Marijuana Law, Policy & Reform

Editor: Douglas A. Berman
Moritz College of Law

Thursday, May 18, 2017

Minnesota health department reports "perceptions of a high degree of benefit for most patients" in state's medical marijuana program

Rsz-minnesota-patients-with-chronic-pain-now-qualify-for-medical-marijuana-640x401Minnesota's medical marijuana program has garnered some headlines this week in part because of reports of big economic losses being suffered by industry players.   As this local article details, "Minnesota's medical marijuana manufacturing companies have lost $11 million in just two years of sales."  But the story emerging from the state this week that seems greater potential import and impact concerns a state study of patients noted this AP piece headlined  "Study: Minnesota medical marijuana patients report benefits."

The study comes from the Minnesota Department of Health and is titled "Minnesota Medical Cannabis Program: Patient Experiences from the First Program Year."  The complete report is due to to be released next month, but this Executive Summary was released this week and includes these passages:

Between July 1, 2015 and June 30, 2016 a total of 1660 patients enrolled in the program and 577 health care practitioners registered themselves in order to certify that patients have a medical condition that qualifies them for the program. The most common qualifying conditions were severe and persistent muscle spasms (43%), cancer (28%), and seizures (20%). Each of the remaining six qualifying conditions during the first year – Crohn’s Disease, Terminal illness, HIV/AIDS, Tourette Syndrome, glaucoma, and ALS – accounted for less than 10% of patients. Ten percent (167 patients) were certified for more than one qualifying condition. Most patients were middle-aged (56% between ages 36-64), 11% were <18, and 11% were ≥65. Distribution by race/ethnicity generally matched the state’s demographics, with 90% of patients describing themselves as white....

Information on patient benefits comes from the Patient Self-Evaluations (PSE) completed by patients prior to each medical cannabis purchase and from patient and health care practitioner surveys. Results of analysis of PSE and survey data indicate perceptions of a high degree of benefit for most patients....

Moderate to severe levels of non-disease-specific symptoms such as fatigue, anxiety, and sleep difficulties were common across all the medical conditions. And the reductions in these symptoms was often quite large. These findings support the understanding that some of the benefit perceived by patients is expressed as improved quality of life.

May 18, 2017 in Medical community perspectives, Medical Marijuana Commentary and Debate, Medical Marijuana Data and Research, Medical Marijuana State Laws and Reforms | Permalink | Comments (0)

Thursday, May 11, 2017

Still more sales data suggesting a Trump bump in Colorado marijuana sales

In a post last month, I asked "Is the Trump Administration driving a 2017 spike in Colorado marijuana sales?" based on data showing increased marijuana sales in Colorado the first two months of this year.  Now, via this new Cannabist piece, headlined "Colorado marijuana sales top $131M, set record in March 2017," we have additional data on ever-increasing sales, though there is no way to tell from basic sales data if the market is experiencing general growth or if folks in Colorado may be stocking up on marijuana in light of uncertainty concerning federal marijuana policies under a new administration.   Speculations about reasons aside, here are the basic sales details along with some perspectives via The Cannabist:

The Colorado cannabis industry’s unbridled growth hasn’t waned — in fact, it’s still setting records. The state’s licensed marijuana shops captured nearly $132 million of recreational and medical cannabis sales in March, according to The Cannabist’s extrapolations of state sales tax data made public Tuesday.

The monthly sales haul of $131.7 million sets a new record for Colorado’s relatively young legal marijuana industry, besting the previous high of $127.8 million set last September, The Cannabist’s calculations show.  It’s the tenth consecutive month that sales have topped $100 million.

Sales tax revenue generated for the state during March was $22.9 million, according to the Colorado Department of Revenue.  March’s sales totals were 48 percent higher than those tallied in March 2016, according to The Cannabist’s calculations. The month closes out a quarter in which sales were up nearly 36 percent from the first three months of last year.

In 2016, the year-over-year quarterly growth rate ranged between 29 percent and 39.6 percent.  The Cannabist also found that March 2017’s year-over-year percentage growth outpaced much of what was seen on a monthly basis last year.  Monthly growth rates from calendar year 2015 to 2016 averaged nearly 34 percent.

It was this continued rate of growth that caught the attention of some analysts and economists contacted by The Cannabist. Andrew Livingston, director of economics and research for cannabis law firm Vicente Sederberg, separately calculated out the year-over-year monthly growth rate for Colorado cannabis sales and saw a trend emerge.

“The year-over-year rates of growth have continued at a steady pace, which to me indicates that we have not yet reached the point at which we are starting to cap out the market,” he said. At that point, he added, the growth rates would start to decline.

If the current growth rates keeps up, April 2017 should be another record month, and the summer of 2017 should set new highs, Livingston predicted. And by the end of the year, that could add up to an industry boasting $1.6 billion in sales, he said.

“We’re surprised that sales continue to grow so quickly,” said Miles Light, an economist with the Marijuana Policy Group, a Denver-based financial, policy, research and consulting firm focused on the marijuana industry.  “We are not surprised that almost all of the sales growth is in the retail marijuana space.”  Adult-use sales, which hit a new monthly high of $93.3 million, accounted for the lion’s share of the March totals.  Medical cannabis transactions totaled $38.4 million.

Light and other economists have previously projected that Colorado’s marijuana market would eventually hit a ceiling as the draw from the black market becomes more complete, regular economic cycles take hold and other states implement adult-use sales.  It’s hard to predict when that plateau may occur, but the license and application fees in the March 2017 report were telling, Light said.

Ten months into Colorado’s fiscal year (the latest report for March sales show tax revenue remitted in April), the license and application fees for medical marijuana businesses and retail marijuana businesses were down 25.4 percent and 8.5 percent, respectively, according to the Colorado Department of Revenue report.  “This shows that fewer new firms are entering and, I believe, shows that … sales should be tapering off or declining,” he said.

