Marijuana Law, Policy & Reform

Editor: Douglas A. Berman
Moritz College of Law

Wednesday, August 24, 2016

New York Department of Health releases two-year report on "Medical Use of Marijuana Under the Compassionate Care Act"

ThI was pleased to find this big new data-rich report from the New York Department of Health titled simply "Medical Use of Marijuana Under the Compassionate Care Act: Two-Year Report."  For those really interested in really understanding how really serious medical marijuana programs are operating (as I am), this kind of official report is terrifically interesting and valuable.  Here is the 13-page report's introduction and some of its closing recommendations:

On July 7th, 2014, Governor Andrew M. Cuomo signed into law the Compassionate Care Act to establish a comprehensive Medical Marijuana Program (“program”). Just eighteen months after the Compassionate Care Act was signed into law, the first New Yorkers obtained medical marijuana. The program launched on time and statewide, providing access to a new treatment option for patients in a manner that protects public health and safety. Within the first six months of operation, over 5,000 patients were certified with the program. The program also registered more than 600 physicians across the State. In just six months, New York’s program has more physicians registered than other states whose programs have been in existence for significantly longer than New York’s. The program continues to oversee the manufacture and sale of medical marijuana to ensure that it is dispensed and administered in a manner that protects public health and safety.

Pursuant to Public Health Law (PHL) § 3367(3), this report provides an overview of Medical Marijuana Program activities since the signing of the Compassionate Care Act, as well as recommendations to the Governor and the Legislature. The data for this report was obtained on June 15, 2016, from the New York State Department of Health’s (NYSDOH) Medical Marijuana Data Management System (MMDMS) and the Prescription Monitoring Program Registry (PMPR)....

1.  NYSDOH recommends authorizing Nurse Practitioners (NPs) to certify New Yorkers for medical marijuana, consistent with their current authority to prescribe controlled substances (including opioids) for patients diagnosed with qualifying conditions covered in the Compassionate Care Act. Allowing NPs to issue certifications for medical marijuana would allow them to properly treat patients suffering from severe, debilitating or life threatening conditions, particularly in many rural counties where there are fewer physicians available to treat such ailments....

4.  NYSDOH recommends evaluating allowing distribution of Medical Marijuana to certified patients through home delivery services provided by registered organizations, and review of policies and procedures from other jurisdictions to help craft guidelines to provide for a safe and effective home delivery program.....

5.  NYSDOH recommends working with the registered organizations to make more brands of medical marijuana products available to patients....

7.  NYSDOH recommends a review of evidence be conducted for the medical use of marijuana in patients suffering from chronic intractable pain....

9.  To meet additional patient demand and increase access to medical marijuana throughout New York State, NYSDOH recommends registering five additional organizations over the next two years, using a phased-in approach to permit their smooth integration into the industry.

August 24, 2016 in Medical community perspectives, Medical Marijuana Data and Research, Medical Marijuana State Laws and Reforms | Permalink | Comments (0)

Sunday, August 21, 2016

Noting the lack of racial diversity in recipients of first Maryland medicial marijuana licenses

This Washington Post article, headlined "Missing from Maryland’s legal marijuana growers? Black business leaders," reports on an all-too-common business pattern that tends to emerge as a state gets started with modern marijuana reforms.  Here is how the article gets started:

Maryland set up its legal medical marijuana industry with hopes of racial diversity and equity in spreading profits, but none of the 15 companies that were cleared this week for potentially lucrative growing licenses is led by African Americans.

Some lawmakers and prospective minority-owned businesses say this is unacceptable in a state where nearly a third of the population is black, the most of any state with a comprehensive legal pot industry.  They say the lack of diversity is emblematic of how, across the country, African Americans are disproportionately locked up when marijuana use is criminalized yet are shut out of the profits when drug sales are legalized.  “We are not going to see this industry flourish in the state of Maryland with no minority participation,” said Del. Cheryl D. Glenn (D-Baltimore), chairwoman of the Legislative Black Caucus.

Glenn was a key player in the legalization battle, and the commission that awards medical marijuana business licenses and oversees the industry is named after her mother, Natalie LaPrade, who died of cancer.  She is considering filing a legal injunction to halt the licensing process and is weighing other options, such as pushing the commission to award additional licenses to minority-owned companies.

The law legalizing medical marijuana says regulators should “actively seek to achieve” racial and ethnic diversity in the industry.  But the commission did not provide extra weight to applications submitted by minority-owned businesses because a letter from the attorney general’s office suggested that preferences would be unconstitutional without there being a history of racial disparity in marijuana licensing to justify the move.

A spokeswoman for the Maryland Medical Cannabis Commission said there will be future opportunities to expand minority participation when the agency awards dispensary licenses and when it considers issuing more cultivation licenses in 2018 if supply doesn’t meet demand.  Businesses must also submit annual reports on the racial breakdown of their ownership and workforce, providing a more comprehensive look at the industry’s diversity.  “The Commission believes a diverse workforce is in the best interest of the industry,” said Vanessa Lyon, the spokeswoman.

But Glenn and other critics say the state hasn’t done enough to ensure diversity in the blossoming business that’s already worth billions nationwide.

August 21, 2016 in Business laws and regulatory issues, Medical Marijuana Commentary and Debate, Medical Marijuana State Laws and Reforms, Race, Gender and Class Issues | Permalink | Comments (0)

Sunday, August 14, 2016

Highlighting myriad challenges for doctors in a world of widespread state medical marijuana reforms

Dt_160517_medical_marijuana_cannabis_800x600This recent USA Today piece, headlined "As states OK medical marijuana laws, doctors struggle with knowledge gap," puts a needed spotlight on what I think may be the most under-examined aspect of modern state medical marijuana reforms. Here are excerpts:

Medical marijuana has been legal in Maine for almost 20 years.  But Farmington physician Jean Antonucci says she continues to feel unprepared when counseling sick patients about whether the drug could benefit them.  Will it help my glaucoma?  Or my chronic pain?  My chemotherapy’s making me nauseous, and nothing’s helped.  Is cannabis the solution? Patients hope Antonucci, 62, can answer those questions.  But she said she is still “completely in the dark.”

Antonucci doesn’t know whether marijuana is the right way to treat an ailment, what amount is an appropriate dose or whether a patient should smoke it, eat it, rub it through an oil or vaporize it.  Like most doctors, she was never trained to have these discussions. And, because the topic still is not usually covered in medical school, seasoned doctors, as well as younger ones, often consider themselves ill-equipped.  Even though she tries to keep up with the scientific literature, Antonucci said, “it’s very difficult to support patients but not know what you’re saying.”

As the number of states allowing medical marijuana grows – the total has reached 25 plus the District of Columbia – some are working to address this knowledge gap with physician training programs.  States are beginning to require doctors to take continuing medical education courses that detail how marijuana interacts with the nervous system and other medications, as well as its side effects.

Though laws vary, they have common themes. They usually set up a process by which states establish marijuana dispensaries, where patients with qualifying medical conditions can obtain the drug.  The conditions are specified on a state-approved list. And the role of doctors is often to certify that patients have one of those ailments. But many say that, without knowing cannabis’ health effects, even writing a certification makes them uncomfortable.  “We just don’t know what we don’t know. And that’s a concern,” said Wanda Filer, president of the American Academy of Family Physicians and a practicing doctor in Pennsylvania.

This medical uncertainty is complicated by confusion over how to navigate often contradictory laws.  While states generally involve physicians in the process by which patients obtain marijuana, national drug policies have traditionally had a chilling effect on these conversations.  The Federation of State Medical Boards has tried to add clarity. In an Aug. 9 JAMA editorial, leaders noted that federal law technically prohibits prescribing marijuana and tasks states that allow it for medical use to “implement strong and effective ... enforcement systems to address any threat those laws could pose to public safety, public health and other interests.”  If state regulation is deemed insufficient, the federal government can step in.

That's why many doctors say they feel caught in the middle, not completely sure of where the line is now drawn between legal medical practice and what could get them in trouble. In New York, which legalized marijuana for medicinal purposes in 2014, the state health department rolled out a certification program last October. (The state’s medical marijuana program itself launched in January 2016.)  The course, which lasts about four hours and costs $249, is part of a larger physician registration process. So far, the state estimates 656 physicians have completed the required steps.  Other states have contacted New York’s Department of Health to learn how the training works.

