Big Pharma Co. Lobbies Against Legal Weed – So It Could Market Its Own Synthetic Version
Last year, backers of an Arizona initiative to legalize recreational marijuana ran into stiff resistance from a large pharmaceutical company. Opponents of Proposition 205 got a huge boost from drug company Insys Therapeutics in the form of a $500,000 donation. At the time, an Insys spokesperson said the company was opposing legalization because "it fails to…/* > Related Stories
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Cannabis has been a friend to humankind since before the written word, providing fiber for cordage and cloth, seeds for nutrition, and roots, leaves and flowers for ritual and healing. During the Neolithic period, our ancestors discovered uses for every part of cannabis, which was one of the first agricultural crops, perhaps the first, ever to be grown and harvested some 12,000 years ago.
Agriculture, strictly speaking, is not a natural phenomenon. It is an expression of human ingenuity, an invention that has been described as the basis – literally the ground – of modern civilization. “The onset of agriculture was probably one of the most dramatic and important developments in human history,” writes Swiss scientist Jürg Gertsch, who explores the profound consequences of dietary changes brought on by food cultivation in a recent article in the British Journal of Pharmacology, entitled “Cannabimimetic phytochemicals in the diet – an evolutionary link to food selection and metabolic stress adaptation?”
Gertsch’s provocative thesis is that chronic metabolic disorders, currently a worldwide pandemic, are rooted in “a mismatch between ancient genes and high caloric diets” that ensued with the introduction of agriculture. “The multimillion year evolutionary process during which nearly all genetic change reflected the life circumstances of our ancestors [was] suddenly disturbed” when “carbohydrate farming” supplanted the “hunter-gatherer diet rich in animal food,” says Gertsch, who maintains that “the interplay between diet and the endocannabinoid system” is key to understanding today’s obesity/diabetes crisis and its potential remediation.
The endocannabinoid system, an ancient biological signaling network, regulates numerous physiological processes, including intestinal function, glucose metabolism, and the stress response. A dysregulated endocannabinoid system is implicated in metabolic and bowel pathologies and many other diseases. Gertsch discusses the different, yet complementary, roles of the cannabinoid receptors – CB1 and CB2 – pertaining to diet, digestion, and energy metabolism.
Mammalian CB1 receptors are concentrated in the brain and the central nervous system. They are also present in taste buds and the enteric nervous system (the gut-brain axis). Tetrahydrocannabinol (THC), marijuana’s main psychoactive component, boosts appetite and food intake by binding to the CB1 receptor – a phenomenon playfully known as “the munchies.” But CB1 receptors, as Gertsch points out, “can exert paradoxical effects on food intake,” facilitating essential nourishment as well as metabolic imbalance.
CB1 receptor signaling triggers a newborn’s suckling instinct. Mother’s milk is well endowed with arachidonic acid, a basic building block of the brain’s own marijuana-like compounds, anandamide and 2AG. These endogenous cannabinoid compounds bind to the same cell receptors – CB1 and CB2 – that mediate many of the effects of marijuana. Found in eggs, meat, and dairy products, arachidonic acid intake increases endocannabinoid levels in different tissues and is crucial for pre- and post-natal brain development.
Early hominids lived a precarious wilderness existence, requiring significant physical exertion (hunting and gathering) for survival. Famine, microbial infection, traumatic encounters with predators, fight or flight – all were hallmarks of a pre-agriculturist, subsistence lifestyle. Given the metabolic demands of their large brains and strenuous daily activities, our ancestors needed to consume energy-dense, nutrient-rich food.
In addition to heightening one’s sense of smell and stimulating appetite, CB1 receptor signaling “may facilitate survival after excessive physical activity, stress and trauma by restoring homeostasis, suppressing negative memories and reducing anxiety at the level of the central nervous system,” writes Gertsch, who explains that “CB1 receptor activation is associated with increased energy intake and decreased energy expenditure by controlling neural pathways.”
And CB1 taketh away
Combined with rigorous, day-to-day aerobics, the hunter-gatherer diet did not engender obesity, metabolic problems or cardiovascular disease. But the high-fat hunter-gatherer diet, which served our ancestors well, changed significantly with the advent of cultivated food. “Carbohydrate farming incited the most important dietary transition, which is still ongoing to the present day,” says Gertsch. There is a continuum, he maintains, between plant carbohydrate cultivation of yore and today’s over-starched, over-sweetened and over-processed Western diet.
Grain, carbs, sugar, alcohol, high fructose corn syrup: What started as the basis of civilization has spiraled into a mass-marketed refined sugar binge. “Dietary carbohydrates once essential for the cognitive and social development of Paleolithic humans gradually turned into a metabolic stress factor as a function of their glycemic indices,” Gertsch explains. “Epidemiological evidence points toward a pandemic diet-induced glucose toxicity due to excess sugar intake.”
The endocannabinoid system is deeply implicated in this unhealthy worldwide trajectory. Linked to both motivation and reward, CB1 receptor signaling encourages sugar consumption by enhancing neural responses to sweet flavors. It has been shown that chronic CB1 receptor activation in mice causes obesity-related insulin resistance. Aberrant CB1 activity reinforces a metabolically skewed feedback loop: In obese humans, high endocannabinoid levels are found in the liver, pancreas, adipose tissue, and skeletal muscle, where they contribute to insulin resistance, decreased glucose uptake, oxygen depletion, and cardiometabolic distress.
“The generation and excess use of sugars could be seen in analogy to the detrimental impact of the first distilled alcohol on humans. The sudden availability of excess sugars in combination with fats in diet may have led to a collision of genes that evolved to cope with high energy demands due to constant physical activity,” says Gertsch. “Excessive consumption of high-energy palatable food without physical activity contributes to obesity.” Which, in turn, leads to metabolic syndrome, heart disease, and other degenerative conditions.
CB2 to the rescue
CB1 receptors and CB2 cannabinoid receptors play different roles with respect to diet and nutrition. In animal studies, CB2 receptor activation generally causes the opposite effects of CB1. Whereas CB1 receptors promote appetite and food consumption, CB2 receptors tend to inhibit food intake.1
Expressed primarily in immune cells, adipose (fatty) tissue, and the peripheral nervous system, CB2 receptors confer broad anti-inflammatory effects in various disease models. Noting that obesity is a low-grade inflammatory condition, Gertsch discusses the “protective role of CB2 receptors in diet-induced metabolic malignancies.” Preclinical research indicates that CB2 receptor activity can prevent or ameliorate diabetes-associated peripheral neuropathy and pro-inflammatory obesity. CB2 signaling is also protective against brain damage from strokes, concussions, and neurodegenerative ailments.
Gertsch suggests that the contemporary “mismatch between ancient genes and high caloric diets” might be reconciled in part by CB2’s ability to mediate the effects of secondary plant metabolites (terpenes, flavonoids and other polyphenolic compounds) that are found in kitchen spices, leafy greens, and other vegetables. “Dietary secondary metabolites from vegetables and spices are able to enhance the activity of CB2 receptors and may provide adaptive metabolic advantages and counteract inflammation,” Gertsch reports.
Beta-caryophyllene (BCP), for example, is a seemingly ubiquitous aromatic terpene present in many spices (black pepper, cloves, rosemary, etc.) and bitter greens, as well as in numerous cannabis varietals. This versatile plant compound conveys significant health benefits by directly activating the CB2 receptor and via other molecular pathways. BCP has been shown to stimulate insulin production and inhibit tumor growth in human cell lines. Mounting evidence suggests that a steady diet of BCP-rich foods could prevent or mitigate non-alcoholic fatty liver disease through CB2-mediated channels. Eating green leafy vegetables and spices rich in essential oils “may counteract metabolic stress induced by excessive carbohydrate intake,” Gertsch advises.