Whatever the particular reasons for the strong and steady sales growth in Colorado, there numbers seem certain to keep investors and other business players "bullish" on the marijuana industry at least for the time being.  And such business bullishness will likely continue to fuel various efforts in various jurisdictions to continue moving forward with or expand the reach of marijuana reform.

Prior related post:

May 11, 2017 in Business laws and regulatory issues, Medical Marijuana Data and Research, Medical Marijuana State Laws and Reforms, Recreational Marijuana Data and Research, Recreational Marijuana State Laws and Reforms, Taxation information and issues | Permalink | Comments (0)

Saturday, May 6, 2017

Prez Trump issues notable statement when signing spending bill with DOJ limit on going after medical marijuana states

170301105323-trump-marijuana-780x439As reported in this Bloomberg piece, headlined "Trump Spurns Congress as He Signals Medical Marijuana Fight," the President made a significant statement on a number of topics, including marijuana enforcement, while signing the latest spending bill. Here are the details:

President Donald Trump signaled he may ignore a congressional ban on interfering with state medical marijuana laws, arguing in a lengthy statement that he isn’t legally bound by a series of limits lawmakers imposed on him.

Trump issued the “signing statement” Friday after he signed a measure funding the government for the remainder of the federal fiscal year, reprising a controversial tactic former presidents George W. Bush and Barack Obama used while in office.  Trump also suggested he may ignore gender and racial preferences in some government programs as well as congressional requirements for advance notice before taking a range of foreign policy and military actions....

In the signing statement, Trump singled out a provision in the spending bill that says funds cannot be used to block states from implementing medical marijuana laws.  “I will treat this provision consistently with my constitutional responsibility to take care that the laws be faithfully executed,” he said.

Obama also occasionally released signing statements objecting to congressional restrictions on his authority.  The White House described Trump’s signing statement as routine, but did not indicate whether the president planned to take action to defy Congressional restrictions....

Tim Shaw, a senior policy analyst at the Bipartisan Policy Center, said that the president is bound by the language in the spending bill that now bears his signature.  “Part of the argument here in this signing statement is that he has the constitutional requirement to execute the law,” Shaw said in an interview.  “But this is one of those laws, and Congress has the ultimate authority over funds getting spent.”

Because the language used in this signing statement is somewhat boilerplate, I am disinclined to view this development as a direct announcement or even an indirect signal of any new firm policy of the Trump Administration in the arena of marijuana reform.  Still, given that the President has said almost nothing about marijuana reform since his election and given that some members of his Cabinet are clearly not fans of the marijuana reform movement, this statement provides more evidence that Prez Trump and others within the White House are not eager to be active cheerleaders for state marijuana reform efforts.

May 6, 2017 in Campaigns, elections and public officials concerning reforms, Federal Marijuana Laws, Policies and Practices, Medical Marijuana Commentary and Debate, Medical Marijuana State Laws and Reforms, Who decides | Permalink | Comments (0)

Wednesday, April 26, 2017

"Osbeck and Bromberg's Marijuana Law in a Nutshell"

The title of this post is how West Academic Publishing is promoting its latest notable nutshell publication authored by Mark Osbeck and Howard Bromberg. In part because I think it is near impossible to summarize modern marijuana law in short form, I view this nutshell effort as extraordinary in various respects. And here is how West briefly describes the product:

Concise yet comprehensive text that provides an overview of marijuana law. It discusses important issues pertaining to public policy, legal history, constitutional law, criminal law, and jurisprudence, as well as practical legal issues that concern both marijuana-related businesses and individuals, in areas such as banking, employment, tax, bankruptcy, and child custody.

The text provides in-depth coverage of federal laws governing marijuana, along with an overview of international, state, and local laws relating to marijuana regulation. It also provides an overview of arguments for and against medical and/or recreational legalization, as well as an analysis of how marijuana compares to other potentially harmful substances, both legal and illegal.

April 26, 2017 in Assembled readings on specific topics, History of Marijuana Laws in the United States, Medical Marijuana State Laws and Reforms, Recreational Marijuana State Laws and Reforms | Permalink | Comments (0)

Pennsylvania receives "flood of applications" seeking one of a few dozen medicial marijuana licenses

This local report from Pennsylvania highlights the large number of applications received by state officials from businesses looking to get in on the ground floor of the state's medical marijuana industry.  Here are the basic details:

Hundreds of applicants have asked for licenses to grow or sell medical marijuana in Pennsylvania, including dozens in the state's southeastern corner.

In their first accounting of the flood of applications, Health Department officials said Wednesday that they received more than 500 packages by the March 20 deadline, and have sifted through 258 applications. Among those have been 31 applications to grow medical marijuana in Philadelphia or its surrounding suburbs.

But officials wouldn't release the names of the principals behind the company names — or divulge the locations where they propose to grow or sell the drug. More company names will be released after additional applications have been reviewed.

Still, the data suggests the frenzied interest in getting in on the ground floor of the potentially lucrative medical marijuana industry, which some advocates hope will be the first step toward broader legalization of the drug.

Only 12 growing permits will be granted statewide. The state has been moving swiftly to implement a law passed last year with support from both parties in the Republican-controlled Legislature. The law aims to supply cannabis to seriously ill patients who have any one of 17 qualifying ailments.

March 20 was the deadline for all materials for people vying for one of 12 initial grower licenses. The state also received applications for would-be operators seeking one of 27 permits that would allow up to 81 dispensaries, where prescriptions could be filled, across the state.

