MJ News for 06/27/2014

7greeneyes

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http://www.nytimes.com/2014/06/27/h...ions-for-marijuana-defy-doctors-and-data.html




Politicians’ Prescriptions for Marijuana Defy Doctors and Data


New York moved last week to join 22 states in legalizing medical marijuana for patients with a diverse array of debilitating ailments, encompassing epilepsy and cancer, Crohn’s disease and Parkinson’s. Yet there is no rigorous scientific evidence that marijuana effectively treats the symptoms of many of the illnesses for which states have authorized its use.

Instead, experts say, lawmakers and the authors of public referendums have acted largely on the basis of animal studies and heart-wrenching anecdotes. The results have sometimes confounded doctors and researchers.

The lists of conditions qualifying patients for marijuana treatment vary considerably from state to state. Like most others, New York’s includes cancer, H.I.V./AIDS and multiple sclerosis. Studies have shown that marijuana can relieve nausea, improve appetite and ease painful spasms in those patients.

But New York’s list also includes Parkinson’s disease, Lou Gehrig’s disease and epilepsy, conditions for which there are no high-quality trials indicating marijuana is useful. In Illinois, more than three dozen conditions qualify for treatment with marijuana, including Alzheimer’s disease, lupus, Sjogren’s syndrome, Tourette’s syndrome, Arnold-Chiari malformation and nail-patella syndrome.

“I just don’t think the evidence is there for these long lists,” said Dr. Molly Cooke, a professor of medicine at the University of California, San Francisco, who helped research a position paper on cannabis for the American College of Physicians. “It’s been so hard to study marijuana. Policy makers are responding to thin data.”

Even some advocates of medical marijuana acknowledge that the state laws legalizing it did not result from careful reviews of the medical literature.

“I wish it were that rational,” said Mitch Earleywine, chairman of the executive board of directors for Norml, a national marijuana advocacy group. Dr. Earleywine said state lawmakers more often ask themselves, “What disease does the person in a wheelchair in my office have?”

Research into marijuana’s effects is thin not because of a lack of scientific interest, but chiefly because the federal government has long classified it as a Schedule 1 drug with “no currently accepted medical use.” Scientists who want to conduct studies must register with the Drug Enforcement Administration and win the approval of the National Institute on Drug Abuse, which is the only supplier of legal, research-grade marijuana and can decline to supply it.

The legal and administrative hoops make it hard for investigators to start the randomized, placebo-controlled trials that are the gold standard of medical research and the basis for determining which drugs are effective, at what doses, and in which patients.

“It’s one thing to say we need to have more research, and it’s another thing to obstruct the research,” said Dr. Steven A. Jenison, former medical director of New Mexico’s medical cannabis program.

The dearth of data has not prevented legislators and voters across the nation from endorsing marijuana for more than 40 conditions. Patients with rheumatoid arthritis, for instance, qualify for marijuana treatment in at least three states.

Yet there are no published trials of smoked marijuana in rheumatoid arthritis patients, said Dr. Mary-Ann Fitzcharles, a rheumatologist at McGill University who reviewed the evidence of the drug’s efficacy in treating rheumatic diseases. “When we look at herbal cannabis, we have zero evidence for efficacy,” she said. “Unfortunately this is being driven by regulatory authorities, not by sound clinical judgment.”

New York considered including the chronic inflammatory disease on its list, a development that astonished Dr. Mary K. Crow, an arthritis expert at the Hospital for Special Surgery, in Manhattan. People with rheumatoid arthritis have higher rates of certain respiratory problems, she noted.

“Inhaling into your lungs is not a great idea with rheumatoid arthritis, given the substantial number of patients who have lung disease,” Dr. Crow said. (The final version of New York’s law prohibits smoking marijuana and did not end up including rheumatoid arthritis.)

In Arizona and Rhode Island, among other states, people with Alzheimer’s disease may receive medical marijuana to help quell nighttime agitation. But Dr. Gary Small, director of the division of geriatric psychiatry at the University of California, Los Angeles, said he does not recommend cannabis to Alzheimer’s patients: Agitation and increased confusion are possible side effects.

