Pages tagged "Rescheduling"

  • Marijuana Prohibition Turns 75, Feds Continue Attacks on Medical Marijuana



     

     

     

     

     

     

     

     

     

     

    Today is the 75th anniversary of marijuana prohibition in the U.S. and, as a society, we’re no better off for it. In fact, many would argue that we’re far worse off with prohibition than if at any point we had developed a sensible public health policy with regard to marijuana use.

    The effects of marijuana prohibition have been unmistakable from a law enforcement standpoint -- the U.S. imprisons more people for marijuana than any other country. However, the effects on society of criminalizing marijuana for therapeutic use are also significant and undeniable.

    Before the Marihuana Tax Act (MTA) was passed in 1937, medical marijuana (also known as cannabis) was commonly sold by pharmaceutical companies like Eli Lilly. However, Harry Anslinger, the country’s first drug czar, made sure that no exception was made for such therapeutic uses.

    Today, the federal government maintains a similar policy on marijuana. Ever since President Nixon ushered in the Controlled Substances Act of 1970, subsequent administrations have upheld the unscientific conclusion that marijuana is a dangerous drug with no medical value.

    The federal government employs this outdated policy on marijuana not only to obstruct meaningful research into cannabis, but also to target patients and providers of medical marijuana with aggressive SWAT-style raids and costly criminal prosecutions.

    Despite President Obama’s purported relaxation of marijuana enforcement, his administration has conducted an unprecedented attack on medical marijuana with more than 200 Drug Enforcement Administration (DEA) raids and over 70 new federal indictments.

    Tragically, a month ago, Richard Flor, 68, a medical marijuana provider in Montana died while in federal custody after being convicted and sentenced to 5 years. Flor was raided by the DEA in 2011, and like so many others, was denied a medical marijuana defense or the ability to provide evidence of state law compliance.

    This past Wednesday, federal agents worked with local and state police to raid more than 40 locations in Sonoma and Butte Counties. Approximately 300 law enforcement officials were used to aggressively target medical marijuana patients and providers. From the 10 homes raided in Butte County, officials allegedly came up with less than 100 plants per parcel, an acceptable amount even for personal use in some areas of the state. And the 1,150 plants allegedly seized from 33 locations raided in Sonoma County, amounted to less than 35 plants per parcel.

    In Sonoma County, law enforcement targeted a poor Latino neighborhood, reminiscent of the Drug War’s racist roots. Families, including women with babies in their arms, were made to wait outside while their homes were ransacked by police. An alphabet soup of federal agents --including FBI, DEA, DHS and ICE -- were dressed in military garb, armed with automatic weapons, and came with an armored vehicle. To call the raids overkill would be an understatement. The involvement of ICE also underscores the cynical tactic of targeting Latinos in the U.S. Drug War.

    So, this is where we find ourselves after 75 years of prohibition. The U.S. continues to imprison people for marijuana crimes at unprecedented rates, while simultaneously denying the scientific evidence of marijuana’s medical efficacy.

    Seventy-five years is a long time, but this indefensible position cannot be maintained forever. Later this month, on October 16th, Americans for Safe Access will use scientific evidence to argue before the federal D.C. Circuit that the federal government has acted arbitrarily and capriciously in its classification of marijuana. The government may yet be forced to prioritize science over politics. Only then can we begin to develop a public health policy that will replace this country’s antiquated Drug War.
  • A Plaintiff Speaks: Why I'm Suing for Safe Access

    I am a disabled United States Air Force veteran who is one of the plaintiffs suing over the placement of marijuana in the Controlled Substances Act, in the ASA v DEA case which will be heard by the United States Court of Appeal for the DC Circuit on October 16th. In order to understand why I would be willing to put my name on the line in this lawsuit over the schedule number of cannabis it is first important to review a little bit of history.

    Most people know that marihuana (spelled just that way) was the subject of a national law called the Marihuana Tax Act but less known is the fact that this law was based upon the Machine Gun Tax Act. It was legal trickery at best, as the whole point of the new law was to prohibit the sale and possession without the bother of a Constitutional Amendment as was done with alcohol prohibition.

