Marijuana Law, Policy & Reform

Editor: Douglas A. Berman
Moritz College of Law

Wednesday, March 28, 2018

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

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

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

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

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

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

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

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

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

"Enforcing Federal Drug Laws in States Where Medical Marijuana Is Lawful"

Jama-logoThe title of this post is the title of this  new Viewpoint commentary authored by Lawrence Gostin, James Hodge, and Sarah Wetter published earlier this week on line at JAMA. Here is how it concludes:

Toward Rational Medical Marijuana Policies

Although public opinion and state action have trended strongly toward permitting use of marijuana, especially for medical purposes, controversy continues to exist.  The specter of federal prosecution could refrain physicians, patients, and dispensaries from providing marijuana in states where the drug is lawful and dissuade additional jurisdictions from legalizing marijuana.  Public policy formed and implemented in the context of inconsistent federal and state laws, unpredictable legal enforcement, and insufficient scientific evidence is unsustainable.  Rational policies should follow a 3-pronged agenda.

A Solid Research Foundation

Sound policy requires a strong evidence base.  Scientific studies could quell ongoing disagreements about marijuana’s medical effectiveness, harms, and status as a gateway drug.  Yet limited funding and restrictive access to uniformly high-quality cannabis have sharply curtailed longitudinal studies on a drug already in wide use. Physicians require rigorous evidence to inform prescribing practices and counseling of patients.  At present, wide regional variations in prescribing practices exist, and patients do not have access to consistently high-quality, uncontaminated cannabis — where the purity, potency, and dosage can be ensured.  Health officials, moreover, rarely conduct careful surveillance of marijuana use incidence, prevalence, and outcomes.  Public policy on a potentially hazardous psychotropic drug is difficult when short- and long-term effects across populations are underreported, insufficiently studied, and poorly funded.

A Harmonized Legal Environment

Substantial variability of legal approaches to marijuana use exists across jurisdictions and between states and the federal government.  Individuals in certain jurisdictions can lawfully access marijuana for medical use, recreational use, or both, whereas individuals in other jurisdictions cannot do so.  Conditions under which physicians can prescribe (or patients can access) marijuana fluctuate extensively.  Federal law is inconsistent with policy in virtually all states.  The CSA should be revised to operate harmoniously with prevailing state law. Model legislation for medical use of marijuana, based on scientific evidence, could help reconcile activities across jurisdictions.

Federal Law Enforcement Respectful of States’ Sovereignty

Under US constitutional design, states and localities are laboratories for innovation, with state sovereignty and local home rule respected and preserved.  This requires federal prosecutorial discretion to hew to the legal environment of states that have legalized marijuana use.  Respecting marijuana laws is essential in states where cannabis is prescribed and used for medical purposes.  On an issue as consequential as marijuana, the nation needs consistent legal norms based on the best available scientific evidence.

March 28, 2018 in Criminal justice developments and reforms, Federal Marijuana Laws, Policies and Practices, Medical community perspectives, Medical Marijuana Commentary and Debate | Permalink | Comments (0)

Monday, March 26, 2018

Senate Majority Leader Mitch McConnell announces plans for new hemp bill to remove plant from CSA

Pjimage-34As reported in this new AP article, the "U.S. Senate’s top leader said Monday he wants to bring hemp production back into the mainstream by removing it from the controlled substances list that now associates it with its cousin — marijuana." Here is more:

Senate Majority Leader Mitch McConnell told hemp advocates in his home state of Kentucky that he will introduce legislation to legalize the crop as an agricultural commodity. The versatile crop has been grown on an experimental basis in a number of states in recent years. “It’s now time to take the final step and make this a legal crop,” McConnell said.

Kentucky has been at the forefront of hemp’s comeback. Kentucky agriculture officials recently approved more than 12,000 acres (4,856 hectares) to be grown in the state this year, and 57 Kentucky processors are helping turn the raw product into a multitude of products.

Growing hemp without a federal permit has long been banned due to its classification as a controlled substance related to marijuana. Hemp and marijuana are the same species, but hemp has a negligible amount of THC, the psychoactive compound that gives marijuana users a high.

Hemp got a limited reprieve with the 2014 federal Farm Bill, which allows state agriculture departments to designate hemp projects for research and development. So far, 34 states have authorized hemp research, while actual production occurred in 19 states last year, said Eric Steenstra, president of the advocacy group Vote Hemp. Hemp production totaled 25,541 acres (10,336 hectares) in 2017, more than double the 2016 output, he said.

The crop, which once thrived in Kentucky, was historically used for rope but has many other uses, including clothing and mulch from the fiber, hemp milk and cooking oil from the seeds, and soap and lotions. Other uses include building materials, animal bedding and biofuels.

Hemp advocates fighting for years to restore the crop’s legitimacy hailed McConnell’s decision to put his political influence behind the effort to make it a legal crop again. “This is a huge development for the hemp industry,” Steenstra said. “Sen. McConnell’s support is critical to helping us move hemp from research and pilot programs to full commercial production.”

Brian Furnish, an eighth-generation tobacco farmer in Kentucky, has started making the switch to hemp production. His family will grow about 300 acres (120 hectares) of hemp this year in Harrison County. He’s also part owner of a company that turns hemp into food, fiber and dietary supplements. Furnish said hemp has the potential to rival or surpass what tobacco production once meant to Kentucky. “All we’ve got to do is the government get out of the way and let us grow,” he told reporters.