Still, he said he would not discourage a caregiver from providing it if it calmed a family member with dementia.

Parents of children with intractable epilepsy have lobbied hard in several states, including New York, for inclusion in medical marijuana legislation. They want access to an oil called Charlotte’s Web that is rich in CBD, a nonpsychoactive ingredient of marijuana that they say reduces the number of seizures.

This month, Gov. Rick Scott of Florida, a conservative Republican, signed a law allowing epilepsy patients access to the oil, calling it “the best treatment available.”

Scientists have begun randomized, placebo-controlled research to determine whether CBD effectively treats severe forms of childhood epilepsy. But at the moment, high-quality research showing that marijuana is a safe or effective treatment for epilepsy does not exist, experts say.

“As far as data out there, there are great animal models and very provoking anecdotes,” said Dr. Orrin Devinsky, director of the Comprehensive Epilepsy Center at NYU Langone Medical Center. “The human data is not there right now.”

Psoriasis was included in the New York legislation after representatives of Gaia Plant-Based Medicine, a Colorado company operating dispensaries, met with State Senator Diane J. Savino and suggested that cannabis lotions helped people with those red, raised skin plaques. It was dropped from the measure after questions were raised about the lack of supporting evidence — as were other conditions, like diabetes and lupus.

Medical marijuana advocates contend that suffering people should not have to wait for scientific research to catch up to patients’ needs. And why limit marijuana use to only certain conditions, they ask, when doctors routinely prescribe drugs off-label for anything they feel like?

Amanda Hoffman, 35, an information technology specialist in Basking Ridge, N.J., struggles with ulcerative colitis, an inflammatory bowel disease. She has tried steroids and Remicade, an intravenous infusion, but no drug has given her as much relief from frequent daily diarrhea and abdominal pain as her homemade cannabis caramels.

On a recent Sunday, Ms. Hoffman used a green buttery sludge made with marijuana she bought for $500 an ounce from Garden State Dispensary to make a new batch. She is grateful that the state legalized marijuana for patients like her, whatever the scientific evidence.

“Cannabis to a lot of people is a punch line, but it can also be a lifesaver,” she said.

Even if strong medical research regarding marijuana did exist, it is not clear that state lawmakers would be swayed.

“It would be possible to take case studies or anecdotal information from patients or research done from a university, put it in front of a legislator and say, ‘We need to include this disease,’ ” said State Representative Lou Lang, sponsor of the medical marijuana law in Illinois.

“But the legislative mind, be it in D.C. or in Springfield, Illinois, doesn’t always go to public policy,” Mr. Lang said. “The default position is politics.”

Often state legislators have been motivated not just by constituents in distress, but also by the desire to restrict access to limited patient populations so that legal marijuana does not become widely available as a recreational drug in their states.

For example, while there is research suggesting that marijuana alleviates certain kinds of chronic pain, Mr. Lang noted, legislators in Illinois were reluctant to legalize its use in such a broad patient population. The state’s list of qualifying conditions is lengthy partly because lawmakers tried instead to specify a number of diagnoses that result in pain, some quite rare.

“I’ll bet there are hundreds of conditions that cause pain, and now 30 are listed,” Karen O’Keefe, director of state policies at the Marijuana Policy Project, said of Illinois’s legislation.

Medical experts, rarely included in these statehouse discussions, have often been caught off guard by the sudden passage of laws permitting patients to ask them for marijuana.

Since at least 2009, for instance, the American Glaucoma Society has said publicly that marijuana is an impractical way to treat glaucoma. While it does lower intraocular eye pressure, it works only for up to four hours, so patients would need to take it even in the middle of the night to achieve consistent reductions in pressure. Once-a-day eye drops work more predictably.

Yet glaucoma qualifies for treatment with medical marijuana in more than a dozen states, and is included in pending legislation in Ohio and Pennsylvania. At one point, it appeared in New York’s legislation, too.

