The Great Reefer Barriers: Why We Don’t Know More

grygielny Drug Education, Marijuana Legalization, Medical Marijuana

Politics should not dominate science.  When researchers propose studies about the medicinal value of a drug or substance, research funding  should be determined neither by the whims of politicians nor bureaucratic self-interest. Yet, when it comes to medical cannabis research, politicians and federal officials have an iron grip that have serious consequences on the lives of millions of Americans. The passage of the Controlled Substances Act in 1970 is one of the most important events in the history of the War on Drugs. Fueled by anti-drug rhetoric, the Controlled Substances Act established the Drug Scheduling System. This system,  based more in already debunked drug myths, has determined the legality of various substances for medicinal and research purposes for decades. The most egregious category placement in the scheduling system is undoubtedly cannabis. Congress categorized cannabis as a Schedule 1 drug, deeming it to have a high potential for abuse and no accepted medical use. Incredibly, this placement meant that marijuana was considered as dangerous as heroin, and more dangerous than cocaine and meth. This scheduling placement has suffocated progress on cannabis research for decades. The regulatory hurdles that must be overcome are currently so complex and burdensome that they would be funny were the ramifications of such regulations not so serious. Reading through a recent report from The National Academies of Sciences, Engineering, and Medicine on the barriers to cannabis research are both dizzying and infuriating. Proposals for research involving cannabis must be submitted to the Drug Enforcement Adminstration, the National Institute of Drug Abuse, and any relevant state agencies. Some of these agencies brazenly display their biases in the types of research they approve. In 2015, more than eighty percent of cannabinoid research funded by the NIDA was on the harmful effects of marijuana, rather than any potential medicinal effects.   Who could expect that the Drug Enforcement Administration would support research on cannabis as medicine?  Yet its approval is required. The DEA in 2016 stated its intent to permit marijuana to be available from approved registries.  But it has yet to approve a single application. The only acceptable source for marijuana used in research is the University of Mississippi. Many researchers have pointed out that the samples provided are not nearly as potent as the product sold legally in many states, hampering the effectiveness of research. That researchers in California cannot use marijuana legally grown and sold in California is absurd. As a result, research that could save and improve lives is difficult to perform. The first ever trial of the effect of medical marijuana on Post-Traumatic Stress Disorder in Military Veterans was only approved after seven years. Then, after another twenty months, the NIDA-approved cannabis was finally delivered, and was found to be contaminated with mold. Many medical researchers have been vocal about burdensome regulations. Sachin Patel, who studies cannabis at Vanderbilt University, has spoken publicly about the medical community’s desperate need for “well-controlled unbiased large scale research studies into the efficacy of cannabis for treating disease states.” Researchers also point out the absurdity of the claim that cannabis has a high potential for abuse and no accepted medical value. “In the biomedical research community,” Eckard College’s Gregory Geredemann has said, “it is universally understood that cannabis is a very safe, well-tolerated medicine.” Despite these regulations, and the anti-marijuana bias of the NIDA, research continues to prove that the medical value of cannabis is vast, and that access to it will reduce pain and save lives. Studies have shown that smoking cannabis can help reduce chronic pain in HIV-positive patients, symptoms of multiple sclerosis, and the development of Alzheimer’s. Earlier this year, two studies provided evidence that access to medical marijuana can help stem the rise of the opioid epidemic, potentially saving thousands of lives. More and more states are legalizing marijuana for both medical and recreational purposes, acknowledging that the potential for abuse is low and that there is undoubtedly medical value to the drug. Yet over the last decade attempts to downgrade cannabis from its Schedule 1 placement have been stymied by the federal government. In 2011, DEA Administrator Michele Leonhart rejected a petition to reclassify marijuana on the basis that the “risks of marijuana use have not been shown to be outweighed by specific benefits in well-controlled clinical trials.” The irony of this statement is, of course, that well-controlled clinical trials are almost impossible to run unless marijuana is reclassified. In 2016, the federal government was given another opportunity to reclassify the drug, and again chose to maintain the status quo. Statements in favor of reclassifying marijuana have come from The American Medical Association and the American College of Physicians. Earlier this year, a report from the Senate Appropriations Committee on barriers to marijuana research stated that “At a time when we need as much information as possible about these drugs, we should be lowering regulatory and other barriers to conducting this research.” Given the aggressive anti-drug stance of both President Trump and Attorney General Sessions, it is unlikely that such barriers will be lifted any time soon. For now, researchers must continue navigating highly burdensome  regulations in order to study cannabis, including storing cannabis in a safe or a vault. It seems that knowledge about the medical benefits of cannabis is also being kept in a vault, one that lawmakers who cling to debunked claims about the dangers of marijuana refuse to open. Tom Houseman

