobacco is higher because they are legally available; if marijuana were legally and easily obtainable, they say, the number of people suffering harm would rise. However, a 1995 study for the World Health Organization concluded that even if usage of marijuana increased to the levels of alcohol and tobacco, it would be unlikely to produce public health effects approaching those of alcohol and tobacco in Western societies.
Most of the risks of marijuana use are “small to moderate in size,” the study said. “In aggregate, they are unlikely to produce public health problems comparable in scale to those currently produced by alcohol and tobacco.”
While tobacco causes cancer, and alcohol abuse can lead to cirrhosis, no clear causal connection between marijuana and a deadly disease has been made. Experts at the National Institute on Drug Abuse, the scientific arm of the federal anti-drug campaign, published a review of the adverse health effects of marijuana in June that pointed to a few disease risks but was remarkably frank in acknowledging widespread uncertainties. Though the authors believed that legalization would expose more people to health hazards, they said the link to lung cancer is “unclear,” and that it is lower than the risk of smoking tobacco....
The American Society of Addiction Medicine, the largest association of physicians specializing in addiction, issued a white paper in 2012 opposing legalization because “marijuana is not a safe and harmless substance” and marijuana addiction “is a significant health problem.”
Nonetheless, that health problem is far less significant than for other substances, legal and illegal. The Institute of Medicine, the health arm of the National Academy of Sciences, said in a 1999 study that 32 percent of tobacco users become dependent, as do 23 percent of heroin users, 17 percent of cocaine users, and 15 percent of alcohol drinkers. But only 9 percent of marijuana users develop a dependence. “Although few marijuana users develop dependence, some do,” according to the study. “But they appear to be less likely to do so than users of other drugs (including alcohol and nicotine), and marijuana dependence appears to be less severe than dependence on other drugs.”
There’s no need to ban a substance that has less than a third of the addictive potential of cigarettes, but state governments can discourage heavy use through taxes and education campaigns and help provide treatment for those who wish to quit.
One of the favorite arguments of legalization opponents is that marijuana is the pathway to more dangerous drugs. But a wide variety of researchers have found no causal factor pushing users up the ladder of harm. While 111 million Americans have tried marijuana, only a third of that number have tried cocaine, and only 4 percent heroin. People who try marijuana are more likely than the general population to try other drugs, but that doesn’t mean marijuana prompted them to do so.
Marijuana “does not appear to be a gateway drug to the extent that it is the cause or even that it is the most significant predictor of serious drug abuse,” the Institute of Medicine study said. The real gateway drugs are tobacco and alcohol, which young people turn to first before trying marijuana.
This NY Times piece is a potent and effective review about what we really know about marijuana's health and societal impact. Even more powerful on the same front, though, is this remarkable new Wonkblog piece from the Washington Post that highlights all the problems with all the science claims by the federal government to justify marijuana prohibition. The title of this piece, with is a must-read for anyone who really care about both the science and advocacy realities surrounding marijuana reform, is "The federal government’s incredibly poor, misleading argument for marijuana prohibition." Here is how it gets started:
The New York Times editorial board is making news with a week-long series advocating for the full legalization of marijuana in the United States. In response, the White House's Office of National Drug Control Policy (ONDCP) published a blog post Monday purporting to lay out the federal government's case against marijuana reform.
That case, as it turns out, it surprisingly weak. It's built on half-truths and radically decontextualized facts, curated from social science research that is otherwise quite solid. I've gone through the ONDCP's arguments, and the research behind them, below.
The irony here is that with the coming wave of deregulation and legalization, we really do need a sane national discussion of the costs and benefits of widespread marijuana use. But the ONDCP's ideological insistence on prohibition prevents them from taking part in that conversation.
July 31, 2014 in Assembled readings on specific topics, Federal Marijuana Laws, Policies and Practices, Medical Marijuana Data and Research, Recreational Marijuana Data and Research, Science | Permalink | Comments (0)
Monday, July 28, 2014
As detailed via this report from the folks at Quinnipiac University, the latest polling numbers suggest Florida voters are keenly in support of marijuana reform. Here are the basics concerning a state seemingly poised to bring marijuana reform movement into the south:
Florida voters support legalized marijuana for medical use 88 - 10 percent, with support ranging from 83 - 14 percent among voters over 65 years old to 95 - 5 percent among voters 18 to 29 years old, according to a Quinnipiac University poll released today. The lowest level of support is 80 - 19 percent among Republicans, the independent Quinnipiac University poll finds.
Sunshine State voters also support 55 - 41 percent "allowing adults in Florida to legally possess small amounts of marijuana for personal use," or so-called "recreational marijuana." There is a wide gender gap and an even wider age gap: Men back recreational marijuana 61 - 36 percent while women back it by a narrow 49 - 45 percent. Voters 18 to 29 years old are ready to roll 72 - 25, while voters over 65 years old are opposed 59 - 36 percent. Support is 64 - 32 percent among Democrats and 55 - 40 percent among independent voters, with Republicans opposed 56 - 41 percent.
