Thursday, January 18, 2018
New Maryland report details basis for marijuana measures to "remediate discrimination affecting minority- and women-owned businesses"
As reported in this local article, headlined "State consultant finds grounds to consider race in awarding medical marijuana licenses," a notable report focused on the Maryland business arena was released yesterday. Here are the basics and context:
A state consultant has determined that there are grounds to conclude that minorities are at a disadvantage in Maryland's fledgling medical marijuana industry.
The state’s medical marijuana commission has awarded 15 licenses to growers, but none of them to a minority-owned business. The General Assembly is considering a bill that would create five new licenses and require the commission to consider the race of applicants.
The consultant’s finding, released by Gov. Larry Hogan’s office Wednesday, is a key legal step toward allowing officials to weigh race when awarding any new licenses. Hogan ordered the study in April. “Today’s findings are clear and unequivocal evidence that there is a disparity in the medical cannabis industry,” said Shareese Churchill, a spokeswoman for the Republican governor. “This study is an important part of the process to allow for increased minority participation in our state.”
Del. Cheryl D. Glenn, the chairwoman of the Legislative Black Caucus and a leading advocate for more minority participation in the state’s new marijuana industry, said the finding will help whatever legislation the General Assembly passes withstand a court challenge. “I’m ecstatic Maryland can move forward and be a beacon of light and show it is a serious issue, that everyone should be concerned about having diversity in a multibillion-dollar industry,” the Baltimore Democrat said....
Such disparity studies are commonly used in government contracting to provide a justification for considering the race or gender of bidders for jobs. Civil rights advocates found the commission’s failure to award any licenses to black-owned businesses especially galling because African-Americans have disproportionately faced consequences from marijuana being criminalized.
The full consultant report is available at this link, and here are key passages from its conclusion:
After reviewing and analyzing the information received from the State, and bearing in mind the 2017 Disparity Study’s finding that discrimination continues to adversely impact minority-owned and women-owned firms throughout the Maryland economy, I conclude, based upon the information available to me at this time, that the 2017 Disparity Study provides a strong basis in evidence, consisting of both quantitative and qualitative findings, that supports the use of race- and gender-based measures to remediate discrimination affecting minority- and women-owned businesses in the types of industries relevant to the medical cannabis business.
Moreover, the 2017 Disparity Study details a range of race- and gender-neutral activities that the State has already undertaken to address existing disparities. The 2017 Disparity Study found that, notwithstanding these race- and gender-neutral activities, many of which have been in place for a number of years, disparities continue to exist in both public and private contracting in the same geographic and industry markets in which medical cannabis licensees and independent testing laboratories are likely to operate. These disparities, in general, are large, adverse, and statistically significant. In addition, the 2017 Disparity Study contains both qualitative and quantitative evidence to suggest that economy-wide contracting disparities in Maryland’s relevant markets are even greater than disparities in the public sector. This difference may be due to the fact that the State has, for a number of years, operated an assertive MBE program in an attempt to remedy discrimination, which would tend to reduce, though it has not yet eliminated, the effects of discrimination in public procurement. Absent such affirmative remedial efforts by the State, I would expect to see evidence in the relevant markets in which the medical cannabis licensees will operate that is consistent with the continued presence of business discrimination.
Tuesday, January 9, 2018
Louisiana Gov writes directly to Prez Trump urging him to urge Congress to preserve medical marijuana spending limit
I have been lately wondering if, when and how President Donald Trump might have something to say about federal marijuana policy in the wake of Attorney General Sessions' recent decision to rescinding the Cole Memo (basics here and here). Though we have still not heard from the Prez on this matter, today I see that Louisiana Gov John Bel Edwards has written directly to Prez Trump to discuss medical marijuana in the Bayou State and to seemingly ask Prez Trump to push Congress to preserve the soon-to-expire spending limitation that prohibits the Justice Department from using government funds to go after state medical marijuana programs.
The short but still interesting letter from Gov Edwards to Prez Trump is available at this link. The letter's concluding substantive paragraph reads:
Mr. President, for many people in my state, access to this treatment means a person could return to the workforce, return to school or simply lead a normal life. Simply put, we would be failing the people we represent if we allow any funding bill to move through Congress without the Rohrabacher-Blumenauer language included. This issue is critically important in Louisiana, and I hope we can partner together to ensure the safe distribution of this life-changing form of treatment.
January 9, 2018 in Campaigns, elections and public officials concerning reforms, Federal Marijuana Laws, Policies and Practices, Medical Marijuana State Laws and Reforms, Who decides | Permalink | Comments (0)
Friday, January 5, 2018
As reported in this press release, Oklahoma Governor Mary Fallin yesterday "set a June election date for the medical marijuana ballot measure." Here is more from the release:
Fallin filed an executive proclamation placing State Question 788 on the June 26 primary election ballot. The governor’s other option was to place the issue on the November general election ballot.
Supporters of an initiative petition asking voters to legalize medical marijuana gathered enough signatures in 2016 to schedule a statewide referendum on the measure. “Backers of this proposal to legalize medical marijuana followed procedures and gathered the more than 66,000 required signatures to submit the issue to a vote of the people,” said Fallin. “I’m fulfilling my duty as governor to decide when that election will occur this year.”
If approved by voters, the measure would permit doctors to recommend a patient, who is at least 18 years old, for a state-issued medical marijuana license. A license holder would be allowed to legally possess up to 3 ounces of the drug, six mature plants and six seedlings. These limits can be increased by individual counties or cities.
Primary elections, typically, will bring out many fewer voters than general elections. But it seems elections involving marijuana ballot issues will bring out, sometime, at least a few more than the usual voters. It will be interesting to watch the turn out dynamics, as well as of course the outcome, in the Sooner State now that the Governor has called for a sooner vote.
