Marijuana Law, Policy & Reform

Editor: Douglas A. Berman
Moritz College of Law

Tuesday, June 11, 2019

Notable analysis of full legalization's impact on medical marijuana regimes

800The AP has this new extended article, headlined "Broad legalization takes toll on medical pot," which looks at the impact of full marijuana legalization on medical marijuana programs.  Here are some excerpts:

When states legalize pot for all adults, long-standing medical marijuana programs take a big hit, in some cases losing more than half their registered patients in just a few years, according to a data analysis by The Associated Press.

Much of the decline comes from consumers who, ill or not, got medical cards in their states because it was the only way to buy marijuana legally and then discarded them when broader legalization arrived. But for people who truly rely on marijuana to control ailments such as nausea or cancer pain, the arrival of so-called recreational cannabis can mean fewer and more expensive options....

States see a “massive exodus” of medical patients when they legalize marijuana for all adults — and then, in many cases, the remaining ones struggle, said David Mangone, director of government affairs for Americans for Safe Access. “Some of the products that these patients have relied on for consistency — and have used over and over for years — are disappearing off the shelves to market products that have a wider appeal,” he said. Cost also rises, a problem that’s compounded because many of those who stay in medical programs are low-income and rely on Social Security disability, he said.

In Oregon, where the medical program shrank the most following recreational legalization, nearly two-thirds of patients gave up their medical cards, the AP found. As patients exited, the market followed: The number of medical-only retail shops fell from 400 to two, and hundreds of growers who contracted with individual patients to grow specific strains walked away.

Now, some of the roughly 28,000 medical patients left are struggling to find affordable medical marijuana products they’ve relied on for years. While the state is awash in dry marijuana flower that’s dirt cheap, the specialized oils, tinctures and potent edibles used to alleviate severe illnesses can be harder to find and more expensive to buy....

Ten states have both medical and recreational markets. Four of them — Oregon, Nevada, Colorado, Alaska — have the combination of an established recreational marketplace and data on medical patients. The AP analysis found all four saw a drop in medical patients after broader legalization.

In Alaska, the state with the second-biggest decline, medical cardholders dropped by 63% after recreational sales began in 2016, followed by Nevada with nearly 40% since 2017 and Colorado with 19% since 2014.

The largest of all the legal markets, California, doesn’t keep data on medical patients, but those who use it say their community has been in turmoil since recreational pot debuted last year. That’s partly because the state ended unlicensed cannabis cooperatives where patients shared their homegrown pot for free....

Getting a precise nationwide count of medical patients is impossible because California, Washington and Maine don’t keep data. However, absent those states, the AP found at the end of last year nearly 1.4 million people were active patients in a medical marijuana program. The AP estimates if those states were added the number would increase by about 1 million.

As more states legalize marijuana for all adults, some who have been using it medically are feeling disenfranchised.

In Michigan, where medical marijuana has been legal for over a decade, the creation of a new licensing system for medical dispensaries has sparked court challenges as the state prepares for the advent of general marijuana sales later this year. A cancer patient there filed a federal lawsuit this month, alleging the slow licensing pace has created a shortage of the products she needs to maintain her weight and control pain.

In Washington, medical patients feel they were pushed aside when that state merged its medical and general-use markets, which also is what’s happening in California. Los Angeles dispensary owner Jerred Kiloh sells medical and recreational marijuana and said those markets are quickly becoming one, since few companies are going to produce products for a vanishing group of customers. He said his medical business has dipped to 7% of overall sales and is dropping month to month. “It’s going to be gone,” said Kiloh, president of the LA trade group United Cannabis Business Association.

June 11, 2019 in Medical Marijuana Commentary and Debate, Medical Marijuana Data and Research, Recreational Marijuana Commentary and Debate, Recreational Marijuana Data and Research | Permalink | Comments (0)

New research raises questions as to relationship between medical marijuana reform and opioid overdoses

This new study just published online in the Proceedings of the National Academy of Sciences suggests that previously encouraging findings suggesting that medical marijuana reforms contributed to a reduction in opioid overdose deaths may not hold up over time.  Here is the article's abstract:

Medical cannabis has been touted as a solution to the US opioid overdose crisis since Bachhuber et al. [M. A. Bachhuber, B. Saloner, C. O. Cunningham, C. L. Barry, JAMA Intern. Med. 174, 1668–1673] found that from 1999 to 2010 states with medical cannabis laws experienced slower increases in opioid analgesic overdose mortality.  That research received substantial attention in the scientific literature and popular press and served as a talking point for the cannabis industry and its advocates, despite caveats from the authors and others to exercise caution when using ecological correlations to draw causal, individual-level conclusions. 

In this study, we used the same methods to extend Bachhuber et al.’s analysis through 2017.  Not only did findings from the original analysis not hold over the longer period, but the association between state medical cannabis laws and opioid overdose mortality reversed direction from −21% to +23% and remained positive after accounting for recreational cannabis laws.  We also uncovered no evidence that either broader (recreational) or more restrictive (low-tetrahydrocannabinol) cannabis laws were associated with changes in opioid overdose mortality.   We find it unlikely that medical cannabis — used by about 2.5% of the US population — has exerted large conflicting effects on opioid overdose mortality.  A more plausible interpretation is that this association is spurious.  Moreover, if such relationships do exist, they cannot be rigorously discerned with aggregate data.  Research into therapeutic potential of cannabis should continue, but the claim that enacting medical cannabis laws will reduce opioid overdose death should be met with skepticism.

Some discussion of this research appears in these popular press pieces, among others:

June 11, 2019 in Medical Marijuana Commentary and Debate, Medical Marijuana Data and Research | Permalink | Comments (0)

Wednesday, June 5, 2019

Americans For Safe Access releases detailed "Patient's Guide To CBD"

2CBD_Guide_GraphicThe leading medical marijuana advocacy group, Americans for Safe Access, has this terrific new resource titled "Patient's Guide To CBD."  Though the title of this nearly 50-page report is simple, the contents provide an intricate road-map to the complicated law and science surrounding the status and import of the cannabis-plant compound known as CBD. Here is a section of the publication's introduction:

The Patient’s Guide to CBD was created by Americans for Safe Access (ASA) for the benefit of patients, prospective patients, healthcare providers, consumers, and anyone interested in learning more about CBD.  The goal of this guide is to be an informative and useful reference document that will be shared with others so that patients, doctors, and regulators can make informed decisions regarding CBD....

