The Top Ten Medical Cannabis Developments of 2018

It has been an exciting year in the world of cannabis reform. From studies that underscore the therapeutic potential of cannabis to political changes that bode well for patients and consumers, there is much to celebrate. Before we close the books on 2018, let’s take a look back at ten of the most significant developments over the past year from ASA’s perspective and consider their impact.

1. The DEA Removes Misinformation about Cannabis from its Website

For years, the U.S. Drug Enforcement Agency maintained false and misleading information about cannabis on its website. In December 2016, ASA submitted an Information Quality Act (IQA) petition to compel the DEA to stop disseminating inaccurate information to the public. In January 2018, ASA received a letter from the DEA acknowledging that the materials ASA raised concerns about were removed from the DEA website but asserting that this was due to a “regular review process” rather than the IQA petition.

The removal of inaccurate materials is a significant development, because elected officials rely upon the DEA to provide fact-based information about medical cannabis to inform policy decisions. With misinformation about the gateway drug hypothesis, permanent cognitive declines, and lung cancer off the DEA’s website, politicians have access to higher quality data and cannot take political cover behind pro-prohibition falsehoods.

2. The Expansion of Medical Cannabis to New States

The hard work of advocates, activists, patients, ASA, and other reform-oriented organizations led to the expansion of medical cannabis in Missouri, Oklahoma, and Utah in November 2018. As a result, 33 U.S. states now have a comprehensive medical cannabis program. Before their respective election days, Oklahoma did not have a medical cannabis program and Missouri and Utah had very restrictive low-THC, high-CBD programs. Voters in all three states sent a message about the need for safe and legal access to medical cannabis.

Politicians and bureaucrats in Oklahoma and Utah have tried to limit the reach of the voter-passed initiatives legalizing medical cannabis in those states, but ASA has been fighting back to ensure that the will of the people is heard and that the best possible medical programs are implemented. Momentum continues to build for the further expansion of medical and adult-use regimes throughout the United States. If you would like to help advocate for your state, check out ASA’s Advocate Resources.

3. Illinois and New York Implement End Pain, Not Lives Strategies

The opioid epidemic is a crisis that demands action. Through our End Pain, Not Lives campaign, ASA fights to make medical cannabis a first-line treatment for pain and applauds the expansion of medical cannabis programs to allow cannabis as a substitute for opioids and for the use of cannabis in the treatment of opioid use disorder. Research shows that there is a nearly 25% reduction in opioid overdose deaths in states with medical cannabis laws.

In July 2018, the New York State Department of Health issued emergency regulations adding any condition for which an opioid could be prescribed as a qualifying condition for medical cannabis and further expanding the list of qualifying conditions to include opioid use disorder. That same day, the health department filed a Notice of Proposed Rulemaking to make the new regulations permanent. The next month, Illinois also took a huge step forward when Gov. Rauner signed SB 336 into law, which allows certain individuals who have been given an opioid prescription to trade that prescription in for a medical cannabis card and allows doctors to authorize the use of medical cannabis immediately for any patient who qualifies for a prescription for opioid medication. In both states, the new rules made accessing medical cannabis easier and faster to ensure that patients’ suffering is not needlessly prolonged.

New York and Illinois are setting examples that other states should follow! Please consider donating directly to ASA’s End Pain, Not Lives campaign to ensure that we can continue to educate legislators about the need to make medical cannabis a tool in the fight to stop the opioid epidemic.

4. The FDA Approves Epidiolex

GW Pharmaceuticals’ Epidiolex, an oral solution containing cannabidiol (CBD), received FDA approval for two rare seizure disorders in June 2018. While synthetic cannabinoid medications already exist, Epidiolex is the first cannabinoid medication to be derived directly from the cannabis plant. Unlike most medical cannabis in the United States, FDA-approved medications like Epidiolex can be prescribed by doctors, purchased in pharmacies, and covered by insurance. Epidiolex signified the first time a cannabis derived medication was approved by the FDA, potentially opening the door for more cannabis-derived medicines. If you need more information to better understand cannabis therapeutics or to better navigate your state’s medical cannabis program, check out ASA’s Cannabis Care Certification program for patients and caregivers!

5. 2018 Farm Bill Legalizes Industrial Hemp and Extracts

Congress made history in December 2018 when the House and Senate voted to permanently remove industrial hemp – and extracts derived from industrial hemp – from the schedule of controlled substances. Industrial hemp plants contain no more than 0.3% THC and can be used in tens of thousands of ways across a range of industries, including medicine, manufacturing, construction, and food & beverage. Importantly, some varieties of industrial hemp are high in cannabidiol (CBD), a non-intoxicating cannabinoid with a number of promising medicinal uses.

Among the many benefits of Congress’ move to treat industrial hemp like other agricultural commodities is the fact that therapeutic cannabinoids and terpenes will be more available and accessible once the bill has been signed into law. However, patients and consumers must remain vigilant to ensure that any hemp and hemp-derived products they purchase for consumption or topical application were cultivated and processed or manufactured in accordance with standards as stringent as the Patient Focused Certification standards ASA developed around cultivation, manufacturing, distribution, and laboratory practices to ensure products are safe, pure, and appropriately labeled.