McConnell acknowledged there was “some queasiness” about hemp in 2014 when federal lawmakers cleared the way for states to regulate it for research and pilot programs. There’s much broader understanding now that hemp is a “totally different” plant than its illicit cousin, he said. “I think we’ve worked our way through the education process of making sure everybody understands this is really a different plant,” the Republican leader said.

McConnell said he plans to have those discussions with Attorney General Jeff Sessions to emphasize the differences between the plants. The Trump administration has taken a tougher stance on marijuana. The Department of Justice’s press office did not immediately respond to an email seeking comment.

McConnell said his bill will attract a bipartisan group of co-sponsors. He said the measure would allow states to have primary regulatory oversight of hemp production if they submit plans to federal agriculture officials outlining how they would monitor production. “We’re going to give it everything we’ve got to pull it off,” he said.

In Kentucky, current or ex-tobacco farmers could easily make the conversion to hemp production, Furnish said. Equipment and barns used for tobacco can be used to produce hemp, he said. Tobacco production dropped sharply in Kentucky amid declining smoking rates.

March 26, 2018 in Business laws and regulatory issues, Campaigns, elections and public officials concerning reforms, Federal Marijuana Laws, Policies and Practices, History of Marijuana Laws in the United States, Political perspective on reforms, Who decides | Permalink | Comments (1)

Sunday, March 25, 2018

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

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

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

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

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

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

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

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

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

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

Friday, March 23, 2018

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

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

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

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

Thursday, March 22, 2018

Latest draft federal spending bill again includes protections for state-legal medical marijuana programs

As reported here by Tom Angell at Forbes, "medical marijuana patients and businesses that follow state laws will continue to be protected from U.S. Attorney General Jeff Sessions and the federal drug agents that work for him under a provision contained in new must-pass legislation revealed on Wednesday."  Here is more:

The policy, which has been federal law since 2014, bars the U.S. Department of Justice from spending money to interfere with the implementation of state medical marijuana laws. Its continuance was in question, however, after Sessions specifically asked Congress not to extend it and House leaders blocked a vote on the matter. But the rider, which cleared a key Senate panel last year, is now attached to a bicameral deal to fund the federal government's operations through the rest of Fiscal Year 2018, which ends on September 30....

The new bill, which the House is expected to vote on as soon as Thursday, also continues existing provisions shielding state industrial hemp research programs from federal interference.

In a related move, a bipartisan group of members of Congress is stepping up the push to include the medical marijuana protections in Fiscal Year 2019 spending legislation. "We believe such a policy is not only consistent with the wishes of a bipartisan majority of the members of the House, but also with the wishes of the American people," 62 lawmakers wrote in a letter to House appropriations leaders last week.

In January, U.S. Attorney General Jeff Sessions rescinded a separate Obama-era Justice Department memo that has generally cleared the way for states to implement their own marijuana laws without federal interference. Given that action, some members of Congress want to go even further than the current medical cannabis protections in spending legislation by adding a new provision that protects all state marijuana laws -- including those that allow recreational use and businesses -- from federal interference....

The existing medical marijuana rider was first approved by a House floor vote of 219-189 in 2014 and then again in 2015 by a margin of 242-186. The Senate Appropriations Committee has also adopted the language in a series of bipartisan votes, most recently last summer. The provision must be reapproved annually because it concerns restrictions on specific years' Justice Department spending legislation.

In negative news for cannabis law reform supporters, the new FY2018 omnibus spending bill extends a current ban on the Washington, D.C. using its own local funds to legalize and regulate marijuana sales. And, it does not include language approved by the Senate Appropriations Committee last year that would have allowed military veterans to receive medical cannabis recommendations through their U.S. Department of Veterans Affairs doctors. To avoid a government shutdown, Congress must pass, and President Trump must sign, the appropriations legislation by Friday at midnight.

March 22, 2018 in Federal Marijuana Laws, Policies and Practices, Medical Marijuana State Laws and Reforms | Permalink | Comments (0)

Wednesday, March 21, 2018

New Brookings paper takes close lookat Uruguay's recreational marijuana reform efforts

ThF81Z2J9GAt Brookings, John Hudak, Geoff Ramsey, and John Walsh have produced this notable new report on a notable marijuana reform effort in South America.  The 24-page report it titled "Uruguay’s cannabis law: Pioneering a new paradigm," and here is its introduction:

Uruguay is the first country to legalize and regulate its domestic non-medical cannabis market. In light of this pioneering role, the choices and experiences of Uruguayan authorities hold important lessons for other jurisdictions that may consider whether and how to regulate cannabis.  Uruguay’s breakthroughs and challenges related to banking, international treaties, access to the product, enforcement, medical cannabis, tourism, and research and evaluation in particular hold immense value to policymakers and analysts elsewhere.  To this end, this report examines the conditions that led Uruguay’s government to pass its cannabis law in 2013, studies its progress so far, and identifies areas that policymakers should consider addressing in order to maximize the law’s potential benefits.

Key findings include:

• Uruguay should consider long-term measures to ensure that cannabis business entities have access to financial institutions, including outreach to other jurisdictions shifting toward cannabis regulation, such as Canada.

• The medical and law enforcement sectors require substantial education and training, particularly regarding the aims and expected benefits of cannabis regulation, how to broaden access to medical cannabis, and the new enforcement rules under the law.

• Implementation of commercial sales so far has been marked by shortcomings in distribution. Uruguay can overcome these obstacles by widening legal points of sale to include not only pharmacies, but a new form of dispensary, which authorities are already planning.