Healthy fats, healthy people
Several scientific studies have explored the link between the intake of polyunsaturated fatty acids (PUFAs) and the endocannabinoid system. Docosahexaenoic acid (DHA), an omega-3 fatty acid, is the principal long chain PUFA found in the human brain. (Omega oils are considered “essential” fatty acids because they can’t be produced by the body in sufficient amounts and therefore must be ingested.) Dietary DHA and eicosapentaenoic acid (EPA), another long chain PUFA, support neurological function, retinal development, and overall health by up-regulating CB1 receptor gene expression.2 Preclinical research has shown that administering DHA and EPA prevented glucose intolerance and low-grade inflammation of white adipose tissue in obese mice.
The manifold health benefits of omega-3 PUFAs – prominent in oily fish, walnuts, flax and hempseeds, for example – include the prevention of heart disease, dementia, cancer cell proliferation, insulin resistance, and depression. Low levels of DHA and EPA can lead to premature aging, as well as mental illness. Nutritional omega-3 dietary deficiency “abolishes endocannabinoid-mediated neuronal functions” and is associated with neuropsychiatric disease, according to a 2011 report in Nature Neuroscience. Alzheimer’s sufferers and children with attention deficit hyperactivity disorder tend to be deficient in omega-3 fatty acids.
A healthy balance of omega-3 fatty acids and grain-derived omega-6 fatty acids is fundamental for preventing and managing obesity and metabolic syndrome. But a well-balanced ratio of PUFAs is typically lacking in a carb-heavy Western diet that favors greater omega-6 intake at the expense of omega-3. Gertsch suggests that it is possible “to reprogram energy metabolism” by increasing omega-3 and decreasing the amount of omega-6 in one’s diet: “Generally a lower omega-6 to omega-3 ratio is desirable in reducing the risk of many of the chronic diseases of high prevalence in industrial society or societies with high carbohydrate intake.”
A 2014 paper by Japanese scientists reported that the ratio of dietary omega-6 to omega-3 fatty acids influences how CB1 cannabinoid receptors regulate fear memory. The upshot is that altering the omega-6/omega-3 ratio in one’s diet could improve treatment regimens for anxiety and PTSD, as well as for metabolic disorders. Human beings have evolved in such a way as to have “an advanced capacity to digest and metabolize higher fat diets,” says Gertsch, who concludes that a “low-carb, high fat diet should be the most effective measure against obesity” – with the caveat that a high fat diet must be combined with regular physical exercise, much like in the hunter-gatherer days before agriculture.
Given what scientists know about how the endocannabinoid system functions, there is a strong basis for adopting a high fat, low carb diet with lots of fresh vegetables and spices, both as a general health practice and a remedy for many maladies.
The United States is in the grips of the worst drug overdose crisis ever, with prescription opioids and illicit opiates like heroin killing tens of thousands of people each year, but many of those people aren't dying from opioids alone. Another class of prescription drugs is too often involved.
Those drugs are the benzodiazepines—with brand names like Valium and Xanax—and are prescribed by the millions to treat anxiety, They can be deadly on their own, with federal data showing nearly 9,000 fatal benzo ODs in 2015. But here's the kicker: Nearly half of all fatal benzo ODs involve both them and opioids.
And a new study published in the British Medical Journal provides further evidence of the risks of doing benzos and opioids together. That study drew on a sample of more than 300,000 patients continuously enrolled in private health insurance plans between 2001 and 2013, and researchers looked at emergency room visits for drug overdoses among those prescribed only opioids versus those prescribed both opioids and benzos.
The results were dramatic: People prescribed both types of drugs had nearly double the risk of an ER or inpatient visit for a drug overdose. Based on the results, researchers estimated that cutting benzo prescriptions for opioid users reduced the risk of ER visits by 15%. If that figure holds true for overdose deaths, some 2,630 opioid-related overdose deaths could have been prevented in 2015 alone.
The policy implications are clear, said study co-author and Stanford University drug policy expert Keith Humphreys: Don't prescribe benzos to people being prescribed opioids.
"Even if we didn’t change opioid prescribing at all, the data here suggest that we could cut overdoses dramatically just by getting prescribers to not put people on a benzodiazepine at the same time," Humphreys said.
That would require a real shift in prescribing practices. The number of patients in the study being prescribed both benzos and opioids nearly doubled between 2001 and 2013, from 9% to 17%.
Reducing co-prescriptions could be problematic for some patients. If they are suffering both pain and anxiety, they and their doctors will have to work together to decide which issue is most serious and which could be treated with alternatives. But making such tough choices could lead to a reduced risk of fatal overdose.
The BMJ study has its limits. It looked only at legally prescribed benzos and opioids, missing the effects of concurrent use of illicit drugs, and it looked only at ER and inpatient visits, not fatal overdoses. And it only demonstrated correlation, not causation. It's possible some factor other than co-prescribing was driving up overdose rates among study patients, but given that the overdose risks of mixing benzos and opioids are well established, suggesting that co-prescribing them results in increased overdoses is not exactly controversial.
Doctors can do their part to reduce the number of overdose deaths by reducing benzo and opioid co-prescribing, but since much benzo and opioid use occurs outside legal medical channels, users in non-medically supervised settings are also going to have to be keenly aware of the dangers of mixing those drugs. If they are, the evidence suggests they can save some lives.Click here for reuse options! Related Stories
Barrels of ink have been spilled over the prospect that the Trump administration could attempt to turn back the clock when it comes to legal marijuana. Yet for all the wailing and gnashing of teeth out there, marijuana industry insiders, advocates and activists don't seem all that worried.
"I don't think there's any more reason to be scared than to be hopeful at this point," said Mason Tvert, Denver-based communications director for the Marijuana Policy Project. "The administration has not changed its marijuana policy, and there is reason to believe it may maintain the existing policy or adopt a similar one that respects states' laws regulating marijuana."
"Marijuana is one of the least of my concerns with the Trump administration," said Dale Gieringer, co-author of the pioneering 1996 Prop 215 medical marijuana initiative and long-time head of California NORML. "That's the first time I've been able to say that, but I just don’t see where there's any percentage in them going after marijuana. The polls are on our side, and they can't enforce the law."
The industry, too, seems to think there's not really that much to fear from the Trump administration.
"We are in a posture of cautious optimism," said Taylor West, communications director for the National Cannabis Industry Association (NCIA). "We're definitely not taking anything for granted—it's quite clear that Sessions has really strong personal opposition to the industry—but we are encouraged by the intense pushback, not just from the industry, but from elected officials, regulators, and lawmakers from both sides of the aisle. That is probably the most powerful signal to the Justice Department that dramatic changes to current policy would cause them a lot of problems."
West pointed to the strong reaction from state officials in marijuana-legal and medical marijuana states, as well as support from federal lawmakers—and not just Democrats. She cited Nevada U.S. Sen. Dean Heller as an example of a Republican lawmaker siding with the industry over the administration.
"They are speaking up because the industry and individual businesses and consumers have spoken up as their constituents and taught them about the industry and what we stand far and why we deserve respect from the federal government," she said.
And the marijuana money people appear largely unperturbed, too. In a report released Thursday, Arcview Market Research projected that the industry is going to continue to boom regardless of what happens in Washington, with revenues of nearly $7 billion this year and an astounding projected annual growth rate of 27% through 2021.