Patients and consumers should also be aware of the legal and regulatory status of CBD products.  As of May 2019, 47 U.S. states have passed some type of legislation permitting the use of cannabis or cannabinoids such as CBD; nevertheless, cannabis with THC in excess of 0.3% by dry weight is a Schedule I controlled substance under U.S. Federal law.  Therefore, CBD-containing products that were produced from cannabis plants that exceed the federal threshold on THC may be legal at the state level, but are federally illegal.  Additionally, even CBD products that are derived from plants containing not more than 0.3% THC by dry weight may violate laws such as the Food, Drug and Cosmetics Act and create further legal challenges for patients and consumers.

The passage of the Agriculture Improvement Act of 2018 (also known as the 2018 Farm Bill) will make industrial hemp (i.e., cannabis with no more than 0.3% THC by dry weight), including CBD-rich industrial hemp, an agricultural commodity in the United States, but the U.S. Department of Agriculture has yet to promulgate federal regulations or approve state regulations regarding the cultivation and processing of industrial hemp. Further, the U.S. Food & Drug Administration has yet to provide a pathway for the introduction of hemp-derived CBD products into the marketplace.  Therefore, it is not yet federally legal to market hemp-derived CBD as a drug, dietary supplement, food product, or cosmetic.  Patients and consumers are encouraged to stay up to date on these changing regulations to ensure that they, and their products, are in compliance with applicable laws.

Globally, the use of products containing CBD has risen dramatically as more and more people seek alternative ways to improve their health and their lives.  The data has shown an increase in the sales of products containing CBD every year, and sales are expected to continue to rise in the coming years.

June 5, 2019 in History of Marijuana Laws in the United States, Medical community perspectives, Medical Marijuana Commentary and Debate, Medical Marijuana Data and Research, Medical Marijuana State Laws and Reforms | Permalink | Comments (0)

Tuesday, May 21, 2019

New research suggests CBD can reduce craving and anxiety for those with heroin use disorder

Long-time readers know I have long been covering the (never-quite-clear) connection between modern marijuana reform and the modern opioid crisis.  (Just some of many, many prior posts on this front are linked below.)   Today brings notable research news on this front, which is already getting a lot of attention from the mainstream press in articles from CNN, from NBC News, from Newsweek, and from US News & World Report, among others.  All these stories are about a new study published in The American Journal of Psychiatry from multiple authors under this catchy title: "Cannabidiol for the Reduction of Cue-Induced Craving and Anxiety in Drug-Abstinent Individuals With Heroin Use Disorder: A Double-Blind Randomized Placebo-Controlled Trial."  Here is the study's abstract:

Objective:

Despite the staggering consequences of the opioid epidemic, limited nonopioid medication options have been developed to treat this medical and public health crisis. This study investigated the potential of cannabidiol (CBD), a nonintoxicating phytocannabinoid, to reduce cue-induced craving and anxiety, two critical features of addiction that often contribute to relapse and continued drug use, in drug-abstinent individuals with heroin use disorder.

Methods:

This exploratory double-blind randomized placebo-controlled trial assessed the acute (1 hour, 2 hours, and 24 hours), short-term (3 consecutive days), and protracted (7 days after the last of three consecutive daily administrations) effects of CBD administration (400 or 800 mg, once daily for 3 consecutive days) on drug cue–induced craving and anxiety in drug-abstinent individuals with heroin use disorder. Secondary measures assessed participants’ positive and negative affect, cognition, and physiological status.

Results:

Acute CBD administration, in contrast to placebo, significantly reduced both craving and anxiety induced by the presentation of salient drug cues compared with neutral cues. CBD also showed significant protracted effects on these measures 7 days after the final short-term (3-day) CBD exposure. In addition, CBD reduced the drug cue–induced physiological measures of heart rate and salivary cortisol levels. There were no significant effects on cognition, and there were no serious adverse effects.

Conclusions:

CBD’s potential to reduce cue-induced craving and anxiety provides a strong basis for further investigation of this phytocannabinoid as a treatment option for opioid use disorder.

Some (of many) prior related posts:

May 21, 2019 in Medical community perspectives, Medical Marijuana Data and Research | Permalink | Comments (0)

Encouraging research on "Medical Marijuana Laws and Suicide"

Download (24)I just saw a report on this notable research reporting on the relationship between marijuana reform and suicide in California in the years before and after the legalization of medicial marijuana in 1996.  Just published in the Archives of Suicide Research, this article is titled " "Medical Marijuana Laws and Suicide," and is authored by Bradley J. Bartos, Charis E. Kubrin, Carol Newark & Richard McCleary.  Here is the article's abstract: 

Objective: To estimate the causal effect of a medical marijuana initiative on suicide risk.  In 1996, California legalized marijuana use for medical purposes. Implementation was abrupt and uniform, presenting a “natural experiment.”

Method:  Total, gun and non-gun suicides were aggregated by state for the years 1970-2004.  California’s control time series was constructed as a weighted combination of the 41 states that did not legalize marijuana during the time-frame.  Post-intervention differences for California and its constructed control time-series were interpreted as the effects of the medical marijuana law on suicide. Significance of the effects were assessed with permutation tests.

Results: The 1996 legalization resulted in mean annual reductions of 398.9 total suicides, 208 gun suicides, and 135 non-gun suicides.  The effect estimates for total and gun suicides were statistically significant (p<.05) but the effect estimate for non-gun suicides was not (p≥.488).

Conclusions: Since the effect for non-gun suicides was indistinguishable from chance, we infer that the overall causal effect was realized through gun suicides.  The mechanism could not be determined, however.  Participation in the medical marijuana program legally disqualifies participants from purchasing guns.  But since most suicides involve guns, it is possible the effect on total suicide is driven by gun suicide alone.

May 21, 2019 in Medical Marijuana Data and Research | Permalink | Comments (0)

Wednesday, May 1, 2019

Shouldn't every major marijuana investor make major investments in marijuana research?

Research-data-analysisThe question in the title of this post is prompted by this notable story out of Boston headlined "Harvard, MIT share $9 million gift to study marijuana's health effects." Here are the interesting details:

An investor in the cannabis industry has donated $9 million to Harvard and MIT to study the drug’s health effects, in what the institutions describe as the largest private gift to support marijuana research in the United States.  The Broderick Fund for Phytocannabinoid Research, announced Tuesday morning, will be shared equally by Harvard Medical School and the Massachusetts Institute of Technology, with the goal of filling vast gaps in the understanding of how marijuana affects the brain and behavior.

“The lack of basic science research enables people to make claims in a vacuum that are either anecdotal or based on old science,” said the donor, Charles R. “Bob” Broderick, an alumnus of both universities. “For generations we haven’t been able to study this thing for various sorts of societal reasons. That should end now, as well as the prohibitions that are falling around the world.”