• In order for the regulated cannabis market to displace the black market more effectively, authorities may need to reconsider rules that require users to choose only one of the three legal forms of cannabis supply: homegrowing, clubs, or commercial purchase.

• Uruguayan authorities may also need to address a growing informal market by allowing legal sales to noncitizen tourists.

• In order to better position themselves to assess these adjustments, authorities should work closer with independent researchers and civil society to ensure that they have access to key information and institutional support for their work.

March 21, 2018 in International Marijuana Laws and Policies, Recreational Marijuana Commentary and Debate | Permalink | Comments (0)

Reviewing the work of Representative Pete Sessions to block marijuana reform efforts in Congress

ThPolitico has this extended new article on federal marijuana reform focused on a Sessions who is even more important than AG Jeff.  The full title of the article explains: "Washington’s Most Powerful Anti-Pot Official Is Named Sessions. It’s Not Who You Think: Rep. Pete Sessions has quietly used his chairmanship of the House Rules Committee to stifle popular amendments that would protect legal marijuana." I recommend this lengthy piece in full, and here are highlights:

[W]hile the nation’s top law enforcement officer has made it abundantly clear over the years that he views marijuana as a scourge equal to heroin, it turns out the unofficial title of Washington’s most powerful marijuana opponent belongs to someone else named Sessions: Pete, the longtime congressman from Texas’ 32nd district in Dallas. No relation to the attorney general, Pete Sessions nevertheless shares the former Alabama senator’s unforgiving attitudes toward all things cannabis.

“Marijuana is an addictive product, and the merchants of addiction make it that way,” Pete Sessions said in January. “They make it to where our people, our young people, become addicted to marijuana and keep going.” In February, at an opioid summit at the University of Texas Southwestern, Rep. Sessions stretched scientific fact when he said, today’s product is “300 times more powerful” than when he went to high school. (Later, his communications director confirmed that he meant three times more powerful.)

What Pete Sessions has, however, that Jeff Sessions doesn’t have is the power to change laws. Very quietly, but with implacable efficiency, Pete Sessions has used his position as the chair of the House Rules Committee to stymie or roll back amendments that protected legal marijuana in the 29 states that have approved it (30 states if you count Louisiana). States that have grown increasingly dependent on tax revenue from newly legal marijuana businesses, and investors who are pumping millions into an industry that is projected to hit $28 billion globally by 2024, have sought assurances that federal authorities wouldn’t try to invoke national drug law that still classifies marijuana as one of the most serious of all illegal drugs. Short of changing federal drug law, legislators in the states with forms of legal pot have sought the next best protection: using the power of the purse to curtail enforcement. But Sessions, with the approval of House leadership, has thwarted his colleagues. He neutralized one amendment that sailed through with a comfortable bipartisan majority and smothered others that would pass if they were ever allowed to see the light of day.

So far, the only people who have complained are the legislators whose amendments he has torpedoed and pro-marijuana lobbyists. That criticism has never troubled Sessions in his 21-year career (representing two districts). But recent polling indicates that 83 percent of Texas voters now favor legalizing medical marijuana, and that seems to be feeding a nascent campaign to use Sessions’ anti-marijuana influence against him in the 2018 midterm election. Even some Texas Republicans think his zealousness on the issue violates essential conservative principles of less government. “He’s got this personal viewpoint; he’s just personally against it. And there’s nothing that’s going to change his mind,” said Zoe Russell, of Republicans Against Marijuana Prohibition (RAMP). “That’s the absolute worst of big government.”

The only thing that has prevented Pete Sessions from completely wiping out protections for medical marijuana, and freeing Jeff Sessions’ Department of Justice to execute the crackdown he seems to pine for, is Congress’ own dysfunction. Because Congress could not agree on a budget, Rohrabacher-Farr has remained alive through a series of never-ending continuous resolutions. In addition, the Senate hasn’t been quite so willing to stifle its members’ wills on this issue; Senator Patrick Leahy (D-Vt.) has proposed a companion amendment to Rohrabacher-Farr, which passed the Senate’s appropriations committee by acclamation....

The question of whether the appropriations conference committee will approve the Senate version with the Leahy amendment or the House version that killed Rohrabacher-Farr remains to be answered. The current continuing resolution ends on Friday at midnight. Don Murphy, director of conservative outreach for the Marijuana Policy Project, bemoaned the fact that the Republican Party has surrendered ownership of marijuana reform as Democratic support for the issue gains steam: “What had once been a GOP effort known simply as ‘Rohrabacher’ after [Republican Dana Rohrabacher’s] decade-long sponsorship, will now be known as ‘the Leahy Amendment.’ It’s a missed opportunity for the GOP.”

When he speaks publicly about marijuana, Pete Sessions often positions himself as a bulwark against just that kind of Republican accommodation, insisting even against mounting evidence to the contrary that marijuana is a gateway drug to the opioid epidemic. This is a viewpoint shared by Jeff Sessions but not by the American Society of Addiction Medicine, generally an anti-marijuana group, which acknowledges “the observed drop in opioid overdose death rates in states where marijuana use is legal for medicinal purposes. One study found that states with ‘medical marijuana’ laws had a 24.8 percent lower average annual opioid overdose death rate compared to states without similar laws.”...