Oklahoman Op-Ed: Answering Evangelicals

grygielny Evangelical Perspectives, Medical Marijuana, OK

The following op-ed appeared in the Oklahoman, the newspaper with the largest circulation in Oklahoma, three days before the vote on a medical marijuana ballot initiative.  It was co-authored by Rev. Bobby Griffith, pastor, City Presbyterian Church, Oklahoma City; and Rev. Alexander E. Sharp, Executive Director, Clergy for a New Drug Policy. On June 26th Oklahoma voters approved Proposition 788 by a 12-point margin. This op-ed is republished here with the permission of the Oklahoman. Voters in Oklahoma will decide next Tuesday whether to approve Proposition 788, which would make medical marijuana available in the state.  Some clergy are urging them to oppose the measure. Though they may be sincere, their opposition denies the very God of healing, compassion, and mercy they claim to worship. Harsh words, yes, but here is why they are sadly accurate.  Even the most casual reader of the Gospels knows that Jesus devoted much of his ministry to healing the sick and the infirm. That, more than any other reason, is why people flocked to him. On what basis, then, would Christian leaders oppose making a substance that offers healing available to those who suffer? I can think of three reasons. One reason might be the misguided view that cannabis does not really help people.  But there is simply no room for doubt that it does. The most prestigious medical journals testify to its effectiveness in addressing severe pain of those suffering from cancer; nausea from chemotherapy; multiple sclerosis; epilepsy; degenerative spinal disease; and many other forms of suffering. Perhaps these opponents fear that medical marijuana will increase use among children, who will raid their parents’ or grandparents’ medical cabinets.  But the evidence is clear on this point, too. Medical marijuana has not led to increased teen use in any state that has adopted it. Why, then, do these Christian leaders not have eyes to see? Perhaps because they are blinded by penultimate rather than ultimate religious values.  I was stunned to read the words of a pastor from an Oklahoma Baptist Church last week: “The two hallmarks of the Christian faith are sobriety and self-control,” he said. “Marijuana inhibits both of these hallmarks. These are virtues, indeed. But to call them “the hallmarks” is to overlook the essential Christian message, which is to “Make love your aim.”  Elsewhere in the Gospel: “God is love, and those who abide in love abide in God, and God abides in them.”  And, of course, 1 Corinthians 13: “Faith, hope and love abide these three, but the greatest of these is love.” Very few things made Jesus angry, but the Pharisees did.  Why? Because they stressed rules over substance. That’s why He was willing to heal, and feed the hungry, on the sabbath, even though it made those Pharisees apoplectic.   Another reason some oppose making medical marijuana available is fear that legalizing medical marijuana will open the door to recreational use.  This view disrespects how people function in a democracy. With good information, citizens generally make wise decisions. Yes, some states have moved eventually from medical to full legalization.  But this has happened only after full, robust, extended debate. It has not happened quickly or easily in any state. Nor would it in Oklahoma. At the end of the day, what may drive clergy opposition is a misguided view of sin. They preach personal salvation. Abstinence from earthly pleasures is the only path.  This sense of what constitutes personal wrong conduct is so narrowly constructed that it leads them to think that any use of drugs, even for healing, is immoral. It leaves virtually no room for compassion, indeed, for Jesus. Fear- and rule-mongering which cause so many to miss the essence of the Christian faith should not guide next Tuesday’s vote on medical marijuana.