Friday, December 29, 2017
"Medical marijuana laws and adolescent use of marijuana and other substances: Alcohol, cigarettes, prescription drugs, and other illicit drugs"
The title of this post is the title of this new research to appear in print in the February 2018 issue of the journal Drug and Alcohol Dependence. Here is its abstract:
Historical shifts have taken place in the last twenty years in marijuana policy. The impact of medical marijuana laws (MML) on use of substances other than marijuana is not well understood. We examined the relationship between state MML and use of marijuana, cigarettes, illicit drugs, nonmedical use of prescription opioids, amphetamines, and tranquilizers, as well as binge drinking.
Pre-post MML difference-in-difference analyses were performed on a nationally representative sample of adolescents in 48 contiguous U.S. states. Participants were 1,179,372 U.S. 8th, 10th, and 12th graders in the national Monitoring the Future annual surveys conducted in 1991–2015. Measurements were any self-reported past-30-day use of marijuana, cigarettes, non-medical use of opioids, amphetamines and tranquilizers, other illicit substances, and any past-two-week binge drinking (5+ drinks per occasion).
Among 8th graders, the prevalence of marijuana, binge drinking, cigarette use, non-medical use of opioids, amphetamines and tranquilizers, and any non-marijuana illicit drug use decreased after MML enactment (0.2–2.4% decrease; p-values: <0.0001–0.0293). Among 10th graders, the prevalence of substance use did not change after MML enactment (p-values: 0.177–0.938). Among 12th graders, non-medical prescription opioid and cigarette use increased after MML enactment (0.9–2.7% increase; p-values: <0.0001–0.0026).
MML enactment is associated with decreases in marijuana and other drugs in early adolescence in those states. Mechanisms that explain the increase in non-medical prescription opioid and cigarette use among 12th graders following MML enactment deserve further study.
Wednesday, December 20, 2017
As hinted by this recent post, which asks "Are there 1.9 millions or 2.35 million or some other big number of medical marijuana patients?," I fear that states and the nation as a whole are doing insufficient data collection and analysis of medical marijuana regimes. This view is indirectly enhanced by this recent article from Rhode Island, headlined "Medical marijuana cultivators, patients on rise in R.I.," reporting on some interesting data concerning its medical marijuana program. Here are excerpts:
More than 8,430 pounds of marijuana have been produced and sold through the state’s medical marijuana dispensaries and cultivators this year, translating into some $27 million in retail sales. Nearly one-quarter of that marijuana was grown by the state’s new cultivators — licensed businesses only allowed to sell the drug to the state’s three dispensaries. To date, 18 such businesses have been approved to operate in the the state, according to data from the state Department of Business Regulation.
Dozens more are waiting in the wings for their chance to get into the burgeoning industry. Forty applicants have passed the first stage of the process but are still awaiting a license, and another 53 applicants are behind them in the pipeline. The state has collected nearly $1 million in licensing and application fees from these new marijuana-growing businesses.
“It seems a large number of cultivators. That’s always been my concern ... we’re setting up these cultivators for failure,” Rep. Scott Slater, D-Providence, said at a meeting of the state’s medical marijuana oversight commission Tuesday.... Greenleaf Compassionate Care Center in Portsmouth and Summit Medical Compassion Center in Warwick together have purchased roughly half of the medical marijuana sold this year from cultivators. The state’s largest dispensary, the Thomas C. Slater Center in Providence, has not purchased any marijuana from cultivators.
Norman Birenbaum, the state’s top medical marijuana regulator, said the state hopes that for safety and quality-control reasons eventually more patients will shift from growing marijuana in their homes to buying it from dispensaries. There are currently more than 61,500 marijuana plants being grown in the state by medical marijuana patients and caregivers.
Meanwhile, the state now has 19,161 medical marijuana patients, a 17-percent increase from one year ago. The number of patients in the program typically grows between 20 percent and 30 percent each year. Roughly 65 percent of patients qualify with severe, debilitating or chronic pain.
But Birenbaum agreed that many cultivators will potentially fail. The state chose not to cap the number of cultivators, in part because doing so would require a competitive evaluation process for applications that almost inevitably would end up in court and could have resulted in shortages in the supply of medical marijuana.
Dr. Todd Handel, a physician who sits on the oversight panel, questioned what the state is doing to control the profit margins of the state’s dispensaries, which are state-registered nonprofits. Birenbaum cautioned against making generalizations about the dispensaries’ profits. He noted that the dispensaries cannot take many normal business deductions on their taxes because the federal government still considers selling marijuana to be illegal. He also noted the significant costs of growing marijuana.
The average wholesale price of medical marijuana produced by the licensed cultivators is $4.16 a gram, according to state data. An average retail price was not available because some marijuana flower is turned into other products such as edibles and oils that are not sold in a form measurable by grams. Still, it’s clear there is a markup. On Tuesday, Greenleaf was offering three strains grown by cultivators for $15 a gram.
As this article reveals, Rhode Island has a lot of cultivators/growers but only three dispensary/sellers servicing its medical marijuana program. That is distinct from some other states that have limited both growers and sellers and others that have no limits on growers or sellers. In addition, Rhode Island's medical marijuana regime allows for home grow, while other states do not (and, of course, nearly every state has at least slight variations on who qualifies to be a medical marijuana patient and/or caregiver).
Though there are plenty of resources highlighting formal legal differences in different medical marijuana states, I am not aware of many objective analysis of whether and how different medical marijuana regulatory structures in different states impact the development and functionality of medical marijuana access and efficacy for patients. In other words, while states are conducting a wide array of "laboratories of democracy" experiments in this medical marijuana area, we need a lot more analysis of early lab results.
December 20, 2017 in Business laws and regulatory issues, Medical Marijuana Commentary and Debate, Medical Marijuana Data and Research, Medical Marijuana State Laws and Reforms, Who decides | Permalink | Comments (0)
Monday, December 18, 2017
New data from West Virginia showing strong physician interest in state's developing medical marijuana program
As reported in this local article, headlined "Survey: 82 percent of WV doctors 'interested' in medical marijuana," a notably large percentage of surveyed physicians have expressed an interest in an emerging medical marijuana regime. Here are the basics:
An overwhelming majority of surveyed West Virginia physicians are “interested” in medical cannabis, according to the Department of Health and Human Resources. Of 1,455 physicians who took the online survey, 82 percent of them indicated their interest in medical marijuana, which will be legal in the state in July 2019 thanks to a law passed during the last legislative session.