The signs that the Drug War is thawing even in deep-red Texas are hard to miss In 2015, the Texas legislature passed an extremely limited medical marijuana program that grants access to non-psychoactive CBD concentrates to Texans suffering from epilepsy. Given that the Drug Enforcement Administration still considers non-psychoactive CBD to be a drug with no medicinal value, Texas’ tiptoe into the waters of medical marijuana legalization has been an act of civil disobedience against a federal drug enforcement policy that is staunchly defended by the likes of Pete Sessions. In Dallas County, where the majority of Sessions’ constituents reside, police no longer arrest people caught with up to a quarter pound of marijuana, opting instead for a cite-and-release program meant to unclog the jails and judicial system, following the example of similar programs in San Antonio, Houston and Austin.

Against this backdrop, Sessions finds himself defending his congressional seat in 2018 in a district that Hillary Clinton won by nearly 2 percentage points just two years ago. The Cook Political Report rates the race as leans Republican, but does Sessions’ opposition to marijuana law reform make him more vulnerable to a Democratic challenger in November? Some Republicans fear that medical marijuana might be an effective wedge issue that could steer Republican voters toward a Democrat who supports marijuana law reform at the national level....

“Pete Sessions has made himself the No. 1 target of drug policy reformers in the 2018 general election,” Don Murphy of MPP told POLITICO Magazine. “Defeating Pete Sessions in 2018 will send a message to Washington that even the tone-deaf GOP can’t miss.” In fact, Murphy’s prediction appears to be taking shape in Texas. “It doesn’t matter which Democrat wins. Either way, we’re going to un-elect him,” said Rob Kampia, the former executive director of MPP. Kampia’s new venture is the Marijuana Leadership Campaign and its companion Marijuana Leadership PAC. “Our invitation-only launch meeting was held in Dallas,” he told POLITICO Magazine, “and I can safely say we'll be spending $500,000 on this singular congressional race.”

March 21, 2018 in Campaigns, elections and public officials concerning reforms, Federal Marijuana Laws, Policies and Practices, Who decides | Permalink | Comments (0)

Tuesday, March 20, 2018

"Early Evidence on Recreational Marijuana Legalization and Traffic Fatalities"

The title of this post is the title of this notable new paper authored by Benjamin Hansen, Keaton Miller and Caroline Weber. Here is its abstract:

Over the last few years, marijuana has become legally available for recreational use to roughly a quarter of Americans.  Policy makers have long expressed concerns about the substantial external costs of alcohol, and similar costs could come with the liberalization of marijuana policy.  Indeed, the fraction of fatal accidents in which at least one driver tested positive for THC has increased nationwide by an average of 10 percent from 2013 to 2016.  For Colorado and Washington, both of which legalized marijuana in 2014, these increases were 92 percent and 28 percent, respectively.  However, identifying a causal effect is difficult due to the presence of significant confounding factors.

We test for a causal effect of marijuana legalization on traffic fatalities in Colorado and Washington with a synthetic control approach using records on fatal traffic accidents from 2000-2016. We find the synthetic control groups saw similar changes in marijuana-related, alcohol-related and overall traffic fatality rates despite not legalizing recreational marijuana.

Some prior related posts:

"Medical or Recreational Marijuana and Drugged Driving"

NHTSA releases "Marijuana-Impaired Driving A Report to Congress"

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

Examining issues surrounding "Driving Under the Influence of Marijuana"

Still more on drugged driving laws and marijuana

"The April 20 Cannabis Celebration and Fatal Traffic Crashes in the United States"

March 20, 2018 in Assembled readings on specific topics, Recreational Marijuana Data and Research | Permalink | Comments (1)

Friday, March 16, 2018

"Evaluating ballot initiative support for legalised marijuana: The case of Washington"

The title of this post is the title of this interesting new piece authored by Loren Collingwood, Ben Gonzalez O’Brien and Sarah Dreier published int The International Journal of Drug Policy. Here is the abstract:

Background

In 2012, Washington and Colorado became the first U.S. states to legalise recreational marijuana. By 2016, eight states and the District of Columbia had legalised recreational marijuana, with more expected to consider it in 2018. Despite this trend, little academic research explains what drives ballot-initiative vote choice on marijuana legalisation.

Methods

This paper uses a pre-election random sample voter survey to examine the individual characteristics that correlated with Washington voters’ support for legal recreational marijuana.

Results

We find that voting on marijuana ballot initiatives largely reflects public opinion about marijuana and is particularly shaped voters’ political ideology, party affiliation, religious affiliation and practice, and education. Notably, we find that those reporting experiences (i.e., someone they know) with the criminal justice system are more supportive of legalisation than those who do not.

Conclusion

We conclude that marijuana legalisation voting behavior generally aligns with public opinion on the issue. However, one key aspect of Washington’s legalisation campaign–the criminal injustices of marijuana illegality–helped shape Washington state voting behavior. Further research is needed to examine if, when, and in what contexts criminal justice campaign themes are likely to strengthen or undermine future states’ marijuana legalisation efforts.

March 16, 2018 in Campaigns, elections and public officials concerning reforms, History of Marijuana Laws in the United States, Polling data and results, Recreational Marijuana Commentary and Debate, Recreational Marijuana Data and Research, Recreational Marijuana State Laws and Reforms | Permalink | Comments (0)

Wednesday, March 14, 2018

SAM releases major new report on "Lessons from Marijuana Legalization"

6a00d8341bfae553ef01bb09f38626970d-320wiThe leading national group opposed to modern marijuana reform, Smart Approaches to Marijuana (SAM), today released this big new report titled "Lessons from Marijuana Legalization in Four U.S. States and D.C." Here is how this big report was introduced and described via an email sent my way (with links from the original):

Today, Smart Approaches to Marijuana (SAM), the leading, nonpartisan U.S. organization offering a science-based approach to marijuana policy, released the most comprehensive study to date today entitled: Lessons from Marijuana Legalization in Four U.S. States and D.C.  This study, validated by scientists from around the country, found that since legalization, marijuana use has soared, the black market is thriving, and communities of color are being negatively affected.

