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2016 Year in Review
ASA in 2016: Protecting Patients, Defending Facts, Educating Leaders
- ASA Files Demand to Correct DEA Misinformation
- Roadmap for Medical Cannabis Policy Shows Solutions
- Report Shows Cannabis Can Address Opioid Crisis
- ASA Brings Patient Pleas for Reform to UN
- Medical Cannabis Educational Resource Launches Online
- Annual Report on Safe Access Finds States Improving
Federal Medical Cannabis Developments
- Congress Extends State Medical Cannabis Protections through April
- Appeals Court Says DOJ Can’t Prosecute State-Legal Individuals
- Appeals Court Rules Medical Cannabis Patients Can’t Buy Guns
- DEA Again Denies Medical Use of Cannabis, Rejects Rescheduling
State Medical Cannabis Progress
- Lawmakers Enact New Medical Cannabis Laws in Ohio and Pennsylvania
- Lawmakers in Many States Expand and Accelerate Safe Access
- Arkansas, North Dakota, Florida, Montana Voters OK Initiatives
ASA in 2016: Protecting Patients, Defending Facts, Educating Leaders
Americans for Safe Access took several important steps in 2016 that will pay off for patients in years to come. As the leading grassroots organization for medical cannabis patients, ASA lobbied, educated and litigated on the federal, state and local levels. That included groundbreaking reports on how cannabis can ease the opiate overdose crisis, what elected officials can do now to resolve policy conflicts, and how states are implementing medical cannabis programs. ASA's strategic partnerships are creating new legal and educational opportunities for patients and professionals, and ASA staff have been at the center of international policy reform and medical research efforts.
Annual Report on Safe Access Finds States Improved in 2015
At the start of last year, ASA issued its annual report, “Medical Marijuana Access in the US: A Patient-Focused Analysis of the Patchwork of State Laws.” The 2016 report used a new rubric that put added emphasis on quality assurance and product safety regulations that protect vulnerable consumers from pesticides and other potential risks.
Nineteen states introduced legislation to legalize medical cannabis in 2015. More than a dozen of the states with robust programs passed legislation in 2105 or created new regulations to expand or improve them, including California, which adopted a comprehensive regulatory approach and added civil protections for patients.
The report evaluates each state medical cannabis law on: 1) patients' rights and protection from discrimination, 2) access to medicine, 3) ease of navigation, 4) functionality, and 5) product safety protocols. The report finds that, while many states have important elements helpful to patients, no state has yet established an ideal program.
The most notable state trend in 2015 was the spread of comprehensive product safety rules, many based on the Recommendations to Regulators from the American Herbal Product Association (AHPA).
ASA Brings Patient Pleas for Reform to UN
In April, ASA was part of the International Medical Cannabis Patients Coalition (IMCPC) urging the UN to update its drug policies. The United Nation’s General Assembly Special Session (UNGASS) on drug policy opened with a discussion of the conflict between medical cannabis laws and the UN treaties prohibiting marijuana, with the UNGASS president noting “access to drugs for medical use is a human right to protect.”
ASA Executive Director Steph Sherer (pictured at right addressing a UN meeting) was one of those who met with UN officials to reconsider its classification of cannabis, which is based on a 1935 report from the League of Nations.
To help educate UN member states, ASA and IMCPC created a one-page document, Moving Global Cannabis Policy Forward, that ties cannabis into the UN’s stated priorities for drug policy, explaining why “cannabis must be rescheduled in order to meet the objective of ensuring the availability of and access to controlled substances exclusively for medical and scientific purposes.” ASA also distributed a 94-page report, Cannabis and Cannabis Resin: Critical Review Preparation Document, which reflects the consensus of more than a dozen experts and was refined and peer-reviewed by more than 200 patients, doctors and advocates as part of ASA’s 2016 Unity Conference.
Since then, ASA has successfully lobbied the World Health Organization Expert Committee on Drug Dependence to create a pre-critical review document to be presented at next year's annual meeting in Geneva, the first step in rescheduling cannabis under the UN Single Treaty.
ASA Report Shows Cannabis Can Alleviate Opioid Crisis
Medical cannabis can alleviate the opiod painkiller crisis, according to an ASA report released in July and delivered to all members of Congress. The report, Medical Cannabis Access for Pain Treatment: A Viable Strategy to Address the Opioid Crisis, shows legislators and health practitioners how medical cannabis can ease the overdose epidemic that has seen fatalities quadruple over the last 20 years.
Based on research data showing cannabis can be an effective painkiller that reduces opiod use, the report provides recommendations for elected officials and physicians. Congress can harmonize federal and state laws by passing the Compassionate Access, Research Expansion, and Respect States (CARERS) Act (S.683). State lawmakers can ensure chronic pain is included as a qualifying condition for their state's medical cannabis program; currently many states exclude it, even though pain is the most common condition for which patients use medical cannabis. Lastly, state medical boards can promote medical cannabis education for practitioners.