The permit applications that are pending represent just the first phase of the bidding process. The state also is preparing to offer clinical registrant licenses, which would attach medical marijuana to existing hospitals that also serve as academic medical institutions. That credential would allow eight academic medical centers to select investor partners to establish research, growing, and dispensary networks of their own. Health systems have been soliciting potential suitors for months....

Each applicant was required to put up a non-refundable $10,000 fee, in addition to a $200,000 permit fee that will be returned only to the unsuccessful applicants. The ante for dispensary licenses, which will allow the winner to operate up to three storefronts, was $5,000, and those checks were accompanied by a refundable permit fee of $30,000 per storefront.

I am expecting that the same sort of "frenzied interest" will also be the medical marijuana story here in nearly Ohio when the has its license application process fully up and running in the coming months.   (This short column from an Ohio business publication, headlined "Intense competition for state-issued medical marijuana licenses necessitates advance preparation," suggests I am not alone in that view.)  The old "Field of Dreams" adage, "if you build it, they will come," seems fitting here. Though perhaps in this setting the adage should be tweaked to "if you build it, they will come with checks with lots of zeroes."

April 26, 2017 in Medical Marijuana Data and Research, Medical Marijuana State Laws and Reforms | Permalink | Comments (0)

New research highlights increased "illicit cannabis use and cannabis use disorders" in medical marijuana states through 2013

JAMA Psychiatry has this notable new research published under the title "US Adult Illicit Cannabis Use, Cannabis Use Disorder, and Medical Marijuana Laws, 1991-1992 to 2012-2013." Here are parts of its abstract:

Over the last 25 years, illicit cannabis use and cannabis use disorders have increased among US adults, and 28 states have passed medical marijuana laws (MML). Little is known about MML and adult illicit cannabis use or cannabis use disorders considered over time....

Differences in the degree of change between those living in MML states and other states were examined using 3 cross-sectional US adult surveys: the National Longitudinal Alcohol Epidemiologic Survey (NLAES; 1991-1992), the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC; 2001-2002), and the National Epidemiologic Survey on Alcohol and Related Conditions–III (NESARC-III; 2012-2013)....

Overall, from 1991-1992 to 2012-2013, illicit cannabis use increased significantly more in states that passed MML than in other states (1.4–percentage point more; SE, 0.5; P = .004), as did cannabis use disorders (0.7–percentage point more; SE, 0.3; P = .03)....

Medical marijuana laws appear to have contributed to increased prevalence of illicit cannabis use and cannabis use disorders. State-specific policy changes may also have played a role. While medical marijuana may help some, cannabis-related health consequences associated with changes in state marijuana laws should receive consideration by health care professionals and the public.

April 26, 2017 in Medical Marijuana Data and Research, Medical Marijuana State Laws and Reforms | Permalink | Comments (0)

Friday, April 21, 2017

Heading out to speak at 2017 World Medical Cannabis Conference & Expo

Blogging in this space will be light over the next few days because I am about to travel to Pittsburgh to attend and participate in the 2017 World Medical Cannabis Conference & Expo.   As this schedule details, I am speaking tomorrow afternoon (Saturday) on a panel titled "Higher Education & Its Role in the Industry." Here is how the panel is previewed:

The cannabis industry is set to create more jobs than established industries like manufacturing by 2020.  However, there is still no clear path to getting involved in the industry or clear educational path.  Students need more courses and curriculum that teaches the fundamentals of the industry.  These include all areas of the industry including business, agriculture, research, etc.  This panel will talk about what courses are currently available for students and what still needs to be offered as well as how higher education can translate their findings into commercial services and products the industry can use to advance itself.

April 21, 2017 in Business laws and regulatory issues, Employment and labor law issues, Medical Marijuana Commentary and Debate, Medical Marijuana Data and Research, Medical Marijuana State Laws and Reforms | Permalink | Comments (0)

Wednesday, April 19, 2017

West Virginia officially becomes first new medical marijuana state of the Trump era

St small 215x235-pad 210x230 f8f8f8.lite-1As reported in this local article, headlined "WV governor signs medical marijuana into law," the latest state to reform its marijuana laws is the Mountain State.  Here are the details:

Gov. Jim Justice signed a comprehensive medical marijuana bill into law Wednesday, wrapping up what might have been the legislative underdog story of the session. Justice signed Senate Bill 386, which will put a medical cannabis commission into place to begin forming the regulatory infrastructure for the Bureau of Public Health to begin issuing marijuana patient ID cards on July 1, 2019.

This action makes West Virginia the 29th state to legalize medical marijuana.

Surrounded by Democratic legislators who helped push the bill through, Justice said the law will help those who are suffering obtain access to a treatment approved by the medical community. “Our doctors are telling us, this is a pathway to help those people [who are suffering],” Justice said. “How could you turn your back on that? How could you turn your back on a loved one who is really suffering? To have a vehicle to be able to help, and to turn our back on it and say, ‘No, we’re not going to do that.’ To me, that’s not listening to the wise, and it’s not being charitable and caring, like we ought to be.”

The new law will allow patients suffering from 16 conditions to apply for a card with permission from their doctor, who must be approved to recommend marijuana by the Board of Public Health. Acceptable conditions include terminal illnesses, cancer, HIV or AIDS and Parkinson’s disease.

The law does not allow patients to grow or smoke marijuana. Only a licensed dispensary can issue marijuana in the form of pills, oils, topicals (gels, creams, ointments), tincture, liquid, dermal patch or non-whole plant forms for administration through a vaporizer or nebulizer.

Sen. Richard Ojeda, D-Logan, who sponsored the legislation and served as its point man, said he thinks the bill will help ease suffering of fellow veterans who have been diagnosed with Post Traumatic Stress Disorder, and simultaneously cut into the state’s opioid crisis, by taking money out of illegal drug dealers’ pockets.