    I think the chief drug bureaucrat at the time, Harry Anslinger, knew full well that the Marijuana Tax Act was on shaky Constitutional ground as he made it his life's work to sure up the law. In the 1960¹s he succeeded with the Single Convention treaty and thereby sought a back door Constitutional authority for his prohibition because it is written in our Constitution that treaties, once ratified, become “the supreme law of the land.”

    The United States Supreme Court wasn¹t impressed with Mr. Anslinger¹s efforts. however, and in 1969 they sided with Dr. Timothy Leary and ruled the Marihuana Tax Act unconstitutional. This opened the door for Congress to create a new federal law on marihuana using the Interstate Commerce Clause to define their jurisdiction and the new treaty system as part of its basic constitutional authority.

    The new federal law, the Controlled Substances Act, is a basically good law that allows for fairly seamless control of and access to thousands of medicinal substances, but unfortunately the arbitrary inclusion of marihuana in the most restrictive category - Schedule I - makes this good law as bad at the Marihuana Tax Act in practice.

    Every day the federal government maintains marihuana's Schedule I status, the more damage it causes to our system of government. It is no surprise that this Schedule I placement of marihuana is now causing a serious rift between many states and the federal government that to an outside observer appears to be an extraordinary conflict, even a constitutional crisis.

    The definition of cannabis as Schedule I has caused my fellow patients to be imprisoned, denied work, housing, right to own a firearm, a place on a transplant list, and of greatest concern to me, is the latest casualty of the drug war, my VA doctor. My Veterans Affairs Medical Center doctor is now prohibited from recommending cannabis to me and instead the VA has explicitly relegated their sovereign power to the state to handle all aspects of a veteran¹s medical treatment with cannabis. Since the recommendation of cannabis has been shown by court cases in the 9th Circuit to be a free speech activity crucial to the doctor patient relationship it is now apparent that the VA can not effectively operate while this conflict between state and federal law exists.

    That is why I am very proud to put my name on this effort to right a wrong and acknowledge that cannabis does in fact have accepted medical use in the United States.

    Michael Krawitz is a plaintiff in the case ASA v DEA.
  • Cannabis, the Gateway Herb: A Doctor Responds

    David Sack in his recent HuffPo post entitled "Marijuana: The New Snake Oil" challenges the status of medical marijuana, an increasingly popular alternative treatment, as "good medicine." This question is particularly relevant because the Washington DC federal Court of Appeals will soon hear a lawsuit disputing the status of marijuana in Schedule I of the Controlled Substances Act, brought by Americans for Safe Access, a national member-based organizaton advocating for medical cannabis access and research. I am a doctor and a board member of the ASA Foundation, and I'm proud to present a medical professionals' perspectives to the cause.

    Dr. Sack’s anti-marijuana platform is built on the foundation of addiction psychiatry, practiced through the lens of pharmaceutical medicine, resting primarily on a characterization of the FDA approval process as a gold standard of medical evaluation. This same contention, that without FDA approval marijuana cannot have medical value, has been repeated as medical cannabis laws are decided by voters. However, the FDA process is not an infallible one, and it is important to point out about half of FDA approved drugs have been subject to recall or black box warnings. There is no need to belabor this point, but just bear in mind: Accutane, Serzone, Clozapine Pradaxa, Reglan, Yasmin, Chantix, Celebrex and Rosiglitozone, to name a few. The FDA process is not perfect, and the "gold standard" randomized controlled clinical trial is not a one-size-fits-all process: it was particularly designed for single molecule synthetic compounds. As a clinical study tool, it has its limitations, especially where integrative medicine and herbal supplements are concerned.