Dr. Rahul Gupta, state health officer and commissioner of the state Bureau for Public Health, said the high response volume gives the state a sound outlook on patient and physician views of the looming change. “We found that to be compelling that there is a certain level of interest, not just from patients, but from the physician community,” he said.
Along with doctors, the bureau analyzed survey results from 6,003 West Virginians, as well as Public Employees Insurance Agency and Medicaid claim data to tease out what tweaks, if any, might be needed for the nascent program. Of the patients who responded, 2,120 reported suffering from chronic pain, 1,579 reported suffering from post-traumatic stress disorder and another 980 reported suffering from a mental health disorder.
The Medicaid and PEIA data shows crossover between some of the most prevalent conditions in the state and the list of conditions whose victims qualify to obtain medical marijuana....
There is still work to be done and change for the organization to consider. Among the questions Gupta said the board is considering: Should the state limit how many dispensaries can obtain a permit to sell? Should the board approve the sale of marijuana in plant form? Should patients be allowed to grow their own marijuana plants? Should patients be able to purchase any other forms of marijuana?
Marijuana will be available to certified patients in the form of a pill, oil, topical, via vaporization or nebulization, tincture, liquid, or dermal patch. Gupta said the board is scheduled to meet again in February.
Friday, December 15, 2017
Applicant Sues to Block Ohio from Using Racial Preferences in the Award of Commercial Marijuana Licenses
Over at my blog, I've just posted some details about a new lawsuit challenging Ohio's purported use of a "racial quota" in the award of its large-scale marijuana cultivation licenses. Check out the post here. The suit could have some far-reaching ramifications for state efforts to boost minority participation in the state licensed marijuana industry.
Saturday, December 9, 2017
The title of this post is the headline of this new Rolling Stone article. Here are excerpts (with some links from the original preserved):
The pain-relieving properties of cannabis are no longer hypothetical or anecdotal. At the beginning of the year, the National Academies of Science, Medicine and Engineering released a landmark report determining that there is conclusive evidence that cannabis is effective in treating chronic pain. What's even more promising is that early research indicates that the plant not only could play a role in treating pain, but additionally could be effective in treating addiction itself – meaning marijuana could actually be used as a so-called "exit drug" to help wean people off of pills or heroin.
"We're not just saying opioids make you feel good and so does cannabis, and now you're addicted to cannabis. There are direct reasons why this could actually help people get off of opioids," says Jeff Chen, director of UCLA's new Cannabis Research Initiative. "If there is a chronic pain component, the cannabis can address the chronic pain component. We also find opioid addicts have a lot of neurological inflammation, which we believe is driving the addictive cycle. We see in preliminary studies that cannabinoids can reduce neurological inflammation, so cannabis could be directly addressing the inflammation in the brain that's leading to opioid dependency."
The theory that cannabinoids could decrease cravings for opioids is further supported by a small 2015 study published in the journal Neurotherapeutics, which found that the non-psychoactive cannabinoid CBD was effective in reducing the desire for heroin among addicts, and remained effective for an entire week after being administered. Similar effects have long been observed in animal studies.
Cannabis, in fact, may be exactly the kind of opioid replacement that politicians and pharmaceutical executives claim to be searching for. "I will be pushing the concept of non-addictive painkillers very, very hard," President Trump said in October, when declaring opioid abuse a national public health emergency. The CEO of Purdue Pharma, which makes OxyContin, recently referred to the possibility of a drug that helps with pain but isn't physically addictive as the "Holy Grail."...
But already, many Americans seem to be replacing their pills with pot. A survey of pain patients in Michigan, published in 2016 in the journal of the American Pain Society, found medical cannabis use was associated with a 64 percent decrease in opioid use. A 2016 study published in the health policy journal Health Affairs found that states with medical marijuana saw a drop in Medicare prescriptions and spending for conditions that are commonly treated with cannabis, including chronic pain, glaucoma, seizures and sleep disorders. And a 21-month study of 66 chronic pain patients using prescription opioids in New Mexico found that those enrolled in the state's medical cannabis program were 17 times more likely to quit opioids than those who were not.
At the same time, opioid-related deaths and overdose treatment admissions appear to be declining by nearly 25 percent in states where patients have access to legal marijuana. That number comes primarily from a 2014 study in the Journal of the American Medical Association, and has been supported by additional data from the American Journal of Public Health, the American Academy of Nursing, and the Journal of Drug and Alcohol Dependence.
However, more research is sorely needed. Stanford professor and drug policy expert Keith Humphreys described the studies concerning cannabis legalization and the decrease in opioid-related deaths and hospital admissions as falling victim to a form of logical error known as ecological fallacy. "It's correlation, not causation," he told me, because you cannot use statistical information about entire populations to understand individual behavior.
And researchers are eager for more solid evidence. The Cannabis Research Initiative at UCLA is working on establishing one of the first studies that will directly administer cannabis to patients addicted to opioids, potentially providing a much more comprehensive understanding of how this all works. Chen, the initiative director, says he has scientists, clinics and a study design all lined up, but funding has been a struggle. "You're forced to go an extra ten miles with zero gas in the tank when it comes to cannabis research," he says. Between the lack of support from the federal government and pharmaceutical companies, Chen says he is "pretty much dependent on philanthropy."
Some (of many) prior related posts:
- "The use of cannabis in response to the opioid crisis: A review of the literature"
- Given latest opioid death data, should Ohio officials be fast-tracking access to medical marijuana?
- "The Case for Pot in the Age of Opioids: Legalizing medical marijuana could save lives that may otherwise be lost to opioid addiction."
