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ASA Activist Newsletter
In the August 2019 Issue:
- Annual State of the States Report Released at Legislative Summit
- CME Credits on Cannabis with Cannabis Care Certification Program
- Montana Laboratory Achieves Dual National Certification
- Congress Holds More Hearings on Reforming Cannabis Laws
- ASA Sonoma Chapter Sponsoring Symposium
- CLE Credits Part of NCIA Conference
- Activist Profile: Jana Adams, Sonoma, California
- ACTION ALERT: Share the States Report with Your Lawmakers
Annual State of the States Report Released at Legislative Summit
Americans for Safe Access released its annual report evaluating state medical cannabis laws today at the Legislative Summit of the National Conference of State Legislatures (NCSL) in Nashville. Tennessee.
The 2019 State of the States Report: An Analysis of Medical Cannabis Access in the United States grades each state’s laws and regulations on how they affect patient access. The report finds that while medical cannabis access has improved significantly nationwide since California passed the first state law in 1996, state programs are still struggling to serve all patients in need. Between the 2018 and 2019 legislative sessions, there were over 2,000 state bills introduced that dealt with creating or amending existing cannabis programs in a variety of ways.
The nearly 200-page report provides a detailed analysis of the state of medical cannabis programs in 47 states, the District of Columbia, and four territories on a ‘A’ to ‘F’ scale.
Each state was assessed in six categories: 1) Patient rights and civil protections; 2) Access to medicine; 3) Ease of navigation; 4) Functionality; 5) Consumer safety and provider requirements; and 6) Medical cannabis as a tool in combating the opioid epidemic. Special consideration was given for developing policies to help alleviate the opioid crisis.
In addition to evaluating state medical cannabis program according to ASA’s patient-focused grading rubric, the report also includes responses from a survey of over 500 individual patients. This survey revealed that even in states with adequate medical cannabis programs, affordability has been one of the most consistent critiques of patients and remains the single greatest challenge that patients face. While some states have worked to clarify the role of health insurance when it comes to medical cannabis, no state has yet adopted a law that requires insurance companies to cover its costs.
Top marks for their medical cannabis programs went to Illinois and Oregon, which each received an A-. Every state limiting access to only CBD or low-THC products received a failing grade. Delays in implementation meant a failing grade for West Virginia, too, despite passing legislation for a comprehensive medical cannabis program.
“Thousands of lawmakers come to NCSL looking for policy ideas to bring home, so we’re providing a tool for how best to serve their medical cannabis patients,” said David Mangone, Director of Government Affairs for Americans for Safe Access. “We’re releasing our State of the States Report at the Legislative Summit because it suggests specific improvements for each individual state medical cannabis program, such as adopting product safety provisions, as well as model legislation to guide lawmakers nationwide.”
ASA is distributing printed versions of the report among the thousands of state legislators and staff attending the NCSL Summit from August 4-8. ASA staff will be answering questions and speaking to policy makers at booth number 1216.
ASA is also co-hosting two events in Nashville to raise awareness of steps lawmakers can take to better serve their constituents who use medical cannabis. The first reception is Sunday evening, August 4 and is sponsored by WeedMaps. The second is on Wednesday evening, August 7 and is sponsored by Eaze. Both events are open to NCSL attendees and the public. Anyone interested in attending these events can contact [email protected]
ASA Partners with TheAnswerPage.com on Continuing Medical Education Credits
ASA has joined with TheAnswerPage.com to help educate medical professionals on the therapeutic potential of cannabis for a variety of conditions. Last month, ASA and TheAnswerPage.com launched a new initiative to provide professionals with continuing medical education (CME) credits through their Cannabis Care Certification (CCC) website, which has offered education for patients and caregivers since 2016.
The CCC Comprehensive Medical Marijuana Curriculum, created by The Answer Page, starts with the endocannabinoid system and its interaction with the components of the cannabis plant. The curriculum also addresses clinical considerations for cannabinoid-based medicines, including routes of administration, therapeutic use, drug metabolism, physiologic and cognitive effects, potential risks, and drug interactions.
“TheAnswerPage is theresource that I recommend for accredited education on the endocannabinoid system, medical cannabis, opioid prescribing, and pain medicine,” says Raphael Mechoulam, PhD, the pioneering Israeli chemist who discovered THC.