Broderick has invested heavily in the booming marijuana business, starting in Canada in 2015 and more recently the United States, through his family-run Uji Capital. Although Broderick stands to profit if the studies find benefits from marijuana, the universities and the researchers said the donor will have no say in the work process or its results. They also pledged to publish their findings even if they find marijuana doesn’t help or causes harm.

Broderick recalled the first time he raised the idea of funding cannabis research with a Harvard development officer: “There was silence on the other end. Then she said, ‘I don’t think we do it.’ And I said, ‘That’s the problem.’ ” The official soon called back to say that Harvard researchers studying brain chemicals would be interested in examining marijuana’s effects.

Dr. Igor Grant, a longtime California marijuana researcher who is not involved with the Harvard-MIT project, said the grant “will really let them move forward with research that has been difficult to fund.”

“The work in this area has been very, very slow coming,” said Grant, director of the Center for Medicinal Cannabis Research at the University of California San Diego.

“This is exactly the type of research we need,” said Dr. Peter Grinspoon, a Massachusetts primary care doctor and board member of Doctors for Cannabis Regulation, a group promoting legalization and regulation of marijuana. Whether for or against marijuana, Grinspoon said, “Everybody wants more research.” The marijuana studies to date vary in quality, often have conflicting results, and typically involve either purified extracts or smoked marijuana — not the gummies, cookies, vapor, oils, or highly potent buds that people consume today....

Until recently researchers could work only with marijuana grown at a federal farm in Mississippi, whose plants are less potent than those purchased at dispensaries in states where the drug is legal. But John Gabrieli, a professor of brain and cognitive sciences at MIT and one of the grant recipients, said “a fast-changing regulatory environment” is allowing access to better material.

The MIT researchers intend to use extracts from the plants to tease out the effects of marijuana in people with schizophrenia — about half of whom are heavy cannabis users, Gabrieli said. The researchers want to pursue intriguing evidence that a component in marijuana known as tetrahydrocannabinol, or THC, improves cognitive function in people with schizophrenia. They will look at how THC as well as another key component — cannabidiol, or CBD — affect cognition alone and in combination.

Another MIT researcher will study how chronic exposure to THC and CBD may alter the cell types implicated in schizophrenia, potentially shedding light on why teens who use cannabis are at greater risk of developing schizophrenia and why the drug may be more dangerous for teens than adults.

Other studies at MIT will examine whether marijuana ingredients can help people with autism and with Huntington’s disease, and will study the effects of cannabis ingredients on attention and working memory. It’s been “incredibly hard” to get funding for marijuana research, Gabrieli said. “It’s been illegal all over the place until very recently. Without the philanthropic boost, it could take many years to work through all these issues.”

At Harvard, the $4.5 million gift establishes the Charles R. Broderick Phytocannabinoid Research Initiative, involving some 30 basic scientists and clinicians at the medical school and its affiliated hospitals. The Harvard team plans to study the effects of marijuana ingredients on brain cell function and the connections between brain cells, testing purified ingredients on mice and rats.

Researchers at Harvard have been studying natural brain chemicals known as endocannabinoids, which are involved in a variety of functions, including memory, appetite, and stress response. The grant will enable them to expand that research to encompass cannabinoids derived from plants. “Marijuana has about 100 different cannabinoid compounds. We understand very little about the specific effects of each of them on the nervous system,” said Bruce Bean, Harvard neurobiology professor and one of the project’s researchers....

The research, however, is funded by someone who could profit if the findings are favorable or lose money if new dangers are discovered.  Could knowing this somehow, even unconsciously, bias the results?  Josephine Johnston, director of research at the Hastings Center, a think tank concerned with bioethics, said such conflicts of interest are commonplace. “In a pure world, you wouldn’t have a situation like this.  But it’s pretty much a fact of life of biomedical research in the United States that you have interested parties funding research,” said Johnston, co-editor of a book on conflicts of interest in biomedical research. Institutions can enact safeguards to ensure both that the research is unbiased and that it’s perceived as trustworthy.

Both MIT and Harvard said they have such policies in place, requiring that gifts come without strings attached and that researchers have control over their work and its publication.  Grant, the California marijuana researcher, agreed that conflict of interest is an important concern. But, he added, if people profiting from the marijuana boom invest in science, “maybe that’s not a bad thing. They could just as easily buy yachts or do something else.”

Because I am a kind of marijuana researcher (focused on law and social science, rather than medical science), I realize I have a bias when suggesting that everyone involved in the marijuana industry ought to be funding academic marijuana research.  Also, as a director of the Drug Enforcement and Policy Center at The Ohio State University, I am sensitive to the concern that research funded by the marijuana industry or investors carries real conflict risks that can come with any private funding of public research. 

All that said, this article helps highlight just some of the many reasons why a lot more private funding (and a lot more public funding) is needed for all sorts of marijuana research.  There are many times I end up feeling truly overwhelmed by all the important research questions that arise in this space and all the formal and informal barriers to conducting all the needed research.   And especially with so many legal and social changes in this space, this period seems like an "all hands on deck" moment.  And I do not think it is misguided to believe that everyone involved in the marijuana industry and especially its investors ought to be swabbing the deck as best they can.

May 1, 2019 in Business laws and regulatory issues, Medical community perspectives, Medical Marijuana Data and Research, Recreational Marijuana Data and Research, Who decides | Permalink | Comments (0)

Friday, April 12, 2019

Medical marijuana proving very popular in Oklahoma

Oklahoma-cannabis-glut-1This local article spotlights the (surprising?) popularity of medical marijuana in the Sooner State under the headline "Oklahoma Medical Marijuana Authority estimated licensing 80,000 patients in year one. It's on track for 150,000."  Here are excerpts:

The Oklahoma Medical Marijuana Authority last year projected licensing 40,000 to 80,000 patients in its first year of operations. But in a surprise to OMMA personnel, the agency surpassed the 80,000-patient mark last week and could reach 150,000 by its first anniversary if the current pace of applications remains steady.

"We're probably averaging just over 5,000 a week," OMMA Director Adrienne Rollins said Thursday, which represents an increase of about 1,000 applications per week since early February, when OMMA shuttered its call center to free up time for application reviews. "We thought we would really be hammered in the very beginning and then it would start to level out. But as the number of physicians who are getting on board as far as recommending has increased, we've seen our numbers drastically increase," Rollins said. "I think at this point we're on track to have potentially 150,000."...

OMMA Communications Director Melissa Miller provided documentation to the Tulsa World showing the number of licensed patients in Oklahoma this week is more than 20 percent higher than it was the week of March 18. Miller said about 150 business license requests are submitted each week on average in recent weeks. Rollins said five OMMA employees specialize in reviewing those types of applications....