ASA Files Demand to Correct DEA Misinformation
ASA took legal action in December 2016 to compel the Drug Enforcement Administration (DEA) to immediately correct misinformation about cannabis. The petition filed with the Department of Justice (DOJ) cites 25 violations by the DEA of the Information Quality Act, the federal law that requires administrative agencies to ensure the “quality, objectivity, utility, and integrity of information” they distribute.
Some of the erroneous DEA claims challenged by ASA’s petition were refuted by the DEA itself in documents it released in August. ASA argues that the DEA’s presentation of inaccurate information jeopardizes public health by making it difficult for public officials and medical providers to make informed decisions.
The petition, ASA’s second such challenge to government claims about cannabis, was prepared with unpaid assistance from Orrick, Herrington & Sutcliffe. The global law firm is providing pro bono assistance to patients in partnership with ASA. The partnership between ASA and Orrick will include new legal manuals in early 2017 for patients and guides for public defenders who represent them in court. Orrick will also coordinate attorneys to support ASA’s legal hotline for individual patients and monitor implementation of state medical cannabis programs.
Roadmap for Medical Cannabis Policy Shows Solutions
2017 can be the year federal policy makers resolve the 20-year conflict over medical cannabis programs. They just have to follow the roadmap released by ASA in December. ASA’s briefing book, “Medical Cannabis in America,” shows what the federal-state conflict means for the millions of medical cannabis patients and what Congress can do to fix it. The report includes steps for President Obama to take immediately, as well as suggestions for the incoming Congress and President-elect.
ASA’s briefing book provides up-to-date science on medical cannabis, outlines how federal agencies can help states increase the quality and safety of their programs, and details a role for federal oversight after the passage of comprehensive legislation.
The immediate opportunities for President Obama include directing the DEA to correct misinformation, ordering federal agencies to reevaluate barriers to cannabis research and rescheduling, and working with the United Nations on updating the classification of cannabis. He can also use his clemency power to release from federal prison the remaining medical cannabis POWs.
Medical Cannabis Educational Resource Launches Online
The Cannabis Care Certification (CCC) educational program launched in December. The comprehensive online resource for doctors and patients is a collaboration with TheAnswerPage, which has provided accredited continuing medical education since 1998.
The CCC Medical Professional Education Program features a comprehensive introduction to medical cannabis, from the endocannabinoid system to the therapeutic use of cannabis in multiple disease states. Healthcare professionals who complete the Medical Professional Program will be awarded a “Cannabis Care Certification,” CME credits, patient education subscription, and an option to be listed on the referral section of the CCC website. The CCC Patient & Caregiver Education Program for patients or anyone interested in medical cannabis features two hours of video education on issues such as determining dosage and participating in state programs.
FEDERAL MEDICAL CANNABIS DEVELOPMENTS
Comprehensive medical cannabis legislation languished in Congress this year, waiting on committee hearings that have never been scheduled, but the House and Senate have extended the protections they extended to state-compliant medical cannabis activities. Federal courts have begun to acknowledge those limits on federal prosecutions and civil actions, leading the Department of Justice to drop some civil asset-forfeiture cases targeting medical cannabis providers. The Drug Enforcement Administration continued its obstruction of science and rational policy but has now admitted that some of the key reasons previously provided for opposing medical cannabis are based on myth not fact.
Congress Extends State Protections through April
At the end of 2016, Congress extended through April the limits on the Department of Justice (DOJ) that protect state-legal medical cannabis patients and providers. The restrictions are part of budget approval for the DOJ. The Rohrabacher-Farr amendment language from last year's DOJ spending package was included in H.R. 2028, a continuing resolution that funds the federal government through April 28, 2017.
The Rohrabacher-Farr amendment has figured in cases such as U.S. vs. McIntosh, which held that, so long as the amendment remains in effect, federal medical cannabis prosecutions cannot proceed unless the government can show there was a violation of state law. The new US Attorney General could decide to resume pursuing medical cannabis cases, but the Rohrabacher-Farr amendment is binding law, at least through April.
The amendment must be reauthorized every year with the Commerce-Justice-Science appropriations bill, which Congress will likely debate and vote on in late April. ASA members and other advocates will lobby Congress directly during ASA's 2017 Unity Conference Lobby Day on April 11.
The amendment has been staunchly defended by its sponsors, Reps. Dana Rohrabacher (R, CA) and Sam Farr (D, CA), pictured here with ASA's Steph Sherer and ASA patient-lobbyist of the year, the late Larry Harvey.