Dr. Paul N. Orloff, the legislative chairman for the New York State Ophthalmological Society, reached out to Richard N. Gottfried, a Manhattan Democrat and sponsor of the Assembly bill, and succeeded in getting glaucoma removed.

“It’s very illogical to prescribe a medication where it’s not standardized,” Dr. Orloff said, adding, “None of my 60-year-old patients are interested in being stoned to treat their glaucoma.
 

7greeneyes

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http://time.com/2929263/marijuana-pot-americans/




Americans Are Smoking More Pot


The World Drug Report found that as laws in the U.S. have relaxed toward marijuana, prices for the herb have dropped, far more people have begun to partake, and more people have landed in the hospital due to "cannabis-related treatment admissions"

Americans are increasingly consuming marijuana but also seeking treatment for problems caused by their use of the drug, according to a new report.

The World Drug Report was released Thursday against the backdrop of a country whose states are increasingly liberalizing legal access to marijuana for both recreational and medical purposes. The report suggests that as laws have relaxed toward the herb, more people have begun to use it — from 2008 to 2012, marijuana use among “people 12 years and older” increased almost 2 percentage points, from 10.3 to 12.1.

Washington State and Colorado recently legalized pot for recreational use, numerous states allow it for medical use, and residents in other states — New York, Alaska and Kentucky, among others — are working to legalize various forms of marijuana use, and legalization has become a staple in youth discourse and liberal politics.

The report cautions that the relationship between legalization and use remains a correlation only, not necessarily a cause, particularly since the information included in the study only extends through 2012, which is when the recreational legalizations were just taking hold in Washington and Colorado. “It will take years of careful monitoring to understand the broader effects of those novel regulatory frameworks in order to inform future policy decisions,” the report states.

Experts cited in the report predict that legalization and retail integration of marijuana will reduce production costs, thereby boosting consumption. For each 10% drop in price — the average price of marijuana fell 12% between 2009 and 2012 — there will be an estimated 3% increase in users.

There may also be an insidious side to the flowering embrace of marijuana as extracurricular pleasure. The study suggests that lower prices, greater availability and a shift in perception on how dangerous the drug can be may lead to addiction issues. Data shows a significant uptick in marijuana-related emergency-room visits over the past several years — up 59% between 2006 and 2012 — along with a 14% increase in “cannabis-related treatment admissions.”

Globally, however, marijuana use has fallen. Though Uruguay became the first country to legalize growing, selling and using marijuana in December, the worldwide decline reflects lower estimates that were reported by several countries in Western and Central Europe.
 

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http://dcist.com/2014/06/what_the_housess_marijuana_decrimin.php




What The House's Marijuana Decriminalization Amendment Means For D.C.


Though the D.C. Council passed a bill to decriminalize small amounts of marijuana, which was later signed into law by Mayor Vince Gray, the future of relaxed pot laws in the District is still in jeopardy, thanks to a committee in the U.S. House of Representatives.

Earlier today, the House's Appropriations Committee passed an amendment introduced by Maryland Rep. Andy Harris to block D.C.'s marijuana decriminalization law. The amendment passed in a 28 to 21 vote.

So what does this mean for the future of D.C.'s marijuana decriminalization law? Is it up in smoke, thanks to 27 Republicans and one Democrat? Is this the end for the Simple Possession of Small Amounts of Marijuana Decriminalization Act of 2013? Hardly.

Now that the amendment passed the House's Appropriations Committee, it'll be voted on by the entire House of Representatives. If that passes, it still has to pass a vote with the majority of the Senate, and then it has to be formally approved by President Obama. Only three times in the history of Home Rule has a D.C. bill been disapproved by a president.
But, even if that was to happen, there's a chance that the House's amendment could create de facto legalization of marijuana in D.C., according to one group. Yes, you read that right.