Sporting a cannabis leaf-shaped pin on the breast of his jacket, Nitro resident Rusty Williams watched Justice sign the bill. Williams survived a late-stage diagnosis of testicular cancer. He said his doctors prescribed him aggressive doses of chemotherapy to combat the cancer, and he used illegally purchased marijuana to help him handle the treatments....

Sen. Mike Woelfel, D-Cabell, said that, although some might be frustrated by the gap between the bill’s passage versus its 2019 full activation date, it will be a good thing for the state to not botch such a promising, although complex, initiative. He said other states have tried to shoot the moon and get things rolling prematurely, and it only served to their detriment. Woelfel also pointed out that the Legislature can revisit the bill in any session down the road and add to it, as needed.

April 19, 2017 in History of Marijuana Laws in the United States, Medical Marijuana State Laws and Reforms | Permalink | Comments (0)

Monday, April 17, 2017

Denver Post rounds up series of "Perspectives on Cannabis"

The Denver Post, as highlighted here, this past weekend had a section of its "Sunday Perspective" focused on marijuana reform. Included among the section's contributors were "former Cannabist editor Ricardo Baca, U.S. Rep. Jared Polis, Greenwood Village Police Chief John Jackson, L’Eagle grow and dispensary owner Amy Andrle, Kayvan Khalatbari co-founder of Denver Relief Consulting, and former teachers turned science-based marijuana curriculum developers Sarah Grippa and Molly Lotz." Here are the headlines of the pieces with links:

April 17, 2017 in History of Marijuana Laws in the United States, Medical Marijuana Commentary and Debate, Medical Marijuana State Laws and Reforms, Recreational Marijuana Commentary and Debate, Recreational Marijuana State Laws and Reforms | Permalink | Comments (0)

Tuesday, April 4, 2017

West Virginia seemingly poised to become latest medical marijuana state (and first new one in the Trump era)

West-va-750x420This new local article, headlined "Medical marijuana bill passes WV House; Senate likely to concur," reports on some interesting and notable marijuana reform news out of the Mountain State.  Here are the basic details:

A bill that would permit the use of medical marijuana in West Virginia was approved by the House of Delegates on Tuesday.

The bill (SB 386), which would have created a West Virginia Cannabis Commission charged with overseeing medical marijuana regulation in the state, passed the Senate last week.On Monday, the House of Delegates amended the bill so that instead of a commission, it would create an advisory board within the state Department of Health and Human Resources’ Bureau for Public Health. They also made several other changes.

In a 51-48 vote, delegates approved an amendment by Delegate John Shott, R-Mercer and House Judiciary chairman, that would prohibit smoking, ban people from growing their own plants, and charge $100,000 annual fees for growers and processors. That fee was cut in half during a late-night floor session.

Senate President Mitch Carmichael said this afternoon that the Senate plans to concur with the House’s changes. Jacque Bland, spokeswoman for the Senate, said that likely won’t occur until Wednesday. “That’s our expectation, unless we find something that is just totally out of bounds in this bill,” Carmichael said. “We trust the House of Delegates and Chairman Shott’s work on this piece of legislation.”

If it occurs, the governor would still need to sign the bill for it to become law, and no patient identification cards would be issued until July of 2019....

The bill defines serious health conditions as cancer, HIV or AIDS, amyotrophic lateral sclerosis, Parkinson’s disease, multiple sclerosis, damage to the nervous tissue of the spinal cord with objective neurological indication of intractable spasticity, epilepsy, neuropathies, Huntington’s disease, Crohn’s disease, post-traumatic stress disorder, intractable seizures, sickle cell anemia, severe chronic or intractable pain of neuropathic origin or intractable pain in which conventional therapeutic intervention and opiate therapy is contraindicated or has proven ineffective, or having a medical prognosis of one year or less.

The bureau would regulate medical cannabis in the state, review physician applications, issue permits to growers, dispensaries and processors, maintain an electronic database to include “activities and information relating to medical cannabis organizations certifications and identification cards issued, practitioner registration and electronic tracking of all medical cannabis,” and maintain a directory of patients and caregivers to whom it has issued ID cards.

April 4, 2017 in History of Marijuana Laws in the United States, Medical Marijuana State Laws and Reforms, Who decides | Permalink | Comments (0)

Monday, April 3, 2017

Examining distinctive state laws on home growing marijuana for medicinal or recreational purposes

Among the many exciting topics for student presentations in my Marijuana Law, Policy & Reform seminar this coming wee is a look at "recent trends and varying approaches in allowing/restricting home growing marijuana for medicinal or recreational purposes and the plant count and possession limitations these laws impose." As preparation for this topic, my student has provided these links for background reading:

Law review article: Ryan Stoa, “Marijuana Appellations: The Case for Cannabicultural Designations of Origins.”

A research paper expounding upon the possible iterations of a post-legalization marijuana market in the United States. Predictions concerning the form of a future market and the potential regulatory hurdles in the way. The possibility of the marijuana market evolving similarly to the wine industry and avoiding the widespread concern with “Big Marijuana."

Press article: "Costs of Growing Cannabis at Home vs. Buying Bud at a Dispensary"

A helpful guide comparing the costs to a consumer of either cultivating their own marijuana or simply purchasing marijuana from a dispensary.

Press article: "16 people indicted in massive home-grown marijuana operation across Denver area"

A recent article from Denver concerning home grown marijuana entering into the black market.

NORML map with links

A helpful visual summary of which states have adopted medical/recreational marijuana policies.

Press article: "Home Cannabis Cultivation Laws by State"

A quick reference to the laws of each state that has legalized marijuana for recreational or medical purposes with regard to home cultivation.