The study found that legalized states are leading the nation in past-year marijuana use among every age group. Among those states, Colorado currently holds the lead for first-time marijuana use among youth aged 12-17, representing a 65% increase since legalization. Young adult use is also highest in legalized states. Further, the number of young people arrested for marijuana use in Colorado saw an increase from 2015-2016.
 
Not only are more young people being arrested for marijuana use in states that have legalized the substance, but Colorado has also seen an increase in the amount of youth on probation who have tested positive for the drug.
 
This rise in youth use of marijuana is particularly frightening to see given the longterm implications involved with young people becoming addicted to marijuana. "Since commercialization, those of us in addiction treatment have been seeing an increase in the number of patients who have become addicted to marijuana. Their symptoms, particularly sleep disturbance, appetite disturbance and psychosis, don't consistently remit after ninety days of treatment,"  said Bari Platter, Clinical Nurse Specialist at the University of Colorado Hospital's CeDAR (Center for Dependency, Addiction and Rehabilitation). "We need to do more research about the devastating long-term effects of marijuana before considering commercialization in other states," continued Platter.

Some supporters of legalization have argued that the relaxing of marijuana laws would lead to lower rates of alcohol consumption. The data prove otherwise. In the immediate year following legalization of marijuana, there was a clear drop off, but by year three alcohol consumption was at a multi-year high. 

Commercialization advocates have long argued that legalization will reduce black market marijuana activity in legalized states. However, criminal activity has only been amplified. In 2016 alone, Colorado law enforcement confiscated 7,116 pounds of marijuana, carried out 252 felony arrests, and made 346 highway interdictions of marijuana headed to 36 different U.S. states. The U.S. mail system has also been affected by the black market, seeing an 844% increase in postal marijuana seizures. Narcotics officers in Colorado have been busy responding to the 50% increase in illegal growing operations across rural areas in the state.

One of the most common arguments prevalent amongst the pro-marijuana lobby is that the legalization of the substance will greatly assist communities of color. The study found that the common disparities among use and criminal offense rates continue among race, ethnicity, and income levels. The District of Columbia saw public consumption and distribution arrests nearly triple and a disproportionate number of those marijuana-related arrests occur among African-Americans.

Finally, the study found a disturbing trend in that drugged driving and motor vehicle fatalities have increased in states that have legalized recreational marijuana. The number of drivers in Colorado intoxicated with marijuana and involved in fatal traffic crashes increased 88% from 2013-2015 and marijuana-related traffic deaths increased 66% between the four-year averages before and after legalization.

March 14, 2018 in Criminal justice developments and reforms, Recreational Marijuana Commentary and Debate, Recreational Marijuana Data and Research, Recreational Marijuana State Laws and Reforms | Permalink | Comments (1)

Tuesday, March 13, 2018

"Cannabis Decriminalization: A Study of Recent Policy Change in Five States"

The title of this post is the title of this new paper recently posted to SSRN authored by Rick Grucza, Melissa Krauss, Andrew Plunk, Arpana Agrawal, Frank J. Chaloupka and Laura Bierut. Here is the abstract:

Background: A number of public health professional organizations support the decriminalization of cannabis due to adverse effects of cannabis-related arrests and legal consequences, particularly on youth. We sought to examine the associations between cannabis decriminalization and both arrests and youth cannabis use in five states that passed decriminalization measures between the years 2008 and 2014: Massachusetts (decriminalized in 2008), Connecticut (2011), Rhode Island (2013), Vermont (2013), and Maryland (2014).

Methods: Data on cannabis use were obtained from state Youth Risk Behavior Survey (YRBS) surveys, years 2007-2015; arrest data were obtained from federal crime statistics. Using a “difference in difference” regression framework, we contrasted trends in decriminalization states with those from states that did not adopt major policy changes during the observation period.

Results: Decriminalization was associated with an immediate and strong reduction in the rate of drug-related arrests for youth (OR=0.38; 95% CI: 0.37, 0.39) and adults (OR=0.40; 95% CI: 0.38, 0.42). Decriminalization was not associated with any increase in the past-30 day prevalence of cannabis use (OR=0.99; 95% CI: 0.95, 1.04). Significant declines in prevalence were observed for Rhode Island (OR=0.92; 95% CI; 0.87, 0.97) and Vermont (OR=0.91, 95% CI; 0.87, 0.95).

Conclusions: Decriminalization of cannabis in Massachusetts, Connecticut, Rhode Island, Vermont, and Maryland resulted in large decreases in drug-related arrests for both youth and adults, suggesting that the policy change had its intended consequences. Our analysis did not find any increase in the prevalence of youth cannabis use during the observation period.