"Basically what would happen is, this amendment—the way it's written—would not re-criminalize or rewrite the laws around criminalization of marijuana," Dr. Malik Burnett, Policy Manager for the Drug Policy Alliance, says. "Police issuing tickets to people who they found to have marijuana on their person wouldn't be able to do so, that would create a sort of de facto legalization."

While the law is scheduled to take effect in D.C. on July 17th, it wouldn't be until much later that the amendment would take effect, if it did happen to pass the House and Senate, and was signed by the President. So if it were to pass, and D.C. police officers who are writing tickets for the possession of small amounts of marijuana under the law are suddenly forced to stop doing that because of this amendment, then they wouldn't be able to arrest for possession, because the amendment does not address the criminalization of marijuana—just the decriminalization of it. Thus it "would have practical effect of making marijuana possession essentially legal in the Nation’s Capital," Burnett says.

Of course, this is something that, once Andy Harris figures out, he will almost certainly rewrite the language of the amendment to ensure doesn't happen. Because if it did, well, irony (and no, not the Alanis Morrisette definition).

But it's still a long shot that the amendment makes it past the House, Senate, and gets signed off by the President. Still, the whole amendment makes Harris and the House Republicans look bad, Burnett thinks, especially at a time when marijuana decriminalization laws are popping up all over the country, even in Harris' own state.

"I think that the fact is that this act, as much as Rep. Andy Harris tries to shy away from it, it's an attempt to politically grandstand around the issue of marijuana hear in the District of Columbia," Burnett says. "It's just an opportunity to make a statement of his personal views. Unfortunately, his personal views do not mesh well with his own constituents in Maryland, nor do they mesh with those of the residents of the District of Columbia."
 

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http://www.chicagotribune.com/news/sns-rt-us-usa-north-carolina-marijuana-20140626,0,1117692.story




North Carolina legislature approves limited medical marijuana use


RALEIGH N.C (Reuters) - North Carolina is on the verge of joining the wave of states to approve a form of medical marijuana as lawmakers voted to allow its limited use for treating seizures.

The Hope 4 Haley and Friends bill is named for 6-year-old Haley Ward of Newport, who suffers from multiple daily seizures. The measure passed unanimously in the state Senate on Thursday, having cleared the house last week, and now awaits the signature of Governor Pat McCrory, who has not taken sides on the issue.


In passing the law, North Carolina would join a handful of other states nationwide, including conservative southern states such as Alabama, Mississippi and Florida, to allow the use of a cannabis extract, cannabidiol (CBD), in certain circumstances.

A chemical found in marijuana plants, CBD has been shown in early studies to reduce seizures, particularly in children who suffer from epilepsy.

The medicine is gathered from cannabis plants genetically engineered to contain only tiny amounts of the compound THC, the component that causes marijuana to produce a high.

The narrowly tailored measure that passed on Thursday overcame early concerns it would open the door to legalizing other forms of the drug.

The bill authorizes the sale of CBD only to patients who suffer persistent seizures and must register with the state. It also calls for research into the drug's effectiveness. Selected universities in the state would be allowed to grow cannabis for study.

"This is going to give hope to a lot of precious children who have been waiting a long time," said bill sponsor state Representative Pat McElraft, a Republican. "This is not the camel's nose under the tent."

Parents offered emotional testimony as the bill went through legislative committees, citing CBD as a last hope for children who suffer sometimes dozens of seizures in a single day. Other medications, they said, have been ineffective with debilitating side effects.

"The medicines we're giving her today are ripping her apart," said Steve Carlin, whose daughter Zora, 5, has a rare form of epilepsy.
 

7greeneyes

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http://www.abc.net.au/news/2014-06-27/new-push-for-legalising-cannabis-for-medicinal-use/5555456



Tasmania mooted as growing site for medicinal cannabis


The bid to legalise cannabis for medical use is gaining momentum, and Tasmania has been suggested as a growing site.

A cross-party delegation from New South Wales will be in Tasmania next week for a site visit and will meet the state Health Minister.