Pennsylvania and Ohio are also developing similar programs.  Meanwhile in Massachusetts, doctors who wish to participate in the state medical marijuana program are required to take courses approved by the American Medical Association. Maryland doesn’t require training but encourages it through its Medical Cannabis Commission website, a policy also followed in some other states.

Physicians appear to welcome such direction.  A 2013 study in Colorado, for instance, found more than 80% of family doctors thought physicians needed medical training before recommending marijuana.  But some advocates worry that doctors may find these requirements onerous and opt out, which would in turn thwart patients’ access to the now-legal therapy, said Ellen Smith, a board member of the U.S. Pain Foundation, which favors expanded access to medical cannabis.

Education is essential, given the complexity of how marijuana interacts with the body and how little physicians know, said Stephen Corn, an associate professor of anesthesiology, perioperative and pain medicine at Harvard Medical School.  Corn also co-founded The Answer Page, a medical information website that supports the New York program and is also bidding to supply information for the Pennsylvania program, Corn said....

From a medical standpoint, the lack of information is troubling, Filer said. “Typically, when we’re going to prescribe something, you’ve got data that shows safety and efficacy,” she said.  With marijuana, the body of research doesn’t match what many doctors are used to for prescription drugs.

Still, Corn said, doctors appear pleased with the state training sessions. More than 80% of New York doctors who have taken his course said they changed their practice in response to what they learned.  But even now, whenever Corn speaks with doctors about medical marijuana, people ask him how they can learn more about the drug’s medical properties and about legal risks.  Those two concerns, he said, likely reduce the number of doctors comfortable with and willing to discuss marijuana’s place in medicine, even if it’s allowed in their states.

August 14, 2016 in Federal Marijuana Laws, Policies and Practices, Medical community perspectives, Medical Marijuana Commentary and Debate, Medical Marijuana Data and Research, Medical Marijuana State Laws and Reforms, Who decides | Permalink | Comments (2)

Wednesday, August 10, 2016

"The Biggest Legislative Marijuana Policy Reforms Of 2016"

The title of this post is the headline of this notable new Huffington Post commentary authored by Rob Kampia, who is the co-founder and executive director of the Marijuana Policy Project. Here are excerpts:

On July 29, Illinois Gov. Bruce Rauner (R) signed a bill removing the threat of arrest for small amounts of marijuana, capping a record year of legislative and administrative marijuana policy reforms throughout the country.

Two states, Pennsylvania and Ohio, enacted effective medical marijuana laws via their legislatures, making them the 24th and 25th states to do so, respectively.  As a result, more than half of the U.S. population now lives in states that have opted to legalize medical marijuana.

This year has also seen improvements to several existing medical marijuana programs. Colorado adopted “Jack’s Law,” which provides protections for medical marijuana patients who attend public schools.  Connecticut, New Hampshire, Rhode Island, and Vermont expanded the lists of medical conditions for which patients can qualify to use medical marijuana.  Vermont also enacted a law that reduces the required time for a patient-provider relationship from six to three months, allows marijuana to be transferred to research institutions, and requires labeling and child-resistant packaging for edibles sold at dispensaries.  Oregon increased access to medical marijuana for veterans who receive assistance from the VA program.  In Illinois, Gov. Rauner signed a bill to extend and expand the state’s pilot medical marijuana program, and in Maryland, lawmakers enacted a law allowing nurse practitioners, dentists, podiatrists, and nurse midwives to recommend medical marijuana to qualifying patients....

In addition to Illinois, a number of other states enacted laws to reduce marijuana possession penalties. Kansas lowered the maximum jail sentence for first-time possession and reduced second offenses from felonies to misdemeanors. Louisiana and Maryland removed criminal penalties for possession of paraphernalia, with the Maryland Legislature overriding Gov. Larry Hogan’s (R) veto.  Oklahoma cut the penalties for second marijuana possession offenses in half, and Tennessee reduced a third possession offense from a felony to a misdemeanor, making the maximum penalty less than a year in jail.  At the local level, New Orleans and a number of Florida counties passed ordinances that give police the option to issue summons or citations instead of arresting people for low-level possession.

In states where marijuana is legal for adults, legislators and regulators made notable improvements and progress toward full implementation.  In Colorado, lawmakers passed a bill to allow out-of-state ownership of marijuana businesses and increased the amount of marijuana that non-residents may purchase at retail establishments. Colorado also increased local control of testing laboratories and created a new business category for businesses that transport marijuana.  And in Washington State, a number of bills were passed to streamline practices in the marijuana industry and make it easier to apply for research licenses.

Alaska regulators began licensing marijuana cultivators and expect to begin issuing retail licenses soon.  Oregon is in the process of licensing adult-use marijuana retailers while currently allowing any adult to purchase marijuana from existing medical dispensaries; Oregon also passed comprehensive regulations that, among many other things, increase cooperation between the medical and adult retail programs, exempt patients from being taxed, allow out-of-state investment in marijuana businesses, and protect financial institutions from prosecution under state law for doing business with the marijuana industry.

August 10, 2016 in Campaigns, elections and public officials concerning reforms, Medical Marijuana State Laws and Reforms, Recreational Marijuana State Laws and Reforms | Permalink | Comments (1)

Thursday, August 4, 2016

Reviewing all the states where voters will weigh in on marijuana reform during Election 2016

With now only three months to Election Day 2016, I thought it useful to reprint the start of this new International Business Times article headlined "Where Will Pot Be Legal Next? Recreational Marijuana On The Ballot In 5 States On Election Day 2016":

Despite Americans' statistical lack of enthusiasm for both Donald Trump and Hillary Clinton, the Green Party still has little chance of getting nominee Jill Stein into the White House. But another kind of green is poised to have a big election day this year: recreational marijuana.

Alaska, Colorado, Oregon and Washington might soon have some company in the ranks of states that have legalized recreational marijuana use.  Five states — Arizona, California, Maine, Massachusetts and Nevada — will vote on recreationally legalizing pot on ballot measures this year on election day in November.  The states would determine individually what the parameters of legalization would be — California has signaled that recreational pot would be legal for adults over 21 and subject to a 15 percent sales tax.

In addition to those states, four other states — Arkansas, Florida, Montana and Missouri — will have ballot measures this year to make marijuana legal for medical use.  The eight ballot measures will be the largest swath of voters weighing in on the issue of marijuana legalization in history.  "This is really a watershed year for marijuana legalization, so I'm hoping that we'll see some big changes in November," F. Aaron Smith, co-founder and executive director of the National Cannabis Industry Association, told CNN.

By my count, five recreational initiatives and four medical initiatives adds up to NINE ballot issues. Perhaps even more significant if we are counting heads is that around 25% of the entire national population will be voting on marijuana reform issues, making the 2016 election year arguably the closest possible thing to a national referendum on blanket marijuana prohibition. If the majority of these ballot initiatives pass, and especially if the initiaitive pass big in the really big/significant states of California and Florida, I do it will be all but certain that federal marijuana prohibition is reformed in some significant way before the end of the decade.

August 4, 2016 in Campaigns, elections and public officials concerning reforms, Initiative reforms in states, Medical Marijuana State Laws and Reforms, Recreational Marijuana State Laws and Reforms | Permalink | Comments (0)

Wednesday, August 3, 2016

"Marijuana Agriculture Law: Regulation at the Root of an Industry"

The title of this post is the title of this notable forthcoming paper authored by Ryan Boudin Stoa available via SSRN.  Here is the abstract:

Marijuana legalization is sweeping the nation.  As many as thirty marijuana legalization initiatives may appear on election ballots in 2016, legalizing the recreational or medicinal use of marijuana in as many as 17 states and adding to the growing number of states that have already legalized marijuana.  Many of these legalization initiatives propose to regulate marijuana in a manner similar to alcohol, and many titles are variations of “the regulate marijuana like alcohol act.”  For political and public health reasons the analogy makes sense, but it also reveals a regulatory blind spot.  States may be using alcohol as a model for regulating the distribution, retail, and consumption of marijuana, but marijuana is much more than a retail product. It is also an agricultural product, and by some measures, the largest cash crop in the United States.  Since marijuana prohibition laws were passed long before any regulations for cultivation were developed, states are facing an unprecedented challenge: regulate, for the first time ever, one of the country’s largest agricultural industries.