March 13, 2018 in Criminal justice developments and reforms, Recreational Marijuana Data and Research | Permalink | Comments (0)

Detailing how racial justice concerns are driving marijuana reform debate in New Jersey

732521_1One of many great lines in the great musical Hamilton is "Everything is legal in New Jersey."   But that is not quite right with respect to marijuana yet, though the recent election of a Governor who ran advocating for marijuana reform led to many reform advocates thinking the Garden State could become the next big legalization state.  But, as is often the case, legislative reform is full of complications, and this New York Times article highlights how completing views on racial justice is shaping the debate in New Jersey.  The piece is headlined "Racial Justice Drives Fight for, and Against, Legal Pot in New Jersey," and here are excerpts:

During his campaign for governor of New Jersey, Philip D. Murphy, a Democrat, pledged to legalize the recreational use of marijuana, telling Democrats at a party conference last year in Atlantic City that creating a new tax revenue was not what was motivating him.

“People ask me all the time, ‘Hey, are you sure you can generate $300 million from the legalization of marijuana?” Mr. Murphy said, citing a figure that his campaign had trumpeted. “I say, ‘You know what, I’m not sure, but that’s not the question. We’re not doing it for the dollars. We’re doing it for social justice.’”

Mr. Murphy argues that the disproportionate number of African-Americans who are jailed on marijuana charges is a main reason to legalize the drug, and he has the support of civil rights groups, cannabis business lobbyists, lawyers, doctors who prescribe medical marijuana and out-of-state cannabis growers.

But now that Mr. Murphy occupies the governor’s office, a major legislative obstacle is emerging: Ronald L. Rice, the state’s longest-serving black senator and the leader of its Black Caucus. “It’s always been said the issue is not money, the issue is social justice,” said Mr. Rice, a Democrat and a former Newark police officer. “But, it’s being sold on the backs of black folk and brown people. It’s clear there is big, big money pushing special interests to sell this to our communities.”

Medical marijuana became legal in New Jersey under former Gov. Jon Corzine, a Democrat, but his successor, Gov. Chris Christie, a Republican, rejected proposals to make recreational cannabis use legal.

The growing and selling of marijuana has already generated billions of dollars in the nine states where it is legal — but it is an industry that is overwhelmingly white. Mr. Rice fears the consequences would be dire in cities like Newark, which is already wrestling with a variety of problems, including widespread heroin addiction and a foreclosure crisis. Cannabis stores, he believes, would proliferate in black communities, much like liquor stores, and would produce a new generation of drug abusers....

His position on cannabis legalization not only puts him at odds with the governor and members of his party, but also with many African-Americans.

In New Jersey, African-Americans are three times more likely to be charged with marijuana possession than whites, even though both populations use the drug at similar rates. That has galvanized civil rights groups like the N.A.A.C.P. and the American Civil Liberties Union of New Jersey to support legalization. “All the collateral consequences that come with an arrest — jail time, losing your job, losing your housing — are disproportionately falling on communities of color,” said Dianna Houenou, a lawyer with the A.C.L.U. of New Jersey. “Through legalization we can begin to address the harms that have been inflicted.”

A statewide coalition of black pastors, the N.A.A.C.P. and the New Jersey chapter of the Drug Policy Alliance is pushing for legalization as a social justice issue, but only if it is linked to some type of compensation for the harm they say was done to black and brown families whose sons were incarcerated. The pastors said they wanted to make sure members of their communities were able to participate in the billion-dollar cannabis industry as growers and sellers, not just workers. They are frustrated that the wealth being generated in the other states where marijuana is legal is not reaching people of color.

Researchers at Marijuana Business Daily, an industry news site based in Denver, found that 81 percent of cannabis business owners were white, while less than 4 percent were black....

At a marijuana legalization forum held recently at Bethany Baptist Church in Newark, the Rev. Charles Boyer of Bethel A.M.E. Church in Woodbury said the worst thing that could happen was for communities most harmed by the prohibition to not have a say about legalization. “Do we want to be the ones responsible for playing a part in a system that will make tons of young white millionaires after years of making hundreds of thousands of poor black felons?” Pastor Boyer said.

The Drug Policy Alliance is lobbying for a bill that includes the automatic and retroactive expungement of criminal records for possession, making permits for cannabis shops affordable so that the market is accessible to lower-income entrepreneurs, and a commitment that a portion of the revenue from marijuana sales be used to provide education and job training for people of color. Some social justice activists are also calling for allowing people to grow their own cannabis plants.

State Senator Nicholas Scutari, a Democrat from Linden, is the author of a bill that would legalize the possession of small amounts of marijuana for anyone over 21 and would establish a state Division of Marijuana Enforcement. But it does not include any language discussing compensation. Mr. Scutari agrees that arrests for marijuana possession are disproportionately higher for blacks and Latinos and says his bill addresses the issue of social justice. “The individuals that are previously convicted of marijuana possession will no longer be subject to prosecution,” Mr. Scutari said....

For his part, Mr. Rice has proposed his own marijuana bill that would decriminalize the possession of 10 grams or less of marijuana, and make carrying more a disorderly persons charge that would impose only a fine. It would also expunge criminal records and release incarcerated people serving sentences for possessing small amounts of marijuana. But Mr. Scutari said that decriminalization would simply create an open-air drug market that would allow drug dealers to get richer without creating any kind of regulatory system to control how marijuana is sold.

Ultimately, any effort to promote civil rights could depend on what kind of bill Mr. Murphy is willing to sign. In a statement, Daniel Bryan, a spokesman for the governor, said that Mr. Murphy was committed to “the goal of building a stronger and fairer New Jersey, and supports the legalization of marijuana to advance the cause of social justice and combat the racial disparities in our criminal justice system.”