The new CCCcurriculum for medical professionals was approved for CME credit under the latest rules for dealing with controversial subjects. The course provides physicians, pharmacists, nurse practitioners, nurses, and psychologists with peer-reviewed, accredited educational content appropriate for both those new to medical cannabis and those with years of clinical experience.
Continuing education credits are approved through the Accreditation Council for Continuing Medical Education (ACCME), Accreditation Council for Pharmacy Education (ACPE), American Association of Nurse Practitioners (AANP), American Nurses Credentialing Center (ANCC), and the American Psychological Association (APA).
A special $20 discount and other benefits are available to those who enroll through the CCC websiteusing code CCC2019. In addition to CME/CE credit, those benefits include a full year of access to course materials and educational videos for patients and caregivers, membership in the CCC program for medical professionals, optional inclusion on a referral list for patients, and resources on state and federal law.
“More than half of the country--33 states and counting--now has access to medical cannabis. It is essential for medical professionals to obtain education on the endocannabinoid system and medical cannabis in order to provide needed guidance to their patients,” said Debbie Churgai, Interim Director of Americans for Safe Access. “Patients look to their health professionals for medical recommendations. Cannabis should be treated like any other medicine that patients can discuss openly with their health practitioners.”
Montana Laboratory Achieves Dual National Certification
Last month, Stillwater Laboratory in Olney, Montana became the first analytic laboratory in that state to achieve dual certification through both ASA’s Patient Focused Certification (PFC) program and the ISO/IEC 17025 standard of the American Association for Laboratory Accreditation (A2LA).
The dual certification is the result of a collaboration between ASA and A2LA that began in October 2018 to expand PFC accreditation based on the requirements of both ISO/IEC 17025 and the PFC standards.
"Stillwater Labs is honored to have received dual PFC/ISO 17025 accreditation,” said Dr. Ron Brost, Laboratory Director. “ISO 17025-compliant quality processes are the backbone of our lab, but the cannabis-specific standards that come with PFC are a much-needed addition to the emergent medical marijuana testing world. To this end, PFC requirements have been adopted as an essential part of our toolbox for continuous improvement. We look forward to our ongoing relationship with A2LA and ASA in this very important segment of the medical marijuana establishment.”
To achieve PFC certification, laboratories must pass two assessments each cycle. Assessments involve a facility inspection and document review for criteria such as method validation reports, employee training records, and other requirements that are applicable by law.
PFC’s nonprofit, third-party certification is based on guidelines issued by the American Herbal Products Association and the American Herbal Pharmacopoeia’s Cannabis Inflorescence monograph. PFC also has partnerships with ASTM International and the International Cannabis and Cannabinoids Institute (ICCI).
“We’re excited to continue to grow the PFC program through our dual accreditation with A2LA, and we’re thrilled that a lab of Stillwater’s caliber is representing the program” said Heather Despres, the Director of Patient Focused Certification.
Montana’s overall product safety rating was a “B” in ASA’s 2019 State of the States Report. Stillwater Labs is working to improve the state’s rating by implementing the best practices outlined under PFC certification to ensure quality cannabis products are available to patients.
Congress Holds More Hearings on Reforming Cannabis Laws
Bipartisan support in Congress for resolving the conflicts between state cannabis laws and federal prohibition has never been stronger. On July 10, the House Judiciary Subcommittee on Crime, Terrorism and Homeland Security held a hearing called “Marijuana Laws in America: Racial Justice and the Need for Reform.” The status quo had no defenders, with lawmakers and witnesses from both sides of the aisle discussed how to change federal law to harmonize with state medical cannabis and adult-use programs.
Among the proposals are the STATES Act, introduced in the House by Rep. Earl Blumenauer (D, OR) with 25 bipartisan cosponsors, and the MORE Act, introduced in the House by Rep. Jerrold Nadler with 32 bipartisan cosponsors. The STATES Act would shield participants in state cannabis programs from prosecution under the federal Controlled Substances Act. The MORE Act goes further, legalizing cannabis nationally and addressing the disproportionate impact marijuana prohibition has had on communities of color in the U.S. by reinvesting in those communities and expunging some criminal records.