"While the uncertainty created by the mixed signals coming out of the administration may cause a temporary dip in some valuations of cannabis companies and some more risk-averse institutional investors and multinational companies may continue to stay on the sidelines, it won’t impact the growth of the market much at all," said Troy Dayton, CEO of Arcview Market Research. "No matter what the administration does, states will continue to issue cannabis licenses to a long line of applicants and licensed cannabis outlets will continue to have long lines of consumers ready to purchase this product from regulated establishments."
Maintaining the Status Quo
Medical marijuana is now legal in more than half the states and adult recreational use is legal in eight, including the entire West Coast. Some early enforcement actions notwithstanding, the Obama administration largely turned a blind eye to state-legal but federally-illegal marijuana. The Obama Justice Department adhered to the Cole memorandum, a 2013 "guidance" to federal prosecutors that essentially limited them to going only after legal marijuana operations that crossed specified lines: selling to minors, diverting product to non-legal states, being involved in violence or other trafficking, and the like.
Medical marijuana states at least are also protected by the Rohrabacher-Farr amendment, which bars the Justice Department from using federal funds to go after state-compliant medical marijuana operations. A similar measure, the McClintock-Hollis amendment, would have extended that same shield to the adult-legal states, but came up just short in the last Congress. Both amendments will be offered again this year.
"Jeff Sessions doesn't like marijuana—that much is clear—but that's not the question," MPP's Tvert argued. "The question is whether he believes limited federal resources should be used to interfere in state marijuana laws. As of right now, there's no reason to believe that's the case."
Tvert pointed to Sessions' seeming acceptance of the Cole memo, as well as a memo Sessions sent to federal prosecutors last month telling them to go after "the worst of the worst" and violent crime.
"State licensed and regulate marijuana businesses are by no means violent or the 'worst of the worst,'" Tvert noted. "They want to go after cartels and violent criminals and focus on serious crime, so why force marijuana back into the underground market?
"President Trump said states should be able to determine own marijuana policies, and he also had strong support for legal access to medical marijuana, and we haven't heard anything new from him on it," said Tvert. "But again, it's not a question of the president's personal views, but of what the federal laws are and the realities of enforcement. Sessions has said on multiple occasions that the federal government cannot effectively enforce federal prohibition in states where it is legal."
The view was not quite as sanguine from Washington, DC, where national NORML has its offices.
"As far as the industry goes, even the threat of a crackdown by the Justice Department has a chilling effect," said Justin Strekal, NORML political director and lobbyist. "While medical marijuana is protected under Farr-Rohrabacher, the adult use economy has no such protections—at least for now."
"The Cole memo is just a piece of paper," Strekal said, "and there is nothing stopping Sessions from just throwing it away, as the Heritage Foundation has called for him to do. But the Justice Department has no way to force states to recriminalize marijuana in decrim or legal states. The worst case would be that the adult use states are rolled back to a situation where there is no way to have a legal distribution system, but local law enforcement is not going to be enforcing federal marijuana prohibition."
Where apprehension about the direction of Trump administration pot policy is having a real impact right now is in causing politicians to think twice about legalization in states that are considering it, Strekal said.
"We're hearing feedback from legislators in Connecticut and Maryland saying that the attorney general's comments are acting as a road block, while in Georgia, we just saw a defelonization bill defeated. The mere presence of a Reefer Madness-era Jeff Sessions is frightening off potential supporters of ending prohibition."
Still, Bad Things Could Happen
While an oppositional Trump administration may retard the expansion of legal marijuana in the states, the status quo of a fifth of the country living under legalization and more than half with access to medical marijuana appears unlikely to be rolled-back. But that doesn't necessarily mean a free ride for legal weed.
"There could be some sort of federal action against some adult use facility or grower or cultivation company whose product is found to have gone across state lines in quantity, or something like that," CANORML's Gieringer offered. "Like if you have a situation where Nebraska complains, maybe that could stir up pressure in the Justice Department. But that's the most I expect. I could be wrong, though.
"Since Colorado started its licensing program, there's always been a fear that the Justice Department would just bring a lawsuit saying the state is participating in an on-going conspiracy to distribute a Schedule I drug," Gieringer observed. "They had their chance and they didn't do it. If they tried it now, they will have taken away hundreds of millions of dollars from Colorado and potentially billions from other states and leave anarchy. They can't enforce the marijuana laws anyway; it’s a drain on federal resources to even try."
"A federal injection is a potential threat, but it was a potential threat six months ago, too," said MPP's Tvert. "It's still a question of resources. If that were to happen, marijuana would continue to be legal, but the federal government would be preventing states from controlling its production and sale. That would be a real serious problem."
But Tvert warned that the heavy hand of the federal government could still reach out and slap someone down.
"Sean Spicer said they would have greater enforcement, and that could mean anything," he said. "They could be planning to more rigorously enforce the laws against people not in compliance with state laws, there could be more enforcement against illegal actors, they could push states to strengthen their regulations to prevent interstate trafficking. They perhaps could encourage states to increase funding to law enforcement to investigate illegal activity. There is plenty they could do without interfering with the legal market."
The Fightback Against Rollback Will Only Grow Stronger
The advent of a potential hostile Trump administration isn't changing the way NORML does business, Strekal said.
"We're continuing to do what we've always done and act as a grassroots consumer advocacy group," he explained. "We have 150 chapters and we're engaging as an advocacy group at every level of government from city councils to state legislatures to the federal government. At the federal level, we're very encouraged by the formation of the congressional cannabis caucus. We've been working with them to host a few events."
"This moment in time, where there is a lot of uncertainty at the federal level, is the kind of moment the NCIA was created for," said West. "We've been building relationships and allies in D.C. around industry issues, so when we need those allies, we have them.
Like MPP, the NCIA has a full-time staff lobbyist in Washington. It also works with another D.C.-based lobbying firm to work the Hill, and with legislators and elected officials.
"You've been able to see, through our work and the work of others, a very strong pushback from people who previously wouldn't have been in favor of the marijuana industry," West said. "The federal government can try to enforce marijuana prohibition in states where it is legal, but it doesn't really have the personnel to do that without the full cooperation of state and local law enforcement. If states are resisting that crackdown, which elected officials have said they would do, it becomes very difficult, if not impossible."
Legal marijuana is on guard, but it's not running away from a fight. The question for the Trump administration becomes whether this is a fight worth fighting.Related Stories
Ever since the 2016 election, marijuana legalization supporters have been wondering if President Trump will crack down on state-approved recreational and/or medical marijuana programs. The Heritage Foundation believes it knows the answer.
According to the conservative think tank, there are actions the government can take without needing to pass any new legislation or expend much political capital, such as reaffirming the federal government’s position as supporting marijuana’s illegality under the Controlled Substances Act (CSA) and reasserting support for the international treaties that require countries to enforce marijuana prohibition. These actions would make headlines, send a chill across the industry (particularly in states that have yet to formally launch their legal marijuana markets) and make clear the direction the White House has decided to go when dealing with legal marijuana businesses.
The Washington, D.C.-based group calls for rescinding the Obama Administration’s Cole memo, which gives leeway to the states to implement legalization and replace it with a memo that makes it clear that the DOJ “fully expects states to not permit commercialized marijuana production and sale.” With this memo in place, the DOJ could then select a number of marijuana businesses for prosecution of a violation of state and/or federal law, which would create “a real threat of prosecution.”
The right-wing policy shop recommends overturning previous guidance from the Financial Crimes Enforcement Network, which opened the door to very limited banking for a handful of businesses in the marijuana industry. This would scare off the already minuscule number of financial institutions working, or considering working, with marijuana-related businesses. Using the Racketeer Influenced and Corrupt Organizations Act, the government could target investors.