NSW MP Kevin Anderson, who is working on a private member's bill to legalise medicinal cannabis for the terminally ill in that state, will lead the delegation.

Tasman Health Cannabinoids, a private company, is proposing trials to grow medical cannabis after conducting extensive tests in partnership with the University of Tasmania.

Medicinal cannabis is being touted as a crop that would complement Tasmania's lucrative poppy harvest.

Cannabinoids can be extracted from the cannabis flower in the same way as opiates are extracted from the poppy flower.

Advocates say the side effects are few, the benefits great and the risk of addiction much lower than for many conventional medications.

Tasman Health Cannabinoids chairman Mal Washer, a general practitioner and former West Australian Liberal MP, says traditional anti-nausea medicines fail many people.

Dr Washer, who is also the former head of the national Alcohol and Other Drugs Council, says he wants to educate policymakers about the potential of medicinal cannabis.

"It's illegal [but] we're not talking about using cannabis for that purpose, for recreational purpose, we're talking about doing appropriate medical trials," he said.

He said he looked forward to discussing medicinal cannabis with Tasmanian Health Minister Michael Ferguson and other state legislators.

Mum of three with terminal cancer praises cannabis oil

Tasmanian woman Natalie Daley, 32, is happily married with three young children whose life changed after a CT scan.

"That's when they found a tumour the size of a football in my abdomen, on my kidney," she said.

"The cancer I've got is called adrenal cortical carcinoma, it's a very rare cancer of the adrenal gland.

"The diagnosis isn't good. They've told me it's terminal."

She needed seven weeks of radiation followed by chemotherapy after nodules on her lungs spread.

"I wasn't able to get up and play with the kids because I was so tired and weak and it impacted on my husband a lot as well," she said.

"He was having to come home and cook meals, I just felt like a failure as a wife and a mother."

I truly believe I wouldn't be here now, or I'd be in hospital not very well at all. I'd be pretty much on my death bed.

Prescribed anti-nausea medication did not work, and a friend of a friend suggested cannabis oil.

"It's just been amazing the results that this oil has done for me it's just changed my life," she said.

A capsule twice a day and a few drops in a cup of tea means Ms Daley can now eat full meals and enjoy time with her children.

The capsules are sent to her by a supporter interstate, and she says medical cannabis should be legalised.

"I truly believe I wouldn't be here now, or I'd be in hospital not very well at all. I'd be pretty much on my death bed right now," she said.

Troy Langman, who set up Tasman Health Cannabinoids last year, says trials would focus on users such as Ms Daley.

"We have designed our first clinical study which does focus on chemo-induced nausea and vomiting," Mr Langman said.

"I want to make this my life's work and I'd like to base it here. I believe it's a huge opportunity for Tasmania.

"It's a win-win situation. Not only can we make sick people feel better but we can also provide employment."

Mr Langman hopes to finalise plans for a trial within next two weeks and will then seek approval from the University of Tasmania's ethics committee.

"In conjunction to that we have begun the process of obtaining licensing to actually grow the cannabis in a highly secure facility," he said.

Licensing would require consent from the Tasmanian Government.

Medical cannabis may have export potential

There has already been interest from overseas, Mr Langman said.

"We had an order from Canada, where it's legal to have medical marijuana, for an order for 1,000 kilograms of marijuana from Tasmania if we can get it legalised and start getting it into production," he said.

"So there's a big export potential."

The medicinal use of cannabis has been legalised in a several countries around the world, and was legal in Australia until the middle of the last century.

The President of the Australian Drug Law Reform Foundation, Dr Alex Wodak, says legalisation in the United States has had no impact on recreation use.

"The states where medicinal cannabis is made available were compared with states where medicinal cannabis isn't available and the number of people using recreational cannabis was no different in the two groups," he said.
 