    As Dr. Sack and other cannabis opponents point out, it is truly unfortunate that there is a dearth of clinical trials assessing the efficacy of a variety of cannabis products for a wide array of diagnoses. We can thank our Federal government for this, because research is strictly limited. However, what little research has been conducted demonstrates an utter lack of detrimental health impacts, including no mechanism for an “overdose” bodily response, which can be triggered by virtually all other drugs. In the last decade or so, the American Medical Association, the National Nurses Association, the National College of Physicians, and even the federally-run National Health Institute have all recommended that cannabis be removed from Schedule I and become available as part of treatment regimes.

    Despite Dr. Sack’s firmly-worded assertions, we have much to learn about what predisposes individuals to addictive behavior. In the mean time, there is a massive uncontrolled clinical trial being conducted by millions of Americans who are using Cannabis to treat quite a wide range of symptoms and diagnoses. With an explosiong of marijuana use both recreational and medical since the Controlled Substances Act was passed in 1969, mental illness and other supposed ills of marijuana use have not materialized in the general population.

    Regardless of what status cannabis has with the FDA, it behooves us as physicians to be interested in and informed about what our patients are using as medicine. As for meeting FDA criteria, a recent study proposed by the Multidisciplinary Association for Psychedelic Studies on smoked and/or vaporized marijuana for symptoms of PTSD in veterans of war, was approved by the FDA in April of 2001, but hindered by the National Institute on Drugs of Abuse. The National Cancer Institute has published a comprehensive Physician Data Query (PDQ) and The Institute of Medicine both have publications where the science base of Cannabis has been assessed. And unlike drugs that go through the FDA approval process, cannabis had been part of the American pharmacopoeia long before the Pure Food and Drug Act was passed. Federal hindering of new scientific studies of marijuana does not erase millenia of human cultural experience with the medical value of this plant.

    Though some physicians are uncomfortable with this fact, we are in an era of a revival of natural approaches to health. The National Center for Complementary and Alternative Medicine in 2008 estimated that 40% of adults in the US are using some form of complementary alternative care, spending 33.9 billion out-of-pocket dollars. Many of the tools and herbs they access have been practiced and used literally for centuries (ten centuries for cannabis), and what Dr. Sacks characterizes as "anecdotal" evidence is the safety data.

    There are some in the medical community who question the reliability of the current FDA approval system (especially where complex plant mixtures are concerned), work with their patients toward optimal whole health, and are not threatened by new paradigms of healthcare. The ultimate yardstick under federal law is whether or not a substance has "accepted medical use in the United States." ASA will be challenging the DEA's assertion that marijuana has not medical value in court on October 16th, and we've created a sign-on letter for prescribing medical professionals to express their agreement. Cannabis seems to be opening the door to what some may consider a "Pandora's Box", and other simply see as Robert Frost saw, the gate to a road "less traveled by".

    Michelle Sexton, N.D., is an Assistant Research Scientist at Bastyr University Research Institute, and a member of the ASA Foundation Board.
  • Medical Cannabis News in Review

    Is Paul Ryan's statement similar to Obama's position on medical marijuana? Is there evidence that marijuana has accepted medical uses? Are there really more dispensaries than Starbucks in LA? Recent news about medical marijuana:

    • Paul Ryan’s position on medical pot: “up to Coloradans,” and “not a high priority” for a Romney/Ryan Administration. Associated Press in the San Jose Mercury News

    • What if Obama called a real marijuana user instead of actors? Huffington Post

    • From dispensary operator to illicit dealer. Is medical marijuana being driven underground? LA Times

    • Study shows marijuana use among teens in Colorado, a medical cannabis states, dropped even as it increased nationwide. Huffington Post

    • Far fewer dispensaries in Los Angeles than ban proponents claimed, UCLA study finds. UCLA Newsroom

    • Author Martin Lee presents slideshow of seminal moments in the post-ban history of cannabis - Huff Post Books

    • Summary of research in the Daily Beast finds strong evidence of cancer-fighting effects of cannabis. Daily Beast

    • Prescribing medical professionals launch sign-on letter disputing Federal position that cannabis has no medical value, in advance of the October 16th hearing. ASA

    • Southern California’s only Sheriff-permitted dispensary closed by US Attorney Laura Duffy. San Diego ASA

    • Senior learns to bust the myths around medical cannabis. HuffPost Post 50

  • Medical Prescribers Launch National Letter for Medical Cannabis

    After this blog was posted, prescribing medical professionals have signed a letter acknowledging that cannabis has medical use and should be rescheduled.