With all of this in mind, the only option we truly have to ensure our victories are upheld and that we move forward with nationwide legalization is to change federal law. Amendments such as Rohrabacher-Blumenauer stem the bleeding a bit, but require a new political fight every year. Congress needs to pass The Respect State Marijuana Laws Act, which would prevent the federal government from interfering in state-approved adult use or medical programs. Even better, Congress should remove marijuana from the CSA entirely.
If you want to see the cannabis revolution continue, call your members of Congress today and tell them to support federal marijuana law reform. For more information on pending legislation and to easily email your elected officials, visit norml.org/act.Related Stories
People have inhaled cannabinoids for many generations, from the Scythians through its ban by the federal U.S. government, and beyond.
Now we find that patients suffering from mesothelioma cancer can use medicinal marijuana as a means to reduce their troublesome symptoms. Many are beginning to personally explore the helpful aspects of this natural medicine as researchers continue their quest toward a cancer cure.
Mesothelioma is cancer of the mesothelium, a protective lining found on most of the body’s internal organs. Three out of every four cases cases of mesothelioma disease begin in the pleural mesothelium of the chest cavity. Mesothelioma can also begin in the abdominal cavity and around the heart.
Some common signs and symptoms of Mesothelioma include coughing, shortness of breath, fatigue, weight loss and poor respiratory function. Most early-stage patients are not aware that they are carrying the cancer or have developed Mesothelioma because its symptoms overlap with many other health conditions.
According to the American Cancer Society, marijuana improves a cancer patient’s appetite. Although the cellular function is still vague, this plant seems to trigger neurons that deal with taste and hunger.
Mesothelioma and other cancer patients need to eat during their treatment because the nutrients boost their fight against the ailment. However, treatment procedures typically cause nausea and a strong feeling to avoid food. Medicinal cannabis can be the answer to an upset stomach.
Reducing overall pain
Some cancer patients report a lot of pain in their bodies both during and after chemotherapy. Pain is incredibly debilitating, and it can have ill effects on a patient’s prognosis. Cannabis is known to dull the pain in the body, which helps any patient with cancer. Researchers believe that the plant works at the cellular level to block pain signals across the axons. Depending on the cannabis’s potency, a patient can feel relaxed for an hour or more with just a little bit of the plant in the body system.
Lifting the mood
When a person fights cancer, a negative mindset can be detrimental to the treatment. Cannabis is known to lift the spirits of anyone taking the substance. The subsequent high allows the person to feel good for an hour or longer. If the person continues to take the substance, this high and positive feeling can be extended. Good moods benefit the person so that they can fight off any more cancer tumors.
Possible ailment relief
The National Cancer Institute reports that laboratory test results reflect the direct relationship between declining cancer cells and cannabis use. Although more studies must be conducted, it’s possible that patients might have some cure to their ailment through this common weed. Patients simply need to inhale or consume the substance in order to see these possible results. Researchers are still concluding whether smoking or eating the cannabis is the best choice. The body must metabolize the substance in different ways, and it’s possible that eating or smoking it is better or worse for a condition.
Although the federal government still deems this plant as a Schedule 1 controlled substance, many states have medicinal laws that override this rule. Cancer patients may want to explore their options with this medicine in order to ease their symptoms. Dealing with cancer is difficult, but it can be tolerable with a natural substance offered through legal pathways.
You can contact Virgil Anderson at email@example.com
CBD (cannabidiol) is getting a lot of attention these days as the medicinal cannabinoid in marijuana. CBD-only products are all the rage in the ever-expanding medical marijuana market, and CBD-only medical marijuana laws are becoming a favorite resort of red state politicians who want to throw a sop to those clamoring for medical marijuana, but are hesitant to actually embrace the demon weed.
But is CBD the miracle molecule on its own? Or would users benefit from using preparations made from the whole pot plant? Not to knock CBD, which even by itself clearly provides succor for many people, but advocates of "whole plant medicine" make a strong case.
That case is based on the entourage effect, which posits an interactive synergy between the components of the plant, and not just the major cannabinoids, such as THC and CBC, but also the lesser-known but still therapeutically active cannabinoids, such as CBG, CBN, THC-a, and THC-v, and even the terpenoids, the molecules that make pot plants smell and taste lemony (limonene) or piney (pinene), earthy (humulene) or musky (myrcene). The entourage effect suggests that if people want to unlock the full benefits of medical marijuana, they need to be using whole plant medicine.
"CBD and THC seem to work better together. They lessen each other’s side effects," said Eloise Theisen, RN, MSN, director of the American Cannabis Nurses Association.
"CBD has value, but its value can be enhanced with the whole plant and we can develop more individualized medicine," said Mary Lynn Mathre, RN, MSN, and president and co-founder of Patients Out of Time.
And again, it's not just the cannabinoids.
"THC seems to potentiate all the effects of CBD and conversely, CBD affects THC," explained Dr. Perry Solomon, chief medical officer for HelloMD. "Dr. Ethan Russo further supports this theory by demonstrating that non-cannabinoid plant components such as terpenes serve as inhibitors to THC’s intoxicating effects, thereby increasing THC’s therapeutic index. This ‘phytocannabinoid-terpenoid synergy,’ as Russo calls it, increases the potential of cannabis-based medicinal extracts to treat pain, inflammation, fungal and bacterial infections, depression, anxiety, addiction, epilepsy, and even cancer," he said.
"Terpenes act on receptors and neurotransmitters; they are prone to combine with or dissolve in lipids or fats; they act as serotonin uptake inhibitors (similar to antidepressants like Prozac); they enhance norepinephrine activity (similar to tricyclic antidepressants like Elavil); they increase dopamine activity; and they augment GABA (the 'downer' neurotransmitter that counters glutamate, the 'upper')," Solomon continued.
The entourage effect makes whole plant medicine the preferred means of ingesting therapeutic marijuana, the trio agreed.
"I think that any whole plant medicine is more effective than any CBD-only product," said Solomon.
"Whole plant medicine is the only way to go," echoed Theisen.
"It's safer and more effective, and tolerance will develop more slowly—if at all," Mathre concurred.
The traditional method of consuming whole plant marijuana has been to smoke it, but that's not an especially favored route among medical marijuana advocates. And there are other options.
"Vaporization or tinctures of whole plants. Any sort of extraction method that isn’t going to deplete it," said Theisen.
"Delivery methods vary greatly in terms of their efficiency and their effects. I heard a colleague say that smoking a joint for therapeutic effect is akin to opening your mouth in the rain to get a drink of water," said Constance Finley, founder and CEO of Constance Therapeutics. "Our preferred methods are buccal (cheek) ingestion or sublingual ingestion, vaping from a vaporizer or vape pen whose hardware is safe to use with cannabis extracts, and topical for additional localized impact."
With whole plant superior to single-cannabinoid preparations, people living in states that have only passed CBD-only laws are not able to enjoy the full benefits of medical marijuana. That's a damned shame, said an exasperated Mathre.
"We have lawyers and politicians practicing medicine without a license—they don’t know what they are talking about," she said. "Clearly there may be some patients who need little to no THC, but the vast majority will benefit from it. Patients should have all of the options open to them and research needs to continue to help determine how to best individualize cannabis medicine."
My People Are Dying: Rollback of Medicaid Expansion Could Mean the End of Life-Saving Treatment for Far Too Many
It has been only three weeks since Speaker Paul Ryan unveiled the American Health Care Act, legislation that repeals portions of the Affordable Care Act (ACA). This legislation, in its current form, would rollback provisions in the ACA that have provided coverage for millions of people who struggle with substance use or mental health disorders through Medicaid.