There are major regulatory challenges ahead, and how states respond to those challenges will shape the course of the marijuana industry.  At present there is a gap in understanding the regulatory challenges presented by marijuana agriculture, and the options states have to address them.  This Article identifies those challenges and the regulatory approaches most capable of addressing them.  The study begins by describing the existing state of marijuana agriculture regulations.  States are likely to find that the marijuana industry’s unique characteristics justify a tailored regulatory approach; relying on existing agricultural policies may be ineffectual or lead to perverse outcomes.  

Next, fundamental questions about the “marijuana fragmentation spectrum” are explored.  Will the industry come to be dominated by agricultural conglomerates mass-producing a marijuana commodity, as many have feared?   Or will governments and the industry adopt the appellation model favored by the wine industry, to protect local farmers and differentiate between products?  The major environmental impacts of marijuana agriculture are analyzed as well, including regulations that address water allocation, water quality, energy, organic certification, and crop insurance.  Finally, the study addresses power distribution trade-offs within marijuana agriculture regulation frameworks, including local vs. state, and consolidated vs. fragmented, regulatory authority dilemmas.  The findings suggest that responsible and sustainable marijuana agriculture can be fostered at the state level, but only if regulations are responsive to the unique and unprecedented challenges that marijuana agriculture presents.

August 3, 2016 in Business laws and regulatory issues, 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)

Saturday, July 30, 2016

Why Florida has become such an interesting and important marijuana reform state to watch closely

MarijuanaThis new local article, headlined "Medical marijuana war heads to next battle," reports on various recent developments in Florida that reinforce my view that the Sunshine State has become in 2016 one of the most fascinating states to watch for both proponents and opponents of marijuana reform.  Here are some of the details:

Marijuana was sold legally in Florida for the first time this week since it was outlawed by the federal government in 1937.

In a staid Tallahassee storefront more akin to a doctor's office than a head shop, Dallas Nagy, a Tampa-area native with chronic seizures and muscle spasms, plunked down $60 for a non-euphoric strain of marijuana on Tuesday.  "I thank you for the hope of getting better," Nagy said at the opening of Trulieve, the first medical marijuana dispensary in the state.

The milestone, hailed by legalization activists, some doctors, owners of nascent pot nurseries and the parents of children with debilitating ailments, is really just the beginning of Florida's battle over marijuana laws.  Groups on both sides of the medical marijuana debate are battling it out over an amendment on the November ballot that would give access to marijuana with higher levels of THC — the chemical that creates a user's "high" — for a wider range of illnesses.

Anti-drug activists and law enforcement say the amendment would lead to de facto legalization of the drug. Amendment 2, as it will appear on the ballot, makes patients with "debilitating medical conditions" eligible – a vague term ripe for abuse, they say. "It's unlimited, so if you have headaches a doctor could say marijuana could alleviate your headache," said Christina Johnson, spokeswoman for Drug Free Florida, a group fighting the amendment.

Along with "debilitating conditions," the amendment states that patients with glaucoma, HIV/AIDS, post-traumatic stress disorder, amyotrophic lateral sclerosis (ALS), Crohn's disease, Parkinson's disease or multiple sclerosis would be eligible for medical marijuana.  The amendment doesn't specify in what form the drug could be sold.

The fight over Amendment 2 is already drawing big bucks on both sides.  Drug Free Florida got a boost this week in the form of an $800,000 contribution from Carol Jenkins Barnett, a major Publix shareholder and the daughter of the founder of the Lakeland-based grocery store chain.  The group has about $1.7 million in cash on hand.

On the other side is United for Care, a group funded and promoted with the help of Orlando trial attorney John Morgan, which rounded up signatures to get the amendment on the 2016 ballot.  A similar effort in 2014 failed, receiving 57 percent of the vote, 3 percent shy of the 60 percent required to pass.  Over the past two elections, the group has raised and spent more than $11.5 million.  A Quinnipiac poll from May showed 80 percent support for the amendment among likely voters.

The success or failure of Amendment 2 could have a huge impact on Florida's small, legally sanctioned marijuana industry, which is still in its infancy.  Jason Parnell, chief operating officer of Trulieve, said there are currently enough patients to serve and stay in business under the existing law, but the additional patients opened up by the amendment would allow them to offer lower prices.  "If you have a bigger pool you can have economies of scale, and we can do price compression," said Parnell, whose current low-THC products include oils, gelcaps and a smokable version....

But for people such as Tallahassee resident Rosalyn Deckerhoff, access to cannabis is essential to providing her son Barrett, 20, who suffers from epilepsy, some relief and a better life.  She's exhausted all other options. "We've done everything medically in the book for the last 20 years, including brain surgery," Deckerhoff said.

Two years ago she urged the Legislature to pass a bill allowing patients with cancer or debilitating diseases that cause frequent seizures like epilepsy to legally obtain a noneuphoric strain of marijuana known as "Charlotte's Web."  Because of red tape and legal challenges from growers and dispensaries seeking licenses to distribute the drug, it wasn't until this week that it became available to patients.

Subsequent laws will allow terminally ill patients access to marijuana with more potent tetrahydrocannabinol, or THC, the main active chemical in pot.  To obtain medical pot in Florida, a patient must be diagnosed with a qualifying condition by a doctor and receive a recommendation for medical marijuana by a doctor registered with the state Office of Compassionate Use.

Doctors must complete a course to receive a license from the office. As of July 22, there were 82 doctors who have taken the eight-hour course, including 10 in Central Florida, according to the department. In addition, doctors recommending medical marijuana must have a minimum three-month history of treating the patient.

As this article details, Florida is already, in a sense, a medical marijuana state thanks to the work of the state legislature AND a majority of Florida voters two years ago voted in favor of the state having a much more "robust" form of medical marijuana legalized. But with a 60% vote requirement for approval, advocates for more robust reform will need to convince a super-majority of voters that existing state efforts are not good enough. And, unlike in some other states, it appears that both supporters and opponents of the proposed ballot reform will be able to run well-funded campaigns.

Moreover, Florida is historically a critical "swing state" in national elections, and I am certain the major Prez candidates know well that opposing a sizeable majority of Florida voters have already revealed their support for significant reform. Thus, I think it likely that all the candidates when campaigning in Florida will be asked about the state's 2016 ballot initiative, and it seems possible (perhaps likely?) that Libertarian candidate Gary Johnson will not be the only one to express support for it.

Stay tuned.

July 30, 2016 in Campaigns, elections and public officials concerning reforms, Initiative reforms in states, Medical Marijuana State Laws and Reforms, Political perspective on reforms, Who decides | Permalink | Comments (0)

Thursday, July 28, 2016

Democrats formally approve platform calling for "pathway" to marijuana legalization

I continue to not know just how much import and impact official party platforms have. Nevertheless, I still think this press piece about formal events at the DNC, headlined "Democrats become first major party to back pathway to legalizing pot," is reporting on events that are a pretty big deal for marijuana reform advocates now and in the years ahead. Here is the official language from the party platform embraced by Dems:

“Because of conflicting federal and state laws concerning marijuana, we encourage the federal government to remove marijuana from the list of ‘Schedule 1’ federal controlled substances and to appropriately regulate it, providing a reasoned pathway for future legalization. We believe that the states should be laboratories of democracy on the issue of marijuana, and those states that want to decriminalize it or provide access to medical marijuana should be able to do so. We support policies that will allow more research on marijuana, as well as reforming our laws to allow legal marijuana businesses to exist without uncertainty. And we recognize our current marijuana laws have had an unacceptable disparate impact in terms of arrest rates for African-Americans that far outstrip arrest rates for whites, despite similar usage rates.”

Here is more from the press piece with reactions to these developments from leading marijuana reform advocates:

Legalization backers applauded the vote and said it reflected polls that found a majority of Americans wanted to legalize the drug.  “The fact that one of the country’s two major parties has officially endorsed a pathway to legalization is the clearest sign we’ve seen yet that marijuana reform is a mainstream issue at the forefront of American politics,” said Tom Angell, chairman of Marijuana Majority, a pro-legalization group. “A clear and growing majority of voters want to end prohibition.”

Former Secretary of State Hillary Clinton, the Democratic presidential candidate, does not back across-the-board legalization at the federal level. The platform includes her often-used language that marijuana legalization should be left to the states, allowing them to be “laboratories of democracy.”  That’s good news for Washington state, Colorado, Oregon and Alaska, which that have already approved recreational marijuana, along with the District of Columbia....