Rollins, who became the OMMA's director in October, said her department received about 3,500 patient applications between Aug. 26 and the first week of September. The number of submissions remained manageable until the winter holiday season, which is when Rollins said she noticed a "big jump" ahead of the expected widespread opening of dispensaries across the state.

By February, the OMMA closed its customer service call center, reassigning those five employees to review applications at least on a temporary basis. The move, Rollins said, means the OMMA can make decisions on up to 500 more patient applications per weekday. Of continuing to keep the call center shuttered, she said it was a "drastic change" from the OMMA's desires but maintained it was necessary to ensure applications are reviewed within the 14-day limit provided in State Question 788.

The House Rules Committee on Thursday passed a heavily amended version of Senate Bill 1030, which has a clause that if signed into law would expand the business applicant decision time to 90 days.

April 12, 2019 in Medical Marijuana Data and Research, Medical Marijuana State Laws and Reforms | Permalink | Comments (0)

Spotlighting racial and regional differences in modern marijuana reform dynamics

I am very sad that presentations in my my Marijuana Law, Policy & Reform seminar have wrapped up, but that reality gives me a bit more time and space here to catch up on the marijuana law, policy and reform stories that most catch my eye.  One such important story that I missed a few weeks ago comes here from Stateline under the headline "African-Americans Missing Out on Southern Push for Legal Pot."  I recommend the extended article in full, and here are some excerpts:

Medical cannabis laws typically lay out the conditions for which the drug may be prescribed. But the laws in Arkansas and Florida — the only Southern states that have legalized medical cannabis — don’t cover sickle cell disease, which causes acute pain and disproportionately affects African-Americans. The bills advancing in Tennessee and Kentucky also exclude that condition. Three states that have legalized medical but not recreational cannabis — Connecticut, Ohio and Pennsylvania — allow sickle cell disease patients to use it....

Black legalization advocates also fear that even if medical cannabis becomes legal, white politicians won’t regulate licensing and permitting in a way that ensures equitable opportunities for people of color. “Without that, it’ll be more of the same,” said Dr. Felecia Dawson, a board-certified physician who closed her Georgia-based OB-GYN practice to focus on advocating for medical cannabis. “Legislators will keep people of color ... from the benefits of cannabis.”

Nationally, research suggests that medical marijuana use is more common among whites with high incomes, perhaps in part because of the long history of racial disparity in drug enforcement....

Every Southern state by 2016 had legalized the treatment of a limited number of conditions using CBD oil. As public support increased, so did lawmakers’ willingness to expand the list of eligible conditions. But some conditions that affect minority populations at higher rates than white ones — such as sickle cell disease, which affects 73 in 1,000 African-Americans at birth compared with 3 whites, according to federal estimates — are not included in proposals currently making their way through several Southern statehouses.

In a 2017 hearing co-hosted by the Arkansas Medical Marijuana Commission, following a ballot initiative that had legalized medical cannabis, advocates wore “Diversity for All” T-shirts to emphasize the drug’s importance to minority residents. “We know that such diseases as hypertension, sickle cell, neuropathy and so on are more predominant in blacks,” Casey Caldwell, a black cannabis advocate, said at the hearing.

“It is safe to say that African-American communities would benefit the most,” she added. “In the past, pharmaceutical drugs have been priced so high that [we] have to make a decision whether or not they should eat or whether they should purchase medication.”

Those concerns echoed what Dee Dawkins-Haigler, a former Democratic Georgia representative who headed the state’s Black Caucus, said in 2015 about the initial absence of black people among the state’s 17 appointees to the Commission on Medical Cannabis. The Black Caucus eventually fought to get sickle cell disease added to the list of conditions eligible for CBD oil....

In Florida, black farmers initially cried foul at being shut out of the state’s multibillion-dollar cannabis trade over policies that required license holders to have operated for 30 straight years. According to Roz McCarthy, founder of the Florida-based advocacy group Minorities for Medical Marijuana, the state’s law lacked the teeth needed to ensure that medical cannabis license holders adhered to requirements to ensure diversity in hiring. A spokesperson for the Florida Department of Health said that state law “does not require medical marijuana treatment centers to report the race or ethnicity of its owners.”

McCarthy said, “We’re trying to push lawmakers to understand that they have the ability and the power to ensure exclusionary practices don’t happen. Barriers are there. But the opportunity to reduce barriers is also there.”

April 12, 2019 in Campaigns, elections and public officials concerning reforms, History of Marijuana Laws in the United States, Medical Marijuana Commentary and Debate, Medical Marijuana Data and Research, Medical Marijuana State Laws and Reforms, Race, Gender and Class Issues, Who decides | Permalink | Comments (0)

Wednesday, April 10, 2019

Critically and skeptically examining the claims in support of medical marijuana

The third planned presentations from a student in my Marijuana Law, Policy & Reform seminar this coming week will, in his words, "marshal the tools of critical thinking and scientific skepticism against the mounting claims about medical marijuana."  Here is how this student explains his plans and suggested background reading:

I have noticed worrying signs in the medical cannabis industry that bear all the hallmarks of pseudoscience and “alternative medicine.” For example, how many ailments fall under the ever-broadening curative umbrella of CBD? The ability to think critically and skeptically is the most useful skill we have as humans for discerning the truth, and it is most important to engage such skills when our biases most threaten our steady course. Remember the frequent allusions this semester to those who embrace medical legalization as a stepping stone to recreational use? Such people may be more inclined to jettison their critical thinking capabilities when it comes to scrutinizing claims in whose outcome one holds an interest.

I will provide a brief primer on thinking critically and skeptically, and then describe the signs of pseudo-scientific reasoning. Then, armed with this toolkit of sorts, I will explore the various claims about the benefits of cannabis as a medicine, including the current research, its blind spots, and its shortcomings. I will then critically explore the ethics and policy behind prohibition, comparing and contrasting cannabis with prescription drugs and alcohol; we shall see how the claimed justifications for cannabis prohibition stand up to critical scrutiny.

Links to Reading Matter

It is not vital that people read anything prior to the presentation, but here are some useful links for those wishing to get ahead of the game:

  • Steven Novella et al., The Skeptics’ Guide to the Universe 57–140 (2018).

Of course, I understand that people might not have access to the above-mentioned book, in which case the following website will suffice (although I commend the book highly in its entirety to anyone interested in how we get at the truth of things).