    Most would agree with the premise that medical decisions regarding the appropriateness of a treatments are best left to doctors and other medicine prescribers in conjunction with patients. When it comes to herbal marijuana or cannabis, Congress and federal regulatory authorities have taken it upon themselves to judge across the board whether this substance has a currently accepted medical use in treatment in the United States, taking little or no input from clinicians who are responsible for actually providing treatments in this country.

    Responding to the fact that nothing has been done to organize individual medical professionals to clearly state with one voice to the federal regulatory authorities that there are indeed currently accepted medical uses for cannabis (aka herbal marijuana) in the United States today, the medical prescribers on the board of ASA have started a sign-on letter to give the opportunity for their colleagues to stand and be counted. On Friday August 31st, in collaboration with fellow ASA board and staff, an open national-sign on letter was launched. This sign-on letter is in advance of the federal DC Circuit Court of Appeals hearing on October 16 when judges will consider questions regarding the appropriate classification of marijuana or cannabis in the drug scheduling framework.

    Invited signatories to the letter are licensed physicians, physician assistants, and advanced registered nurse practioners - professions with prescribing privileges - who recognize that safe, currently accepted medical uses in treatment for marijuana presently exist in the United States. The letter cites national medical professional consensus statements which signal that the current Schedule I status of cannabis is suspect.

    Maintaining the Schedule I status for marijuana in federal law requires drug regulatory authorities to assert and maintain that no accepted medical use in treatment in the US currently exists for marijuana. To do so in the face of the accumulated evidence requires strained and ill-conceived arguments. In their July 2011 decision rejecting ASA’s petition to reschedule marijuana (the appeal of which is the subject of the upcoming hearing), the DEA included the required scientific assessment from the US Department of Health and Human Services (HHS) which had been prepared 5 years prior. Writing on December 6, 2006, HHS found that there were no "NDA-quality [new drug application] studies that have assessed…efficacy and…safety…of marijuana for any medical condition." They went on to say that "at this time, it is clear that there is not a consensus of medical opinion concerning medical applications of marijuana," that "a material conflict of opinion among experts precludes a finding that marijuana has been accepted by qualified experts", and finally that there is no opportunity for "adequate scientific scrutiny" of the existing scientific evidence as the data were "only in summarized form, such as a paper published in the medical literature, rather than in a raw data format."

    It is without merit to assume that the only way that a drug or substance can be judged to have accepted medical use is through the completion of "NDA-quality studies," which is another way of saying "Phase III" randomized controlled trials. There are many medically accepted uses of drugs for indications that have not undergone Phase III level testing. For example, take the use of platelet-rich plasma (PrP) injections for the treatment of Achillies tendonitis or tennis elbow. While it is being prescribed by a great number of physicians and being reimbursed by insurance companies, there are no completed Phase III "NDA-quality" studies that have been done to evaluate this medical application. However, it would be wrong to say that that PrP has no currently accepted medical use in treatment in the United States – just ask the American Academy of Physical Medicine and Rehabilitation or other medical specialty societies who hold, sponsor, or advertise training workshops on PrP. Clearly, medical acceptance for treatments depends on presently accepted clinical practices by the medical community. Given that the two largest physicians groups in the United States, the AMA and the ACP, have both come on record saying that the Schedule I status of marijuana needs to be reviewed and that, according to the ACP, such a review would likely lead to reclassification of the drug, it is not accurate to say that there is not a consensus medical expert opinion about the medical utility of marijuana. While it is true that these positions of medical associations were formally taken after the 2006 position prepared by the HHS, they were available at the time the DEA issued its ruling.