Mason Tvert, spokesman for the Marijuana Policy Project, a pro-legalization group, said a growing number of state Democratic parties had already backed legalization in their platforms this year.  That includes California, which will vote on recreational marijuana in November.  “It’s not particularly surprising that the platform calls for rolling back the failed policy of marijuana prohibition, seeing as the vast majority of Democrats – and a majority of Americans – support making marijuana legal for adults,” he said. 

Despite the support, Tvert said he wouldn’t be surprised if the issue didn’t get much attention from speakers at the Democratic convention this week.  “The platform typically reflects the positions of most party members, but it does not necessarily reflect the political or policy priorities of candidates and party leaders,” he said.

July 28, 2016 in Campaigns, elections and public officials concerning reforms, 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 (0)

Friday, July 22, 2016

Illinois judge orders reconsideration of making migraines an eligible condition for medical marijuana in the state

Migraines-spousesAs reported in this Chicago Tribune article, in Illinois "a judge has ordered state officials to reconsider adding migraine headaches to the list of conditions that qualify a patient to buy" marijuana.  Here is more about this significant ruling:

Cook County Circuit Court Associate Judge Rita Novak overturned Illinois Department of Public Health Director Dr. Nirav Shah's denial of a petition to add migraines to that list.  The judge ordered Shah to reconsider evidence presented to the Medical Cannabis Advisory Board before its members voted to recommend approval of marijuana to treat migraines.

The court ruling came in response to a suit filed by a man whose name was kept secret because he already has been using marijuana to treat his headaches, his attorneys said.  Since adolescence, the middle-age man has suffered migraines up to three times a week, lasting from several hours up to three days, attorney Robert Bauerschmidt said.

The man has tried triptans, the most common treatment for migraines, but they didn't work well.  He tried narcotic painkillers but had a bad reaction that keeps him from using them, the attorney said.  "He's been through everything," Bauerschmidt said. "Marijuana doesn't cure it, but he finds the pain less severe and believes the headaches are less frequent when he's using it."

Though federal law still prohibits marijuana possession, state law allows it for patients who have any of about 40 specific medical conditions, including cancer, AIDS or multiple sclerosis.  Patients may buy the pot only from state-approved dispensaries.

The latest ruling comes after another judge last month ordered the state to add post-traumatic stress disorder as a qualifying condition for medical pot.  That ruling has been rendered somewhat moot, since Gov. Bruce Rauner recently signed a law adding PTSD and terminal illness as qualifying conditions.  But taken together, the separate rulings by different judges suggest that judicial review may further expand the program.

Attorney Mike Goldberg, whose firm handled the two prior cases, has pending lawsuits asking to add six other conditions: irritable bowel syndrome, chronic postoperative pain, osteoarthritis, intractable pain, autism and polycystic kidney disease.  "It's a potential game-changer for the industry," Goldberg said.

But Annie Thompson, a spokeswoman for the Illinois attorney general's office, which represents the state in court, emphasized that the ruling does not require adding migraines to the list.  It instead orders the director to reconsider within the parameters of the law and the judge's findings.

Joe Wright, the former director of the state's medical cannabis program, agreed that the case is not a done deal. "I'm not sure that means you'd necessarily have to add it," he said.  "That means they have to look at it again in light of what the advisory board considered."  If migraines and other conditions are added, Wright said, "That would open up the patient population fairly sizably."...

If the director adds migraines as a qualifying condition, that could greatly enlarge the number of patients. Migraines are a widespread condition, occurring in about 16 percent of Americans, according to two surveys cited by the American Headache Society.  Because there is no widely accepted blood test or brain scan to verify migraines, they typically are diagnosed by medical history, symptoms and a physical and neurological examination, according to the Mayo Clinic.  Typically Migraines occur repeatedly to the same patient, involving moderate to severe head pain that last for hours or days, nausea or vomiting and sensitivity to noise and light.

July 22, 2016 in Court Rulings, Medical community perspectives, Medical Marijuana Data and Research, Medical Marijuana State Laws and Reforms, Who decides | Permalink | Comments (0)

Thursday, July 7, 2016

Arkansas voters now sure to consider (at least one) medical marijuana initiatives in November 2016

ArkThis AP article, headlined "It’s official: Arkansas will vote on medical marijuana in November," provides the interesting details on another state now sure to be considering marijuana reform through initiative this fall. Here are the dynamic details:

A proposal to legalize medical marijuana in Arkansas qualified for the November ballot on Thursday, putting the issue before the state’s voters for the second time in four years. The secretary of state’s office said it had verified at least 77,516 of the more than 117,000 signatures submitted for the proposed initiated act by Arkansans for Compassionate Care were from registered voters.

Initiated acts need at least 67,887 signatures, while constitutional amendments need at least 84,859. Friday is the deadline for groups to turn in signatures for their ballot measures.

Arkansas voters narrowly rejected a similar medical marijuana proposal in 2012, and this fall could face two competing legalization measures. Melissa Fults, campaign director for Arkansans for Compassionate Care, repeated her call for the sponsor of the competing proposal to abandon his efforts.

“It does complicate it tremendously if he does turn in because it’s going to greatly decrease our chances of either one passing,” Fults said. The measure from Fults’ group would allow patients with a range of medical conditions and a doctor’s recommendation to buy marijuana from dispensaries. Unlike the competing proposal, it would allow patients to grow their own marijuana if they don’t live near a dispensary.

David Couch, the sponsor of the competing measure, said he planned to submit petitions for his proposed constitutional amendment Friday morning and said he didn’t believe having two marijuana proposals on the ballot would doom either. “If you support medical marijuana and you believe that sick people should have this medicine, you should say vote for both,” Couch said. “That’s what I’m going to say.”

The conservative Family Council Action Committee, which campaigned against the marijuana proposal in 2012, said it would review the petitions for a potential legal challenge and was also considering challenging the proposal’s language in court. “This same issue was defeated in the election of 2012, and I believe the people of Arkansas are wise enough to see through this sham and vote it down again,” Jerry Cox, the committee’s executive director, said in a statement.

Republican Gov. Asa Hutchinson, a former head of the federal Drug Enforcement Administration, said he opposed the measure and urged members of the medical community to share concerns they may have about the legalization efforts. “I believe that while we want to provide medicine to anyone who needs it, this opens a lot of doors that causes more problems than it solves,” Hutchinson told reporters.

July 7, 2016 in Initiative reforms in states, Medical Marijuana Commentary and Debate, Medical Marijuana State Laws and Reforms | Permalink | Comments (0)

Wednesday, July 6, 2016

"Small businesses prepare for Ohio medical marijuana market months before regulations announced"

The title of this post is the headline of this lengthy new local article which gets started this way:

The rules for Ohio's medical marijuana growers and dispensaries are months away from being written, but entrepreneurs are already eyeing the future market here.

Dozens of marijuana and cannabis-related business names have been registered with the state since the legislature passed Ohio's medical marijuana law in late May. Existing Ohio companies are considering how they can service the marijuana industry. Companies working in legal marijuana states are planning to expand.

The coming months will likely be filled with medical marijuana conferences, workshops and panels for would-be marijuana business owners. But much of the preparation will be speculative, as crucial details -- such as the number of business licenses available and the criteria used to award them -- are unknown.

Ohio's medical marijuana law goes into effect Sept. 8 and requires the system to be fully operational by September 2018. The commerce department has until May 6, 2017, to issue rules and regulations for cultivators, and the rest of the rules must be set by October 2017.

But that's not stopping aspiring "potpreneurs" from getting a head start.

July 6, 2016 in Business laws and regulatory issues, Medical Marijuana Commentary and Debate, Medical Marijuana State Laws and Reforms | Permalink | Comments (0)

Tuesday, July 5, 2016

"Ohio’s New Medical Marijuana Industry Business, Politics, Law & You"

The title of this post is the name of this timely event scheduled for tomorrow afternoon on the campus of The Ohio State University.  I will be one of a number of speakers at an event being sponsored by the Ohio Cannabis Association. Here is the planned schedule for the event:

Wednesday, July 6th;  5:00pm – 8:00pm (Networking from 5-6. Program Begins Promptly at 6.)