Medicaid is a federal insurance program that provides health coverage for low income, elderly, and disabled people. The ACA expanded Medicaid funding for states and eligibility requirements allowing millions of new people to access drug and alcohol treatment they could not afford out of pocket. 32 states and D.C. subsequently agreed to expand Medicaid coverage for low-income residents.
The American Health Care Act pending in Congress this week, however, would suspend this Medicaid expansion by 2020. The bill would also eliminate a federal mandate that states that expanded Medicaid cover mental health and substance use treatment coverage.
Because most states won't bear the cost without federal help, these eliminations of coverage mean a likely end to medication-assisted treatment (MAT) for people who are currently covered. So far, it's been clear that medications like buprenorphine and methadone are critical to stepping down the opioid crisis, even incrementally. Without means to pay for MAT or other treatment access out-of-pocket, or adequate coverage under the proposed health care plan, people who currently rely on Medicaid could be forced into a Catch-22: try and fail to find access to affordable treatment options, or relapse into what could become problematic substance use.
Full stop, the implications of passage of the American Health Care Act in its current form would be a stripping away of coverage and access to care for the most marginalized. As we endure a nationwide opioid crisis, this likely means the difference between life and death for many.
As a person in long-term secular recovery from problematic substance use, I know first-hand the life-saving value of access to clinical, science-based treatment. These programs are often medically assisted, which is especially necessary in the case of many opioid users.
In virtually all cases, one must have insurance coverage to even think about having access to treatment.
Medicaid expansion did not magically cure problematic substance use, nor can health insurance coverage alone solve the opioid epidemic — but it has made a dent. People who previously had no means to seek treatment — nearly three million of them — now have coverage. Many of these individuals who now have coverage are opioid users, in many cases residing in states with surging opioid deaths like Ohio, Kentucky, and West Virginia.
As a former substance user, I can tell you — sustained, adequate treatment is the key to saving lives. Those disenfranchised by the passage of the American Health Care Act will continue struggling, and could relapse into more dangerous and fatal drug seeking and use behaviors. In some cases, it's virtually guaranteed.
Additionally, turning our backs on this public health crisis directly increases the likelihood of substance users developing expensive and potentially deadly medical conditions, or contracting and transmitting blood borne disease. If you can't get your methadone and mental health care, it's all too easy to slip back into sharing syringes and practicing dangerously unsafe substance use.
The Drug Policy Alliance advocates for increased federal and state funding for drug treatment and believes that treatment should be available to anyone who wants it. The American Health Care Act would take drug treatment away from millions of people, and worsen the opioid crisis.
Any replacement health care bill in Congress must include the continued expansion of Medicaid, including Medicaid coverage of mental health and substance use treatment. The bill must also mandate the continued requirement that all insurance providers include coverage for substance abuse treatment at parity with medical and surgical services.
These are my people, and my people are dying at alarming rates from problematic substance use and overdose. If passed, the American Health Care Act would eliminate drug treatment coverage by suspending Medicaid expansion and rolling back federal assistance to states, leaving millions vulnerable to the opioid crisis. Congress and President Trump must understand that a suspension in coverage and access yields the end of services and treatment for millions. For many, this could be a death sentence.
This piece first appeared on the Drug Policy Alliance BlogRelated Stories
House Republicans introduced their American Health Care Act on March 7 to “repeal and replace Obamacare” (the Affordable Care Act). Neither the bill nor Speaker Ryan’s website announcement mentions “tobacco.” But as tobacco researchers, we believe it would have a substantial negative impact on control efforts.
The ACA includes a Prevention and Public Health Fund that supports prevention and public health programs, including tobacco prevention (US$931 million for all programs in 2016).
In addition, the ACA Medicaid Incentives for Chronic Disease Prevention Program includes $85 million for state Medicaid for tobacco cessation and other goals.
The ACA also:
- Requires most private and public insurers to cover tobacco cessation as one of 10 “essential health benefits” at no cost to the patient
- Requires most insurers to cover treatment of substance use disorders, which may include tobacco dependence, as another essential health benefit on an equal basis with other medical and surgical benefits
- Allows insurers to charge tobacco users up to 50 percent higher premiums
- Allows employers to reward or penalize employees up to 50 percent of the cost of insurance coverage based on participation in wellness programs that include reducing tobacco use
- Encourages community-based prevention through Community Health Needs Assessment requirements for nonprofit hospitals and funding for public health fellowship training, promotion of community health workforce and community health centers.
What the American Health Care Act would change
Most discussion of the AHCA has focused on the estimate that 24 million people would lose insurance and costs for many would go up.
But by our reading of the bill, the AHCA would also damage health in other ways.A “tip” video from former smoker Rose, who later died of lung cancer. Such “tips” were very successful in showing the deadly effects of smoking.
It ends the Prevention and Public Health Fund that provides 12 percent of Centers for Disease Control and Prevention’s program funding, including tobacco control across the country. Among other things, the fund allowed CDC to create the first federal paid anti-smoking media campaign: Tips From Former Smokers (Tips).
The AHCA also drops the requirement that some Medicaid programs cover preventive care like smoking cessation. It also fundamentally changes the structure of Medicaid funding, which will likely lead states to reduce eligibility and cut smoking cessation and other benefits.
While the AHCA does increase funding for Community Health Centers, this money will likely be needed to deal with the bill’s prohibition on funding Planned Parenthood. The AHCA also establishes a Patient and State Stability Fund, which could be used for preventive care and substance use disorder prevention, treatment, or recovery efforts, which could theoretically include tobacco cessation. However, it is unlikely that tobacco cessation will be a priority for this new fund, as it is projected to be used primarily to reimburse insurers for some high-cost enrollees. In our view, neither of these new funding sources would make up for the loss of the Prevention and Public Health Fund, which has prioritized public health goals and provided support for effective tobacco prevention and cessation programs across the nation.
Who will be the losers if the bill becomes law? Smokers and the public who will have to absorb the increased costs of caring for them. The winner: Big Tobacco.
On time and intact implementation of California’s Proposition 64, the Adult Use of Marijuana Act, is critical to realizing the benefits of legalization and reducing the harms from decades of prohibition that have resulted in the mass incarceration and criminalization of low-income people of color, and utterly failed to protect public health and public safety.
Efficient implementation of Prop. 64 is urgent. While Prop. 64 legalized possession and consumption of cannabis products for adults 21 and over, there is still no legal source to obtain it, except for patients with a doctor’s recommendation, or grow at home (six plants per household).
There should be no delay in creating a system that guarantees California consumers access to products free of contaminants, clearly labeled for potency, and that bear warning labels and childproof packages as mandated by the voters’ initiative. Further, it is urgent to begin the taxation of cannabis products to pay for community reinvestment, drug prevention and substance use disorder treatment, youth programming, road safety, environmental remediation, consumer protection and other vitally needed services—all of which will be receiving a collective $1 billion per year once licensing is fully implemented.
Any efforts to roll back the sentencing reforms, to create new forms of discrimination or additional penalties for activities that are now legal, to limit community reinvestment, or to create barriers to economic participation by persons with limited capital or prior criminal justice records would undermine the basic fairness of Prop. 64, and reinforce the historical and institutional racism of the war on drugs.
It is disappointing to see many in the California State Legislature taking steps to do just this. Federal and state data demonstrate that whites, Latinos, and Blacks sell and use drugs at similar rates, but that Black people and Latinos have borne the brunt of arrest, prosecution, incarceration and the lifetime collateral consequences of felony convictions, including statutory limits on licensure and ownership in various fields. Prop. 64 implementation must avoid further codification of these forms of institutional racism.