- "Can medical marijuana be used to treat heroin addiction?"
- Yet another study suggests link between medical marijuana availability and decreased opioid use
- "Could medical marijuana solve Ohio's opioid problem?"
- "Legalize marijuana and reduce deaths from drug abuse"
- "Is marijuana a secret weapon against the opioid epidemic?"
- "Cannabis as a Substitute for Opioid-Based Pain Medication: Patient Self-Report"
Thursday, December 7, 2017
Stateline has this interesting new piece on banking in the marijuana sector under the headline "Why It’s Getting Easier for Marijuana Companies to Open Bank Accounts." Here are excerpts:
State and local officials in places that recently legalized marijuana are bracing for the arrival of a sector that largely runs on cash. They’re anxiously envisioning burglars targeting dispensaries and business owners showing up at tax offices with duffel bags full of money. But the marijuana industry’s banking problems may be more manageable than many officials realize.
Just ask Washington state, which last year successfully pushed almost all legal marijuana businesses to open bank accounts and pay their taxes with a check or other non-cash method. Or Hawaii, which earlier this year announced a “cashless” system for buying medical marijuana, reliant on a technology analogous to PayPal.
“We’re definitely seeing more businesses in the industry getting banked every day,” said Aaron Smith, executive director of the National Cannabis Industry Association, a trade group. Despite the legal risk involved in serving the cannabis industry, almost 400 banks and credit unions now do, according to the U.S. Treasury — a number that has more than tripled since 2014.
That’s reassuring news for California, where sales of recreational pot start next month, as well as for Nevada, Maine and Massachusetts, where voters approved recreational marijuana sales last year, and Arkansas, Florida, Montana and North Dakota, where voters approved medicinal sales.
But the progress that has occurred in some legal markets remains fragile. The federal government still considers marijuana to be a dangerous, illegal drug. States can only permit marijuana sales — and financial institutions can only serve marijuana-related businesses — thanks to Obama-era guidelines that create wiggle room in federal law....
Local institutions that are chartered at the state level have been particularly willing to work with the industry. In Oregon, where sales of recreational marijuana began in 2015, Salem-based Maps Credit Union decided to serve marijuana businesses after audits revealed some of its members were already in the industry. “It didn’t really square with our philosophy to kick members out,” said Shane Saunders, chief experience officer.
Taking on the new line of business required investments in staff, anti-money laundering software, and extra security at bank branches, said Rachel Pross, the credit union’s chief risk officer. Under the current federal guidance, Maps has to send a report on each marijuana-related account to the U.S. Treasury every 90 days, plus a report each time an account experiences a cash transaction of over $10,000.
Maps staff run background checks on marijuana-related business owners who want to open an account. They conduct regular, in-person inspections of the businesses whose accounts they manage, and they require business owners to share their quarterly financial statements. Dispensaries that bank with Maps make most of their sales in cash, because credit- and debit-card processors typically won’t touch marijuana money. As of October, the credit union had handled $140 million in cash deposits from 375 marijuana-related accounts in 2017, Pross said. Some companies hold multiple accounts.
In neighboring Washington, where recreational marijuana sales began in 2014, several financial institutions are openly working with the industry. Washington has helped banks and credit unions monitor marijuana-related customers by collecting and publishing extensive data on monthly sales and legal violations to the liquor and cannabis control board’s website. State regulators last year nudged marijuana licensees to open deposit accounts, aware that banking services were available and worried that cash-based businesses threatened public safety....
In some states, such as Alaska and Hawaii, regulators say they’re not aware of any credit unions or banks that currently serve the industry. Recreational marijuana sales began in Alaska in 2015, and medical marijuana dispensaries opened in Hawaii in 2017. But Hawaii is pioneering a workaround. Regulators have given a Colorado-based credit union permission to serve the state’s medical marijuana dispensaries. The credit union, in turn, has partnered with CanPay, an app that allows patients to transfer money from their bank accounts directly to the dispensary’s account....
Seattle dispensary owner [John] Branch notes that stores with ATMs make money when they dispense cash, and store owners may not embrace an electronic payment system that instead will cost them 2 percent of each transaction, as CanPay’s service does.
A change in federal law would solve the cannabis industry’s banking problem and wipe away the need for services tailored to the industry, such as CanPay. But Congress has so far failed to pass — or even seriously consider — a law that would reclassify marijuana as a less dangerous substance or allow banks and credit unions to work with businesses without risking their charters. U.S. Rep. Ed Perlmutter, a Colorado Democrat who proposed a bill on the issue this year, says no action is expected anytime soon.
December 7, 2017 in Business laws and regulatory issues, Federal Marijuana Laws, Policies and Practices, Medical Marijuana State Laws and Reforms, Recreational Marijuana State Laws and Reforms | Permalink | Comments (0)
Tuesday, December 5, 2017
The title of this post is the somewhat amusing headline of this somewhat amusing article in the Columbus Dispatch. Here are excerpts:
A company that failed to win a state license to cultivate medical marijuana is criticizing the state for apparently hiring a man with a felony drug conviction to score the applications. “The state of Ohio has a lot of explaining to do ... they hired a convicted drug dealer for $150,000 to score applications for the Ohio medical marijuana industry,” said Jimmy Gould, chairman of CannAscend Ohio, the rejected would-be cultivator.
Applicants to grow medical marijuana were required to undergo criminal background checks, Gould noted. “Did the Department of Commerce not think it important to check and report the fact that at least one of the scorers of the medical marijuana control program had a criminal record for dealing drugs ... did they require a background check to get a license, but not to give a license?” Gould asked in a statement.
Court records verified by The Dispatch show a Trevor C. Bozeman was convicted of manufacturing, delivering and possessing drugs, with intent to manufacture or deliver, in Middleburg, Pennsylvania, in 2005. The records do not provide details of the offense. They also show misdemeanor charges of use and possession of drug paraphernalia and possession of a small amount of marijuana for personal use, that were dismissed.