The Ohio State University - Student Union - Great Hall Meeting Room 1739 N. High St, Columbus, OH 43210

Featuring leading experts on all aspects of the new industry…

State: State Sen. Kenny Yuko; State Rep. Kirk Schuring

National: John Hudak, Brookings Institute

Business: Andy Joseph, Apeks Supercritical; Jimmy Gould, Ohio House Medicinal Marijuana Task Force and GLA; Roberto Ryan, QC Infusion

Medical: Dr. Brian Santin, Ohio House Medicinal Marijuana Task Force; Janet Brenneman, Ohio Cannabis Nurses Association

Legal: Deb Tongren, Esq.; Douglas A. Berman, OSU Professor of Law

July 5, 2016 in Medical community perspectives, Medical Marijuana Commentary and Debate, Medical Marijuana State Laws and Reforms, Who decides | Permalink | Comments (0)

Sunday, July 3, 2016

Detailing the (disconcerting?) doctor dynamics in a state with (strict?) medical marijuana rules

This lengthy new Boston Globe article, headlined "Most Mass. doctors wary of approving marijuana use," reports on the distinctive and arguably disconcerting dynamics that have developed in the Bay State with respect to doctors making medical marijuana recommendations. Here are the highlights:

A small circle of physicians — 13, to be precise — has provided the vast preponderance of approvals needed by Massachusetts patients to gain access to medical marijuana, state records show, a pattern that underscores the continued growing pains of a new industry.  These doctors certified nearly three-quarters of the 31,818 patients who had received permission to use medical marijuana by early June.

The concentration of approvals in the hands of so few physicians is a story of both opportunity and fear.  For the baker’s dozen of doctors, medical marijuana certifications provide a robust stream of patients, who typically pay $200 out of pocket for an initial office visit.  But their grip on such a large share of patient certifications illustrates that many other physicians in the state are reluctant to sign off on patients using the drug, according to the Massachusetts Medical Society.

The hesitance reflects persistent concerns about the possible legal repercussions for their medical licenses if they prescribe a drug the federal government classifies as dangerous, with “no currently accepted medical use.”  It also underscores the lingering doubts about marijuana’s health risks and benefits, said Dr. James Gessner, president of the society.

These worries only intensified when state regulators in May and June yanked the licenses of two physicians accused of improperly certifying thousands of patients for marijuana use. Both suspended doctors worked in offices that specialize in issuing marijuana certificates. Some major teaching hospitals forbid their physicians from certifying patients for marijuana use, but in some cases, doctors have been circumventing restrictions by referring patients to clinics that specialize in granting certification....

State rules require physicians to complete one course about marijuana, including its side effects and signs of substance abuse, if they want to recommend the drug to patients.  Physicians then must register online with the state Health Department, which grants them permission to certify patients as eligible for medical marijuana use. Patients must also register with the online system to complete the certification process.

State regulations list nine diseases and conditions that can qualify a patient for marijuana use, including cancer, multiple sclerosis, Parkinson’s disease, and Crohn’s disease, but also gives physicians wide latitude to recommend use for any other “debilitating condition,” such as nausea and pain....

One physician who is receiving scores of referrals is Dr. Jill Griffin, who opened a medical marijuana practice in Northampton in 2013.  State records show Griffin, 56, has certified the most patients in Massachusetts — 3,284 by early June.  Griffin’s attorney, Michael Cutler, said many of the certifications Griffin has issued were for patients referred to her by other physicians. Griffin, who directed the emergency department at one Springfield hospital and worked in the emergency department of another facility, is well known in the region, Cutler said.

“Almost all of the doctors out here are part of group practices, and for a long time, all of the group practices prohibited their doctors from writing marijuana certifications,” Cutler said. “So, the only way a patient could be certified, for virtually all the doctors out here, was to refer patients out of their practice.”

But state records suggest sentiment among doctors may be slowly changing.  The number of physicians registered with the state to certify patients for medical marijuana use has nearly doubled in the past year, to 150 — although that still represents only a tiny fraction of the more than 30,000 doctors practicing in the state.

July 3, 2016 in Medical community perspectives, Medical Marijuana Commentary and Debate, Medical Marijuana State Laws and Reforms, Who decides | Permalink | Comments (0)

Thursday, June 23, 2016

Some good hard questions in Ohio following passage of its medical marijuana reform

These two recent newspaper article raise two good and challenging questions concerning the policies and practicalities soon now to become reality when Ohio's medical marijuana reforms formally become law in the coming months:

June 23, 2016 in Medical Marijuana Commentary and Debate, Medical Marijuana State Laws and Reforms, Race, Gender and Class Issues, Who decides | Permalink | Comments (0)

Saturday, June 18, 2016

Women in Maryland marijuana industry savoring absence of a glass ceiling in new industry

WG_New_Logo_rgbRegular readers know that one  aspect of the burgeoning marijuana industry that I find especially interesting is the role that women can and will play within a new modern industry that has little legitimate business history and thus has little history of traditional gender discrimination in its businesses.  Against this backdrop, this lengthy new article from the Baltimore Sun caught my attention this weekend.  The piece is headlined "Women see no ceiling in Maryland medical marijuana industry," and here are excerpts:

Maryland's long-promised medical marijuana industry doesn't exist yet, and that's precisely why more than 60 women, mostly dressed like a PTA crowd, banded together there — to rise to the top before anyone gets in their way. "How vital are women to the success of the cannabis business in Maryland? If you're asking, I probably don't want to talk to you," said Megan Rogers, a co-founder of the Baltimore chapter of Women Grow and an applicant to open a dispensary. "We're here to ensure that the cannabis industry has no glass ceiling."

As the state considers hundreds of pending medical marijuana licenses, the women gathered to network, celebrating the opportunity to create an industry from scratch. Dozens of the organization's members have applied to grow marijuana or open dispensaries or processing businesses. Others plan to sell specialized marijuana containers, offer legal services, do product testing or provide event planning for women who secure a coveted license.

There is more collaboration than competition, the women say. There's no snatching of ideas or secretive cloaking of business plans, no assumptions that they need to get in line behind men to get ahead. "We have an opportunity to take an industry, from the ground up, and insert women in the upper echelons," said Carissa Cartalemi, a co-founder of the group and a holistic therapist who applied for a dispensary license with Rogers. "I do think there's something very feminine to that spirit of collaboration."

Women's marijuana business groups have grown by leaps and bounds as 25 states across the country have legalized some form of medical marijuana, and four states and the District of Columbia have approved recreational cannabis.

Women Grow began in Denver two years ago and now includes more than 45 chapters in the United States and Canada. Its conference in February attracted 1,300 people and was headlined by singer and marijuana activist Melissa Etheridge.

Women are much less likely to become entrepreneurs than men. In Maryland, women are half as likely as men to own their own businesses, according to the Kauffman Index of Entrepreneurship, which tracks business activity across the country. A survey released this month showed women hold 91 of the 630 board seats of Maryland companies that trade on one of the three stock exchanges — less than 14 percent of board seats and well under the national average. Other new industries — including the booming tech field — have largely been dominated by men, who worked disproportionately in the academic fields that fed those industries.

But women in Maryland and across the country see a different landscape in the emerging cannabis industry, which was born out of the advocacy community that persuaded legislatures to legalize it. "This is an industry that was led by a movement, by both women and men," said Giadha Aguirre DeCarcer, a former venture capitalist who launched a Washington-based cannabis market research company. DeCarcer is familiar with Women Grow but not active in the Baltimore chapter.

"There are no barriers to entry, but also no glass ceiling," said DeCarcer, CEO and founder of New Frontier Financials. "There hasn't been time for a good-ol'-boys club to develop. … The culture is very different because it stems from a movement."

Jessica White, 48, runs a holistic health center in White Marsh and applied for four dispensary licenses and a kosher processing license — she can hold only one, but was trying to increase her chances of being selected from among the 811 applications for just 94 licenses. "My market is 65-plus, chronic pain, not candidates for surgeries," White said. "We're talking little old church ladies."

White attends meetings of several other medical cannabis organizations, too, but said the vibe is different with the Women Grow crowd. "In a lot of the other groups I'm friendly with, it's a bunch of old white guys," White said. "A lot of the men in the industry keep things to themselves. Here, it's 'I'm Jessica. I want to open a dispensary. What about you?'"...