"Forget the stereotypes of stodgy old folks living out their golden years playing canasta and golf," said Peter Brown, assistant director of the Quinnipiac University poll. "Almost nine- in-ten Floridians favor legalizing medical marijuana and a small majority says adults should be able to possess small amounts of the drug for recreational purposes.
"Even though a proposal to legalize medical marijuana, on the ballot this November, must meet a 60 percent threshold, these numbers make a strong bet the referendum is likely to pass," said Peter Brown, assistant director of the Quinnipiac University poll....
If medical marijuana is legalized in Florida, voters say 71 - 26 percent they would support having a marijuana dispensary in the town or city where they live. Support ranges from 57 - 37 percent among voters over 65 years old to 79 - 21 percent among voters 18 to 29 years old.
July 28, 2014 in Medical Marijuana Data and Research, Medical Marijuana State Laws and Reforms, Recreational Marijuana Commentary and Debate, Recreational Marijuana Data and Research | Permalink | Comments (0)
Friday, July 11, 2014
Elizabeth Rodd has posted a Note to SSRN on workplace discrimination and medical marijuana titled: "Light, Smoke, and Fire: How State Law Can Provide Medical Marijuana Users Protection from Workplace Discrimination".
Here is the abstract:
Currently, twenty-one states and the District of Columbia have enacted legislation providing an affirmative defense to prosecution under state law for medical marijuana use by qualified patients. Despite growing public and legislative support for the legalization of medical marijuana, medical marijuana use—either recreational or medicinal—remains illegal under the Federal Controlled Substances Act. Given the inconsistency between state and federal law concerning the legality of medicinal marijuana, there is significant uncertainty regarding the rights of employees to engage in state-sanctioned, off-duty use of medical marijuana. To date, courts have refused to grant protections to employees’ who have suffered adverse employment action for their off-duty, state sanctioned medical marijuana use. Although the existing case law appears employer-friendly, employee-friendly dissenting opinions and states that have adopted explicit statutory discrimination protections for medical marijuana users signify that this current trend could easily change. This Note argues that courts should allow employees’ claims for disability discrimination to proceed under state law, and state legislatures should amend their current medical marijuana statutes to afford employment discrimination protection to qualified patients. In doing so, states will be able to protect disabled employees from discrimination due to their use of a state sanctioned therapeutic remedy.
Thursday, June 5, 2014
State AG backs corporation in notable Colorado case concerning fired quadriplegic medical-marijuana patient
As reported in this Denver Post piece, the Colorado "state attorney general's office says Coloradans do not have a right to use marijuana off the job, siding with a satellite television company in its firing of a medical-marijuana patient." This position is articulated in a brief filed in the Colorado Supreme Court in the notable case involving a quadriplegic medical-marijuana patient who was fired by Dish Network after testing positive for marijuana. Here is more of the context:
In a brief filed with the state Supreme Court last month, the Colorado attorney general's office argues that giving workers a right to use marijuana off duty "would have a profound and detrimental impact on employers in the state."
"Contrary to popular perception, Colorado has not simply legalized marijuana for medical and recreational purposes," state attorneys write in the brief. "Instead, its citizens have adopted narrowly drawn constitutional amendments that decriminalize small amounts of marijuana."
The Colorado Court of Appeals — the state's second-highest court — last year upheld Dish Network's firing of a quadriplegic medical-marijuana patient for a positive drug test. Although there is no allegation that Brandon Coats was stoned at work, the company said it has a zero-tolerance policy on marijuana.
Coats say his off-the-job marijuana use should be protected by Colorado's Lawful Off-Duty Activities Statute, which prevents companies from firing employees for doing things outside of work — like smoking cigarettes — that are legal. Dish Network argues that marijuana use can't be considered lawful while cannabis remains illegal federally.
In its brief supporting Dish Network, the state attorney general's office says zero-tolerance policies ensure that employees are able to perform their jobs competently. Requiring employers to prove that workers are stoned on the job before they can be fired would require companies to conduct "intrusive investigations into the personal life of an employee."
"Simply put, zero tolerance policies provide businesses with an efficient means of avoiding difficult employment decisions and even litigation," the attorney general's brief states.
Coats' case is the first time Colorado's highest court has taken up questions about the scope of marijuana legalization in the state, and it has drawn at least six outside groups filing briefs in support of Coats or Dish. The Colorado Mining Association, the Colorado Defense Lawyers Association and the Colorado Civil Justice League — which claims an allegiance with several businesses and groups including the Denver Metro Chamber of Commerce — have filed briefs on behalf of Dish. The Colorado Plaintiff Employment Lawyers Association and the Patient and Caregivers Rights Litigation Project have filed briefs supporting Coats.
The Supreme Court has not announced when it will hear the case.