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In the July 2017 Issue:
- Mexico President Approves Safe Access
- Greece Announces Medical Access
- Attorney General Asks Congress to End Patient Protections
- New Revision to Cannabis Law for California
- ASA Urges Administration to Fight Opiate Crisis with Cannabis
- PFC Launches Training with Univ. of Maryland
- PFC Webinars Offer Online Help for Businesses
- ASA Activist Profile: Frank Buress, Wisconsin
- National Action Alert: Urge Congress to Renew Patient Protections
Mexico President Approves Safe Access
On June 19, President of Mexico Enrique Peña Nieto enacted a bill making medical use of cannabis legal in the country. The bill passed 374-7 in Mexico’s lower house at the end of April. It passed the country’s senate in December on a vote of 98-7.
Mexico’s Secretary of Health, Dr. José Narro Robles, stated on Twitter “I welcome the adoption of the therapeutic use of cannabis in Mexico.”
The bill authorizes the Health Ministry to create regulations for producing low-THC cannabis products for patient use. The new law allows only one percent THC or lower. Cannabis cultivation for medical and scientific purposes will be legal. A regulatory framework for patient eligibility and use, as well as cannabis cultivation and distribution is expected within a few weeks.
In the past year, courts in Mexico have granted to a handful of individual patients the legal right to cultivate and use cannabis. This is the first change to law or policy on medical cannabis.
Greece Announces Medical Access
In a press conference at the end of June, the Prime Minister of Greece, Alexis Tsipras, announced that his will become the sixth European country to allow medical use of cannabis.
Greece will down-schedule cannabis to allow doctors to prescribe it for a variety of medical conditions.
“From now on, the country is turning its page, as Greece is now included in countries where the delivery of medical cannabis to patients in need is legal.” Mr Tsipras was reported as saying at the press conference.
No plans to allow cultivation or distribution have been announced, but import of cannabis products from the Netherlands or elsewhere could begin soon. Other countries in Europe that recognize medical use are the Czech Republic, Finland, the Netherlands, Portugal and Spain.
Attorney General Asks Congress to End Patient Protections
Despite unequivocal statements of support for medical cannabis by Donald Trump as a candidate, his administration is attempting to end the limited protections Congress created in 2014.
Attorney General Jeff Sessions sent a letter to congressional leaders in May, urging them to scrap the Rohrabacher-Farr amendment which prohibits the Department of Justice from interfering with state medical cannabis programs. The letter was made public by Tom Angell of Massroots.com and confirmed by other journalists.
Sessions said that: “I believe it would be unwise for Congress to restrict the discretion of the Department to fund particular prosecutions, particularly in the midst of an historic drug epidemic and potentially long-term uptick in violent crime.” This concern runs counter to all evidence, as public health research has shown that opiate overdoses decrease substantially in states that enact medical cannabis laws, and no nexus between distributing medical cannabis and crime has been identified. In fact, a study by the Los Angeles police chief found that dispensaries attract less crime than banks.
Sessions also claimed that “[t]he Department must be in a position to use all laws available to combat the transnational drug organizations and dangerous drug traffickers who threaten American lives.” Yet state medical cannabis laws are all designed to prevent any involvement by organized crime.
A spokesman for the amendment’s lead sponsor, Rep. Dana Rohrabacher (R-CA), said “Mr. Sessions stands athwart an overwhelming majority of Americans and even, sadly, against veterans and other suffering Americans who we now know conclusively are helped dramatically by medical marijuana.”
The Rohrabacher-Farr amendment has passed by larger bipartisan margins each year. More than 9 out of 10 Americans believe medical cannabis should be legal, with an April Quinnipiac poll pegging support at 94 percent. Almost 3 out of 4 voters also said they disapprove of federal enforcement in states that have made cannabis legal.
New Revision to Cannabis Law for California
California’s effort to craft regulations for both medical and adult-use cannabis was transformed at the behest of the governor. An omnibus “trailer bill” attached by Gov. Jerry Brown to the state’s budget, unifies cannabis licensing and regulation as one bill – the Medicinal and Adult-Use Cannabis Regulation and Safety Act (MAUCRSA), was passed by the legislature and signed into law late last month. The changes it includes reflect feedback from patient advocates such as ASA and cannabis industry lobbyists.
The new law creates a more uniform approach that benefits patients, as the separate medical and adult-use laws had created discrepancies between the two. The new, parallel structure eliminates inconsistencies which had left the medical side more restricted than adult-use. The same license types will now be available for both.
Business licensing is generally less segmented, with individuals and organizations no longer limited on the number of services they can provide. That will allow vertical integration from seed to sale. The state residency restriction on licensees has also been eliminated, as has the license for transporters.