While power grabs over regulatory provisions and food fights over the revenue ensue in Sacramento, DPA will continue to insist that Prop. 64 be implemented as written and mandated by a wide margin of California voters. DPA is working to ensure an inclusionary framework that opens up access for women and communities of color, including affordable licenses for micro-businesses and small businesses, equal licensure opportunity for people with prior drug convictions, preventing new forms of discrimination and penalties associated with legalized activity, and immediate implementation of the penalty reduction provisions, both retroactively and under current law enforcement practice.
We also remain deeply concerned by the overreach of local ordinances, many of which outright ban commercial activity—which they can lawfully do, along with severely restricting the right to home grow—which is legally more nuanced. We believe that efforts to assign high registration fees per plant and requiring inspectors to regularly visit your home to “inspect” your plants and growing area is a violation of basic privacy rights and civil liberties. We expect to see those cities in court.
And perhaps most frightening, we must now protect Prop. 64 from federal intervention and continue to protect patient access to medical marijuana. DPA is working with legislators to pass a bill to protect Californians who are operating lawfully under our state laws by providing that absent a court order, local and state agencies, including regulators and law enforcement, shall not assist in any federal enforcement against state authorized medical cannabis or commercial or noncommercial marijuana activity.
The prior federal administration provided assurances that if California developed a robust regulatory and enforcement system for medical or personal marijuana use by adults, California residents who complied with state laws and regulations would have a reasonable expectation that they would not be subject to harassment, arrest or incarceration by the federal government. However, the new administration has given mixed signals on enforcement priorities, but made it clear they do not want to end marijuana prohibition.
The good news is that the criminal penalty reductions that went into effect on November 9, 2016, are being applied to all new cases coming into the courts all over the state. And in LA County, the public defender’s office has already identified over 200 people eligible for resentencing for a marijuana charge, and DPA has been partnering with community organization to hold legal clinics for formerly incarcerated people to get their records changed. Detailed guides and information about record reclassification and resentencing can be found at www.myprop64.org.
The work to end prohibition and its disastrous effects on our communities did not end last November. Prop. 64 implementation is incredibly challenging, complex, and demanding. We hope the nearly eight million Californians who voted #Yeson64, and our allies across the nation, are ready to stand with us to protect and defend our victory.
This piece first appeared on the Drug Policy Alliance Blog
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While an embarrassing number of Americans still swallow the drug war’s laughably fictitious marijuana prohibition propaganda, SWAT raids to confiscate the plant ludicrously deemed illegal by the State kill people at an exponentially higher rate than weed, itself.
Cannabis has never been the cause of a fatal overdose.
Data amassed by the New York Times “or the most part, governments at all levels have chosen not to quantify the toll by requiring reporting on SWAT operations. But The Times’s investigation, which relied on dozens of open-record requests and thousands of pages from police and court files, found that at least 81 civilians and 13 law enforcement officers died in such raids from 2010 through 2016. Scores of others were maimed or wounded.”
Euphemistically-termed “dynamic entry” raids allow militarily-clad police to smash through doors with assault weapons drawn, demand anyone present comply immediately, and, far too frequently, shoot first and claim imminent threat later.
Such reprehensible exertion of control through violent tactics seemingly lifted from gestapo manuals — particularly to enforce the much-maligned prohibition of cannabis — was never the intended use of police SWAT. As the Washington Post explains,
“The modern-day SWAT team originated in Los Angeles in the late 1960s as a way to deal with gunmen targeting police officers or civilians. But today SWAT teams are mostly used to handle routine warrant work, especially drug warrants. A 2014 ACLU study found that nearly 80 percent of SWAT deployments were to serve search warrants. Just 7 percent of SWAT deployments involved ‘hostage, barricade, or active shooter scenarios.’”
A patchwork of state laws now govern the legality of the plant falsely classified as lacking any medical value, as a Schedule 1 substance, by the FDA and Drug Enforcement Agency — whose own website hypocritically also states, “No death from overdose of marijuana has been reported” — making it possible to buy weed in a store in one state, and die because of it just over state lines.Related Stories
1. Consuming marijuana lowers intelligence.
“The best evidence is that you lose, if you use marijuana as a teenager regularly, eight IQ points. I don’t know about the rest of the table, but I don’t have eight (IQ points) to lose.” —Washington Post columnist Ruth Marcus, July 27, 2014
The source of this oft-repeated claim is a 2012 longitudinal study by Madeline Meier and colleagues that associated the persistent use of cannabis prior to age 18 with lower IQ at mid-life. However, a separate review of Meier’s data, published in the same journal, disputed any direct link between cannabis use and declined IQ. That review argued that Meier’s team had failed to properly control for potential confounding factors, such as subjects’ socio-economic status. After accounting for these variables, the author theorized that the “true effect (on early onset cannabis use and IQ) could be zero.”
More recent longitudinal studies further dismiss the notion that cannabis exposure negatively impacts IQ. A 2016 British study published in the Journal of Psychopharmacology assessed IQ and educational performance among a cohort of 2,235 marijuana-using teens and never users. Authors concluded, “[T]he notion that cannabis use itself is causally related to lower IQ and poorer educational performance was not supported in this large teenage sample.”
Most recently, researchers at the University of California, Los Angeles and the University of Minnesota evaluated whether marijuana use was associated with changes in intellectual performance in two longitudinal cohorts of adolescent twins. Participants were assessed for intelligence at ages 9 to 12, before marijuana involvement, and again at ages 17 to 20. Investigators found no dose-response relationship between cannabis use and IQ decline. They also found no significant differences in performance among marijuana using subjects when compared to their non-using twins, concluding: "In the largest longitudinal examination of marijuana use and IQ change, ... we find little evidence to suggest that adolescent marijuana use has a direct effect on intellectual decline. ... [T]he lack of a dose-response relationship, and an absence of meaningful differences between discordant siblings lead us to conclude that the deficits observed in marijuana users are attributable to confounding factors that influence both substance initiation and IQ rather than a neurotoxic effect of marijuana."
2. Legalizing marijuana spawned the opioid epidemic.
“I think that when you see something like the opioid addiction crisis blossoming in so many states around this country, the last thing we should be doing is encouraging people (by regulating the adult use of marijuana).” —White House Press Secretary Sean Spicer, Feb. 23, 2017
Recent claims by the new administration that the use of marijuana may be linked to the rising use and abuse of opioids is unsupported by the available evidence. In reality, numerous studies find just the opposite result.
Specifically, researchers have linked legal marijuana access to lower rates of opioid use, hospitalization, and mortality. For instance, a 2016 study by investigators at the University of Michigan reported that chronic pain patients reduced their opioid use by 64 percent when cannabis became available. Israeli researchers documented similar results in a cohort of patients with treatment-resistant pain, reporting a 44 percent reduction in participants’ opioid consumption following the introduction of medical cannabis. Such a substitution effect can result in saved lives. Writing last month in the journal Drug and Alcohol Dependence, authors reported that medical marijuana legalization laws are associated with significant reductions in hospitalizations due to opioid-related abuse or overdoses. Similarly, a 2014 study published in the journal JAMA Internal Medicine determined that legalizing medical cannabis is associated with as much as a 33 percent reduction in deaths attributable to the use of prescription opiates and heroin.
3. Cannabis smoke exposure is more damaging to the lungs than tobacco smoke.
“Smoking marijuana clearly damages the human lung.” —website of the American Lung Association, Marijuana and Lung Health
While some studies have linked chronic marijuana smoke exposure to higher instances of cough, phlegm, and bronchitis, science has refuted claims that cannabis inhalation causes the sort of serious adverse respiratory events commonly associated with smoking tobacco.