April 3, 2017 in Assembled readings on specific topics, Business laws and regulatory issues, Medical Marijuana State Laws and Reforms, Recreational Marijuana State Laws and Reforms | Permalink | Comments (0)

Saturday, April 1, 2017

A Survey of Legal Issues & Risk Management Methods for Medical Marijuana Start-ups in Ohio

A terrific guest speaker for part of my last class means that my Marijuana Law, Policy & Reform seminar students are going to be making a large number of class presentations this week.  So, blog readers should be prepared and excited to be seeing a bunch of posting about diverse topics that are the focal point for student work.  For example, one student is focused on medical marijuana "start ups" in the Buckeye State, and he has provided the following synopsis and links as a preview of his presentation:

The conflict of Ohio law and applicable federal law on medical marijuana presents a myriad of legal issues for individuals and businesses to consider when deciding whether to participate in the new cannabis industry.  But because federal law preempts conflicting state law, the primary goal of participants should be to manage the risk of federal enforcement uncertainty to an acceptable level.  For those who are willing and able to manage the risk of uncertainty, participation in the new cannabis industry is not just about making money -it’s also about making history.  Meanwhile, those who are unable to navigate the complex contours of cannabis law are left watching from the sidelines.

1.      Federal Preemption: Risk of Forfeiture. August 2013 Cole Memo; The Role of Local Law Enforcement in Civil Forfeiture

2.      Local Government Law: Risk of Local Zoning/Land Use Restrictions. Ohio H.B. 523; Garcia v. Siffrin Residential Ass'n, 63 Ohio St. 2d 259, 407 N.E.2d 1369 (1980)

3.      Banking Law: Risk of Money Laundering Liability. BSA Expectations Regarding Marijuana-Related Businesses.

4.      Intellectual Property Law: Risk of Unsecured Enforcement Rights. In re Morgan Brown, U.S.P.T.O. Trademark Trial and Appeal Board, Serial No. 86/362,968 (2016); In re Christopher C. Hinton, U.S.P.T.O. Trademark Trial and Appeal Board, Serial No. 85/713,080 (2015).

5.      Tax Law: Risk of Preclusion. Capitalization of Inventoriable Costs; Californians Helping to Alleviate Med. Problems, Inc. v. Comm'r, 128 T.C. 173 (2007).

6.      Employment Law: Risk of Disputes. Ohio HB 523; Casias v. Wal-Mart Stores, Inc., 695 F.3d 428 (6th Cir. 2012).

7.      Bankruptcy Law: Risk of Relief Dismissal. In re Arenas, 514 B.R. 887 (Bankr. D. Colo. 2014); In re McGinnis, 453 B.R. 770 (Bankr. D. Or. 2011).

April 1, 2017 in Assembled readings on specific topics, Business laws and regulatory issues, Medical Marijuana Commentary and Debate, Medical Marijuana State Laws and Reforms | Permalink | Comments (0)

Wednesday, March 29, 2017

"Too Stoned to Drive? The question is trickier than you’d think for police and the courts to answer."

Download (1)The title of this post is the headline of this ABA Journal article appearing in the April 2017 issue. Here are excerpts:

Massachusetts is one of eight states, plus the District of Columbia, where recreational marijuana use is now legal.  Twenty more states have legalized medical marijuana.  But science and the law have not kept pace with this rapid political change.

We take for granted that not being able to walk a straight line or stand on one leg means you’re drunk, and that being drunk means it’s unacceptably dangerous to drive.  But there is no clear scientific consensus when it comes to smoking pot and driving.  And few of the tools police officers have long relied on to determine whether a driver is too drunk to drive, such as the Breathalyzer, exist for marijuana....

Most (but not all) studies find that using pot impairs one’s ability to drive.  However, overall, the impairment appears to be modest — akin to driving with a blood-alcohol level between 0.01 and 0.05, which is legal in all states. (The much greater risk is in combining pot with alcohol.)

The increased crash risk with pot alone “is so small you can compare it to driving in darkness compared to driving in daylight,” says Rune Elvik, a senior research officer at the Institute of Transport Economics in Oslo, Norway, who conducted several major meta-analyses evaluating the risks of drugged driving.  “Nobody would consider banning people from driving in the dark.  If you tried to impose some kind of consistency standard, then there is no strong case, really, for banning it.”

When it comes to alcohol, science and the courts have long established a direct line between number of drinks, blood-alcohol level and crash risk.  As one goes up, so do the others.  Not so for pot.  Scientists can’t say with confidence how much marijuana, in what concentration, used in what period of time, will reliably make someone “high.” (This is especially difficult to gauge because most of the existing studies used pot provided by the National Institute on Drug Abuse, which tends to be a lot less potent than what smokers can buy on the street or in shops.)

Blood levels of THC — the chemical component of pot that makes you high — spike quickly after smoking and decline rapidly in the hours afterward, during the window when a smoker would feel most high.  What’s more, regular smokers could have THC in their blood for days or weeks after smoking, when they are clearly no longer high.

Still, laws in 18 states tie drugged driving charges to whether drivers have THC or related compounds in their blood.  Some states prohibit driving with any amount, and some specify a threshold modeled after the 0.08 limit states use for blood alcohol.  But the lag time between being pulled over and being transported to a hospital for a blood draw — on average, more than two hours — can lead to false negatives, while the tolerance developed by regular users (and the tendency for THC to stick around in their bloodstreams) can lead to false positives.  This is why, researchers say, blood THC laws make little sense....

The more sensible strategy appears to be prohibiting driving while high, and 31 states take this approach. But proving that a driver is high turns out to be tricky terrain, too....