April 10, 2019 in Assembled readings on specific topics, Medical Marijuana Commentary and Debate, Medical Marijuana Data and Research | Permalink | Comments (0)

Sunday, March 31, 2019

Federal scheduling and research challenges for cannabis and psychedelics

The second of four student presentation this coming week in my Marijuana Law, Policy & Reform seminar will focus on  federal scheduling under the Controlled Substances Act and the research and market realities impacted by the placement of marijuana in Schedule I.  Here is how my student has summarized his topic, along with the background readings he has provided:

The placement of cannabis in Schedule I practically prevents comprehensive and meaningful research into its medical applications and potential harms.  The federal government cites cannabis' placement in Schedule I as the reason rigorous research must be conducted before it can be rescheduled, but places restrictions on its research, because of its schedule, that are nearly impossible to overcome.  Is there an alternative pathway to federal cannabis legalization, or at least rescheduling, so that more meaningful research can be conducted? 

My presentation will examine U.S. drug scheduling, looking at the criteria and examples of substances in each schedule.  I will then provide an overview of the FDA research model by which new drugs come to market, contrast it with the type of research conducted on cannabis, and discuss why meaningful, rigorous research into cannabis is so difficult.  With this background, I will discuss the findings of a former UK drug-policy adviser that suggests substantial rescheduling is necessary, and how these findings helped initiate research into other Schedule I drugs.  Finally, I will provide an overview of research into other Schedule I substances, particularly psychedelics, and how this research may accelerate the rescheduling or federal legalization of cannabis so that its impact on health may be studied more effectively.

Background Resources:

March 31, 2019 in Assembled readings on specific topics, Federal Marijuana Laws, Policies and Practices, Medical Marijuana Data and Research, Recreational Marijuana Data and Research, Who decides | Permalink | Comments (1)

Wednesday, March 27, 2019

Rounding up just some (of so many) stories about CBD

There is so much talk and so many stories about CBD, I know I can barely scratch the surface on this topic.  But it seems this past week I have seen an especially notable number of notable stories on this front.  Below I provide a partial round-up, and suggested particular attention to the first linked piece for its science and thoughtfulness:

March 27, 2019 in Assembled readings on specific topics, Business laws and regulatory issues, Medical Marijuana Commentary and Debate, Medical Marijuana Data and Research, Recreational Marijuana Commentary and Debate | Permalink | Comments (0)

Monday, March 25, 2019

"The Effect of Marijuana Use on American Veterans with PTSD, and How the U.S. Department of Veterans Affairs Ought to Respond"

The title of this post is the title of a presentation to be made by one of my students in my Marijuana Law, Policy & Reform seminar this coming week.  Here is part of his explanation of his topic and links to some background reading:

Because the U.S. Department of Veterans Affairs (VA) is required to follow all federal laws, the VA is prohibited from prescribing, recommending, or assisting veterans in obtaining marijuana.  While veterans may discuss marijuana use with VA providers, VA doctors cannot help their patients participate in a state medical marijuana program and veterans cannot obtain reimbursement funding through the VA when they seek medical marijuana from state programs.

The inability of the VA to prescribe or recommend marijuana to American veterans with PTSD denies former service members an opportunity to receive treatment that many veterans not only want, but which also has the potential to be safer than the VA’s history of doling out addictive prescription drugs such as opioids, antidepressants, and anti-anxiety pills.  PTSD is a serious disease that is relatively common among combat veterans — it causes varying symptoms such as flashbacks, nightmares, severe anxiety, and uncontrollable thought about a triggering event.

The medical research in this arena has reached mixed findings.  While some researchers have found that the use of medical marijuana by veterans with PTSD has positive results, other studies suggest that marijuana use by those with PTSD may actually make symptoms worse.  There simply has not been enough controlled studies to conclusively state whether marijuana is beneficial for those with PTSD.  Nonetheless, there is plenty of anecdotal evidence by veterans suggesting that their use of marijuana has improved, or in some cases eliminated, symptoms associated with their PTSD.  Fortunately, the first clinical trial of marijuana for American veterans with PTSD is currently underway in Colorado.  My presentation will suggest that we need more controlled clinical trials such as this to further identify whether marijuana could (or should) truly be used as a remedy for veterans with PTSD.

* Medical journal article, "Post-Traumatic Stress Disorder" (discussing what PTSD is and various treatment options, including cannabis).

* Medical journal article, "Use and effects of cannabinoids in military veterans with posttraumatic stress disorder"(reviewing several studies and noting that while there is a need for more randomized and controlled studies, some PTSD patients report benefits in terms of reduced anxiety and insomnia and improved coping ability).

* Medical journal article, "Posttraumatic Stress Disorder and Cannabis Use Characteristics among Military Veterans with Cannabis Dependence" (exploring the negative effects of treating PTSD with marijuana and finding that individuals with PTSD may have a particularly difficult experience when attempting to quit marijuana).

* Medical journal article, "Marijuana and other cannabinoids as a treatment for posttraumatic stress disorder: A literature review" (explaining that conclusions cannot yet be drawn about the therapeutic effects of marijuana and related cannabinoids for PTSD; suggesting that rapidly changing legal landscape will permit promising clinical research).

* Medical journal article, "A review of medical marijuana for the treatment of posttraumatic stress disorder: Real symptom re-leaf or just high hopes?" (finding some positive data for use of marijuana for PTSD but also noting conflicting findings and limits of studies conducted thus far).

* Report on study, "Marijuana for Symptoms of PTSD in U.S. Veterans" (first clinical trial of marijuana for PTSD in American veterans underway).

* Recent Weedmaps article, "Marijuana Study Findings Could Hold Promise for Veterans With PTSD" (noting that MAPS study mentioned above could pave the way toward an FDA-approved prescription medicine; anecdotal evidence of veteran using black market rather than expensive medical marijuana program in CA)

March 25, 2019 in Federal Marijuana Laws, Policies and Practices, Medical community perspectives, Medical Marijuana Commentary and Debate, Medical Marijuana Data and Research, Medical Marijuana State Laws and Reforms, Who decides | Permalink | Comments (0)

Saturday, March 9, 2019

Leafy report finds"more than 211,000 cannabis jobs across the United States"

DownloadThis story at Leafy, headlined "As of 2019, Legal Cannabis Has Created 211,000 Full-Time Jobs in America," reports on Leafy's effort to account for job creation in the legal marijuana industry.  Here is how the article starts:

How many jobs are there in the legal cannabis industry?  It’s a common question — and one the government refuses to answer. Because cannabis remains federally illegal, employment data agencies such as the Bureau of Labor Statistics ignore all jobs related to the industry.

Over the past three months Leafly’s data team, working in partnership with Whitney Economics, has gone state-by-state to tally the total number of direct, full-time jobs in the state-legal cannabis industry.

There are now more than 211,000 cannabis jobs across the United States.

The Leafy accounting is set forth in this relatively short document titled "Special Report: Cannabis Jobs Count."  Here is an excerpt:

In early 2017, roughly 120,000 Americans worked in the legal cannabis industry.  At that time, 29 states allowed medical marijuana.  Four states and the District of Columbia had legalized the adult use of cannabis.  National sales in legal markets topped $6.7 billion.