ASA’s Government Affairs Director David Mangone was at the House hearing to add the patient perspective. ASA also submitted its support for a letter signed by a coalition of more than 100 organizations including the ACLU and the NAACP urging Congress to pass the MORE Act.
Hearings last month in the Senate included one in the Banking, Housing and Urban Affairs Committee on financial services for cannabis businesses, and one in the Agriculture Committee on how the federal government is implementing hemp and hemp extract legalization under the 2018 Farm Bill.
H.R.2093: Strengthening the Tenth Amendment Through Entrusting States Act
H.R.3884: Marijuana Opportunity Reinvestment and Expungement Act of 2019
ASA Sonoma Chapter Sponsoring Symposium Aug. 10
Sonoma ASA is partnering with Whole Plant Access for Autism (WPA4A) to host an educational symposium, Medical Cannabis for Neurological Conditions, will be held Saturday, August 10, from 10am-2:30pm at Luther Burbank Center for the Arts in Santa Rosa, California.
Pediatric cannabis specialists Dr. Bonni Goldstein and Dr. Bao Le will be speaking, along with the cofounders of WPA4A and ASA’s PFC Director, Heather Despres. Guest speakers include Joe Rogoway, Vicki Lynn (caregiver/mother), and Martin Lee of Project CBD. Sonoma ASA chapter chair Sara Shrader will be moderating the Q&A panel.
The symposium is a chance to learn more about how cannabis-based medicines can be used to treat various neurological conditions. See the activist profile of Jana Adams below for more info on how and why the symposium was organized.
ASA chapters and affiliates can send event information to [email protected] for mention in the ASA Activist Newsletter.
ASA Education Efforts Include CLE Credits at NCIA Conference
ASA's education efforts last month included participation in a panel offering Continuing Legal Education credits for attorneys at the National Cannabis Industry Association (NCIA) Cannabis Business Summit in San Jose, California.
ASA’s Director of Government Affairs David Mangone contributed to Testing Laboratories: Perspectives from the Marketplace, sponsored by the International Cannabis Bar Association. Also on the panel were Mitzi Vaughn, Chief Legal Officer, AltoTerra Capital Partners, Ltd.; Andrew Subin, an attorney from Vermont Cannabis Solutions; Reggie Gaudino, Ph.D., President, Director of R&D and Director of Intellectual Property for Steep Hill Labs, Inc.; and Dr. Jayashree Mitra, a partner at Zuber Lawler & Del Duca LLP.
Activist Profile: Jana Adams, Sonoma, California
Jana Adams is on a two-pronged mission to educate people about what medical cannabis can do for children with seizure disorders. On the one hand, she’s spent the last few years explaining to California lawmakers why state law needs to accommodate medical cannabis in schools. On the other, she’s sharing with others the knowledge and resources that were so hard for her to come by as she looked for solutions for her daughter Brooke.
Brooke hadn’t even reached her first birthday when the seizures started. In March 2014, she was diagnosed with Dravet Syndrome, a rare, severe seizure disorder. Soon she was on three seizure medications but still having episodes that lasted up to three hours. Attempts to control them at the hospital led toher being given so much medication she couldn’t breathe on her own, coded, and had to be intubated. The local hospital transferred her to Oakland for more advanced care.
“It was the scariest time in my life,” Jana says, “as I watched her seize over and over again, even after getting multiple doses of strong anti-seizure medications.”
After a few days in the pediatric ICU in Oakland, Brooke was able to go home, now with four medications to take twice a day. Jana quit her job to be a fulltime caregiver for Brooke and try to figure out a treatment plan.
A mutual friend introduced her to another parent of a child with Dravet Syndrome, Jason David, who had been exploring cannabis treatments after doctors had said there was nothing more they could do for his son, Jayden. Through trial and error with various types of cannabis extracts, Jason developed a cannabis oil he calls Jayden’s Juice that has proven effective when nothing else worked. At an event for parents Jason put on in Modesto, Jana heard from doctors, specialists, and other parents about the potential cannabis holds for treating neurological conditions. She took her sister-in-law, a nurse, so she could understand and explain the medical side.