    In fact, many more patients have been involved in randomized-controlled clinical studies involving cannabis and cannabis-based medicinal extracts than many other drugs. While only a few of these studies rise to the level of Phase III, that does not mean that a strong evidence base is lacking (nearly all controlled clinical trials of cannabis done in the United States have been positive). One pharmaceutical company in England, GW Pharmaceuticals, has conducted large Phase III studies with a cannabis-based medicinal extract produced directly from liquid CO2 extraction of herbal cannabis. While the company would like to contend that studies related to this extract don’t apply to marijuana, as they indicated in a letter from their lawyer to HHS, it is hard to see how they do not apply to marijuana given that the long-standing enforced definition of "marihuana" in federal law since 1937 has been "all parts of the plant Cannabis sativa L., whether growing or not; the seeds thereof; the resin extracted from any part of such plant; and every compound, manufacture, salt, derivative, mixture, or preparation of such plant, its seeds, or resins." Certainly the DEA has recently created a separate classification for cannabis extracts in their Scheduling schema, but it is clear that this is little more than pharmacolegal jujitsu to somehow create a privileged parsing of "marijuana extracts" from "marijuana" for the benefit of drug pipelines.

    HHS’s claim that "raw data" is needed and that published papers in the medical literature will not do is bizarre and unusual. Medical education, research, and evidence-based consensus-statement writing relies on the same pool of data with findings commonly presented in journal articles. Not having it all together in "one big paper" is really no reason to deny judgment about accepted medical use of marijuana.

    The prescribers signing on to the letter are able to judge based on their expertise developed out of clinical experience, study, and collegial discussions, that marijuana or cannabis has an accepted medical use in treatment in the United States. With likely over 10,000 physicians authorizing patients to used cannabis in medical marijuana programs, which have been around for 16 years, and with the string of positive outcome clinical trials of cannabis and cannabis extracts, there is more than enough medical experience and evidence available to recognize that a currently accepted medical use in treatment in the United States exists for marijuana. If strong scientific evidence and clinical professional opinions count for anything in policy, then it is time to re-schedule/de-schedule marijuana.

    Sunil Aggarwal, M.D., Ph.D., is an Americans for Safe Access Foundation Board Member
  • Cannabis News Around the Nation

    Two weeks of medical cannabis news in review.
    • Congresswoman Introduces Bill to Protect Landlords of Compliant Medical Marijuana Businesses - ASA PR
    • Michigan court rules localities cannot use federal law as an excuse for violating state laws protecting medical cannabis patients - The Detroit News
    • Case on Benefits of Marijuana Heads to Court - Huffington Post
    • LA Councilman Bill Rosendahl comes out at as a medical cannabis patient - LA Times
    • Detailed Rules for Medical Marijuana Proposed in Maine - Kennebec Journal
    • Pharmacy Shutdown Hoax Revealed - San Diego ASA
    • Medical Marijuana Advocates Mourn Pot Club Closures with Mock Funeral - SF Weekly
    • Arizona prosecutors urge Governor Jan Brewer to end the medical marijuana program, citing threats from federal prosecutors. The Governor declined to intervene - Arizona Republic
    Jonathan Bair is ASA's Social Media Director.
  • Wake Up Obama: Cannabis Patients Vote!

    This is a photo of me at the 2008 Democratic National Convention. I had just heard one of the most politically motivating speeches of my life from a candidate for president. I was moved to tears, joyous, and inspired. This candidate not only filled me with hope about the future of our nation, but said he would not interfere with access to legal medical cannabis.

    I was ecstatic to be shedding the dark days of the Bush Administration's war on medical cannabis patients. As a patient myself, I felt counted and part of the Change that would be coming to Washington, and I was proud to support and volunteer for Barack Obama's victorious campaign.

    For his 2008 campaign, I donated money, I went to rallies to show support, I knocked on doors in VA,  and on election night I joined thousands in D.C. who descended on the White House to celebrate and sing "Na, Na, Na, Na, Good bye" to President Bush. I went to sleep that night excited about a new direction for this country that would include me as a recognized medical cannabis patient.