Today, two years later, 34 states have legalized medical marijuana.  Ten states and the District of Columbia have legalized cannabis for adult use.  Annual sales nationwide are nearing the $11 billion mark.  And the number of Americans directly employed in this booming industry has soared to more than 211,000.

When indirect and ancillary jobs — think of all the lawyers, accountants, security consultants, media companies, and marketing firms that service the cannabis industry — are added, along with induced jobs (local community jobs supported by the spending of cannabis industry paychecks), the total number of full-time American jobs that depend on legal cannabis rises to a whopping 296,000.

By comparison, there are currently about 52,000 coal mining jobs in the United States.  American beer makers employ 69,000 brewery workers.  And 112,000 people work in textile manufacturing.

March 9, 2019 in Business laws and regulatory issues, Medical Marijuana Data and Research, Recreational Marijuana Data and Research | Permalink | Comments (0)

Tuesday, February 26, 2019

"The Association between Cannabis Product Characteristics and Symptom Relief"

Download (5)I am grateful for a student in my marijuana reform seminar who made sure that I did not miss this new research in the journal Scientific Reports which share the title of this post and was authored by Sarah Stith, Jacob Vigil, Franco Brockelman, Keenan Keeling and Branden Hall. Here is the research article's abstract:

Federal barriers and logistical challenges have hindered measurement of the real time effects from the types of cannabis products used medically by millions of patients in vivo.  Between 06/06/2016 and 03/05/2018, 3,341 people completed 19,910 self- administrated cannabis sessions using the mobile device software, ReleafApp to record: type of cannabis product (dried whole natural Cannabis flower, concentrate, edible, tincture, topical), combustion method (joint, pipe, vaporization), Cannabis subspecies (C. indica and C. sativa), and major cannabinoid contents (tetrahydrocannabinol, THC; and cannabidiol, CBD), along with real-time ratings of health symptom severity levels, prior-to and immediately following administration, and reported side effects.  A fixed effects panel regression approach was used to model the within-user effects of different product characteristics. 
Patients showed an average symptom improvement of 3.5 (SD = 2.6) on an 11-point scale across the 27 measured symptom categories.  Dried flower was the most commonly used product and generally associated with greater symptom relief than other types of products.  Across product characteristics, only higher THC levels were independently associated with greater symptom relief and prevalence of positive and negative side effects.  In contrast, CBD potency levels were generally not associated with significant symptom changes or experienced side effects.

This public release about the article is headlined "THC found more important for therapeutic effects in cannabis than originally thought," and it provides a useful summary of the research methods and findings.

February 26, 2019 in Medical Marijuana Commentary and Debate, Medical Marijuana Data and Research | Permalink | Comments (0)

Two interesting new articles about the early operation of Ohio's medical marijuana program

OHIO-HERBAL-CLINIC-DOCTORS-OFFICE-OHIO-MEDICAL-MARIJUANA-CARD--300x300Two Ohio papers had two interesting new article about early developments in the operation of Ohio's still-new medical marijuana program.  Here are headlines, links and excerpts:

From the Akron Beacon Journal, "Ohio medical marijuana recommendations coming from clinics, not family doctors"

If you know someone who has received a recommendation to use medical marijuana, odds are the recommendation didn’t come from a family doctor or primary-care physician. The vast majority of recommendations in Ohio come from clinics that employ doctors solely to evaluate patients for medical marijuana, say people familiar with the industry....

“Marijuana-specific clinics fill a huge need,” said Dr. Joel Simmons, who runs the Ohio Herbal Clinic, a Near East Side cannabis clinic. While the clinics, many of which have out-of-state owners, have some critics, patient advocates say primary-care doctors are the ideal source for marijuana recommendations.

Those doctors better understand a patient’s needs and medical history, said Mary Jane Borden, co-founder of the Ohio Rights Group, which advocates for users of medicinal cannabis. When Ohio lawmakers wrote the state’s medical-marijuana law, they hoped that family physicians would be writing most recommendations, Borden said....

Clinics charge between $125 and $200 for an evaluation, which insurance won’t cover.  Because the clinics don’t negotiate with insurance companies, they clinics can charge whatever they want, said Emilie Ramach, founder and CEO of Compassionate Alternatives, a Columbus-based nonprofit agency that helps patients pay for medicinal cannabis.  Several clinic doctors, including Simmons, said they do their best to keep their prices reasonable.

From the Columbus Dispatch, "High prices keep many Ohioans out of legal cannabis market"

As Ohio’s medical marijuana industry finally takes off, some patients and advocates are griping about costs that put it out of reach for many people.  A steep price tag stems partly from the lack of competition, as Ohio only has seven dispensaries spread throughout the state, mostly in rural areas, experts said.  Costs are expected to drop as more dispensaries open and the industry finds its footing.

In the meantime, patients openly acknowledge buying the drug on the black market while they wait for prices to come down.  And without insurance to cover the expense, some worry that low-income people might never be able to afford medical cannabis....

Several local patients said using marijuana has improved their quality of life, but they must stretch their budgets to pay for it or buy it on the street.  “I’m not using as much as I probably need to be using,” said Mary Alleger, 31, of Reynoldsburg, who said she uses cannabis to treat post-traumatic stress disorder (PTSD) and ongoing pain from a botched medical procedure.

Katherin Cottrill, 33, of Newark, has worked with the patient advocacy organization Ohio Rights Group to acquire a medical marijuana card, but said current costs keep her from even getting started.  “I would have to pay $200 to $250 (just to get a recommendation),” Cottrill said.  “And then I have to drive to a dispensary and pay $50. It’s unreasonable for me to even try.”...

Just under 3 grams of medical marijuana costs about $50. Cannabis clinics charge between $125 and $200, and the state charges $50 in fees.  Marijuana is cheaper on the street, patients said.

“On the black market you can buy an ounce for $200,” said Robert Doyle, 61, of Newark, who has a medical marijuana card but still buys the drug on the street due to the cost.  There are about 28 grams in an ounce.  Doyle said he’s visited dispensaries in Michigan with prices comparable to the black market, making him confident that Ohio’s costs will eventually fall....

But even if prices drop, clinic costs and fees will remain a barrier for some, Cottrill said.  “What about low-income people who are desperately seeking medication?” she said. “They can’t even afford to pay $50 to get their card registered.”

