Releaf Magazine

This epidemic needs cannabis to help

opiaOpiate Addiction Experts Turn to Marijuana as Safer Alternative to Pain Relief

LA Weekly - By. Katie Bain - 8/26/2016

The U.S. is in the grips of a well-documented opiate epidemic. More people in the country now die from heroin and prescription opiates than they do from car accidents. In 2014, nearly 19,000 fatal overdoses were related to legal opiates like Oxycontin and Vicodin, and according to theCenter for Disease Control, at least half of all opiate deaths involve a prescription. Sales of OxyContin, which was initially marketed as non-addictive, alone generate roughly $3 billion each year.

As doctors, law enforcement and policymakers scramble to slow the spread of addiction, marijuana continues showing great promise in the treatment of acute and chronic pain, issues that are currently treated primarily via opiates. Dr. Daniele Piomelli, a professor of anatomy and neurobiology at the UC Irvine School of Medicine, has studied the pain management properties of marijuana and its derivative chemicals for the last 25 years, and is calling the use of marijuana in pain management an encouraging turning point in the opiate crisis.

“Despite what the DEA says, their scheduling creates an enormous difficulty to researchers using marijuana or its derivatives.” Piomelli says. “Even harmless derivatives that happen to be present in the plant have been subjected to the same limitations as marijuana.”

On August 11, the Drug Enforcement Administration formally turned down requests to reclassify marijuana from a schedule 1 to schedule 2 controlled substance, choosing to keep it in the category that also includes heroin and LSD.

“[Marijuana] does not have a currently accepted medical use in the United States,” DEA administrator Chuck Rosenberg, (who was criticized last year after calling medical marijuana a “joke”), wrote in a statement. “There is a lack of accepted safety for its use under medical supervision, and it has a high potential for abuse.”

Meanwhile, pharmaceutical companies including Purdue, the maker of OxyContin, have successfully lobbied to derail CDC prescription reform. Still, progress is being made. A 2015 study that found that the “use of marijuana for chronic pain, neuropathic pain, and spasticity due to multiple sclerosis is supported by high-quality evidence.” Another recent study found “moderate-quality evidence” to support the use of cannabinoids for the treatment of chronic pain.

Marijuana is vastly less habit forming than opiates. Especially promising are cannabinoids (CBDs), which, along with THC, are one of the primary chemical derivatives of marijuana. CBDs mitigate pain by targeting the body's endocannabinoid system, which is involved in processes including appetite, pain-sensation, mood and memory. Dr. Piomelli, whose UC Irvine lab has studied the endocannabinoid system for more than two decades, notes that CBDs are particularly promising for researchers, as they don’t have the mind-altering or addictive effects of THC.

Opiates, on the other hand, function by reducing the perception of pain by binding to opioid receptors in the body. While effective, opiates are also massively addictive, especially as one’s tolerance grows and greater doses of the drug must be administered in order to maintain effectiveness. Many people, women in particular, spiral into opiate abuse and addiction after being prescribed opiates after routine procedures and surgeries.

"The mu opiate receptor," says Dr. Piomelli, referring to one of the three receptors activated by opiates, "is so fundamental to the painkilling effects that every opiate by its very definition will cause addiction."

While Piomelli is encouraged by recent marijuana-related studies, he emphasizes that it is not without risks. Although data regarding the long-term effects of marijuana use is limited, a large-scale study in New Zealand found that the primary long-term health effect of continued marijuana use is gum disease. The potential long-term mental effects require much more careful consideration and research, particularly with respect to teenagers and young adults.

While the complete eradication of opiates is unlikely, treating pain with both substances in tandem is a promising area of exploration. “By using a combination of the opioids and the cannabinoids, one can really lower the doses of both quite substantially,” Piomelli says. “By lowering the doses you of course decrease the risk of addiction and the risk of side effects from both classes of compounds.” He stresses that more research is needed to assess the possible risks of taking both substances at once.