A New Frontier for Medical Marijuana

grygielny Drug Education, Marijuana Legalization, Medical Marijuana

The medical marijuana program in Illinois is one of the most restrictive in the nation. It covers only a fraction of the illnesses for which cannabis is an effective treatment. Those who apply are fingerprinted—yes, fingerprinted. And the review process, even for those suffering from cancer, epilepsy, and multiple sclerosis, typically takes more than 90 days, longer than in any other state. Given these tight restrictions and an indifferent administration, it is remarkable that Illinois might become the first state to use its medical marijuana program to combat the opioid crisis. Last year, more than 68,000 Americans died from drug overdose, including 45,000 from opioid abuse. For the first time in US history, because of the opioid crisis, life expectancy has declined. Drug overdose deaths in Illinois increased by more than 70 percent between 2013-2016. There is no simple answer to the opioid crisis, but research is showing that cannabis as medicine can make a difference. Two recent studies published in the Journal of the American Medical Association (which can be found here and here) found a lower level of opioid use and fewer overdose deaths in states where medical marijuana is legal. Researchers at DePaul and Rush universities have also determined that marijuana worked faster to relieve pain than other prescription medication, and had fewer side effects. We applaud state senator Don Harmon (D-39th) for sponsoring legislation in Illinois that would translate this evidence into action. The bill—SB 336 —would expand the existing medical marijuana program to allow individuals to use medical cannabis as a substitute for prescription opioids. Patients would do so under the supervision of a physician who could “limit the length of time a patient may receive the opioid that would have been prescribed.” This makes sense. I remember one of the “poster patients” during the medical marijuana debate. He suffered from degenerative spinal disease. He carried through the halls of the Illinois statehouse a bag of prescriptions that had cost him $50,000 a year and caused horrible side effects. After years of struggle, he was near death in an Episcopal hospital when a nursing nun said to him, “You are going to die if you keep this up. I shouldn’t tell you this, but you should try medical marijuana.” He took her advice, and is now able to live a normal life. Medical marijuana helps opioid victims by reducing the pain that drove addicted individuals to overuse opioids. It also eases the agony of withdrawal as they seek to overcome their addiction. There is simply no comparison when it comes to opioids versus medical cannabis. Opioids are physically addictive, and they can kill. There have been no recorded deaths due to cannabis overdose. Senate Bill 336 will soon reach the Senate floor, and then, hopefully, will be sent for consideration to the Illinois House. We urge all Illinois residents to use the opportunity we provide here. For those in other states, we urge you to commend this bill to your legislators as a model. It will take unified action on many fronts to cope with our national opioid crisis. We believe the use of medical marijuana can be a key part of the solution. Reverend Alexander Sharp 

Medicinal Cannabis and the Opioid Epidemic

grygielny Marijuana Legalization, Medical Marijuana, Uncategorized

There is no silver bullet for solving the opioid epidemic. The Centers for Disease Control estimates that every day more than ninety people in the United States die due to opioid misuse. Opioid overdose is now the most common cause of death in the US, responsible for more annual deaths than vehicular accidents or homicides. Two recent studies add to the mountain of evidence that medicinal cannabis can be a part of reversing that trend. When President Trump declared the opioid epidemic to be a Public Health Emergency, it was a sign that the government was willing to get serious about tackling this problem. Even as federal funding has been increased to deal with the opioid crisis, Trump and Attorney General Sessions have rejected one of the most important steps that they could take: removing cannabis from the list of Schedule 1 drugs. The Controlled Substances Act was signed in 1970 as President Richard Nixon was ramping up the War on Drugs. This act created the Federal Drug Scheduling System, which classifies drugs by both their medical value and potential for abuse. Cannabis is classified as a Schedule 1 drug, signifying that it has no medical value and high potential for abuse. Scientists and doctors have spent the ensuing decades proving the federal government wrong. Despite restrictions on how cannabis can be used in research, evidence has continually demonstrated the medical value of cannabis. As a form of pain management, a way to lessen symptoms, and, in some cases, a way to aid in recovery, cannabis has been proven to be able to treat or help in the treatment of HIV, arthritis, asthma, epilepsy, glaucoma, and multiple sclerosis. There are multiple cannabis infused products like CBD juice, available on many websites. Now, new evidence indicates that cannabis can be used to fight the opioid epidemic. Two recent studies have examined the impact that legalizing medical cannabis at the state level has had on rates of opioid prescriptions and overdose deaths. In Association Between US State Medical Cannabis Laws and Opioid Prescribing in the Medicare Part D Population, researchers found that in states with medical cannabis laws there are significantly fewer people being prescribed opioids under Medicare than in those without. In states with medical cannabis dispensaries that enable even easier access to the drug, those rates are even lower. A second study, Medical Cannabis Laws and Opioid Analgesic Overdose Mortality in the United States, 1999-2010, demonstrates that states with medical cannabis laws had rates of opioid overdose mortality nearly 25 percent lower than in states where medical cannabis is illegal. This difference was more pronounced the longer a state had allowed doctors to prescribe cannabis to patients. Despite this evidence, those fighting against cannabis legalization continue to deny its health benefits. A South Carolina medical cannabis bill never received a vote in the state house, despite the fact that in one poll nearly 80 percent of respondents supported its legalization. Opponents of a similar bill in Kentucky have demanded more research on the drug’s long-term effects and questioned whether legalization actually would reduce opioid use. In Utah, a ballot initiative will give voters the opportunity to decide this November whether or not medical cannabis should be legal in their state. A recent poll by The Salt Lake Tribune found that more than three-fourths of Utah voters support the initiative, indicating that it is likely to pass. However, the bill faces considerable pushback. Governor Herbert has voiced his opposition, demanding more research before he would be willing to consider the medical benefits of cannabis. Because of its federal Schedule 1 classification, cannabis is technically illegal even in the twenty-nine states that permit doctors to prescribe it. To save lives we need every possible tool at our disposal, but with a ban on cannabis, and severe restrictions on even studying its benefits, the federal government is stunting its ability to help those most in need. From my own experience, when I visited the closest dispensary to utah it was obvious how the legalisation of Medical Cannabis had positively impacted those patients able to gain access to the dispensary. Without question the more we learn and experience, the more the need to legalize cannabis and remove it from the list of Schedule 1 drugs becomes clear. What remains to be seen, however, is if those in power will continue to ignore that evidence, or if they will finally make things right. Tom Houseman