Bozeman, now age 33, of Brunswick, Maine, paid $2,131 in fines and costs and was placed on probation for three years, which court records show he successfully completed. Ohio incorporation papers show a Trevor Bozeman formed ICANN Consulting, with a Dublin address, in late 2016, The Dispatch confirmed.... The company was one of three to receive a $150,000 state contract in June to score applications submitted by those seeking licenses to grow medical marijuana. Messages seeking comment from Bozeman were left Tuesday morning at two telephone numbers listed in his name.
Stephanie Gostomski, a spokeswoman for the Department of Commerce, said the agency is checking the allegation made by CannAscend. ICANN Consulting appeared to meet all the requirements to receive the state contract and its scoring appeared to be done professionally, she said.
CannAscend’s bid to win a medical marijuana cultivation contract was rejected after it scored poorly in evaluations and failed to meet requirements, Gostomski said. Gould said the situation reflected “significant irregularities” that should be investigated. “This is the start of a billion dollar industry and the fact that the start is marred by arbitrary and capricious irregularities is troubling and deserves a thorough and deep review,” he said.
Tuesday, November 28, 2017
"Associations between medical cannabis and prescription opioid use in chronic pain patients: A preliminary cohort study"
The title of this post is the title of this small research report emerging from New Mexico that a helpful reader made sure I did not miss. The article has multiple authors and here is its abstract:
Current levels and dangers of opioid use in the U.S. warrant the investigation of harm-reducing treatment alternatives.
A preliminary, historical, cohort study was used to examine the association between enrollment in the New Mexico Medical Cannabis Program (MCP) and opioid prescription use.
Thirty-seven habitual opioid using, chronic pain patients (mean age = 54 years; 54% male; 86% chronic back pain) enrolled in the MCP between 4/1/2010 and 10/3/2015 were compared to 29 non-enrolled patients (mean age = 60 years; 69% male; 100% chronic back pain). We used Prescription Monitoring Program opioid records over a 21 month period (first three months prior to enrollment for the MCP patients) to measure cessation (defined as the absence of opioid prescriptions activity during the last three months of observation) and reduction (calculated in average daily intravenous [IV] morphine dosages). MCP patient-reported benefits and side effects of using cannabis one year after enrollment were also collected.
By the end of the 21 month observation period, MCP enrollment was associated with 17.27 higher age- and gender-adjusted odds of ceasing opioid prescriptions (CI 1.89 to 157.36, p = 0.012), 5.12 higher odds of reducing daily prescription opioid dosages (CI 1.56 to 16.88, p = 0.007), and a 47 percentage point reduction in daily opioid dosages relative to a mean change of positive 10.4 percentage points in the comparison group (CI -90.68 to -3.59, p = 0.034). The monthly trend in opioid prescriptions over time was negative among MCP patients (-0.64mg IV morphine, CI -1.10 to -0.18, p = 0.008), but not statistically different from zero in the comparison group (0.18mg IV morphine, CI -0.02 to 0.39, p = 0.081). Survey responses indicated improvements in pain reduction, quality of life, social life, activity levels, and concentration, and few side effects from using cannabis one year after enrollment in the MCP (ps<0.001).
The clinically and statistically significant evidence of an association between MCP enrollment and opioid prescription cessation and reductions and improved quality of life warrants further investigations on cannabis as a potential alternative to prescription opioids for treating chronic pain.
Friday, November 24, 2017
After the long weekend, my Marijuana Law, Policy & Reform seminar turns to its homestretch and the last group of students are delivering presentations on a marijuana-related topic of their choosing. One student for the next class will be looking at three recently decided cases involving marijuana law. As he has explained, he plans to "present the facts and procedural history regarding the case, and an analysis of how the deciding courts ultimately made their decisions." Here are the case citations, with links to articles discussing the decision and other background information:
Arizona v. Maestas, 394 P.3d 21 (Ariz. App. 1st Div. 2017).
- ASU student saw 'opportunity' to use arrest to fight for medical marijuana on campus
- UC guidance on use and possession of marijuana on UC property
- Colorado State University Guidelines on Marijuana Use and Hemp Research
People ex rel. Feuer v. Nestdrop, LLC, 245 Cal. App. 4th 664 (Cal. App. 2d Dist. 2016).
- Court Shuts Down L.A. Marijuana Delivery App ‘Nestdrop’
- L.A. is set to be a hot market for marijuana sales. But there might not be many places to smoke it
- Eaze is moving into recreational marijuana delivery with $27 million in new funding
State ex rel. Polk v. Hancock, 347 P.3d 142 (Ariz. 2015).
- Arizona justices: OK for probationers to use medical pot
- Medical Marijuana on Probation? Courts Saying Yes!
Wednesday, November 22, 2017
Especially as I am gearing up for my annual football orgy, which it seems others like to call Thanksgiving weekend, I thought it timely to blog this recent Politico article with the headline that serves as the title of this post. Here are excerpts:
During his Hall of Fame career for the Pittsburgh Steelers, Jack Ham was renowned as one of the canniest, fastest linebackers ever to play, doling out his share of bruising punishment to opposing ball carriers. These days the man still celebrated as “The Hammer” has a very different relationship with pain: He’s committed to helping people treat it.
Ham is one of a number of Pennsylvania’s pro-athlete aristocracy, including Franco Harris, his former teammate on the Super Bowl-winning teams of the 1970s, who have quickly embraced medical marijuana as a cure for a scourge that has decimated economically depressed parts of the state: opioid addiction. It’s a cause that has special resonance for pro athletes like Ham because they know many players whose chronic injuries made them dependent on painkillers.
When voters in Pennsylvania approved medical marijuana in 2016, Ham was quick to see both the financial promise of bringing a new industry to moribund coal country but also the therapeutic benefits of letting people manage their pain with a substance that some doctors say is less toxic and less addictive than opiate-based painkillers like Oxycodone....