Specifically, the largest case-controlled study ever to investigate the respiratory effects of marijuana smoking reported that cannabis use was not associated with lung-related cancers, even among subjects who reported smoking more than 22,000 joints over their lifetime. "We hypothesized that there would be a positive association between marijuana use and lung cancer, and that the association would be more positive with heavier use," the study's lead researcher explained to the Washington Post. “What we found instead was no association at all, and even a suggestion of some protective effect" among marijuana smokers who had lower incidences of cancer compared to non-users.” Reviews of similar studies from around the world have reached similar conclusions, finding “little or no association between the intensity, duration, cumulative consumption or age of start of cannabis smoke and the risk of lung cancer in all subjects or never smokers.”
Furthermore, unlike tobacco smoke, marijuana inhalation is not adversely associated with measurements of pulmonary function, such as forced expiratory volume and forced vital capacity even among long-term consumers.
Finally, cannabis consumers can mitigate their exposure to combustive gasses by utilizing a vaporizer, which heats marijuana flowers to a point where cannabinoid vapors form, but below the point of combustion. Clinical studies assessing vaporization as a mode of cannabis delivery report that these devices all but eliminate subjects’ potential exposure to gaseous toxins and are “an effective and apparently safe vehicle for THC delivery.”
4. States that have regulated the marijuana market have experienced a surge in violence.
"We're seeing real violence around that (marijuana legalization). Experts are telling me there's more violence around marijuana than one would think and there's big money involved." —U.S. Attorney General Jeff Sessions, Feb. 27, 2017
Contrary to the Attorney General’s claims, states that license the production and distribution of marijuana have not seen an uptick in violent crime. In fact, many jurisdictions have experienced a drop in violent crime post-legalization.
For example, a 2014 study published by researchers at the University of Texas reported that the enactment of “medical marijuana laws precedes a reduction in homicide and assault. ... In sum, these findings run counter to arguments suggesting the legalization of marijuana for medical purposes poses a danger to public health in terms of exposure to violent crime and property crimes.”
A federally funded study published by UCLA researchers also reported that the proliferation of medical cannabis retailers in urban areas “was not associated with violent crime or property crime rates,” and further speculated that the facilities may potentially reduce neighborhood crime since many retailers hire their own door security, utilize security cameras, and take other steps to deter would-be criminals.
Specific data from states that regulate recreational marijuana sales yield similar results. In Washington, where voters legalized adult use in 2012, violent crime fell ten percent statewide. In Colorado, rates of violent crime and property crime fell in the city of Denver following legalization. Crime rates have similarly declined in Portland, Oregon according to a recent CATO think-tank policy report. Overall, CATO’s researchers concluded that concerns regarding the potential adverse effects of legalization laws on crime have largely been blown out of proportion. “The absence of significant adverse consequences is especially striking given the sometimes dire predictions made by legalization opponents,” they reported.
5. Marijuana legalization is linked with a rise in traffic fatalities.
“Research proves ‘the terrible carnage out there on the roads caused by marijuana.’” —Robert Dupont, March 18, 2012
While some studies find a slightly elevated risk of motor vehicle accident in THC-positive drivers compared to drug free drivers, others do not. However, this elevated risk is well below the risk of accident associated with many other non-criminal behaviors, such as driving with two or more passengers. Further, this risk is significantly lower than the risk of accident associated with driving after consuming alcohol within legal limits, which may increase crash risk as much as 400 percent. According to just published case-control data in the journal Injury Epidemiology, drivers testing positive for alcohol possessed an elevate risk of accident that was more than ten times higher (OR=16.33) than those of drivers who tested positive for THC (OR=1.54).
Most importantly, data from states that have liberalized marijuana’s legal status show no uptick in motor vehicle crashes. Writing in December in the American Journal of Public Health, investigators at Columbia University reported, "[O]n average, medical marijuana law states had lower traffic fatality rates than non-MML states. .... Medical marijuana laws are associated with reductions in traffic fatalities, particularly pronounced among those aged 25 to 44 years. ... It is possible that this is related to lower alcohol-impaired driving behavior in MML-states.” An assessment of traffic fatality data from Colorado yielded a similar conclusion, reporting, “[L]egalization is associated with a nearly 9 percent decrease in traffic fatalities, most likely to due to its impact on alcohol consumption.”
A recent Congressional Research Service report concluded, “[T]here was no trend identified in the percentage of drivers testing positive for marijuana (either marijuana only or marijuana in combination with other drugs/alcohol) for those involved in traffic fatalities and who were tested for drugs or alcohol” in Washington state post-legalization. A similar review of motor vehicle crash data in Oregon similarly reported regulating the adult marijuana market has not led to an increase in fatal accidents.Click here for reuse options! Related Stories
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Recent court rulings in Canada and the U.S. could set a new precedent for insurance companies to pay for doctor-prescribed medical marijuana. In the last few months, in consideration of the addictive potential of opiates and relatively few safety concerns over marijuana, judges in both the U.S. and Canada have ruled in favor of insurance companies covering medical marijuana for pain patients.
In January, a judge in New Jersey made a historic ruling that workers' compensation must cover the costs of medical marijuana. After hearing testimony from Andrew Watson, a lumber worker who used marijuana for a work-related injury, New Jersey administrative law judge Ingrid L. French ruled that workers' comp must cover the costs of Watson's medical marijuana. As the Philadelphia Inquirer reports in a detailed article on the case, this could set a new precedent for medical marijuana patients.
In 2014, Watson used cannabis obtained legally through the state’s medical marijuana program to treat intractable neuropathic pain in his left hand. He testified that it was the best treatment available for his injury and that it did not have the negative side effects of opiate painkillers.
Psychiatrist and neurologist Edward H. Tobe also testified about the well-known risks of taking opiates and the benefits cannabis medicine provided Watson. He said marijuana helped Watson reduce his opiate use, and was also likely to help him, "achieve better function."
"Opiates can shut down breathing (whereas) marijuana cannabinoids won't....Marijuana does not affect the mid-brain. The mid-brain is critical in controlling respiration, heart rate, many of the life-preserving elements," Tobe said, according to an excerpt of his testimony included in the opinion Judge French issued last month.
French’s opinion states that the evidence from the court proceedings, "show that the petitioner's 'trial' use of medicinal marijuana has been successful. While the court is sensitive to the controversy surrounding the medicinal use of marijuana, whether or not it should be prescribed for a patient in a state where it is legal to prescribe it is a medical decision that is within the boundaries of the laws in the state."
Watson’s lawyer, Philip Faccenda, said Watson stopped using cannabis in 2014 because of its cost. Meanwhile, the insurance carrier continued to pay for his use of opiates to treat his pain. Faccenda argued that Watson should be reimbursed for his past medical marijuana purchases, and that the insurance company should continue paying for his medical marijuana.
French’s decision ultimately ruled in Watson's favor, stating that the evidence convinced the court it was “reasonable and necessary” for Watson to relieve his pain using marijuana. The judge explained that she found Watson’s pain management approach “mature” and “cautious.”
"He testified that the effects of the marijuana, in many ways, is not as debilitating as the effects of the Percocet (which is how he refers to his prescriptions for Endocet or Oxycodone)....Ultimately, the petitioner was able to reduce his use of oral narcotic medication.”
As the Philadelphia Inquirerreports, “John Gearney, a Mount Laurel lawyer who writes a weekly blog on workers' compensation cases, says the written ruling may be the first in New Jersey to address whether an insurer should pay for marijuana.”
Gearney reportedly told the Inquirer, "It's not binding, but it's really an important decision. There are about 50 workers' compensation judges in the state, and they will read it and see what the judge thought when a case like it comes before them.”