February 26, 2019 in Business laws and regulatory issues, Medical community perspectives, Medical Marijuana Commentary and Debate, Medical Marijuana Data and Research, Medical Marijuana State Laws and Reforms, Who decides | Permalink | Comments (1)

Tuesday, February 19, 2019

"Marijuana Dispensaries and Neighborhood Crime and Disorder in Denver, Colorado"

Rjqy20.v035.i06.coverThe title of this post is the title of this notable new article just published in the journal Justice Quarterly and authored by Lorine Hughes, Lonnie Schaible & Katherine Jimmerson. Here is the paper's abstract:

Beginning with Colorado and Washington State in 2012, longstanding bans on the sale, possession, and use of marijuana for recreational purposes have been overturned in nine states and the nation’s capital. Consistent with the logic of routine activity theory and broken windows theory, critics of legalized marijuana argue that dispensaries are magnets for crime, attracting criminal offenders to the area with large sums of cash and valuable goods. The current study addresses this possibility by examining the effects of both medical and recreational marijuana dispensaries on yearly crime rates in N = 3981 neighborhood grid cells in Denver, Colorado, 2012–2015. Estimates from Bayesian spatiotemporal Poisson regression models indicate that, except for murder and auto theft, both types of dispensaries are associated with statistically significant increases in rates of neighborhood crime and disorder. The theoretical and policy implications of these findings are discussed.

This notice about the research provides additional background and findings. Here are excerpts therefrom:

"We found that neighborhoods with one or more medical or recreational dispensary saw increased crime rates that were between 26 and 1,452% higher than in neighborhoods without any commercial marijuana activity," notes Lorine A. Hughes, associate professor in the School of Public Affairs at the University of Colorado Denver, who led the study. "But we also found that the strongest associations between dispensaries and crime weakened significantly over time."...

The study found that except for murder, the presence of at least one medical marijuana dispensary was associated with a statistically significant increase in neighborhood crime and disorder, including robbery and aggravated assault. The study also found a relatively strong association between medical marijuana dispensaries and drug and alcohol offenses, with a decline in the strength of the link after recreational marijuana was legalized. The pattern of results was similar for recreational marijuana dispensaries, though the study found no direct relation to auto theft.

The authors caution that the results of the study, based only on information from Denver immediately after legalization and before market saturation, may not be generalizable to other geographic areas. They also note that because the study relied on official police data to measure crime and disorder, it's possible that police targeted neighborhoods with marijuana dispensaries, which would over-estimate the association between these facilities and crime and disorder.

"Our findings have important implications for the marijuana industry in Denver and the liberalization of marijuana laws nationwide," suggests Lonnie M. Schaible, associate professor in the School of Public Affairs at the University of Colorado Denver, who coauthored the study. "Although our results indicate that both medical and recreational marijuana dispensaries are associated with increases in most major crime types, the weak strength typical of these relationships suggests that, if Denver's experience is representative, major spikes in crime are unlikely to occur in other places following legalization."

The authors suggest that, rather than fighting to oppose legalized marijuana, which has become a multibillion-dollar industry and is expected to create more than a quarter of a million jobs by 2020, it may be more expedient to develop and support secure and legal ways for dispensaries to engage in financial transactions.

February 19, 2019 in Criminal justice developments and reforms, Medical Marijuana Data and Research, Recreational Marijuana Data and Research | Permalink | Comments (0)

Saturday, February 9, 2019

Interesting early data about the early operations of Ohio's medical marijuana program

Download (4)Though Ohio enacted its medical marijuana law, HB 523, way back in June 2016, the state took quite some time getting its rules and regulations and licenses in place to make the program operational.  But starting about a month ago, a few medical marijuana dispensaries were open for business and a system for registering doctors and patients in the program has been operational for a few months.

This past week, the Ohio Medical Marijuana Control Program Advisory Committee had a meeting at which this powerpoint presentation was shared showing all sorts of interesting data about how this program is now operating. Though I do not think the data is all too dissimilar to what we see in other states recently bringing a medical marijuana programs on-line, I still found these early facts from these PPT slides notable:

  • Medical Marijuana Sales Figures (from January 16 – February 3, 2019) had total sales of $502,961, with total volume of 68.22 pounds

  • Total Patient Recommendations were 17,077, along with 472 Total Caregivers

  • Patients with Veteran Status were 1,284, with Indigent Status were 405, and with a Terminal Diagnosis were 83

  • 10% of Registered patients are aged 18-29, 21% are aged 30-39, 22% are aged 40-49, 22% are aged 50-59, 19% are aged 60-69, and 6% are over 70

  • Registered patients have twenty-one different conditions, with the top five being Spinal cord disease or injury (998 patients), Cancer (1,082), Fibromyalgia (1,973), Post-traumatic stress disorder (2,622), and Pain that is either chronic and severe or intractable (10,910)

  • There are 374 active Certificates To Recommend (CTRs) among physicians, but only 177 physicians have so far issued recommendations for patients

February 9, 2019 in Medical Marijuana Data and Research, Medical Marijuana State Laws and Reforms | Permalink | Comments (1)

Tuesday, February 5, 2019

"Qualifying Conditions Of Medical Cannabis License Holders In The United States"

The title of this post is the title of this notable new article appearing the jounral Health Affairs and authored by Kevin Boehnke, Saurav Gangopadhyay, Daniel Clauw, and Rebecca Haffajee. Here is its abstract:

The evidence for cannabis’s treatment efficacy across different conditions varies widely, and comprehensive data on the conditions for which people use cannabis are lacking.  We analyzed state registry data to provide nationwide estimates characterizing the qualifying conditions for which patients are licensed to use cannabis medically.  We also compared the prevalence of medical cannabis qualifying conditions to recent evidence from the National Academies of Sciences, Engineering, and Medicine report on cannabis’s efficacy in treating each condition.  Twenty states and the District of Columbia had available registry data on patient numbers, and fifteen states had data on patient-reported qualifying conditions.

Chronic pain is currently and historically the most common qualifying condition reported by medical cannabis patients (64.9 percent in 2016).  Of all patient-reported qualifying conditions, 85.5 percent had either substantial or conclusive evidence of therapeutic efficacy.  As medical cannabis use continues to increase, creating a nationwide patient registry would facilitate better understanding of trends in use and of its potential effectiveness.

February 5, 2019 in History of Marijuana Laws in the United States, Medical Marijuana Commentary and Debate, Medical Marijuana Data and Research | Permalink | Comments (0)

Tuesday, January 29, 2019

"Impact of Medical Marijuana Legalization on Opioid Use, Chronic Opioid Use, and High-risk Opioid Use"

1The title of this post is the title of this notable new article recently published in the Journal of General Internal Medicine and authored by Anuj Shah, Corey Hayes, Mrinmayee Lakkad, and Bradley Martin.  Here is the abstract:

Objective

To determine the association of medical marijuana legalization with prescription opioid utilization.