    From the beginning, the new administration made supportive statements about medical cannabis, including that the President was "not going to be using Justice Department resources to try to circumvent state laws." On October 19, 2009, we got the policy document we had been waiting for. Then-Deputy Attorney General David Ogden issued a memorandum, now know as the "Ogden Memo," instructing U.S. attorneys to limit marijuana enforcement to those operating out of compliance with state law.

    With this legal guidance, the medical cannabis movement went to work to pass new state laws protecting patients and those who provided their medication. Advocates, community members, and officials spent thousands of hours drafting legislation and regulations in at least eleven states. But when legislators and other state and local officials came close to passing or implementing these laws, they received letters from U.S. attorneys, threatening federal arrest and prosecution.

    Dismayed by this apparent reversal in the Obama Administration's policy, patients demanded the President rein in the US Attorneys. Instead we got the "Cole Memo," issued by Deputy Attorney General James Cole, laying out a new interpretation of the Obama Administration's policy. The memo gave the Justice Department free rein in medical cannabis states, to undermine state laws and coerce local lawmakers. The Cole Memo launched an unprecedented attack on the medical cannabis community unprecedented in its scope.

    In fewer then fours years of President Obama, we have seen more raids on dispensaries than during the Bush Administration's entire eight-year tenure. The Obama Administration has taken property from landlords, threatened local officials, forced the release of patient records, used the Internal Revenue Service to bankrupt legitimate dispensaries, told banks to purge medical cannabis clients, evicted patients from low-income housing, and denied a petition to recognize the well-established medical value of cannabis.

    Now as President Obama approaches the vote on his reelection, I and other medical cannabis patients are finding it impossible to renew our support. How can I vote for someone who has broken his promise? How can I vote for someone who can't see very real public health needs? How can I vote for someone who wages war on my fellow patients and me?

    There are more than one million legal medical cannabis patients across the country and millions more waiting to become legal. We have friends and family in every state, and there are many of us in states that are key to the Obama reelection campaign: Colorado, Nevada, and New Mexico.

    I care a lot about this country and my fellow Americans, and I have always volunteered for candidates during election years. Now, instead of going to rallies or buying tickets to fundraisers, I will be protesting at campaign stops like the one today in downtown Oakland. Instead of working to elect a president, I'll be joining thousands of medical cannabis advocates at Camp Wakeupobama, a virtual summer camp during which we will press our case to the President.

    President Obama, you can move medical cannabis policy forward and win this election - 74% of voters disagree with your attacks on state compassionate use laws.

    Medical cannabis patients will be on the campaign trail, however you can still determine what our signs will say.
  • Medical cannabis researcher explains recent scientific review

    The article "Medical Marijuana: Clearing Away the Smoke" by Grant, Atkinson, Gouaux, and Wilsey published this month in Bentham Science's 5-year-old, peer-reviewed, National Library of Medicine-indexed and internationally edited Open Neurology Journal represents a major milestone in the consolidation of knowledge and regularizing of clinical practice with regards to the medicinal use of cannabis.

    The authors, well-established faculty members or associates at leading American academic medical centers, have yet again reviewed the gold-standard clinical trials-based evidence for medical uses of cannabis and related cannabinoids and have found:

    1. that it is inaccurate to say that cannabis lacks medical utility or that information on its safety is lacking

    2. that judgments on relative benefits and risks of cannabis and cannabinoids as medicines need to be viewed within the broader context of risk-benefit of other standard agents as well, many of which are associated with more serious adverse events, and

    3. that enough information and clinical experience exists that an algorithm can be constructed to guide decision-making for physicians who may be considering recommending medicinal cannabis to patients with neuropathic pain, which the authors offer.


    The authors conclude that "it will be useful if marijuana and its constituents can be prescribed, dispensed, and regulated in a manner similar to other medications that have psychotropic effects and some abuse potential" and state that marijuana's Schedule I classification is scientifically untenable and the greatest barrier to forward movement in this area of medicine and medical science. This conclusion is made all the more noteworthy given that the article's first, second, and fourth authors disclose at the end of the manuscript that they have served as consultants and received financial support from major pharmaceutical companies.