Perhaps most importantly for patients, the new law enshrines consumer protections by mandating that manufacturers and vendors test cannabis products and report the results. It also preserves the sales tax exemption for patients with the voluntary state medical cannabis ID card. The bill creates a new type of collective for small cultivators to allow for sharing of resources, replacing the old SB-420 coop and collective model.
“While it doesn’t answer all the questions, particularly the tax burden for patients, the governor’s bill is a big step in the right direction,” said ASA California Director Don Duncan. “Tax reform needs to be addressed, along with licensing barriers -- an over-regulated approach will stifle innovation and keep cost high.”
Under the new law, cannabis businesses will still have to obtain both a local license and a state license. The 15% state excise tax will still apply to both medical and adult-use, as will the cultivation tax of $9.25 an ounce.
The scope of the changes to the law mean that most of the draft regulations put out by the various responsible state agencies have to be withdrawn, revised and reissued for another public comment period. With a statutory deadline of January 2, 2018, time is short.
ASA Urges Administration to Fight Opiate Crisis with Cannabis
Last month Americans for Safe Access submitted comments to the Trump Administration on the role medical cannabis can play in combatting the opiate overdose crisis. The comments were submitted as New Jersey Governor Chris Christie convened the first meeting of the President’s commission on Drug Addiction and Combating Opioid abuse.
The Commission is tasked with evaluating existing federal programs to prevent and treat drug addiction. That includes assessing the availability of drug addiction treatment services and overdose reversal, identifying best practices for addiction prevention including health care provider education, and evaluating the effectiveness of education efforts.
ASA’s comments describe how medical cannabis can help reduce opioid use, the health benefits of cannabis compared to opioids, and the Medicaid savings medical cannabis states have seen. Researchers have found that states that have medical cannabis programs have fewer opioids prescribed and fewer opioid-related deaths.
The Commission has invited testimony from groups such as the Partnership for Drug-Free Kids, the National Council on Alcoholism and Drug Addiction, National Council for Behavioral Health, Shatterproof, Addiction Policy Forum, American Society of Addiction Medicine, Community Anti-Drug Coalitions of America, Young People in Recovery, and the American Academy of Addiction psychiatry.
“Cannabis is a proven tool for alleviating chronic pain without the dangerous side effects of prescription opiates,” said ASA Executive Director Steph Sherer. “States with medical cannabis programs have seen a nearly 25 percent decrease in the opioid overdose deaths. Passing the bipartisan CARERS Act will protect that progress and enable more states to take action to prevent opiate overdoses.”
Gov. Christie is joined on the Commission by Gov. Charlie Baker (MA), Gov. Roy Cooper (NC), Rep. Patrick Kennedy and Professor Bertha Madras, Ph.D.
PFC Launches Training Partnership with Univ. of Maryland
On June 22, ASA’s Patient Focused Certification (PFC) Training Program unveiled its new training platform, developed with the University of Maryland School of Pharmacy. The partnership between PFC and the university’s Center for Innovative Pharmacy Solutions (CIPS) will be the first cannabis training program to be offered through a university and accredited. The partnership will extend the reach of the PFC training program by making courses available through the University of Maryland’s online learning platform at www.pfctraining.org.
PFC is a project of ASA that builds on the organization’s experience educating the medical cannabis industry since 2002. The certified training courses cover best practices and regulatory guidelines for the burgeoning medical cannabis industry, including cultivators, manufacturers, dispensaries and labs. Regulators, operators and industry workers enrolled in the program will learn how to comply with state regulations and industry best practices, ensuring improved safety for patients and providers.
“The University of Maryland School of Pharmacy is responding to the urgent need for a knowledgeable and well-prepared medical cannabis workforce,” said Magaly Rodriguez de Bittner, PharmD, who is the executive director of CIPS as well as associate dean for clinical services and practice transformation, and a professor of pharmacy practice and science at the University of Maryland School of Pharmacy. “The School of Pharmacy’s partnership with ASA uses our online educational technology to meet the training needs of medical cannabis industry employees and advocates in 30 states, the District of Columbia, Guam and Puerto Rico. Through this partnership, we seek to promote medication safety through training and ultimately educate healthcare providers on the consideration of medical cannabis in treatment decisions.”
Each of the US states and territories with a robust medical cannabis program either has or is implementing training requirements for personnel who work in the cannabis industry. The PFC training program was designed to meet that need in those 30 states, as well as the District of Columbia, Puerto Rico and Guam. PFC trains industry personnel based on standards issued by the American Herbal Products Association (AHPA) and the American Herbal Pharmacopoeia (AHP) that ensure safety, quality and professionalism. Training materials are specific to each segment of the medical cannabis industry, from cultivation and manufacturing to distribution and laboratory analysis. With a goal of national standards for policies, operating procedures and products, PFC will continuously update its training programs to incorporate emerging research and accommodate growth and change in both the industry and regulatory environments.