Ham says he does not use medical marijuana himself, but he is not the only former athlete to tout medical marijuana as a solution to addiction. Former Steelers fullback Franco Harris also signed on to be a spokesman for a company that sought to grow medical marijuana in Braddock, an economically distressed former steel town near Pittsburgh.
“We have a unique opportunity to transform Braddock into a center for state-of-the-art urban agriculture and, at the same time, become a first mover in the United States in researching the efficacy of marijuana in replacing opioids for the long-term management of pain,” Harris said in a press release. Ultimately, that company did not get one of the 12 licenses awarded by the state in the first round. Medical marijuana, which is now legal in 29 states, has many constituencies—cancer patients who appreciate how it tamps down nausea from chemotherapy; libertarians who favor decriminalization of drugs generally, among them. But athletes are one of the more notable groups. As Harris said in his press release: “The life of a professional football player is one intrinsically tied to long- term pain management.”
Many pro athletes discovered the analgesic benefits of marijuana during their playing careers, which meant that they were violating their league’s drug policies as well as state and federal law. But now, as the trend toward legalization has picked up pace, those same athletes, now retired and free of their contractual obligations are beginning to speak out together. One of the lobbying groups is called Athletes for Care, an organization of former and current professional athletes who support medical marijuana. Former Philadelphia Eagles offensive guard Todd Herremans and former Philadelphia Flyers hockey player Riley Cote. Cote was connected to one of the 177 companies that applied for — but did not receive — a license to grow.
Some of many prior posts about medical marijuana and pro football:
- ESPN highlights NFL players, past and present, eager to use medical marijuana rather than opioids for pain relief
- NFL commissioner reluctant to support allowing players to use "addictive" marijuana
- "Medical Marijuana Could Help the NFL Cure the Illness Menacing Players' Brains, Activists Say"
- Active player urges NFL to allow its employees to use medical marijuana rather than opioids for pain relief
- Should the NFL fund medical marijuana studies?
- "The NFL Should Let Players Use Marijuana"
- "NFL Seeks Right Answer for Marijuana Use"
Tuesday, November 14, 2017
Just a short five years ago it would have been unusual for a member of Congress to ask the US Attorney General about federal marijuana policies. But circa 2017 it now seems near impossible to have a congressional hearing involving the AG in which marijuana policy is not raised. But, as detailed in this new Forbes piece by Tom Angell headlined "Sessions: Obama Marijuana Policy Remains In Effect," AG Sessions did not really have much new to say on this front during a hearing on Capitol Hill today:
Obama-era guidance that allows states to legalize marijuana without federal interference remains in effect, U.S. Attorney General Jeff Sessions said on Tuesday during a congressional hearing. He also conceded that cannabis is not as dangerous as heroin and that a current budget rider prevents the Department of Justice from prosecuting people who are in compliance with state medical marijuana laws.
"Our policy is the same, really, fundamentally as the Holder-Lynch policy, which is that the federal law remains in effect and a state can legalize marijuana for its law enforcement purposes but it still remains illegal with regard to federal purposes," Sessions said, referring to his predecessors as attorney general during the Obama administration.
Sessions made the comments in response to a question from Rep. Steve Chabot (R-OH) during a House Judiciary Committee oversight hearing. Later, Sessions said, "I think that's correct," when Rep. Steve Cohen (D-TN) argued that cannabis isn't as dangerous as heroin. Under current federal law, both are classified under Schedule I of the Controlled Substances Act, a category that's supposed to be reserved for drugs with a high potential for abuse and no medical value....
Also during Cohen's line of questioning, the attorney general said, "I believe we are bound by" a federal budget rider that bars the federal government from spending money to interfere with state medical cannabis laws. A federal court ruled last year, over Justice Department objections, that the rider specifically bars prosecution of patients and providers who are acting in accordance with those laws. Earlier this year, Sessions, sent a letter to congressional leadership asking that they not continue the annual rider into the next fiscal year.
Sessions, a longtime vocal opponent of marijuana legalization, has previously said that the separate Obama policy on state marijuana laws remains in effect while the Department of Justice reviews potential changes, but has not before so clearly tied the Trump administration approach to that of his predecessors....
[I]n April, Sessions directed a Justice Department task force to review the Obama administration memo and make recommendations for possible changes. However, that panel did not provide Sessions with any ammunition to support a crackdown on states, according to the Associated Press, which reviewed excerpts of the task force’s report to the attorney general. Sessions did not refer to any ongoing consideration of enforcement policy changes during the House hearing.
During a Senate hearing last month, the attorney general said that allowing more researchers to legally grow more marijuana for scientific studies would be "healthy." He has yet to respond to pending written questions stemming from that hearing about a federal budget rider that prevents the Justice Department from interfering with state medical cannabis laws.
November 14, 2017 in Federal Marijuana Laws, Policies and Practices, 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, Who decides | Permalink | Comments (0)
Monday, November 13, 2017
The title of this post is the title of this intriguing new empirical article authored by Michele Baggio, Alberto Chong and Sungoh Kwon now available via SSRN. Here is the abstract (with the key finding emphasized):
We use data on purchases of alcoholic beverages in grocery, convenience, drug, or mass distribution stores in US counties for 2006-2015 to study the link between medical marijuana laws and alcohol consumption and focus on settling the debate between the substitutability or complementarity between marijuana and alcohol. To do this we exploit the differences in the timing of the of marijuana laws among states and find that these two substances are substitutes. Counties located in MML states reduced monthly alcohol sales by 15 percent. Our findings are robust to border counties analysis, a placebo effective dates for MMLs in the treated states, and falsification tests using sales of pens and pencils.