Evidence shows that the increased availability of medical marijuana has decreased the use of opiate drugs in places including California. A 2016 study by researchers at the University of Georgia found that “in the 17 states with a medical marijuana law in place by 2013, prescriptions for painkillers and other drugs dropped significantly compared with states that did not legalize medical marijuana.” Despite these developments, current federal restrictions, along with limited funding for research and a longstanding cultural bias against marijuana, continue to tie the hands of researchers, although a recent development approved for some organizations to explore the possibilities of the plant. 

“The major cause of the delay we have is decades of misunderstanding, misconception, and misinformation on cannabis that only now after 20 years of work on the endocannabinoid system we are finally starting to dispel,” Piomelli says.

Piomelli believes that if California Proposition 64, which would legalize recreational marijuana in the state, passes this November, the government may be pushed to do certain things necessary for research on medicinal marijuana to really take off.

“This is one of the times I’ve felt the most hopeful in my life,” he says. “Things aren’t going to change immediately, but I think over the next five years we’re going to see some fundamental shifts.”

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MMJ Doctors Need To Be More Informed

130814195816-01-marijuana-medium-plus-169Doctors face medical marijuana knowledge gap

CNN - Shefali Luthra - 08/23/2016

Medical marijuana has been legal in Maine for almost 20 years. But Farmington physician Jean Antonucci says she continues to feel unprepared when counseling sick patients about whether the drug could benefit them.

Will it help my glaucoma? Or my chronic pain? My chemotherapy's making me nauseous, and nothing's helped. Is cannabis the solution? Patients hope Antonucci, 62, can answer those questions. But she said she is still "completely in the dark."

Antonucci doesn't know whether marijuana is the right way to treat an ailment, what amount is an appropriate dose, or whether a patient should smoke it, eat it, rub it through an oil or vaporize it. Like most doctors, she was never trained to have these discussions. And, because the topic still is not usually covered in medical school, seasoned doctors, as well as younger ones, often consider themselves ill-equipped.

Even though she tries to keep up with the scientific literature, Antonucci said, "it's very difficult to support patients but not know what you're saying."

As the number of states allowing medical marijuana grows -- the total has reached 25 plus the District of Columbia -- some are working to address this knowledge gap with physician training programs. States are beginning to require doctors to take continuing medical education courses that detail how marijuana interacts with the nervous system and other medications, as well as its side effects.

Though laws vary, they have common themes. They usually set up a process by which states establish marijuana dispensaries, where patients with qualifying medical conditions can obtain the drug. The conditions are specified on a state-approved list. And the role of doctors is often to certify that patients have one of those ailments. But many say that, without knowing cannabis' health effects, even writing a certification makes them uncomfortable.

"We just don't know what we don't know. And that's a concern," said Wanda Filer, president of the American Academy of Family Physicians and a practicing doctor in Pennsylvania.
This medical uncertainty is complicated by confusion over how to navigate often contradictory laws. While states generally involve physicians in the process by which patients obtain marijuana, national drug policies have traditionally had a chilling effect on these conversations.

The Federation of State Medical Boards has tried to add clarity. In an Aug. 9 JAMA editorial, leaders noted that federal law technically prohibits prescribing marijuana, and tasks states that allow it for medical use to "implement strong and effective ... enforcement systems to address any threat those laws could pose to public safety, public health, and other interests." If state regulation is deemed insufficient, the federal government can step in.

That's why many doctors say they feel caught in the middle, not completely sure of where the line is now drawn between legal medical practice and what could get them in trouble.

In New York (PDF), which legalized marijuana for medicinal purposes in 2014, the state health department rolled out a certification program last October. (The state's medical marijuana program itself launched in January 2016.) The course, which lasts about four hours and costs $249, is part of a larger physician registration process. So far, the state estimates 656 physicians have completed the required steps. Other states have contacted New York's Department of Health to learn how the training works.

Pennsylvania and Ohio are also developing similar programs. Meanwhile in Massachusetts, doctors who wish to participate in the state medical marijuana program are required to take courses approved by the American Medical Association. Maryland doesn't require training but encourages it through its Medical Cannabis Commission website, a policy also followed in some other states.