8planets8

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yes fineally we will prevail keep that in youir mind i dont no if this belongs here but i'm going to say it any way one day my son and i were on our way in his car to my doctors appointmentWE WERE DRIVG MYBE 2 MILES OVER THE SPEED LIMIT GUESS WHAT HAPPEN YES WE GOT PULLED OVER THE COPS SAID DO YOU MIND IF WE SEARCH YOUR CAR WE HAD NOTHING TO HIDE SO WE SAID YES THE NEXT THING I NO I'M BEING PULLED OUT OF MY SONS CAR AND TOLD LIKE A CHILD TO STAND BY THE CURB AND BE QUIET SO I COMPLIED AFTER AWHILE THEY STARTED TO HASSEL MY SON THAT IS WHEN I STARTED TO LOSE MY COOL I STARTED QUESTIONING THEM WHY WERE WE PULLED OVER AND WHAT DID WE DO WRONG, ALL HE SAID WAS WERE DID YOU BUY YOUR JACKET,IT WAS A BLACK HOODY AND I GUESS THEY BECAME CONCERNED BECAUSE OF THE WAY I WAS DRESSED MY SON HAD A HEAD BAND ON AND CAMOES SO I GUESS WE LOOKED LIKE GANGSTERS.SO I TRY TO EXPLAIN THAT I HAD TO TRVEL 30 MILES TO MY APPOINTMENT COULD WE LEAVE HE SAID NO WAY WE ARE CALLING IN THE DOGS I SDAID WHAT THE DOGS WHAT IN GODS NAME DID I DO TO DESEVRE THIS TREATMENT,SO AFTER ABOUT 10 MINUTES IT SEEMED THE WHOLE POLICE DEPARTMENT WERE THERE OVER 2 MILES OVER THE SPEED LIMIT WELL THE DOGS GERMAN SEPERDS WERE PRETTY INTIMANATING STATE TROOPERS WERE THERE EVEN THE APL WAS THERE I WAS FREAKING OUT ALL OVER A STUPIT 2 OVER THE MILES SPEED LIMIT IM NOT SURE WE WERE SPEEDING BECAUSE I ALWAYS TELL MY SON TO SLOW DOWN HE HAS A LEAD FOOT SO THIS GOES ON AND ON AND THEY ASK IF THEY CAN SEACH ME,WELL GOOD THING I WAS IN A good mood because i would have put up a haSSEL I NO I WOULD NOT WIN BUT IT WAS THE PRINCYBLE OF THE THING THEY TORE OUR CAR APART LIKE IT WAS NOTHING TO THEM THEY ARE OUT OF CONTROL AND THEY WERE ITCHING FOR ME TO LOSE MY COOL WHICH THANK GOD I DID NOT AND MY POOR SON HE IS SICK IN HIS HEAD AND IT MUST OF BEEN A TRANATIC EXPERIENCE FOR HIM I COULD SEE IT IN HIS EYES,THEY KEPT PUSHING ME AROUND TRYING TO MAKE ME DO SOMETHING STUPIT BUT I'M HIP TO THERE TACTICS SO IT REALLY DIDNT BOTHER ME EXCEPT I WAS LATE FOR MY DOCTORS APPOINTMENT THEY DID NOT CARE ALL THEY CARED ABOUT WAS TO BUST ETHER ME OR MY SON EVEN THE HELICOPTORS CAME ON TO THE SEAN WHAT A WASTE OF RESOURCES.ANYWAY THEY FINELY LET US GO ON OUR WAY WITHOUT EVEN IN SORRY FOR THE INCONVIENCE,THIS IS WHY I TOLD THIS STORY IT HAPPENS EVERY DAY TO INOCENT PEOPLE JUST BECAUSE OF THE WAY WE DRESS YES I DRESS DIFERANT BUT IM NOT A PEA IN A POD AND I REFUSE TO BE ANYONE BUT MYSELF I'M SORRY I GOT ON A RAVE BUT THIS MADE ME MAD AND I HAD TO SAY SOMETHING 888PS WE NEVER GOT CHARGED WITH NOTHING EXCEPT I WAS LATE FOR MY DOCTORS APPOINTNENT OH WELL LATER
 

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