November 13, 2017 in History of Alcohol Prohibition and Temperance Movements, History of Marijuana Laws in the United States, Medical Marijuana Data and Research, Medical Marijuana State Laws and Reforms | Permalink | Comments (0)
Saturday, November 11, 2017
The title of this post is the headline of this local report on a notable new lawsuit seeking to ensure legal access to medical marijuana. (This lawsuit, filed in federal district court in New York, was first discussed in this post in July 2017.) Here are excerpts from the press piece:
Alexis Bortell is hardly the first child whose family moved to Colorado for access to medical marijuana. But the 12-year-old is the first Colorado kid to sue U.S. Attorney Jeff Sessions over the nation's official marijuana policy.
"As the seizures got worse, we had to move to Colorado to get cannabis because it's illegal in Texas," said Bortell, who was diagnosed with epilepsy as a young child.
The sixth-grader said traditional medicine wasn't helping her seizures and doctors in her home state were recommending invasive brain surgery. But a pediatrician did mention an out-of-state option: Medical marijuana.
Shortly after moving to Larkspur, Bortell's family began using a strain of cannabis oil called Haleigh's Hope. A drop of liquid THC in the morning and at night has kept her seizure-free for 2 1/2 years. "I'd say it`s a lot better than brain surgery," Bortell said.
But Bortell said the federal prohibition on marijuana prevents her from returning to Texas. "I would like to be able to visit my grandparents without risking being taken to a foster home," Bortell said on why she's joined a lawsuit that seeks to legalize medical marijuana on the federal level....
Alexis' dad Dean Bortell ... showed his backyard fields, where he grows five acres of marijuana plants used to derive the medicine that helps his daughter and patients he's never met. "When you look at it from a distance and you see it saving their lives, me as a father and an American, I go, what are we doing? How could you possibly look at someone who`s benefiting from this as a medicine and threaten to take it away?" Bortell said....
Alexis' New York attorney Michael Hiller argues it should be legal nationwide. "As it pertains to cannabis, the (Controlled Substances Act) is irrational and thus unconstitutional," said Heller, who added the U.S. government "made a representation that cannabis has medical application for the treatments of Parkinson`s Disease, HIV-induced dementia and Alzheimer's disease and yet at the same time the United States government maintains that there is absolutely no medical benefit for the use of cannabis. That is of course absurd."
Denver attorney Adam Foster represents marijuana businesses. He said he thought the lawsuit was clever but admitted its success might be a long shot. "Whenever you sue the government, the deck is really stacked against you," Foster said.
But he added the federal government might have a hard time arguing medical marijuana has no known medical benefits. "We now live in an era where 62 percent of Americans live in a state where the medical use of cannabis is legal at the state level," he said.
Alexis Bortell said she hopes her lawsuit will normalize medical marijuana but also legalize it. "We'll be able to be treated like what you call 'normal' families," she said.
Bortell is joined in the lawsuit by another child, a military veteran, a marijuana advocacy group and former Broncos player Marvin Washington, who played on the 1998 Super Bowl-winning team. The federal government has already lost its first motion to have the case dismissed.
Prior related post:
November 11, 2017 in Federal court rulings, Federal Marijuana Laws, Policies and Practices, Medical Marijuana Commentary and Debate, Medical Marijuana State Laws and Reforms, Who decides | Permalink | Comments (1)
Sunday, November 5, 2017
I have said to my students at various times that a book or two or three or four could and should be written about the history of marijuana reform in the great state of Ohio. This weekend I discovered that Angela Bacca, a freelance journalist, has provided nearly book-length treatment of some of the recent political stories of reform in the state via a four-part series of Huffington Post article.
The subtitle of each part of the series is "Inside Ohio’s Corrupt Medical Marijuana Rollout," and this reporting of recent Ohio history seems especially eager to play up the theme of greed. But that reporting choice might well be justified, and the tales told in these articles involve more intricate and comprehensive reporting than I have seen anywhere else:
November 5, 2017 in Campaigns, elections and public officials concerning reforms, Medical Marijuana Commentary and Debate, Medical Marijuana State Laws and Reforms, Recreational Marijuana Commentary and Debate, Who decides | Permalink | Comments (2)
Wednesday, November 1, 2017
"FDA warns companies marketing unproven products, derived from marijuana, that claim to treat or cure cancer"
The title of this post is the heading of this press release from the U.S. Food and Drug Administration. Here is how the release begins:
As part of the U.S. Food and Drug Administration’s ongoing efforts to protect consumers from health fraud, the agency today issued warning letters to four companies illegally selling products online that claim to prevent, diagnose, treat, or cure cancer without evidence to support these outcomes. Selling these unapproved products with unsubstantiated therapeutic claims is not only a violation of the Federal Food, Drug and Cosmetic Act, but also can put patients at risk as these products have not been proven to be safe or effective. The deceptive marketing of unproven treatments may keep some patients from accessing appropriate, recognized therapies to treat serious and even fatal diseases.
The FDA has grown increasingly concerned at the proliferation of products claiming to treat or cure serious diseases like cancer. In this case, the illegally sold products allegedly contain cannabidiol (CBD), a component of the marijuana plant that is not FDA approved in any drug product for any indication. CBD is marketed in a variety of product types, such as oil drops, capsules, syrups, teas, and topical lotions and creams. The companies receiving warning letters distributed the products with unsubstantiated claims regarding preventing, reversing or curing cancer; killing/inhibiting cancer cells or tumors; or other similar anti-cancer claims. Some of the products were also marketed as an alternative or additional treatment for Alzheimer’s and other serious diseases.
“Substances that contain components of marijuana will be treated like any other products that make unproven claims to shrink cancer tumors. We don’t let companies market products that deliberately prey on sick people with baseless claims that their substance can shrink or cure cancer and we’re not going to look the other way on enforcing these principles when it comes to marijuana-containing products,” said FDA Commissioner Scott Gottlieb, M.D. “There are a growing number of effective therapies for many cancers. When people are allowed to illegally market agents that deliver no established benefit they may steer patients away from products that have proven, anti-tumor effects that could extend lives.”