March 13, 2018 in Business laws and regulatory issues, History of Marijuana Laws in the United States, Political perspective on reforms, Race, Gender and Class Issues, Recreational Marijuana Commentary and Debate, Recreational Marijuana State Laws and Reforms, Who decides | Permalink | Comments (0)

Sunday, March 11, 2018

New US Attorney for Southern District of West Virginia talking up efforts to "enforce laws against marijuana aggressively - AGGRESSIVELY"

I have just seen via my twitter feed this notable recent tweet posted by US Attorney Mike Stuart, the newly confirmed U.S. Attorney for the Southern District of West Virginia:

Without getting into the particulars of the gateway drug debate, I am eager here to highlight how easy it would be for this new US Attorney to ramp up federal marijuana enforcement relative to what has existed in recent years.  Based on some (too) quick research of US Sentencing Commission data, it seems that there have only been a handful of federal marijuana prosecutions each year in this district.  USA Stewart could "aggressively" increase the federal caseload just by bringing a few more cases each year.

It will be interesting to see if the Southern District of West Virginia does end up having many more marijuana prosecutions in the months ahead, though these statements likely are to be most significant with respect to West Virginia's development of its recently passed medical marijuana legislation.   This local article, headlined "Time runs out on bill making changes to WV's medical cannabis program," suggests that the rescission of the Cole Memo and related concerns about federal prohibition may already be slowing down the state's regulatory efforts.

March 11, 2018 in Campaigns, elections and public officials concerning reforms, Criminal justice developments and reforms, Federal Marijuana Laws, Policies and Practices, Medical Marijuana Commentary and Debate, Medical Marijuana State Laws and Reforms | Permalink | Comments (1)

Wednesday, March 7, 2018

Examining the persistently significant number of marijuana arrest in New York City

Marijuanaarrestsmayors2017The  Leafly folks are doing a three-part series on cannabis in New York City, and this first part looks at arrests under the headline "Racial Disparities in NYC Cannabis Arrests Are Getting Worse." (The discussion in the piece builds off this Politico article last month headlined "Racial disparities persist in New York City marijuana arrests.)  I recommend both pieces in full, and here are portions of the Leafly piece:

Under Mayor Bill de Blasio, cannabis arrests in New York City are significantly down relative to cannabis arrests during the terms of his precedessors, Michael Bloomberg and Rudy Giuliani. But they’re still an order of magnitude higher than cannabis arrests during the 1980s and early 1990s — and the racial disparities in those arrest figures aren’t getting any better. In fact, the disparities in white, black, and hispanic cannabis arrests were worse in 2017 than they were in the previous year.

Under Mayor Bill de Blasio, 85% of the people arrested for cannabis offenses were people of color. Under Michael Bloomberg, that figure was 84%. How can the rest of the country continue to make progress — decriminalizing in big cities, legalizing in more and more states — while New York City actually goes backwards?

That’s what members of New York’s City Council wanted to know last week. In a joint meeting of the Council’s Committee on Public Safety and Committee on the Justice System, councilmembers questioned leaders of the New York Police Department about racial disparities in the enforcement of the city’s cannabis laws. It was not a congenial affair. Councilmembers repeatedly took the NYPD to task for withholding critically important arrest data, and for the glaring racial disparities in the little data that was offered up for public scrutiny.

Councilmember Donovan Richards, head of the public safety committee, started off the session by airing data on marijuana arrests, per New York City mayor, during their first three years in office:

Mayor Koch – 6,000 arrests, with an average of 2,000 per year

Mayor Dinkins – 3,000 arrests, with an average of 1,000 per year

Mayor Gulliani 18,000 arrests, with an average of 6,000 per year

Mayor Bloomberg 112,000 arrests with an average of 37,000 per year

Mayor Di Blasio 61,000 arrests, with an average of 20,000 per year...

Marijuanaarrestsrace2017According to a survey of city residents, in the past year, 33% of whites, 32% percent of blacks and 27% of Latinos in New York City have acknowledged consuming marijuana.

Noting those figures, Councilman Richards, who is black, asked: “Are blacks the only ones using marijuana in New York City? It’s pretty even across the spectrum of marijuana use. So why is so much enforcement happening in communities of color?”

Chief Shea dodged the question. He said that in 2014, the city made a legal differentiation between ‘using marijuana’ and ‘burning marijuana.’ Since then, he said, 90% of arrests for marijuana are for ‘burning.’

That didn’t mollify Richards. “Communities of color are not the only ones ‘burning,’” he said.

Under Mayor de Blasio, 85% of the people arrested for cannabis offenses were people of color. Under Mayor Bloomberg, that figure was 84%. “If the administration is serious about changing the racial disparity of arrests,” said Richards, “we are not seeing that.”

Chief Shea defended the NYPD’s arrest statistics. “We are following specific complaints from the public, regarding marijuana burned in public view.” He added, “We are probably the most transparent we have ever been as a department, as an administration.”

This seemed hard for Council members to believe, because no data was presented by the department to corroborate their claims, despite repeated prior requests for said data to be presented before the hearing.