Appeals Court Says DOJ Can’t Prosecute State-Legal Individuals
In August, the U.S. Court of Appeals for the Ninth Circuit ruled that the Justice Department cannot prosecute individuals for medical cannabis activities which are in compliance with state laws. The three-judge panel’s unanimous ruling covered 10 criminal cases in California and Washington in which the defendants claimed they complied with state medical cannabis law. The court sent the cases back to lower courts to determine if the defendants had "strictly complied" with state law, directing the DOJ to drop the prosecutions if they did.
Congress passed the bipartisan Rohrabacher-Farr amendment to the DOJ budget bill in 2014, after numerous attempts and extensive lobbying by ASA and other patient advocacy organizations. It blocks the DOJ from using budget funds to prevent states from "implementing their own State laws that authorize the use, distribution, possession, or cultivation of medical marijuana."
The appeals court decision echoes that of district court Judge Charles Breyer, who last fall lifted a federal injunction that had closed a Northern California dispensary, saying the appropriations measure plainly prohibits such interference with state medical cannabis programs and that to claim otherwise "defies language and logic."
Following that ruling, prosecutors abandoned two civil cases targeting California dispensaries. Early in April, the DOJ dropped their appeal of that ruling on the 14-year-old injunction that eventually shut the Marin Alliance for Medical Marijuana (MAMM), and later in the month they also dropped their asset forfeiture suit against Harborside Health Center in Oakland. The case against Harborside, the largest dispensary in the nation, was brought by the DOJ back in 2011 as part of a broadly used federal strategy of threatening landlords who rented to licensed medical cannabis businesses. A similar asset-forfeiture case against Berkeley Patients Group, one of the oldest and most respected dispensaries in the country, was dropped late in 2016.
Appeals Court Rules Patients Can’t Buy Guns
A federal appeals court in 2016 ruled that patients who participate in state medical cannabis programs forfeit their Second Amendment right to firearms. The ruling upheld a a 2011 letter the Bureau of Alcohol, Tobacco and Firearms sent to gun sellers stating that the federal law that prohibits gun purchases by an "unlawful user and/or an addict of any controlled substance" applies to patients in state medical cannabis programs. That letter was challenged by a Nevada woman who was not allowed to buy a gun because the store owner identified her as a medical cannabis cardholder. The ruling hinged on earlier cases that found those who committed violent crime were more likely to be a drug addict or have a history of using many types of illegal drugs.
DEA Again Denies Medical Value of Cannabis, Rejects Rescheduling
The Drug Enforcement Administration (DEA) in August rejected the latest attempt to have cannabis reclassified as having medical use. The DEA said its denial of the rescheduling petition filed by the governors of Rhode Island and Washington State reflects a determination by the Department of Health and Human Services (HHS) that “marijuana has a high potential for abuse, has no accepted medical use in the United States, and lacks an acceptable level of safety for use even under medical supervision.”
The DEA did acknowledge that cannabis is not a gateway drug, nor does it cause mental health disorders. It also took a step toward ending the monopoly on research cannabis held by the National Institute on Drug Abuse. The Controlled Substances Act, the 46-year-old law that classifies drugs in the US according to their risk and efficacy, requires an 8-Factor Analysis to be used for determining which schedule a drugs belongs in. ASA conducted an independent 8-Factor Analysis that found cannabis is currently misclassified.
“The DEA disregarded dozens of clinical trials and thousands of published scientific articles that didn’t fit their political agenda for regulating medicine,” said ASA Chief Scientist Jahan Marcu, PhD. "It’s like the last 20 years of research never happened."
STATE MEDICAL CANNABIS PROGRESS
As 2016 came to an end, more than two million Americans were participating in state medical cannabis programs, and only six states remained that do not have allow legal medical use of some type of cannabis product. State officials continued to push the implementation of safe access programs, expanding the lists of qualifying conditions and creating labeling and testing standards for products.
Lawmakers Enact New Medical Cannabis Laws in Ohio and Pennsylvania
Ohio’s new medical cannabis law, HB 523, went into effect in September. There is currently no legal means to obtain it, and physicians do not yet have guidance from the state medical board on issuing the recommendations that will provide patients with an affirmative defense until the state issues patient identification cards. Full implementation of the law may take another two years. Once registered, patients with one or more of 22 qualifying conditions will be able to access certain medical cannabis products from dispensaries that will be licensed by the state Board of Pharmacy. Smoking cannabis is prohibited, but vaporizing, oils, tinctures, edibles and topicals will be allowed.
The Pennsylvania Medical Marijuana Program, signed into law April 17, 2016, is being implemented by the Department of Health in a process expected to take between 18 and 24 months. The state will separately license grower/processors and dispensaries to distribute a limited range of medical cannabis products to qualifying patients. Applications for grower/processor and dispensary permits will be available on January 17 and are due on March 20. The program also includes a research component.