“When considering a training program, one of the first things you should ask is who is accountable for the outcome?” said Dr. Jahan Marcu, ASA Chief Scientist and PFC Director. “PFC’s partnership with a university and accreditation body is unprecedented in the cannabis industry.”
Accreditation for the new PFC training is expected by August 15. Founded in 1841, the University of Maryland School of Pharmacy has a 175-year history of pharmacy education, scientific discovery, patient care, and community engagement. ASA brings 15 years of hands-on expertise in helping develop and implement state medical cannabis laws and regulations. ___________________________________
PFC Webinars Offer Online Help for Businesses
ASA’s Patient Focused Certification (PFC) program is now offering pre-licensing advising services for cannabis businesses. In addition to in-person training and regulatory inspection
preparedness training, PFC is also now offering online webinars. The latest webinar for cannabis businesses, posted last month, covers what to expect when being inspected.
This sort of pre-licensing information is usually included in a PFC contract but is also available in more limited form without in-person training. PFC also provides help with SOPs.
What sets PFC apart is not just the years of nonprofit experience helping develop and implement state law or auditing standards based on the guidance of the American Herbal Products Association and the American Herbal Pharmacopeia. PFC is the only such service where all funds go back to supporting patient access advocacy and medical cannabis laws.
The international work PFC has undertaken also continued this past month. PFC presented at the
ICRS meeting June 25-26 in coordination with ICCI on cultivation centers developed internationally. PFC Director and Chief Auditor Jahan Marcu also presented in New York City at the CWCBE held at the Javitz Center. On July 9, Dr. Marcu will be speaking at the Southeast Michigan Business Conference.
For more information on the PFC program, see www.patientfocusedcertification.org. For the new trainings through the University of Maryland, see www.pfctraining.org. The PFC weminars can be found on the PFC youtube channel.
ASA Activist Profile: Frank Buress, Wisconsin
You have 72 hours to start anti-virus medicine after the shingles rash appears. Miss that window, and your odds of developing painful post-herpetic neuralgia skyrocket. That’s what happened to Frank Buress, whose case of shingles was so severe, covering every bit of his body but the palms of his hands, soles of his feet, face and his genitals, that his doctor misdiagnosed it as hives. When they figured out the diagnosis, it was too late, and the excruciating nerve condition set in and has plagued him for more than 15 years since.
His doctor in Wisconsin was sympathetic, prescribing a raft of opiate painkillers to deal with the condition, including Percocet, Fentanyl, oxyContin, and oxycodone, until Frank was up to 540 morphine equivalents a day – enough to kill a horse.
In 2014, Frank went to the pain rehab program at the Mayo Clinic to learn new ways to cope with pain. The meditation, guided imagery, biofeedback and relaxation techniques all helped distract him from the constant pain but did not really reduce it.
Then last June, he was diagnosed with cancer of the colon and the kidney, a growth on his lung, and six basal cell carcinomas on his chest. Doctors recommended removal of his sigmoid colon, to be followed by ablation on his kidney because it could not be treated with chemo or radiation due to stage 4 renal disease.
That’s when Frank moved to Portland, Oregon for 90 days to try medical cannabis. Once he had an Oregon card, he went on the Rick Simpson Oil (RSO) protocol, starting with 5mg of 3% THC three-times a day, doubling every four days and increasing in potency, until he was using 70% THC at 1000mg a day. The effects were dramatic. Three days after starting the RSO, he was pain free.
“The amazing piece was that after day three, the pain was gone,” said Frank. “I’d been over 10 years with pain. It wasn’t distracted by the cannabis. The pain was just plain gone.”
With that, Frank began to study up on opiates, learning the history of how Purdue Pharmaceuticals had pushed oxyContin as a panacea for pain, and the consequences. Out of that, Frank created a powerpoint presentation on alternatives to opioids that covers what he learned at Mayo plus the medical cannabis option. He’s shown it to the local Criminal Justice Coordinating Council, and is scheduled to make presentations to the Governor’s State Council on Alcohol and Other Drug Abuse Prevention Committee and Intervention and Treatment Committee.
Frank is hoping to see Wisconsin join the 30 states and District of Columbia in creating a robust medical cannabis program that will give him access to the only medicine that gives him relief.
National Action Alert: Urge Congress to Renew Patient Protections
Your Members of Congress need to hear from you today. The ONLY thing protecting state medical cannabis programs from Attorney General Session’s Department of Justice is an amendment to the Commerce, Justice, Science and Related Agencies budget. Since 2014, the Rohrabacher-Farr Amendment has barred the DOJ from spending any money interfering with state medical cannabis programs, including prosecuting patients and providers. But it has to be renewed each year, and the Attorney General has urged Congress not to. That’s why Congress needs to hear from you.
Contact your members of Congress TODAY and ask them to ensure that protections for state medical cannabis programs are in the budget for fiscal year 2018. Go to www.safeaccessnow.org/cjsamendment/.