A similar case took place in Nova Scotia, Canada in February, when a judge ruled that medical marijuana patient Gordon Skinner's cannabis must be paid for by his employee insurance plan.
Skinner suffered chronic pain following an on-the-job vehicle accident. When he was denied coverage of his medical marijuana, he claimed discrimination. A human rights board ultimately determined that his prescribed medical marijuana must be covered by his insurance plan, as Keith Doucette reported for the Canadian Press. Benjamin Perryman, the chairman of the inquiry board, made his descision based on the fact that the marijuana Skinner used was prescribed by a doctor for pain managment.
“[I]t seems there is prima facie support for its medical necessity, owing to the fact that conventional prescription pain management drugs are normally eligible for coverage," he said, according to the Canadian Press. The article notes that Deepak Anand, the executive director of the Canadian National Medical Marijuana Association, thinks the ruling is likely to encourage more people to apply for coverage through their provincial human rights commissions.
Opiate overprescription and a lack of alternative options for pain patients contributes to an epidemic of addiction and overdose in the U.S. and globally, according to the CDC. Numerous pain patients in the 28 states with legal medical marijuana programs report that the federally illegal herb helps reduce their pain while causing few or no negative side effects.Related Stories
It sounds like the lead-in to a joke, but it's not.
In the video below, Rabbi Jim Mirel, emeritus rabbi of the Reform temple B’nai Torah of Bellevue, Washington, Episcopal priest Chris Schuler, and Carlos Diller, a self-described “conservative homosexual atheist,” get baked together and talk religion.
"I'm here to experience one of God's creations," said Mirel, who copped to trying weed before, but not for some time.
Responding to a question about whether marijuana appears in the Bible, Mirel pointed to the anointing oil mentioned in the Book of Exodus: "It had some qualities that would elevate the person" and could have included "oil from the hemp plant," the rabbi argued.
Diller has to show Father Schuler how to hit a bong, with the good priest worrying that "it won't take me much to get stoned out of my gourd" and then coughing explosively.
At one point, Mirel gets so involved in telling Diller that appears to be a "person of faith" despite rejecting a belief in God that he bogarts the joint. "You've been holding that joint for a while," he is reminded. Asked if he needs a light, the rabbi responds, "Yeah, light it up."
Mirel waxes profound, suggesting that “historically, many people have had mystical experiences; I think it’s very likely that they were under the influence of some mind-altering substance.”
Should religious people smoke pot? Mirel thinks so.
"If it helps you become a better person, if it lifts you up and gives you something, a new view of life, it's a positive thing."Related Stories
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Ah, Jamaica. Just a hop, skip, and jump from Miami, the Caribbean island nation is a prime tourist destination. It's got gorgeous beaches, breathtaking mountains, throbbing reggae beats, its own delicious cuisine, and a rich culture born from and steeped in the bittersweet legacy of the West's arrival in the Americas.
It's also got marijuana for incredibly cheap prices, as you can see in the video clip below. This middle-aged white guy bud hunter manages to score a handful of colas that probably yielded somewhere between a quarter- and a half-ounce of Jamaican home grown for $20.
Call it 10 grams, just to be conservative. That's a gram price of $2. Compare that to after-tax gram prices five to 10 times higher in legal marijuana states in the US, and $20 gram sales are not uncommon in the non-legal states, where ounce prices of kind bud are typically over $300 ($12 a gram).
The buds are sugary with resin, and the smoke tastes "as smooth as peanut butter," in the words of a local hustler who somehow appears on the scene shortly after the camera starts rolling and the weed starts burning.
The guys in the video are chortling over their cheap score, but the local guy who sold it to them is probably laughing all the way to the bank. Websites that track Jamaican pot prices report prices of $8 to $80 an ounce for high quality weed, with pounds going for as low as $150. Still the tourist gets cheap weed, the local makes a quick profit, and everybody's happy.
Despite being the land of reggae, Rastas, and reefer, Jamaica has not fully legalized marijuana, but it has decriminalized the possession of up to two ounces, so visitors who don't go too crazy with cheap weed purchases should have no problem with the law. Not that it was a big problem for tourists before; the video you're about to watch was filmed before decrim went into effect, and nobody was too worried then.
This video shows a pretty herb-centric Jamaican experience. One can only hope these guys managed to get out of the smoke-filled rooms long enough to see the rest of what Jamaica has to offer.Related Stories
Travis Bornstein never told his friends about his son Tyler’s drug problem. He was too embarrassed.
Then, on September 28, 2014, Tyler’s body was found in a vacant lot in Akron, Ohio. The 23-year-old had become addicted to opioid pain killers after several sports-related injuries and surgeries. Unable to afford long-term treatment, he ultimately turned to a cheaper drug — the heroin that killed him.
“Now I have no choice but to speak out,” the elder Bornstein, president of Teamsters Local 24 in Akron, told a crowd of thousands at the union’s convention in 2016. As he shared the unvarnished tale of how a middle-class, star athlete wound up in that vacant lot, Bornstein lit a fire under the 1.4-million-member organization.
The Teamsters pledged $1.4 million for a nonprofit organization the Bornstein family set up to expand treatment for addicts in Ohio. They’re also going after the drug industry CEOs who’ve been profiting off a national opioid problem of epidemic proportions.
According to the Centers for Disease Control, the number of overdose deaths involving opioids (including prescription drugs and heroin) has quadrupled since 1999. In 2015, opioid deaths in the United States hit a record-breaking 33,000.
The labor union is targeting the three largest U.S. prescription drug wholesalers — McKesson, Cardinal Health, and AmerisourceBergen — for flooding hard-hit areas with the highly addictive pills.
Between 2008 and 2012, for example, these companies shipped 780 million hydrocodone and oxycodone opioid doses to West Virginia — 433 for every man, woman, and child in the state. During that time period, 1,728 people in the state overdosed on the painkillers.
The companies deny any wrongdoing, pointing the finger instead at corrupt doctors and pharmacists who sell pills directly to addicts and dealers. But as West Virginia Governor Earl Ray Tomblin recently told the Charleston Gazette-Mail, “Obviously, they had to know, with a state this size, and that many pills coming in, that something wasn’t right.”
The Teamsters are using their clout as pension fund investors to demand that drug wholesalers take responsibility for their role in the epidemic, conduct full investigations of their distribution practices, and hold CEOs accountable.
At AmerisourceBergen, for example, CEO Steven Collis hasn’t coughed up a penny of the tens of millions of dollars he pocketed as the firm was reaping opioid windfalls — even though the company has paid $16 million to settle a West Virginia case over their negligence.
The Teamsters are demanding that some of the CEO’s pay be “clawed back,” in the same way that Wells Fargo executives involved in last year’s bogus account scandal had to forfeit some of their compensation.
They’ve made similar demands on McKesson, where CEO John Hammergren’s compensation has amounted to an astounding $368 million over the past five years.
Part of the problem with accountability at McKesson, according to the Teamsters, is the fact that Hammergren serves as both CEO and chairman of the company. The union is filing a shareholder resolution urging the board to appoint an independent chair.
Meanwhile, Travis Bornstein is continuing to speak out, telling his son Tyler’s tragic story to students, policymakers, and others as he works to expand the availability of drug treatment for communities ravaged by the opioid crisis.
Since Tyler’s death, he’s learned that opioid addiction isn’t a moral failure, but rather a disease, like cancer or diabetes. “Now my son is my hero for everything he was able to accomplish with such a gut-wrenching disease,” Bornstein said. “I was the fool.”Related Stories