Research shows that failing a standard field sobriety test correlates closely with having a blood-alcohol level above the legal limit—and officers have the Breathalyzer to confirm their findings.  But “the gap between assessment, cannabis use and driving is really not completely closed,” says Thomas Marcotte, co-director of the Center for Medicinal Cannabis Research at the University of California at San Diego....

Some police departments use drug recognition experts — specially trained officers dispatched to evaluate suspected drugged drivers.  These officers, commonly referred to as DREs, use an hourlong, 12-step process that includes taking the suspect’s blood pressure and pulse and conducting eye exams and balance tests.  They use this information to generate an opinion about whether the driver is intoxicated — and, if so, by what.  Preliminary research seems to indicate their opinions are of mixed quality, and not all judges allow DREs to testify to their findings.

“They’re not EMTs. They’re not medically trained,” says [Nicholas] Lovrich, the Washington State professor who, in a recent study of five years of DRE data in Washington and New Mexico, found a false-positive rate for pot intoxication ranging from 38 percent to 68 percent.  “Everyone in the DRE business knows it’s really hard to do this.”

The gold standard would be a Breathalyzer-like device that can objectively measure whether someone has recently smoked, as well as how much.  Lovrich is working on developing such a tool, using the same type of technology that security screeners use at airports to check for explosives.  He says it will be at least two years before the technology is perfected, miniaturized and engineered to be durable enough to toss in the back seat of a squad car.

March 29, 2017 in Criminal justice developments and reforms, Medical Marijuana State Laws and Reforms, Recreational Marijuana State Laws and Reforms | Permalink | Comments (0)

Monday, March 27, 2017

Analyzing risks, restrictions, and barriers for those providing medical marijuana recommendations

As readers know from recent posts, my Marijuana Law, Policy & Reform seminar students deep into their class presentations. And a student this coming week is "analyzing and comparing the risks, restrictions, and barriers providers face for providing recommendations." Here are the materials this student has prepared for background on this topic:

CNN article about physician medical marijuana education

ABA article about Malpractice Liability

Nurse Practitioner article about APRN recommendations

ACP article about Marijuana Hospital Policies

Ohio Medical Marijuana Control Program - Advisory Committee - Physician Rule Presentation - Notice and Comment Review on Proposed Rule

Ohio's Proposed Rule for Physicians (draft as of 03/21)

March 27, 2017 in Business laws and regulatory issues, Medical community perspectives, Medical Marijuana Commentary and Debate, Medical Marijuana State Laws and Reforms, Who decides | Permalink | Comments (0)

Thursday, March 16, 2017

New Congressional Research Service report on "The Marijuana Policy Gap and the Path Forward"

The folks at the Congressional Research Service do a terrific job summarizing complicated law and policy issues for members of Congress, and their latest marijuana publication is no exception. This latest CRS report is titled "The Marijuana Policy Gap and the Path Forward," and it covers an amazing amount of marijuana law and policy in under 50 pages. Here are excerpts from its summary:

Most states have deviated from an across-the-board prohibition of marijuana, and it is now more so the rule than the exception that states have laws and policies allowing for some cultivation, sale, distribution, and possession of marijuana — all of which are contrary to the federal Controlled Substances Act (CSA).  As of March 2017, nearly 90% of the states, as well as Puerto Rico and the District of Columbia, allow for the medical use of marijuana in some capacity.  Also, eight states and the District of Columbia now allow for some recreational use of marijuana.  These developments have spurred a number of questions regarding their potential implications for federal law enforcement activities and for the nation’s drug policies as a whole.

Thus far, the federal response to state actions to decriminalize or legalize marijuana largely has been to allow states to implement their own laws on marijuana.  The Department of Justice (DOJ) has nonetheless reaffirmed that marijuana growth, possession, and trafficking remain crimes under federal law irrespective of states’ positions on marijuana. Rather than targeting individuals for drug use and possession, federal law enforcement has generally focused its counterdrug efforts on criminal networks involved in the drug trade.

While the majority of the American public supports marijuana legalization, some have voiced apprehension over possible negative implications.  Opponents’ concerns include, but are not limited to, the potential impact of legalization on (1) marijuana use, particularly among youth; (2) road incidents involving marijuana-impaired drivers; (3) marijuana trafficking from states that have legalized it into neighboring states that have not; and (4) U.S. compliance with international treaties.  Proponents of legalization have been encouraged by potential outcomes that could result from marijuana legalization, including a new source of tax revenue for states and a decrease in marijuana-related arrests.  Many of these potential implications are yet to be fully measured.

Given the current marijuana policy gap between the federal government and many of the states, there are a number of issues that Congress may address.  These include, but are not limited to, issues surrounding availability of financial services for marijuana businesses, federal tax treatment, oversight of federal law enforcement, allowance of states to implement medical marijuana laws and involvement of federal health care workers, and consideration of marijuana as a Schedule I drug under the CSA. The marijuana policy gap has widened each year for some time.

March 16, 2017 in Federal Marijuana Laws, Policies and Practices, History of Marijuana Laws in the United States, Medical Marijuana State Laws and Reforms, Recreational Marijuana State Laws and Reforms, Who decides | Permalink | Comments (2)

Wednesday, March 15, 2017

"Tracking the Money That’s Legalizing Marijuana and Why it Matters"

The title of this post is the title of a notable new report issued by National Families in Action. The report can be downloaded at this link, and this press release about the report provides a summary of its themes and core contents:

A new report by National Families in Action (NFIA) uncovers and documents how three billionaires, who favor legal recreational marijuana, manipulated the ballot initiative process in 16 U.S. states for more than a decade, convincing voters to legalize medical marijuana.  NFIA is an Atlanta-based nonprofit organization, founded in 1977, that has been helping parents prevent children from using alcohol, tobacco, and other drugs.  NFIA researched and issued the paper to mark its 40th anniversary.