Lawmakers in Many States Expand and Accelerate Safe Access
In Connecticut, state officials in March expanded their medical cannabis program to protect more patients. Regulators added six conditions to the list for which doctors may recommend medical cannabis, including ALS (Lou Gehrig’s disease), ulcerative colitis, sickle cell disease, and three pain conditions.
In Florida, Gov. Rick Scott in March signed House Bill 307 to allow terminally ill patients to use medical cannabis immediately. The bill expanded the state’s ‘Right to Try Act’ that permits the use of non-FDA approved medicines by the dying. The bill also attempted to resolve implementation problems with the state’s limited 2014 medical cannabis law that has yet to make any medicine available to Floridians. The passage of Amendment 2 by voters should resolve much of that.
In Illinois, lawmakers extended the state’s pilot medical cannabis program for four more years. Despite opposing the program, Gov. Bruce Rauner signed the bill and added PTSD and terminal illnesses to the list of qualifying conditions. The state also issued new forms for physicians that permit them to simply certify their patients as having a qualifying condition without directly recommending medical cannabis as a treatment. Patient Identification cards are now good for three years, and patients with terminal illnesses now qualify for free registration. Illinois has struggled to meet program projections due to regulatory barriers, but the changes are expected to increase participation.
In Louisiana, lawmakers accelerated implementation of the state’s medical cannabis program and expanded the list of qualifying conditions to include seizure disorders, HIV, muscular dystrophy, multiple sclerosis and other conditions. Senate Bill 271 was signed by Gov. John Bel Edwards in May. The program established last year has faced delays, and advocates estimate it may take another two years before patients can access medicine.
In Maryland, the first businesses were selected to cultivate and process medical cannabis. Each must still pass background checks and undergo a facility inspection. Access for patients is not expected until next summer, as none of the up to 94 dispensary licenses have been decided yet.
In Michigan, state lawmakers enacted a trio of bills to implement it by legalizing and regulating edibles and dispensaries, which Governor Rick Snyder signed on September 20. House Bill 4209 creates a framework for licensing, taxing and regulating the cultivation, processing, transport and distribution of medical cannabis. House Bill 4210 amends the original voter-approved Michigan Medical Marihuana Act to allow for the manufacture and use of cannabis-infused products by qualified patients. Edibles will be subject to limits on THC content. House Bill 4827 establishes a seed-to-sale tracking database for all medical cannabis.
In Virginia, SB701, a bill that will allow for the production and distribution of limited cannabis extracts, cleared both houses of the state legislature on unanimous votes and was signed by Gov. Terry McAuliffe on March 29. The new law does not go into effect unless it is reenacted by the Virginia legislature in 2017.
Voters OK Initiatives in Arkansas, North Dakota, Florida, Montana
In November, voters in Arkansas, Florida, Montana, and North Dakota all approved state medical cannabis initiatives. The measures in Florida and Montana expanded limited programs devised by their state legislatures, while Arkansas and North Dakota will be starting fresh. That brings the total of states that allow legal access to some type of medical cannabis product to 44, with 29 now qualifying as comprehensive patient programs.
In Arkansas, Issue 6 prevailed with more than 53% voting in favor. The state Department of Health has 120 days from the election to establish rules for creating a registry for patients qualifying under 17 medical conditions and licensing for cultivators and distributors. A bill has been introduced to delay to July 1, 2017 the deadline for licensing distributors and cultivators. Caregivers will be permitted but not personal cultivation.
In North Dakota, Measure 5, known as the North Dakota Compassionate Care Act, passed in a landslide with more than 63% support and a 27 point advantage over those opposed. Patients may qualify under a broad set of a dozen medical conditions and may petition to add to the list. Patients and caregivers may obtain up to three ounces and cultivate if they live more than 40 miles from a dispensary. The law went into effect Dec. 8.
In Florida, Amendment 2 won with an overwhelming 73% voting in favor, well more than the 60% required for a constitutional amendment in the state. The initiative creates a robust medical cannabis program that supplants the far more limited one established by the state legislature in 2014 which only allowed non-smoked forms of low-THC medicines.
In Montana, almost 58% of voters approved I-182, a new medical cannabis initiative, replacing the stripped-down law left by legislative changes to the 2004 ballot measure. A judge ruled the repeal of the three-patient limit on caregivers goes into effect immediately. The new law removes review requirements for physicians who recommend to more than 25 patients a year. Other provisions go into effect June 30, 2017.
ACTION ALERT: Sign the Petition to Stop the DEA Lies
Sign ASA's change.org petition today urging President Obama to immediately order the Drug Enforcement Administration (DEA) to correct its unscientific information about medical cannabis.
ASA has also filed on your behalf a formal legal action under the Information Quality Act (IQA) that could force the DEA to fix false information it distributes. Department of Justice guidelines require a response within 60 days of filing.
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