Legal Impact and Financial Implications: Attorney General Jeff Sessions Memo

Sanya Singh Marijuana Legalization, Medical Marijuana

Elizabeth Wittemyer, Attorney At Law Prepared at the Request of the Marijuana Education Initiative When U.S. Attorney General Jeff Sessions decided to issue a memorandum on January 4, 2018, rescinding the Cole Memorandum, it was clear that his long-time wish to demonize marijuana and criminalize activities around the legal state markets had come to pass. I am an attorney who represents the cannabis industry, and several worried clients and colleagues have wished to discuss the issue and the possible consequences with me. The interplay of state and federal law can be confusing, especially as we consider the effects the Sessions Memo will have on the cannabis industry. Understanding the hierarchy of the U.S. Justice Department and its authority over the states is one way to view how this interplay works. The Justice Department is an executive-branch agency that deals with crimes at the federal level and that enforces federal law. The U.S. Attorney General is a cabinet member appointed by the president and is the nation’s chief law enforcement officer for federal law. U.S. attorneys are employees of the Justice Department and prosecute federal cases brought to them by federal law enforcement agencies such as the Federal Bureau of Investigation and the Drug Enforcement Administration. The DEA investigates crimes involving cannabis. You might remember from the television show Law and Order, the DEA investigates crimes as law enforcement officers and the U.S. attorneys prosecute in federal courts the crimes brought to them by DEA officers. Marijuana is federally illegal and is classified as a Schedule I drug under the Controlled Substances Act. The DEA is the lead law enforcement agency for the domestic enforcement of the Controlled Substances Act. The Cole Memorandum from 2013 established a new “prosecutorial discretion” regarding cannabis. It was a policy guidance to U.S. attorneys that made the cannabis industry a low prosecutorial priority in states that had legalized cannabis, as long as those states complied with the guidelines contained in the memo—namely, to protect youth and control diversion. What the Jeff Sessions Memo does is reestablish cannabis, regardless of legality within the states, as a prosecutorial priority along with all other federal crimes. In the memo, Sessions encourages the prosecution of other crimes that can be tied to cannabis, such as money laundering and violations of banking regulations. These types of prosecutions will almost certainly include asset forfeiture actions. The Sessions Memo highlights the “Department’s finite resources” and points to principles of prosecution set in 1980, taking us back to the old, failed policies of the war on drugs. Though U.S. attorneys seem to have little appetite to initiate prosecutions against legal cannabis businesses, the same cannot be said of the DEA. In fact, the DEA has always had a Domestic Marijuana Eradication/Suppression Program aimed at completely eradicating cannabis in the United States. According to the Department of Justice Fiscal Year 2016 Budget submitted to Congress, the DEA spent millions of dollars on marijuana eradication efforts, including anti-legalization education programs. Although the cannabis industry blames the DEA for refusing to reschedule cannabis from its present Schedule I status, it is the Department of Health and Human Services that has the legal responsibility to make scientific and medical determinations regarding drug scheduling. The head of HHS Tom Price resigned in a cloud of scandal in September 2017. The president has nominated Alex Azar, a former pharmaceutical company executive, to fill the position, and Mr. Azar’s confirmation hearing began January 9, 2018. As cannabis is a competing product to pharmaceuticals, it is highly unlikely that a former representative of the pharmaceutical industry, which holds one of the most powerful lobbies in Congress, will consider rescheduling marijuana. With Azar as head of HHS, the pharmaceutical industry would have even more control over our federal agencies in their quest to demonize cannabis, with Jeff Sessions leading the charge. The Rohrabacher-Blumenauer amendment (formerly