The NFIA study, Tracking the Money That’s Legalizing Marijuana and Why It Matters, exposes, for the first time, the money trail behind the marijuana legalization effort during a 13-year period.  The report lays bare the strategy to use medical marijuana as a runway to legalized recreational pot, describing how financier George Soros, insurance magnate Peter Lewis, and for-profit education baron John Sperling (and groups they and their families fund) systematically chipped away at resistance to marijuana while denying that full legalization was their goal.  The report documents state-by-state financial data, identifying the groups and the amount of money used either to fund or oppose ballot initiatives legalizing medical or recreational marijuana in 16 states.  The paper unearths how legalizers fleeced voters and outspent — sometimes by hundreds of times — the people who opposed marijuana.

Tracking the Money That’s Legalizing Marijuana and Why It Matters illustrates that legalizers lied about the health benefits of marijuana, preyed on the hopes of sick people, flouted scientific evidence and advice from the medical community and gutted consumer protections against unsafe, ineffective drugs.  And, it proves that once the billionaires achieved their goal of legalizing recreational marijuana (in Colorado and Washington in 2012), they virtually stopped financing medical pot ballot initiatives and switched to financing recreational pot.  In 2014 and 2016, they donated $44 million to legalize recreational pot in Alaska, Oregon, California, Arizona, Nevada, Massachusetts and Maine. Only Arizona defeated the onslaught (for recreational marijuana).

March 15, 2017 in Campaigns, elections and public officials concerning reforms, History of Marijuana Laws in the United States, Initiative reforms in states, Medical Marijuana Commentary and Debate, Medical Marijuana State Laws and Reforms, Recreational Marijuana Commentary and Debate, Recreational Marijuana State Laws and Reforms, Who decides | Permalink | Comments (0)

Sunday, March 12, 2017

"Medical marijuana business in New York is a bust so far"

NEW-YORKThe title of this post is the headline of this lengthy new local article from Buffalo.  Here are excerpts:

The state health commissioner last year declared New York’s medical marijuana program a success. But the five companies that the state selected in 2015 to get marijuana into the hands of people suffering from debilitating and sometimes terminal diseases such as cancer, AIDS and multiple sclerosis tell a different story.

“Our company is not close to break-even yet," said Ari Hoffnung, president of Vireo Health of New York, which has a marijuana-growing facility in Fulton County and dispenses its products in two downstate and two upstate locations. “And based on my understanding, no one has made a dime here in New York."

If other states were a guide, New York should be preparing for at least 200,000 patients enrolled in the program, the industry estimates. But since medical marijuana went on the market in New York State a little over a year ago, just over 14,000 patients have enrolled to buy the drug at one of the 20 dispensaries scattered around the state. Only half of those are regular customers. Many stopped taking the drug because of high costs, distances they must travel to get it or because they died, industry executives say. Fewer than 900 doctors signed on to certify patients to use the drug.

“There are two things the program is lacking: physicians and patients," said Sen. Diane Savino, author of the bill that opened up medical marijuana treatment in New York State. Now, while the five companies producing medical marijuana struggle to stay alive for lack of customers, the Cuomo administration wants to add five more grow-and-distribution licenses.

At the same time, the administration is not opening up a new bidding process. Instead, the Cuomo administration is turning to five companies – from the original 43 bidders – that lost in the application process two years ago. All of this is worrying the companies still trying to stay afloat. “Every single one of them is financially struggling," Savino said....

Instead of adding new grow facilities, the existing licensees say, New York should more aggressively attract physicians to participate and put dispensaries in more locations. Savino, the Staten Island senator who sponsored the legislation, said she is pushing the Cuomo administration to award new “retail license” dispensaries, but to bar the five existing grower/dispensary firms from owning them. She said the administration does not understand how the medical marijuana marketplace works and that adding new growers while supplies exceed demand is “a big mistake.”

Marijuana companies say they are not arguing more licenses should never be issued to grow and sell marijuana. “No one is making any money here. Twenty percent of us have already failed," said Hoffnung, president of Vireo Health, referring to one of the original licensees that sold out to a California company because of financial problems.

March 12, 2017 in Business laws and regulatory issues, Medical Marijuana Commentary and Debate, Medical Marijuana Data and Research, Medical Marijuana State Laws and Reforms | Permalink | Comments (0)

Friday, March 3, 2017

What might marijuana law look like if we really treated marijuana like a medicine?

The question in the title of this post is the question being raised by a student presentation in in my Marijuana Law, Policy & Reform seminar next week. The student addressing this issue has assembled the following background reading:

1.  Press article: "11 key findings from one of the most comprehensive reports ever on the health effects of marijuana"

2.  Information from the FDA: "What is the approval process for a new prescription drug?"

3.  More from the FDA: "FDA and Marijuana"

4.  Press article: "Most uses of medical marijuana wouldn't pass FDA review, study finds"

5.  Press article: "When Your State Says Yes To Medical Marijuana, But Your Insurer Says No"

March 3, 2017 in Assembled readings on specific topics, Medical community perspectives, Medical Marijuana Commentary and Debate, Medical Marijuana State Laws and Reforms | Permalink | Comments (0)

Tuesday, February 21, 2017

"Can Marijuana Ease the Opioid Epidemic?"

The question in the title of this post is the headline of this new Stateline piece.  Regular readers may be tired of my repeated emphasis on the possible connections between the nation's opioid problems and marijuana reform, but I continue to consider the story very important and I am especially troubled to see so little attention seemingly given to these matters by those on the front-lines of the opioid epidemic.  Here are excerpts from the Stateline piece (which discusses medical marijuana more generally):

In the midst of an opioid crisis, some medical practitioners and researchers believe that greater use of marijuana for pain relief could result in fewer people using the highly addictive prescription painkillers that led to the epidemic.