The FDA issued warning letters to four companies – Greenroads Health, Natural Alchemist, That’s Natural! Marketing and Consulting, and Stanley Brothers Social Enterprises LLC – citing unsubstantiated claims related to more than 25 different products spanning multiple product webpages, online stores and social media websites. The companies used these online platforms to make unfounded claims about their products' ability to limit, treat or cure cancer and other serious diseases.
November 1, 2017 in Business laws and regulatory issues, Federal Marijuana Laws, Policies and Practices, Medical Marijuana Commentary and Debate, Medical Marijuana State Laws and Reforms, Who decides | Permalink | Comments (0)
Tuesday, October 31, 2017
Split New Jersey appeals court holds state officials can (and should?) consider reclassifying marijuana under state drug schedules
The Appellate Division of the Superior Court of New Jersey issued an interesting opinion today in Kadonsky v. Lee, No. A-3324-14T4 (N.J. App. Oct 31, 2017) (available here), resolving a appeal of the denial of a petition "seeking to have marijuana rescheduled from a Schedule I controlled dangerous substance to Schedule IV" under New Jersey laws. The majority remanded the case, explaining that reconsideration of marijuana's scheduling could be done under existing laws:
While this issue is not squarely before us, it is certainly ripe for a determination by the Director. When the inconsistencies of sections (a) and (c) of N.J.S.A. 24:21-3 are viewed through the prism of the dicta in Tate, we conclude that the Director erred in determining he lacked the authority to reclassify marijuana without a change in existing federal law.
The dissenting opinion starts with an effective account of the ruling and the judges' disagreements:
The question presented by this appeal is whether, as a result of evolving attitudes about marijuana and its potential for medical uses, the Director of the Division of Consumer Affairs was required to reschedule marijuana, removing it from Schedule I of the New Jersey Controlled Dangerous Substances Act (CDSA), N.J.S.A. 24:21-1 to -56. The Director's decision that he was required, instead, to control marijuana in accord with federal schedules is subject to limited appellate review. Circus Liquors, Inc. v. Governing Body of Middletown, 199 N.J. 1, 9 (2009). In light of the unambiguous language of N.J.S.A. 24:21-3(c) that the Director adhere to federal schedules, his decision must be sustained because there is no "'clear showing' that it is arbitrary, capricious, or unreasonable or that it lacks fair support in the record." Ibid.
My colleagues conclude the Director erred in his interpretation of the law but do not conclude the Director's decision was arbitrary, capricious or unreasonable or consider that a fair interpretation of the governing statute provides support for his decision. They have elected to decide an issue they acknowledge "is not squarely before us." Despite the clear directive in N.J.S.A. 24:21-3(c), the majority concludes the Director may reconsider the classification of marijuana, placing it on a schedule different from its designation on the federal schedules and, because the issue is "ripe for determination" by the Director, remands the issue for his consideration.
The necessary premise for this conclusion is that the Director has the discretion to make a major policy decision regarding the scheduling of marijuana that directly conflicts with the legislative mandate contained in N.J.S.A. 24:21-3(c) and federal law. That premise cannot withstand the application of established principles of statutory construction.
Sunday, October 29, 2017
"A Well-Kept Secret: How Vets And Their Doctors Are Getting Around The VA’s Medical Marijuana Policy"
title of this post is the headline of this lengthy article from Task & Purpose, a website that seeks to "provide authentic and unfiltered perspectives on military and veterans issues in the post-9/11 era." I recommend the article in full, and here are some excerpts:
In states where medical marijuana is legal, the VA’s existing policy allows for veterans and their care providers to candidly discuss cannabis use as part of their overall treatment plan, and in some cases, even test positive on a urinalysis for the drug without consequence — many of the same official changes to VA policy that veteran service organizations have been aggressively advocating for in 2017.
Under VA policy, veterans who participate in state-approved marijuana programs won’t lose access to VA health care, however, due to the drug’s Schedule 1 classification, the VA doesn’t allow physicians to prescribe pot; fill out forms for veterans seeking to participate in state weed programs; or pay for the drug. Nor is its use permitted on VA grounds....
What leaves VA guidelines open to interpretation is what they don’t address. The VA doesn’t explicitly bar patients from discussing their medicinal weed use with their doctors. The policy even leaves room for physicians to alter a veteran’s treatment plan to account for their pot use, but stops short of stating exactly what that entails. When it comes to specifics on how this all plays out in a doctor’s office, the policy at large, and the VA in particular, are quite vague....
Advocates of medicinal marijuana use for veterans — and those simply in favor of more research into its potential benefits — often point to its effectiveness in treating chronic pain, especially compared to highly addictive medications, like opioids. Its efficacy has been well-documented, with one observational study indicating a marked dip in opiate-related deaths in states where medicinal weed is legal, The Washington Post reported earlier this year. Still, when it comes to pot as a treatment option for veterans with PTSD and TBI, hard results are less readily available.
One of the consequences of the VA’s reliance on results from state-run studies and its lack of involvement in an ongoing federal study near a major VA hospital in Phoenix, Arizona, is that much of the research needed to further this conversation at the federal level, in any direction, remains out of reach, and it could stay that way for quite some time.
Currently, the marijuana PTSD study, the only federally approved research into the effects of herb on PTSD, has stagnated, with just 26 veterans enrolled out of the required 76 needed to be viable as of Sept. 19, and the hang-up stems from the VA’s refusal to recommend veteran patients for the study, due to the drug’s classification as Schedule 1. The lack of VA involvement, coupled with the study’s strict requirements — roughly 99% of applicants fail to meet the standards — has limited its recruitment pool. The federal research was further stymied by substandard pot — it had a low concentration of THC, but high levels of mold and lead — provided to the researchers by the federal government’s official grow operation at the University of Mississippi.
October 29, 2017 in Federal Marijuana Laws, Policies and Practices, Medical Marijuana Commentary and Debate, Medical Marijuana Data and Research, Medical Marijuana State Laws and Reforms, Who decides | Permalink | Comments (0)