March 7, 2018 in Criminal justice developments and reforms, History of Marijuana Laws in the United States, Race, Gender and Class Issues | Permalink | Comments (0)

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

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

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

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

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

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

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

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

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

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

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

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

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

Monday, March 5, 2018

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

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

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

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

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

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

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

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

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

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

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

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

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

Sunday, March 4, 2018

Some perspectives on the rescission of the Cole Memo two months later

It has now been a full two months since Attorney General Sessions decided to rescind the Cole Memo which expressly stated that federal prosecutors would not prioritize criminal enforcement against state-compliant marijuana businesses.  A lot could have happened in those two months, but for now it still seems, as I suggested in this prior post, that in the short term the Justice Department may have been impacted more by rescission of Cole Memo than marijuana industry.  But this new Forbes article, headlined "How Cannabis Entrepreneurs Feel About Sessions' Reversal Of The Cole Memo," provides some industry-player perspectives on this front. I recommend the piece in full, as it provides "opinions from a collection of industry experts discussing Sessions’ reversal of Cole’s memorandum [which} cover investment strategies, regulatory compliance, disintermediation and yes blockchain." Here are a few of the quotes I found interesting:

Wil Ralston, President of SinglePoint (OTCMKTS: SING), a publicly-traded cannabis and technology holding company specializing in acquisitions of small to mid-sized companies with an emphasis on mobile technologies and emerging markets:

"Entrepreneurs seeking opportunities in the cannabis industry are still pushing full speed ahead. As an entrepreneur, you're always analyzing the risk:reward of your decision-making; as of right now, the potential success that can be realized in the cannabis industry is such that entrepreneurs will likely continue to find their way, even through the reversal of the Cole Memo. We've already seen quite a bit of pushback to Sessions' reversal of the memo, from the general public to government officials, and in the absence of a seriously damaging development, entrepreneurs will keep running towards the cannabis industry, not away from it."...

Leslie Bocskor, President of Electrum Partners, an advisory services firm specializing in medical and recreational cannabis and ancillary businesses:

“My take is that the sleeper technology for the cannabis industry will be blockchain and cryptocurrency. Whereas many think crypto is a solution for transactions, and it may be, my take is a little different.  Since cannabis is the red-headed step child of the venture and early stage finance world, due to the federal illegality, we will see cryptocurrency ‘tokenomics’ (not my word, Thomas Carter of Dealbox; www.dlbx.io) be used to disintermediate the venture capital world, first in cannabis companies and then beyond.  Using cryptocurrencies with registered compliant offerings to speed up and simplify the capital formation process will be the news we read about one year from now, having been done successfully for cannabis companies first.”

March 4, 2018 in Business laws and regulatory issues, Federal Marijuana Laws, Policies and Practices | Permalink | Comments (0)

Friday, March 2, 2018

"Marijuana for Moms"

The title of this post is the headline of this notable lengthy Atlantic piece, with the subheadline: "In states where weed is legal, new mild cannabis products are catching on with parents."  Here is how it gets started:

Many a meme has been made about “wine moms”—mothers who joke online about their love for a relaxing glass of cabernet, or three.  But a new drug is gaining popularity with the playgroup circuit.  As it becomes more socially acceptable, more moms are using marijuana and its various incarnations to deal with everything from the daily aches and stresses of motherhood, to postpartum depression and anxiety, to menstrual cramps.  And forget the simple bongs and pipes of the past; as the industry expands, it’s creating a whole new world of sprays, drinks, drops, and oils.  The needs of this market of marijuana-friendly mothers have inspired a new crop of cannabis products.

In her recent High Times article, Jessica Delfino discusses the changing social attitudes toward motherhood and marijuana: “Mothers and women who use medical marijuana…are often put into a position in which they feel they have to explain themselves and what their condition is, and then steel themselves for the judgment that will inevitably follow,” she writes.

But also, Delfino tells me: “I think cannabis use in moms is becoming more widespread because it’s becoming more legal, and so people feel more willing and able to discuss it.”

Adam Grossman, the CEO of the cannabis company Papa and Barkley, has also noticed a burgeoning interest in marijuana from moms.  “In the last month alone, we have seen the emergence of cannabis-and-parenthood workshops, new ‘parenting and cannabis’ publications like Splimm, and Facebook groups," he says.  “More and more parents are starting to have the conversation about cannabis and breastfeeding, cannabis and pregnancy, and cannabis and parenting.”

But according to those in the pot industry, one new product in particular is spreading fast in mom circles: sublingual spray, a convenient, THC-infused ingestible liquid.

Once you spritz the liquid under your tongue, it activates quickly (within 60 seconds), it’s hard to overdo, and the high doesn't last very long, says Leslie Siu, the CMO and cofounder of cannabis company Mother and Clone.  “After a minute you’ll start to feel this uplifting euphoric feeling, almost like a gentle rush,” Siu says of her sublingual nano-sprays. (Nano-sprays are a form of microdosing — Mother and Clone bottles deliver a metered dose of the drug.)  By the five-minute mark, she says, you’ll know just how strong the effects will be for the next hour and you can decide to re-up and spray some more — in the industry this is called “stacking.”

Siu was moved to start Mother and Clone after she experienced postpartum depression.  “Everything felt dark,” she recalls of that first “ominous” year after having her daughter Veda.  Siu started searching for ways to ease the overwhelming, stressful feelings she was having.  “Then a few things happened that got me back on track,” Siu says. "Time, therapy, running, and weed.”

Siu wanted to create a cannabis product that would be easy and safe for mothers in similar situations to use, and she landed on sublingual sprays.  Because it’s easier to control the dose with sublingual spray, Siu says that it’s ideal for parents (her products also have child-resistant bottles).  The sprays can also help with sleep, she says.  “A lot of [postpartum depression and postpartum anxiety] sufferers develop terrible insomnia even if the baby starts to sleep through the night.”

March 2, 2018 in Medical Marijuana Commentary and Debate, Race, Gender and Class Issues, Recreational Marijuana Commentary and Debate | Permalink | Comments (0)