A 2016 study by researchers at Johns Hopkins Bloomberg School of Public Health found that states with medical marijuana laws had 25 percent fewer opioid overdose deaths than states that do not have medical marijuana laws. And another study published in Health Affairs last year found that prescriptions for opioid painkillers such as OxyContin, Vicodin and Percocet paid for by Medicare dropped substantially in states that adopted medical marijuana laws.

In December, the New York Health Department said it would start allowing some patients with certain types of chronic pain to use marijuana as long as they have tried other therapies. The state’s original medical marijuana law, along with those in Connecticut, Illinois, New Hampshire and New Jersey, did not include chronic pain as an allowable condition for marijuana use, in part over concerns that such a broad category of symptoms could result in widespread and potentially inappropriate use of the controversial medicine.

Advocates for greater use of medical marijuana argue that including chronic pain as an allowable condition could result in even further reductions in dangerous opioid use. But some physicians remain cautious about recommending the botanical medicine as a pain management tool.

Dr. Jane Ballantyne, a pain specialist at the University of Washington and president of Physicians for Responsible Opioid Prescribing, which promotes the use of alternatives to opioids for chronic pain, said she does not recommend that her patients try marijuana. “There is no doubt marijuana is much safer than opiates. So we don’t discourage its use.” But in general, she said, “non-drug treatments are far more helpful than any drug treatment, and marijuana is a drug.”

At Mount Sinai Hospital here in the city, Dr. Houman Danesh, director of integrative pain management, suggests patients try physical therapy, yoga, acupuncture, stem cell therapy, nutrition counseling, hypnosis and behavioral health counseling before resorting to opioids or any other medications. He said lack of sufficient research to back up marijuana’s safety and efficacy has kept him from adding it to his pain management toolkit, but he doesn’t rule it out in the near future....

Dr. Howard Shapiro, started certifying patients for marijuana about a year ago and quickly became a believer. He’s one of only 371 doctors out of nearly 33,000 in [New York] City’s five boroughs registered to certify patients for medical marijuana. Statewide, only 863 out of roughly 96,000 physicians have signed up for the program....

As a primary care doctor who takes a holistic approach to medicine, Shapiro said trying medical marijuana was a natural for him. But he said he worried that “a bunch of druggies would start showing up.” Instead, he said the patients he began seeing were all very sick and none of them appeared to be seeking drugs for fun. The improvement he saw in those first patients was remarkable, he said. “I really think medical marijuana is the drug of the future,” Shapiro said. “We’re going to find out that it does a lot of things we already think it can do, but don’t have scientific studies to prove it.”

Out of 109 patients he’s seen over the past year, all but a handful reported substantial improvement in their pain and other symptoms within a month or two of using medical marijuana, he said. For Shapiro’s patients, the cost of marijuana treatment ranges from $300 to $400 a month, depending on their level of use.

February 21, 2017 in Medical community perspectives, Medical Marijuana Commentary and Debate, Medical Marijuana State Laws and Reforms | Permalink | Comments (1)

Saturday, February 18, 2017

Highlighting free market fuzziness for GOP when marijuana involved

This Florida newspaper commentary by John Romano, headlined "Doesn't medical marijuana deserve a free market too?," effectively shines a light on the notable fact that the affinity of some Republican leaders for less government regulation and more marketplace freedom often wanes when the commodity at issue is marijuana.  Here is a portion of the commentary:

Around here, free market is the answer. And it doesn't even require an actual question.

Education gap? Let the business community fix it. Health insurance? Keep the government out of it. Minimum wage? Leave it up to the job creators. Yes, free market competition will always be the solution in Tallahassee.

Except when it comes to medical marijuana. Apparently, that's an industry in serious need of a government-sponsored cartel.

When first venturing into the marijuana business a couple of years ago, the state handpicked a small group of well-connected nurseries in a highly suspect procurement process. Now that a constitutional amendment has marijuana on the precipice of becoming a billion-dollar industry, the state is considering a plan to reward that same group of nurseries with a huge head start in the marketplace. And that contradicts everything our state leaders normally preach.

Think I'm exaggerating? State Sen. Rob Bradley, R-Fleming Island, recently introduced legislation to repeal the state's "certificate of need" programs for hospitals. The program allows the state to regulate where hospitals open, ostensibly to make sure private facilities do not cater to an affluent population and ignore the poor. Bradley calls it a "cumbersome process" used to "block expansion" and "restrict competition." He says eliminating the program will create jobs and drive down prices.

And yet Bradley is also the sponsor of a bill that restricts the number of nurseries allowed to produce medical marijuana, which critics say will create price gouging and limit available product. In effect, it would create the same problems Bradley says hamper the hospital industry....

Personally, I'm waiting for House Speaker Richard Corcoran to get involved.  This is a man who does not believe in compromising his principles. He's so committed to free market ideals in education that he called teachers "evil" for pushing back against the privatization of public schools.  He once said he would go to war to fight Obamacare's Medicaid expansion.

Not long ago, Corcoran laid out his political principles in a forceful speech: "No economic system has done more to benefit mankind than the free enterprise system … but when judges or legislatures or local governments continually rewrite the rules or attempt to pick winners and losers, that is when markets fail.  We need to reverse the damage that has been done, untangle the red tape and tear down all these barriers to entry."

Glad to hear it, Mr. Speaker. Looking forward to you joining the fight.

February 18, 2017 in Business laws and regulatory issues, Medical Marijuana Commentary and Debate, Medical Marijuana State Laws and Reforms | Permalink | Comments (0)