Elkridge-based Cannaline sponsored a season's worth of Women Grow events, which allows its saleswoman, Carrie Kirk, to hand out free samples of the company's marijuana packaging options as attendees clink glasses of house wine. Kirk worked for 17 years in pharmaceutical sales and management but now works up and down the East Coast selling Cannaline's marketing products, custom odor-proof bags and child-resistant packaging.

Even though more states east of the Mississippi are launching medical marijuana markets, she said, it's very tightly regulated and the industry here feels very different than that on the West Coast. "We have to do things more conservatively here," she said. A Women Grow event allows her to reach a lot of potential customers in an industry that lacks access to traditional advertising.

In a back corner of the Women Grow event, former regulatory lawyer Leah Heise was holding court at the center of a ring two people deep, enthusiastically connecting people. An illness that would have been more easily treated with medical marijuana than opioids took her out of the workforce for more than a decade, she said. Now that a surgery alleviated the underlying cause of her debilitating pain from chronic pancreatitis, she's rejoined the working world and fashioned a new career as a mentor and attorney for companies trying to navigate Maryland's newest industry.

She's president of Chesapeake Integrated Health Institute, and says Women Grow offers not only camaraderie but also a resource she can't find elsewhere. "This is the only place where someone can come to learn anything. Anything!" she said. She turned her attention to a woman who spent her career working at spas but was looking for a way into the medical marijuana industry. Heise enthusiastically took her card. "Someone like her would be incredible as a dispensary manager," she said. "It's a whole new era, and the industry will be huge."

Some prior related posts:

June 18, 2016 in Medical Marijuana Commentary and Debate, Medical Marijuana State Laws and Reforms, Race, Gender and Class Issues, Who decides | Permalink | Comments (0)

Thursday, June 16, 2016

New Drug Policy Alliance report highlights problems with access and data in New York medical marijuana program

DownloadEarlier this week the Drug Policy Alliance this notable new report detailing and lamenting that New York's medical marijuana program is too restrictive and that information about the program is not readily available.  This DPA press release reports on some of the report's findings, and here are excerpts from the press release:

The Drug Policy Alliance issued a report assessing the first four months on the state’s medical marijuana program.  The report is in response to demand for information in the face of the absence of all but the most limited public information from the New York State Department of Health.  The report, the first systematic assessment of the program so far and its impact on patient access, found patients and caregivers face significant barriers to accessing medical marijuana.

On January 7th 2016, New York became the 23rd state to rollout its medical marijuana program. The law, which was passed in June of 2014, took eighteen months to implement and has been criticized as being one of the most restrictive and burdensome programs in the country.  Since the program was launched, patients and advocates have been frustrated by numerous barriers to accessing the program, including difficulty finding participating physicians, trouble accessing dispensaries and medication, and affordability.

The Department of Health has released only limited data about how the program is performing, offering little more than updates on the number of patients and doctors who have completed registration applications. Working with Compassionate Care NY, the state’s largest grassroots organization of patients and caregivers, the Drug Policy Alliance surveyed 255 people who had sought to access the state’s medical marijuana program.

According to the report, one of most pressing problems is that patients are struggling to find health care providers who are participating in the program.  According to DOH, as of June 9th, only 593 physicians New York physicians registered to certify patients for medical marijuana – less than 1% of all physicians in New York. Because there is no publicly available list of participating physicians, patients are forced to cold-call doctors in hopes of finding one or go through social media or other potentially unreliable sources.

More than half of patients and caregivers surveyed in the DPA report had not yet found a doctor to certify them, and among those, 3 out of 5 have been trying for 3 to 4 months to locate a registered physician.

Geographic inaccessibility is another barrier compounding problems of patient access to medicine.  Under the law, only five producers are licensed to grow medical marijuana in New York, and each can only operate 4 dispensaries.  This means that for a state of almost 20 million people and 54,000 square miles, there are only 20 dispensaries allowed (of which only 17 dispensaries have opened, to date). Patients, many of whom are very sick and disabled, must travel hours in some cases to get to a dispensary.  According to findings from the survey, 27% of registered patients/caregivers travelled for 1 to 5 hours to access a dispensary, while nearly 2 out of 5 reported that the dispensary they visited did not carry the specific kind of medical marijuana that was recommended to them by their physician.

Another major finding of the report is the unaffordability of medicine.  For respondents who had obtained medicine, 70% indicated that their monthly cost would be $300 and above, and more than 3 in 4 patients and caregivers who purchased medicine from a dispensary, stated that they would not be able to afford the monthly cost of medicine.

DPA’s report calls on the New York State legislature to pass bills currently pending in Albany that would amend the Compassionate Care Act, New York’s medical marijuana law, and improve access to medicine for those in need....  “New Yorkers deserve more transparency and information about how the state’s medical marijuana program is performing,” said Julie Netherland, PhD, of the Drug Policy Alliance and Compassionate Care NY. “Our data confirms what we have heard from patients and caregivers for months – New York’s program is not easily accessible, and even for patients who manage access the program, most cannot afford the medication.  We urge the legislature to act quickly and pass these bills to improve the program so patients in need can get relief.”

June 16, 2016 in Medical Marijuana Commentary and Debate, Medical Marijuana Data and Research, Medical Marijuana State Laws and Reforms | Permalink | Comments (0)

Thursday, June 9, 2016

Ohio Gov John Kasich signed medical marijuana bill into law

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As reported in this AP article, headlined "Ohio Becomes Latest State to Legalize Medical Marijuana," the Buckeye State is now officially a medical marijuana state. Here are the basics:

Republican Gov. John Kasich signed a bill Wednesday legalizing medical marijuana in Ohio, though patients shouldn't expect to get it from dispensaries here anytime soon. The bill lays out a number of steps that must happen first to set up the state's medical marijuana program, which is expected to be fully operational in about two years. The law would allow patients to use marijuana in vapor form for certain chronic health conditions, but bar them from smoking it or growing it at home.

Kasich's signature made Ohio the 25th state to legalize a comprehensivemedical marijuana program, according to a count by the National Conference of State Legislatures. [Editor's Note: I think this is really the 26th state, because after recent reforms Louisiana's should be part of this count.] ...

When the law takes effect in 90 days, cities and towns could move to ban dispensaries or limit the number of them. Licensed cultivators, processors, dispensaries and testing laboratories could not be within 500-feet of schools, churches, public libraries, playgrounds or parks. Employers could continue to enforce drug-testing policies and maintain drug-free workplaces. Banks that provide services to marijuana-related entities would be protected from criminal prosecution....

A newly created Medical Marijuana Advisory Committee will help develop regulations and make recommendations. The governor and legislative leaders must appoint people to the 14-member panel no later than 30 days after the bill's effective date. Its members will represent employers, labor, local law enforcement, caregivers, patients, agriculture, people involved in mental health treatment and people involved in the treatment of alcohol and drug addiction. Others include a nurse, academic researcher, two practicing pharmacists and two practicing physicians. No more than six members can be of the same political party. The bill dissolves the committee after five years and 30 days....

The legislation specifies that the medical marijuana program is to be fully operational within two years of the bill.... The Ohio Department of Commerce, State Medical Board and Board of Pharmacy will all play a role. The Commerce Department will oversee licensing of marijuana cultivators, processors and testing labs. The Pharmacy Board will license dispensaries and register patients and their caregivers, and set up a hotline to take questions from patients and caregivers. The Medical Board would issue certificates to physicians seeking to recommend treatment with medical marijuana.

Some prior related posts about Ohio's recent legislative and regulatory medical marijuana activity:

June 9, 2016 in Medical Marijuana Commentary and Debate, Medical Marijuana State Laws and Reforms | Permalink | Comments (0)

Tuesday, June 7, 2016

Minnesota Dept of Health survey shows patients and health-care providers report benefits from medical marijauna including reduced opioid use

Download (20)This local article, headlined "Most Minnesota medical marijuana patients, and their practitioners, find treatment beneficial," reports on some positive results from early surveys of participants in Minnesota's medical marijuana program. Here are basics from the press report (with links from the original, and my emphasis added):

Almost all patients participating in Minnesota’s medical marijuana program say they are benefiting from the treatment, according to the results of a Minnesota Department of Health (MDH) survey released Monday.  Most of the patients’ health-care providers agree, although they tend to be more modest with their assessment of the treatment’s therapeutic benefits, the survey also found.