    Americans for Safe Access is part of a lawsuit challenging the DEA’s scheduling of marijuana as without any currently accepted medical use in treatment in the United States. Download our lawsuit at http://AmericansForSafeAccess.org/downloads/CRC_Appeal.pdf

    Sunil Aggarwal, M.D., Ph.D., PGY-3, is a Housestaff Physician at NYU Medical Center and conducts research on the medical geography of cannabis.
  • DEA’s Leonhart says “We will look at any options for reducing drug addiction,” but what about medical marijuana?



     

     

     

     

     

     

     

     

     

    Administrator Michele Leonhart has created quite a controversy with her comments on medical marijuana made last Wednesday during a Drug Enforcement Administration (DEA) House oversight hearing. From her bumbling response to Rep. Jared Polis (D-CO) on the issue of addiction and comparing medical marijuana to the harmful effects of other Schedule I substances like heroin or methamphetamine, to her commonsense response to Rep. Steve Cohen (D-TN) on leaving the question of medical marijuana treatment, “between [a patient] and his doctor,” Leonhart illustrated her illogical approach to medical marijuana as a public health issue.

    Notably, toward the end of Rep. Polis’s examination, he asked Leonhart if she was “willing to look at the use of medical marijuana as a way of reducing abuse of prescription drugs,” given that reducing prescription drug abuse is the DEA’s top priority. Leonhart candidly responded:
    We will look at any options for reducing drug addiction.

    Well, Administrator Leonhart, you’re in luck. There is indeed evidence that shows patients using medical marijuana to reduce or eliminate their addictive and often-harmful pharmaceutical drug regimen.

    Just this month, eminent medical marijuana researcher Philippe Lucas, M.A. published an article in the Journal of Psychoactive Drugs called, “Cannabis as an Adjunct to or Substitute for Opiates in the Treatment of Chronic Pain.” According to Lucas, “Evidence is growing that cannabis [medical marijuana] can be an effective treatment for chronic pain, presenting a safe and viable alternative or adjunct to pharmaceutical opiates.”

    As if directly addressing Leonhart’s statement to Rep. Polis, and her concern over prioritizing prescription drug addiction, Lucas notes that:
    Addiction to pharmaceutical opiates has been noted by the medical community as one of the common side-effects of extended use by patients (such as those suffering from chronic pain), and a growing body of research suggests that some of the biological actions of cannabis and cannabinoids may be useful in reducing this dependence.

    Lucas further argues that, “[R]esearch on substitution effect suggests that cannabis may be effective in reducing the use and dependence of other substances of abuse such as illicit opiates, stimulants and alcohol.”
    As such, there is reason to believe that a strategy aiming to maximize the therapeutic potential benefits of both cannabis and pharmaceutical cannabinoids by expanding their availability and use could potentially lead to a reduction in the prescription use of opiates, as well as other potentially dangerous pharmaceutical analgesics, licit and illicit substances, and thus a reduction in associated harms.

    Another article on the effects of medical marijuana “substitution” was published in December 2009 by the Harm Reduction Journal. Researcher Amanda Reiman MSW, PhD notes that medical marijuana patients have long been engaging in substitution by using it as an alternative to alcohol, prescription and illicit drugs. In a study Reiman conducted with 350 medical marijuana patients, she found that 40 percent reported using medical marijuana as a substitute for alcohol, twenty-six percent reported using it as a substitute for illicit drugs, and nearly 66 percent use it as a substitute for prescription drugs.
    [S]ixty five percent reported using cannabis as a substitute because it has less adverse side effects than alcohol, illicit or prescription drugs, 34% use it as a substitute because it has less withdrawal potential…57.4% use it as a substitute because cannabis provides better symptom management.