Methods

A 10% sample of a nationally representative database of commercially insured population was used to gather information on opioid use, chronic opioid use, and high-risk opioid use for the years 2006–2014.  Adults with pharmacy and medical benefits for the entire calendar year were included in the population for that year.  Multilevel logistic regression analysis, controlling for patient, person-year, and state-level factors, were used to determine the impact of medical marijuana legalization on the three opioid use measures.  Sub-group analysis among cancer-free adults and cancer-free adults with at least one chronic non-cancer pain condition in the particular year were conducted.  Alternate regression models were used to test the robustness of our results including a fixed effects model, an alternate definition for start date for medical marijuana legalization, a person-level analysis, and a falsification test.

Results

The final sample included a total of 4,840,562 persons translating into 15,705,562 person years.  Medical marijuana legalization was found to be associated with a lower odds of any opioid use: OR = 0.95 (0.94–0.96), chronic opioid use: OR = 0.93 (0.91–0.95), and high-risk opioid use: OR = 0.96 (0.94–0.98).  The findings were similar in both the sub-group analyses and all the sensitivity analyses.  The falsification tests showed no association between medical marijuana legalization and prescriptions for antihyperlipidemics (OR = 1.00; CI 0.99–1.01) or antihypertensives (OR = 1.00; CI 0.99–1.01).

Conclusions

In states where marijuana is available through medical channels, a modestly lower rate of opioid and high-risk opioid prescribing was observed.  Policy makers could consider medical marijuana legalization as a tool that may modestly reduce chronic and high-risk opioid use.  However, further research assessing risk versus benefits of medical marijuana legalization and head to head comparisons of marijuana versus opioids for pain management is required.

January 29, 2019 in Medical Marijuana Commentary and Debate, Medical Marijuana Data and Research | Permalink | Comments (0)

Saturday, January 26, 2019

Reviewing the now "mainstream" and "trendy" (and still uncertain) new world of CBD products

Download (3)NBC News has this new article, headlined "CBD goes mainstream as bars and coffee shops add weed-related drinks to menus," that is worth a read, and I especially liked its closing paragraph. Here are excerpts:

Coffee. Cocktails. Lotion. Dog treats. You name it, CBD is probably in it.

CBD, short for cannabidiol, is a compound found in the cannabis plant.  It promises to deliver the calming benefits of marijuana without the high that comes from THC.  Companies are adding CBD to just about everything — a trend set to accelerate as regulations ease and consumer interest grows.

Most CBD is now federally legal thanks to the farm bill President Donald Trump signed in December. Companies still aren't supposed to add CBD to food, drinks and dietary supplements, but many are doing it anyway.  The Food and Drug Administration has said it plans to continue enforcing this ban but will also look into creating a pathway for such products to legally enter the market.

Some users swear by it, saying it relieves their anxiety, helps them sleep and eases their pain.  And forget stoner stereotypes when thinking about CBD. Moms and even pets are experimenting with it.  One research firm, Brightfield Group, expects the CBD market to reach $22 billion by 2022.

However, most of our current understanding of CBD is anecdotal — not proven through scientific studies.  And because CBD products aren't yet regulated, the quality can vary widely. "There's a lot of interest and excitement, for good reason, but I think people are pushing it too hard, too fast and are overgeneralizing things," said Ryan Vandrey, a professor at Johns Hopkins who studies the behavioral pharmacology of cannabis.

We don't know what exactly CBD interacts with in the brain or the body, but researchers do know that CBD tends to turn down abnormal signaling in the brain, said Ken Mackie, a psychological and brain sciences professor at Indiana University.  That's why CBD may help with epilepsy, anxiety and sleep. CBD and other cannabis compounds tweak systems in the body, a process he compares to lowering the volume. Other compounds, like opioids, ketamine and nicotine, simply turn them on and off.

There isn't much clinical research on the safety and efficacy of CBD. Studying cannabis has been challenging because it's technically illegal under federal law, meaning researchers must overcome a number of hurdles in order to study it.  We don't know anything about indications like sleep, anxiety or pain, Vandrey said.

We do know it's safe and effective in treating seizures in children with Lennox-Gastaut syndrome or Dravet syndrome. GW Pharma studied its CBD-derived drug, Epidiolex, in numerous clinical trials.  After reviewing the company's science, the Food and Drug Administration approved Epidiolex in June.

The lack of clinical evidence hasn't stopped consumers from trying it — and raving about it.  "It's always nice to have strong proof in placebo controlled trials, but if someone's taking a drug and feeling any benefit, more power to them," Mackie said....

The farm bill signed in December legalized hemp. Most CBD hitting shelves is derived from the hemp plant, which contains less than 0.3 percent THC, the psychoactive chemical in weed. Hemp's close cousin, marijuana, can contain upwards of 10 percent THC. So you can't get high from CBD products if the proper dosage is followed, but the industry isn't regulated on a federal level so the amount of THC can vary.

Doses can vary, too. Some shops recommend six milligrams of CBD when taken as a tincture or added to food. Others recommend at least 30. Again, since there isn't much clinical research on CBD, most of the recommendations are based on trial and error.

As more people dabble with CBD, more people are following the money, worrying some that bad products will enter the market and taint CBD's allure. Or worse, harm consumers. "There does need to be some sort of regulatory framework for overall product safety and to protect the customer from purchasing products that contain false advertisements or make unsubstantiated claims," said Pamela Hadfield, co-founder of HelloMD, a medical cannabis company, while cautioning against strict regulations that would be "too difficult for most manufacturers to comply."

Joe Masse, beverage director at The Woodstock bar, added a CBD cocktail to the menu in September. Called The White Rabbit, the drink is made with Bombay Dry Gin, sage simple syrup, honey, fresh lemon juice and 1 milligram of CBD oil.... "It's trendy right now, so I don't know how it will be in six months when we redo the menu," Masse said. "A year ago, activated charcoal was popular and now you can't find it anywhere."

Because I am not hip enough to know that "sctivated charcoal" was once, and now is no longer, a big deal, I am not the right person to be predicting the trend lines on the CBD trend.  But I do know how important and likely unpredictable it will be to see the FDA and/or state regulatory players take on CBD products and marketing in the wake of the new Farm Bill.  Just another important front to watch in the coming months and years and marijuana products and industry players continue to emerge from prohibition's shadow.

January 26, 2019 in Business laws and regulatory issues, Federal Marijuana Laws, Policies and Practices, Food and Drink, History of Marijuana Laws in the United States, Medical Marijuana Commentary and Debate, Medical Marijuana Data and Research, Medical Marijuana State Laws and Reforms | Permalink | Comments (0)