“This was certainly not a clinical trial.  It can’t answer questions about effectiveness,” said Dr. Thomas Arneson, research manager for the MDH’s Office of Medical Cannabis, in a phone interview with MinnPost.  “But I was impressed by the high level of benefit reported,” he added.  “We heard from 55 percent of the patients, which is pretty good. So even if it was a lower presumption of benefit among the others who didn’t respond, it was still pretty substantial.”

In Minnesota, marijuana (cannabis) in liquid or oil form can be prescribed by certified health-care practitioners to patients with nine qualifying medical conditions: cancer (to help treat the disease’s symptoms or the side effects of cancer therapies), glaucoma, HIV/AIDS, Tourette syndrome, amyotrophic lateral sclerosis (ALS), seizures (such as those characteristic of epilepsy), severe and persistent muscle spasms (such as those characteristic of multiple sclerosis), Crohn’s disease and terminal illness.   Starting July 1, patients with intractable pain will also be able to participate in the state’s medical marijuana program....

MDH sent the survey to the 435 patients who purchased medical marijuana during the first three months of the state’s program (July 1 to Sept. 30, 2015) and to the 345 health-care practitioners, including physicians, physician assistants and nurse practitioners, who certified them as being eligible for the treatment. The survey asked the patients and the practitioners to rate the level of benefit received from the use of medical marijuana on a scale of 1 (no benefit) to 7 (a great deal of benefit). 

Surveys were completed by 241 (55 percent) of the patients and by 94 (27 percent) of the health-care practitioners.  The perception of benefit was high in both groups. Almost 88 percent of the patients and 68 percent of the health-care practitioners reported at least some benefit to the patient (a score of 4 or higher) from the treatment.  A “significant” level of benefit (a score of 6 or 7) was reported by 66 percent of the patients and 46 percent of the practitioners.

The top three conditions for which the patients surveyed had been prescribed medical marijuana were severe muscle spasms, seizures and cancer. Although benefits were reported for all of those conditions, patients with cancer reported the highest scores, while the practitioners indicated that they had observed the greatest benefit from the treatments among their patients with muscle spasms.

The practitioners’ reports of benefit for all the conditions were generally more conservative than those of the patients.   “The patients were a little bit higher on the more subjective quality-of-life benefits than the healthcare practitioners were,” said Arneson. “The clinicians tended to respond more with things that were measurable, that were objective,” he added.

One interesting benefit reported by the practitioners was a reduction in the need for other pain medications.  Twelve said their patients were able to reduce their pain medication dosage as a result of the marijuana, including at least six who were able to decrease their use of prescription opioids.

About 20 percent of the surveyed patients and 16 percent of the surveyed practitioners reported patient side effects from the marijuana treatment — a finding that mirrors what has been observed in research conducted elsewhere, said Arneson.  In the MDH survey, the side effects included hives, stomach pains, dizziness, fatigue, a burning sensation in the mouth and paranoia. None of the side effects were life-threatening, although four patients (2 percent) reported an increase in seizures.

Despite the survey's overall positive results, not everybody who receives medical marijuana treatment for one of the qualifying conditions is going to benefit from it, Arneson emphasized.  “How much of this is the placebo factor, we don’t know, although it’s probably quite a bit of it,” he said.  “Cannabis is not a miracle drug,” he added.

Still, the survey suggests that whether or not the placebo effect is in play, many patients believe medical marijuana is helping to ease their symptoms.   “These are individual persons, individual lives, many of whom are having great difficulties in their lives because of their medical conditions,” said Arneson. ... 

FMI:  The MDH’s report on the survey was published online in the June issue of Minnesota Medicine magazine, where it can be read in full.  The complete survey results — including specific comments from patients about the effects of the treatment on their medical condition — can be found on MDH’s Office of Medical Cannabis website.

June 7, 2016 in Medical community perspectives, Medical Marijuana Commentary and Debate, Medical Marijuana Data and Research, Medical Marijuana State Laws and Reforms | Permalink | Comments (0)

Monday, June 6, 2016

Louisiana universities and businesses now clearly think the Bayou State is a serious medical marijuana reform jurisdiction

Medical-marijuana-mms-titlepng-a8616304bffdd15cThere has been some enduring debate and uncertainty as to whether Louisiana should "count" as one of the two-dozen-plus states that have enacted significant medical marijuana reforms.  For a number of reasons, and especially since recent legislative reforms to the state's medical marijuana rules, I think Louisiana should count in any accounting of such states.  And this recent local article, headlined "Louisiana gearing up for marijuana business: How much might LSU, Southern, companies profit? How will it be distributed?," suggests that now shortage of Louisiana officials and institutions are now considering the state's work in this space very seriously. Here are highlights from the interesting article:

Growing up on a cotton farm in Missouri in the 1950s, Bill Richardson didn’t know a thing about marijuana. Nobody talked about it, he never saw it and he certainly never smoked it. “I didn’t inhale,” Richardson, LSU’s 71-year-old vice president for agriculture and dean of the College of Agriculture, said with a smile in a recent interview.

Richardson has become the unlikely leader of an effort to get LSU into the pot business. Last month, the Louisiana Legislature approved a bill that legalizes the use of marijuana for people suffering from a specific list of debilitating diseases. The so-called medical marijuana legislation authorizes LSU and Southern University to grow and produce cannabis to be consumed in a liquid form. (Hold the “Cheech and Chong” jokes — it cannot be smoked, and no, they won’t be offering samples.)

The boards of both universities appear likely to give the go-ahead for pot cultivation. It’s not clear yet, however, who will provide the $10 million to $20 million needed to produce the drug, which will be sold at 10 standalone pharmacies designated by a state agency. None of the people wanting to be treated by pot will have access to it for at least 18 months.

When the Legislature legalized marijuana for patients suffering from 10 specific diseases, lawmakers told emotional stories about the children and loved ones who stood to benefit. Opponents, meanwhile, warned darkly that Louisiana was heading down a slippery slope toward legalizing a dangerous drug. Lost in the debate is what the measure will mean for LSU and Southern — and the private companies that are now emerging to try to profit from the new industry by partnering with the universities.

The legislation by state Sen. Fred Mills, R-Parks, gave LSU and Southern no money to launch this new venture, meaning they will have to rely on private companies to buy the seeds, hire scientists, rent or build growing facilities and pay for all the other costs. “All of the money would have to come from venture capitalists, or you’d have to sell bonds,” said Adell Brown, the point person at Southern as the university’s interim chancellor for its Agricultural Research and Extension Center. Neither Brown nor Richardson can say yet how much it will cost to get the business running at full speed, but both agree that it probably will take at least $10 million.

Brown and Richardson both report getting calls from representatives of companies that want to rent or sell land or provide a growing facility. Others are inquiring about financing the entire venture with the expectation of earning a profit. “It’s a money-making venture,” Brown said.

Neither he nor Richardson knows yet where they might grow the pot, but the universities are not likely to do it together. (The Legislature has authorized them to cultivate the marijuana because of federal laws prohibiting the transport of marijuana across state lines.) The University of Mississippi grows marijuana for research under a special federal license on the edge of its campus, in a field surrounded by two fences and armed guards, said an Ole Miss spokesman. “My recommendation is that it not be grown on campus, for the PR,” Richardson said.

He expects that LSU’s Board of Supervisors will authorize the growing of marijuana at its June 24 meeting. “It’s something we can do,” Richardson said, adding that he sees this as an opportunity for the university to duplicate its pioneering work with rice and other crops. Besides, “over the past year, I’ve heard enough testimonials of the medicinal effects to believe that the benefits outweigh the negatives. Plus, there may be some opportunities to create an income stream to help us balance our budget.”

Brown said he expects Southern’s board to approve the venture at either its June or July meeting. “It will be a highly sophisticated and self-controlled facility with the proper protocols for security,” he said. “We have faculty members who have done work with a lot of different crops that are of the same family.”...

While LSU and Southern are gearing up, several state entities are working to provide the regulatory framework for everyone who wants to be involved. The Louisiana State Board of Medical Examiners already has drafted its rules for doctors who want to apply to treat patients suffering from cancer, multiple sclerosis, epilepsy and seven other diseases, including HIV and AIDS. No doctor can treat more than 100 patients, said Eric Torres, the executive director of the medical board. Mills’ legislation, Senate Bill 271, requires doctors to “recommend,” not “prescribe,” the drug, to get around federal laws.