6. Rohrabacher-Blumenauer Amendment Added to Base Text of Funding Bill

The Rohrabacher-Blumenauer Amendment prohibits the use of federal funds to interfere with the implementation of state laws that authorize the use, distribution, possession, or cultivation of medical marijuana. Given that cannabis is still classified as a Schedule 1 drug under the Controlled Substances Act, this language provides critical legal protections for medical cannabis patients and the people who produce their medicine. From 2003-2012, the amendment was voted down six times. The amendment was successfully added to the Commerce, Justice, and Science (CJS) Appropriations bill for the first time in 2014 and has been renewed in some manner each year since.

In May 2018, the House Appropriate Committee approved inclusion of the amendment language in the base text of the CJS appropriations bill. In addition to signaling broad support for the language, it’s addition to the base text helps to ensure that these critical protections will remain in place each time the appropriations bill is voted on moving forward. It’s crucially important that your elected representatives understand the importance of ensuring that medical cannabis patients receive necessary protections from prosecution under federal law. To learn how to lobby your legislators effectively and further advocate for medical cannabis patients, register for the 2019 National Medical Cannabis Unity Conference today!

7. ICCI-ASTM Partnership

In October 2018, the global standards organization ASTM International and the ASA-cofounded center of excellence International Cannabis and Cannabinoid Institute (ICCI) signed a memorandum of understanding to work together on standards for the cannabis industry.

ICCI is based in the Czech Republic and is the first European organization to join ASTM’s Committee D37 on Cannabis. ICCI is licensed to offer ASA’s Patient Focused Certification (PFC) program globally and will be coordinating PFC resources and efforts with ASTM International to meet the pressing need for international cannabis standards relating to cultivation and use in cosmetics, foods, and extracts as well as medicinal and laboratory-related standards. ICCI’s participation will help the committee identify gaps in knowledge, prevent the duplication of work, and strengthen the development of robust international standards that protect patients, consumers, and businesses. We encourage you to learn more about our Patient Focused Certification program, which patients, health care providers, companies, and regulators can depend on to identify reliable, high-quality medical cannabis, businesses, products, and services.

8. Medical Cannabis Policies Encourage Lower Prescription Opioid Use

Opioid-related mortality rose by almost 320% between 2000 and 2015. In May 2018, the Journal of the American Medical Association (JAMA) published an original investigation into the relationship between U.S. state medical cannabis laws and the prescription of opioids in the Medicare Part D population. The longitudinal analysis found that prescriptions filled for all opioids in the Medicare Part D population fell by 2.11 million daily doses per year when a state instituted any medical cannabis law; prescriptions for all opioids in this population fell by 3.742 million daily doses per year when medical cannabis dispensaries opened in a state.

The JAMA investigation concluded that medical cannabis policies are an effective method by which to encourage lower prescription opioid use and an effective harm reduction tool in the fight against the opioid epidemic. Through our End Pain, Not Lives campaign, ASA will continue to advocate forcefully for the expansion of medical cannabis programs to make cannabis an alternative to opioids for those suffering from severe pain and for those battling opioid use disorder. Join us at our End Pain, Not Lives fundraiser in Washington, DC on January 25, 2019 to learn more!

9. Attorney General Jeff Sessions Becomes Former Attorney General Jeff Sessions

Former Senator Jeff Sessions (R-AL) was President Trump’s first pick for attorney general and served in that capacity until he was unceremoniously fired in November 2018. Advocates and industry leaders alike celebrated the departure of one of the most ardent opponents of cannabis in recent political memory. Jeff Sessions has been on the wrong side of history regarding cannabis for years.

He was a vocal proponent of continuing and expanding the disastrous War on Drugs, tried to use federal muscle to intimidate states experimenting with cannabis reforms, and supported harsher sentences for low-level drug offenses even as a push for sentencing reform and ending mass incarceration gained bipartisan support throughout the country. He famously said, “I thought those guys [the Ku Klux Klan] were OK until I learned they smoked pot” and “Good people don’t smoke marijuana,” and he was a barrier to efforts to expand the availability of cannabis and cannabis products for medical research.

While few politicians are as vocally hostile to cannabis reform efforts as Jeff Sessions, the battle is far from won at the federal level.

10. Former Attorney General Jeff Sessions rescinds the Cole Memorandum

The 2013 Cole Memo, which brought predictability and a measure of stability to legal cannabis markets in the United States by giving federal prosecutors guidance on how to respect state-sanctioned legal cannabis programs while appropriately enforcing federal laws, was rescinded by former Attorney General Jeff Sessions in January 2018.

While it first appeared that the rescission of the Cole memo would be a blow to the cannabis industry, the effects have been more positive than many would have anticipated. Sessions’ decision initially created uncertainty, raised fears of incipient law enforcement actions, and spooked investors, but as it became clear that U.S. Attorneys largely would continue to abide by the terms set forth by the Cole Memo, panic abated.

Industry leaders recognized the need for accountability and compliance to stay on the right side of federal prosecutors, which was a positive development for patients and consumers. Rescinding the memo once again laid bare the unsustainable tension between state and federal laws and prompted important discussions about cannabis reform at the federal level, including pronouncements from politicians of all stripes about the need to respect states’ decisions regarding cannabis laws.

It is critically important that we remain vigilant and continue to hold our elected representatives accountable. With the support of our members and donors, ASA continues to fight for medical cannabis patients at all levels of government. We can not do our work without supporters like you. Please consider making a tax-deductible donation today to help sustain our important work or join us or renew your membership today to help be a part of the exciting developments to occur in 2019!