“It was just the information I needed to talk to Brooke’s neurologist,” Jana says.
Clinical trials were then underway for Epidiolex, the CBD extract developed by GW Pharmaceuticals, but Brooke didn’t qualify to participate because she was too young at not yet two, and her seizures, though they lasted for hours, came only every five weeks. Brooke’s doctor suggested adding a fifth medication, Stiripentol, but Jana and her husband refused. Both were suspicious of cannabis, but it was time to try it.
In September 2014, Brooke got a recommendation from a local physician, and Jana registered as her caregiver. The CBD variety another parent recommended didn’t work, but Jason David visited Santa Rosa that December, and Jana started Brooke on Jayden’s Juice.
The seizures dropped by half.
They went back to the neurologist to talk about weaning Brooke off the benzodiazepines. As she tapered off, they add some THC to ease the withdrawal symptoms. She reduced her previous medications by half and was able to go off the ketogenic diet that may help control Dravet Syndrome.
Once Brooke turned three, she got an IEP as a special education student, but the school district refused to allow her to attend a public preschool because of her need to have cannabis oil with her as a rescue medicine for when seizures started.
“At first, they just offered to send a teacher for an hour a day, but we fought all summer trying to find a preschool,” Jana says. “We negotiated an agreement for the district to pay for a private preschool, a one-on-one nurse to attend, and special help.”
Last September, a judge ruled against the district’s arguments for excluding Brooke and said they have to allow her to attend, and her nurse can give her the cannabis oil as needed.
The district is obliged to provide transportation to school for students, but they refused to allow Brooke on a school bus, even with her nurse in attendance, because the school is a “drug-free zone.” In November the district agreed to send a bus for Brooke and her nurse after it had dropped off all the other kids at school.
“It worked but just kinda seems silly,” Jana says. “She’s with a one-on-one nurse, so the medicine is pretty secure. It’s a rescue medicine, so she has to have it with her to stop seizures when they start.”
Last year, Brooke was in a special education kindergarten classroom with eight students, but this fall she will transition to an inclusion classroom with general education students.
Jana has been pursuing a change in law to accommodate other children like Brooke, encouraging state lawmakers such as Sens. Jerry Hill and Mike McGuire to advance legislation that would allow medical cannabis in public schools.
“When Senator Hill said he didn’t have enough support for his bill, we decided to take the case public, to help other families,” says Jana. “It’s a child’s right to go to school.”
Brooke has three older siblings, ages 13, 15 and 18. The demands of Brooke’s care have meant the family has changed vacations and other routines, often at the expense of the other children, but they understand her needs, and the turn to cannabis. The oldest came home from college to join Jana at the ASA/California NORML lobby day in Sacramento on May 1.
“Going away and coming back helped him see how much it’s changed her quality of life,” Jana says. “He sent me a note saying ‘thanks for doing so much for Brooke.’”
Even Brooke’s 13-year-old sister understands what’s at stake. She’s also in a caregiver role, administering cannabis oil when needed. She even filmed the seizure that was shown during a Today Show segment about Brooke,and intervened with a history teacher who made disparaging comments about cannabis.
“Medical cannabis has been life changing for us,” Jana says. “We couldn’t go camping for fear of being helicoptered out. Now the seizures will stop within minutes, so we can contain it.”
Since Brooke’s case became public, Jana has connected with parents across the country about treatment and lobbying to get bills passed in New Mexico, Colorado and New Hampshire. To help educate folks closer to home in Santa Rosa, Jana helped organize the August 10 symposium with Dr. Bonni Goldstein, Brooke’s physician from Los Angeles, and other experts. Attendees at the symposium will also have a chance to learn how to lobby from other parents who have worked to get bills passed in the other states.
“We were on Dr. Goldstein’s waiting list for two years, but it was worth it to have the benefit of her experience,” Jana says. “I wanted to have this event with a knowledgeable doctor so other parents could see if cannabis might be something to try with their child. This event is to give back what others have given to us.”
ACTION ALERT: Send ASA’s States Report to Your Lawmakers
Your state lawmakers need to know how to better meet the needs of medical cannabis patients. Use the link below to send them ASA State of the States Report so they have the tools to improve safe access in your state. It’s quick and easy, so take action today!