The state Department of Agriculture and Forestry is drafting rules that will govern the growing and production of the medical marijuana. The Legislature has authorized money for the agency to hire outside labs to make sure the marijuana is free of pesticides and heavy metals and has the least possible THC — the active ingredient that makes people high — and to hire staff to regulate the new business. “We have to make sure that end product is safe,” Agriculture Commissioner Mike Strain said in an interview.

The end product is what the patients actually will buy. “The marijuana cannot be inhaled,” said Jesse McCormick, of the Louisiana Cannabis Association, who lobbied to pass SB271. “It could be a cream. It could be in liquid form — tincture. It could be a gel cap. It could be a vitamin gummy. If you’re going to a dispensary to find ‘bud’ — well, you won’t.” The Louisiana Board of Pharmacy will decide on the drug’s final form and is leaning in favor of allowing LSU and Southern to make that decision. “Let the producers be as creative as they wish,” said Malcolm Broussard, the executive director of the board.

The 17 members of this Baton Rouge-based board — who are appointed by the governor to six-year terms — also will decide who will operate the 10 pharmacies throughout Louisiana that will sell the medical marijuana. Under state law, they cannot be part of a normal drugstore, although Broussard said it’s possible that the therapeutic drug could be sold in a convenience store. That store could not also sell prescription drugs, but it could offer over-the-counter drugs, he said.

Next year’s licensing decision will put a spotlight on a board so obscure that Broussard said he had never before been interviewed by an Advocate reporter during 17 years as executive director.

June 6, 2016 in Business laws and regulatory issues, Medical community perspectives, Medical Marijuana Commentary and Debate, Medical Marijuana Data and Research, Medical Marijuana State Laws and Reforms | Permalink | Comments (0)

Wednesday, June 1, 2016

"Is The Cannabis Movement Overextended?"

The question in the title of this post is the headline of this interesting new International Business Times article discussing the state and possible fate of the significant number of marijuana reform initiatives to be appearing on state ballots this fall.  Here is how it gets started and additional excerpts from the middle and end of the lengthy piece:

In early May, the national advocacy group Marijuana Policy Project sent out a panicked email titled “Alone, beaten down and incredulous in Boston.” MPP had been working to land a marijuana legalization measure on Massachusetts’ ballot this November, but a recent fundraising event in Boston had drawn just a single attendee. “What’s worrisome isn’t this one bad event, but that it mirrors the contributions and involvement across Massachusetts since the initiative launch,” MPP Executive Director Rob Kampia wrote in the message. “Simply put, the campaign is broke,” he noted. The organization might not have the money to collect enough signatures to qualify for the ballot in one of the most liberal states in the U.S.

A lack of fundraising dollars in Massachusetts isn’t the only reason marijuana advocates are beginning to feel nervous. 2016 is a pivotal year for the cannabis movement, with an unprecedented 10 states potentially voting on recreational or medical marijuana reforms in November. Planned are medical marijuana initiatives in Arkansas, Florida, Missouri and Montana, as well as recreational cannabis measures in Arizona, Maine, Massachusetts, Michigan, Nevada and California, the last of which would launch a legal cannabis industry in what is the world’s eighth-largest economy. But, according to campaign finance records, the 10 campaigns altogether to date have raised less than $11 million, just slightly more than marijuana advocates amassed in 2014 midterm elections to pass legalization measures in two states, Alaska and Oregon.

While it’s still relatively early in the 2016 campaign calendar, a lot more cash will be needed before November. Representatives of the national advocacy group Drug Policy Alliance (DPA) estimated at a recent webinar that it would likely cost between $40 million and $50 million to win in all 10 states. “There is a little bit of concern among people I have talked to that the movement might be trying to do too much too soon,” said Tom Angell, founder and chairman of the cannabis advocacy group Marijuana Majority, who recently wrote about the issue for Marijuana.com. “There are only so many dollars that can be raised to purchase advertising time and put together get-out-the-vote operations.” It doesn’t help that so far the growing marijuana industry has been reluctant to shoulder much of these campaigns’ costs or that anti-marijuana efforts are gaining traction. This confluence of factors has led some observers to posit that 2016 may not be the watershed year for cannabis legalization that many have predicted. Instead, it could be the year the ascendant cannabis crusade finally faces defeat.

“The marijuana movement is stretched so thin in 2016,” DPA Executive Director Ethan Nadelmann said during a presentation last month at Marijuana Business Daily’s Marijuana Business Conference and Expo in Orlando, Florida. “I think what could happen in 2016 could be a harsh wake-up call.”...

As in years past, the two largest marijuana advocacy groups, DPA and MPP, are dividing their efforts between different reform campaigns. For example, DPA is playing a large role in the big California legalization effort, while MPP is highly involved in recreational marijuana initiatives in Arizona, Maine, Massachusetts and Nevada (MPP suspended a medical marijuana effort in Ohio last week after legislators passed a medical cannabis law).

While MPP may be working on more concurrent state campaigns than it ever has before, Mason Tvert, the organization’s communications director, insisted it isn’t stretched too thin. “We only get involved in campaigns when we are confident we will be able to run an effective campaign and win,” he said. Still, he added that weighing in on the financial fitness of various political efforts can be a dicey prospect in the middle of campaign season. “If you say you have no money, people aren’t going to donate because they don’t think you have a chance,” he said. “If you say you have money coming out of your ears, they aren’t going to donate either.”...

Meanwhile, marijuana advocates are facing increasingly well-organized and well-funded opposition. In Massachusetts, the anti-marijuana campaign has garnered the support of Governor Charlie Baker, Boston Mayor Marty Walsh and House Speaker Rovert DeLeo. In California, opponents of legalization are gathering donations from police associations, prison guard groups and the Teamsters union. In Arizona, a conservative fundraising firm announced an anonymous donor had pledged $500,000 as a matching gift for all donations the anti-legalization campaign received during the month of May. In Florida, real estate mogul Mel Sembler has pledged to raise at least $10 million to fight the state’s medical marijuana initiative, $2.5 million more than he raised to defeat a similar effort in 2014. And Smart Approaches to Marijuana, or Project SAM, the most prominent anti-marijuana group nationwide, just announced it has raised $300,000 and formed new state partnerships to fight the various 2016 marijuana initiatives....

As the marijuana industry has flourished, Project SAM founder Kevin Sabet thinks the cannabis movement has been exposed to new lines of attack, such as that legalization is becoming all about the business bottom lines and not about social justice. “They have written these initiatives as corporate free-for-alls,” said Sabet. “The old-school pot legalizers who are not really in this for the money, a lot of them are pretty stunned and not sure what to do this year.”

But Troy Dayton, CEO of cannabis investment network the ArcView Group, disagrees. He said the marijuana industry isn’t very involved in the reform initiatives — and he thinks that’s a problem. “Our opposition likes to say this is ‘Big Marijuana’ trying to pass laws,” he said. “I wish that was the case. At least so far, that hasn’t really happened.” Dayton is concerned that there’s a false sense of security in the marijuana movement. “The media has done a very good job of suggesting the marijuana industry is making money hand over fist, so a lot of philanthropists who otherwise might be backing these issues are thinking, ‘Hey, there is an industry now, they will take this the rest of the way,’” he said. “But that is not really happening to enough of a degree to fundamentally move the needle.” For example, while ArcView’s members have together invested more than $70 million in various marijuana companies since 2010, the investor network has only contributed roughly a million dollars to various legalization initiatives in that same period.

According to Dayton, marijuana businesses are struggling with various industry headaches — such as sky-high tax rates and a lack of banking services — that make it unlikely they have loads of excess funds they can donate to political campaigns. But at this point, Dayton thinks that is no excuse. He believes marijuana activists and industry stakeholders alike need to realize that 2016 is the make-or-break year for cannabis reform. “I am out there pounding the pulpit, telling people, ‘Come on, folks, whether you are on the business side or the social justice side or both, now is the time. Whatever you would normally give, give three times that,’” he said. “If we win most of these initiatives, it’s really lights out on marijuana prohibition. But if we lose a significant portion of them, that could mean a much longer fight to ultimately end this disastrous policy.”

June 1, 2016 in Campaigns, elections and public officials concerning reforms, Initiative reforms in states, Medical Marijuana Commentary and Debate, Medical Marijuana State Laws and Reforms, Political perspective on reforms, Recreational Marijuana Commentary and Debate, Recreational Marijuana State Laws and Reforms, Who decides | Permalink | Comments (0)