    If Leonhart is serious about combating prescription drug abuse, she should heed the conclusions of researchers like Lucas and Reiman and pay attention to the evidence. Answers to two important public health concerns -- medical marijuana and prescription drug abuse -- lie at her feet waiting to be addressed.
  • Obama (Double) Speaks on Medical Marijuana



     

     

     

     

     

    Finally, President Obama has spoken about his aggressive stance toward medical marijuana. Unfortunately, but not unexpectedly, his statements are underwhelming, inaccurate and do nothing to address medical marijuana as a public health issue. In response to a question from Rolling Stone on why his administration is conducting more medical marijuana raids than the Bush administration, President Obama failed to come clean on reasons for the breadth and intensity of the attacks, which significantly escalated since he took office.
    What I specifically said was that we were not going to prioritize prosecutions of persons who are using medical marijuana. I never made a commitment that somehow we were going to give carte blanche to large-scale producers and operators of marijuana…

    Actually, what Obama said on the campaign trail in 2008 was that he was “not going to be using Justice Department resources to try to circumvent state [medical marijuana] laws.”

    The shell game continued with Obama declaring that, as President, he “can’t ask the Justice Department to…‘ignore…a federal law that’s on the books.’”

    In fact, Obama has complete discretion to let local and state authorities enforce their own medical marijuana laws. When affirming that discretionary authority in 2005, the U.S. Supreme Court also questioned the wisdom of going after medical marijuana patients.

    Obama then declared that his Justice Department should use “prosecutorial discretion and properly prioritize [its] resources to go after things that are really doing folks damage.”

    That, however, seems to beg several questions, not the least of which is “how does one determine what “things” are “really doing folks damage?” Why is that not the purview of local and state officials to enforce? And, is the federal government doing more damage than it’s supposedly preventing? Keep in mind that the damage his administration has inflicted also impacts the fiscal bottom line of local and state governments. In California, dispensary closures precipitated by the federal crackdown have robbed the state of millions of dollars in lost taxes.

    The president seems to seek cover with his comment that, “there haven’t been prosecutions” of medical marijuana users. But, even if it was true, and it’s not (all of the more than 60 people indicted on his watch use medical marijuana), this reasoning would still not justify the SWAT-style raids and the fear and intimidation they create. Nor would it justify the purging of lawful medical marijuana businesses from commercial banking institutions, or the IRS requirement that dispensaries pay taxes on gross proceeds, thereby ensuring bankruptcy, or discrimination against patients in public housing and the Veterans Administration.

    At the end of the day, whether or not Obama’s Justice Department decides to prosecute whom it considers “wrongdoers,” qualified patients are still being denied a safe and legal means of obtaining their medication.

    Even Obama’s “Drug War” excuses don’t match those of his U.S. Attorneys who are directly engaged in the attacks. The president erroneously stated that, “The only tension that’s come up” has been “commercial operations” that may be “supplying recreational users.” However, U.S. Attorneys have made little reference to targeting medical marijuana businesses because they’re allegedly selling to non-patients. The prevailing excuse has been simply that dispensaries are federally illegal or that they are too close to schools and other so-called “sensitive uses” (according to federal standards, not to local or state standards).

    Obama’s weakest rationale for continuing the assault on medical marijuana patients is that he “can’t nullify congressional law.” However, the president can realistically do a number of things to address medical marijuana as a public health issue. First of all, Obama could introduce a bill that would carve out an exception for medical marijuana patients and providers. In fact, he doesn’t even have to introduce his own legislation, he could simply throw his weight behind HB 1983, a bill that would do just that. The president could also issue an executive order, not to change federal marijuana statutes but to exclude medical marijuana so as to let the states enforce their own laws.

    Additionally, the president, through his executive powers, could also reclassify marijuana from its current status as a Schedule I substance -- a dangerous drug with no medical value. Yet, he and his Drug Enforcement Administration choose not to. In addition to four governors who have filed rescheduling petitions within the last year, Americans for Safe Access has a pending federal lawsuit that seeks reclassification.

    At some point, President Obama is going to run out of excuses. Until then, please join ASA in urging him to do the right thing.