the Rohrabacher-Farr amendment) is part of the federal budget established by Congress and has been included in every annual federal budget appropriations since 2014. The amendment prohibits the use of federal funds to supersede legal medical marijuana state laws. What many people do not realize is that the amendment primarily protects medical marijuana and not recreational marijuana. This year, Congress has been unable to agree on the budget and has limped along by making continuing resolutions to keep a government shutdown at bay. The last continuing resolution was on December 22, 2017, and it extended the previous budget to January 19, 2018. The Senate appropriations included the Rohrabacher-Blumenauer amendment; the House version did not after Attorney General Jeff Sessions lobbied against its inclusion. It is unclear what will happen to the amendment amid the many other fights over the budget, including immigration, defense, and domestic programs. Even if the Rohrabacher-Blumenauer amendment is included in the next appropriations bill, the rescission of the Cole Memo places the recreational marijuana industry at particular risk. Federal law supersedes state law, “preempting” state laws that conflict with federal laws. With the Cole Memo, the Obama administration allowed states to experiment with legalization of cannabis, in essence, “promising” not to bring a preemption action in federal court that would shut down a state’s legalization of marijuana. Although many legal scholars argue that the states that have legalized have relied on this federal discretion to their detriment, and therefore there are now legal defenses to a preemption action, the legalized states’ courts are not friendly to cannabis. State law cannot legalize what is illegal under federal law. In several court cases, acts that are legal under state marijuana laws were not protected by the courts owing to the illegality of the act under federal law, and this has led to seizures of inventory and loss of jobs. Cannabis businesses must be very careful in seeking relief in the state courts and should instead opt to negotiate, mediate, or arbitrate disputes whenever possible. Although recreational cannabis stands in particular danger because of its relative lack of credibility compared to medical cannabis, the entire legal cannabis industry is at risk. As we experience the devastating opioid crisis, with thousands of lives lost, the Jeff Sessions Memo begs reason and common sense. President Trump declared the opioid epidemic a national emergency; however, no new federal funds were allocated to address the crisis. Medicaid is under attack and will be cut back; by how much is the only question. States, facing budget shortfalls, have cut treatment programs throughout the nation. First responders dealing with opioid overdoses are vicariously traumatized by the horror they experience every day and their resources are stretched to the point of breaking. Our courts, overwhelmed with opioid-related crime cases, have few options to deal with the social ill of addiction through the criminal justice system. We are losing our family, friends, and neighbors every day to opioids. Yet, rather than spend federal money on prosecuting feel-good doctors, pill mills, and foreign actors to attempt to reduce the opioid epidemic, Jeff Sessions will devote the Department of Justice’s finite resources to prosecuting a drug that no one dies from. In fact, research shows the promise of cannabis as an effective treatment in reducing the need for opioids. The question is, therefore, one of where to direct our government’s limited resources. Do we spend federal dollars prosecuting opioids or prosecuting cannabis? Do we spend federal dollars on anti-legalization education or on education that will help our youth make healthy choices around legalization? Education programs such as those of the Marijuana Education Initiative, which provides reality-based education for youth regarding marijuana, are the initiatives that our tax dollars should fund. Now is the time to press our elected representatives to set the nation’s priorities straight. To learn more about the misinformation surrounding marijuana and the opioid epidemic check out our blogs The Truth and Marijuana and Opioids:   Sorting Through the Misinformation