Physicians appear to welcome such direction. A 2013 study in Colorado (PDF), for instance, found more than 80 percent of family doctors thought physicians needed medical training before recommending marijuana.

But some advocates worry that doctors may find these requirements onerous and opt out, which would in turn thwart patients' access to the now-legal therapy, said Ellen Smith, a board member of the U.S. Pain Foundation, which favors expanded access to medical cannabis.
Education is essential, given the complexity of how marijuana interacts with the body and how little physicians know, said Stephen Corn, an associate professor of anesthesiology, perioperative and pain medicine at Harvard Medical School. Corn also co-founded The Answer Page, a medical information website that provides educational content to the New York program, as well as a similar Florida initiative. The company, one of a few groups to offer teachings on medical marijuana, is also bidding to supply information for the Pennsylvania program, Corn said.
"You need a multi-hour course to learn where the medical cannabis works within the body," Corn said. "As a patient, would you want a doctor blindly recommending something without knowing how it's going to interact with your other medications? What to expect from it? What not to expect?"

But many say the science is too weak to answer these questions.

One reason: the federal Drug Enforcement Agency classifies marijuana as a schedule I drug, the same level as heroin. This classification makes it more difficult for researchers to gain access to the drug and to gain approval for human subjects to participate in studies. The White House rejected a petition this past week to reclassify the drug in a less strict category, though federal authorities say they will start letting more facilities grow marijuana for the purpose of research. (Currently, only the University of Mississippi can produce it, which advocates say limits study.)

From a medical standpoint, the lack of information is troubling, Filer said.
"Typically, when we're going to prescribe something, you've got data that shows safety and efficacy," she said. With marijuana, the body of research doesn't match what many doctors are used to for prescription drugs.

Still, Corn said, doctors appear pleased with the state training sessions. More than 80 percent of New York doctors who have taken his course said they changed their practice in response to what they learned.

But even now, whenever Corn speaks with doctors about medical marijuana, people ask him how they can learn more about the drug's medical properties and about legal risks. Those two concerns, he said, likely reduce the number of doctors comfortable with and willing to discuss marijuana's place in medicine, even if it's allowed in their states.
Though others say this circumstance is starting to ease, doctors like Jean Antonucci in Maine continue to struggle to figure out how marijuana can fit into safe and compassionate medicine. "You just try and be careful — and learn as much as you can about a patient, and try to do no harm," she said.

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Say Good-Bye To Cannabis Gummies. They’ve Been Banned

Say goodbye to the bear

Dee Giznik

It’s important to ensure the safety of children; Keeping medications, cleaning products and other dangerous materials put away and out of reach of curious fingers. When it comes to THC-infused edibles, the strategy should be no different.

However, some people believe gummies shaped like bears, worms, people and fruit slices are just too appealing and tempting to children and need to be banned promptly.

On Friday, Colorado Governor, John Hickenlooper, signed a bill banning the sale and disruption of THC-infused gummies shaped like animals, fruit slices or people. The hope is, with the new bill in order, children will have less access to THC treat that looks all too familiar to them.

The infused version is nearly indistinguishable from standard gummy bears, making it easier and more likely for children to mistake the THC treat for their regular confection.

Colorado edibles must come with a stamp or sticker stating the product contains THC, but apparently that’s not enough for some. Supporters of the ban believe the gummies are simply “too attractive” for youngsters, making it nearly impossible for them not to eat if they should stumble upon them.

Um, what? When was the last time someone’s child ate an entire bottle of gummy antacids? They’re fruit shaped and can cause serious problems if too many are ingested, but responsible parents keep things like that stashed away, just like THC edibles should be.
Banned mid-year

With the gummy bear ban taking effect July 1, the cannabis market will undoubtedly bounce back, but with less fun shaped THC gummies. Squares and disc-shaped edibles are likely to be seen popping up on shelves of local dispensaries, as many manufacturers have already begun phasing out the illegal shapes.

If customers, for whatever reason, have an issue with the new shape, time is running out to stockpile the cute gummies. In less than three weeks, gummies shaped like worms, bears, people, fruit slices and any other whimsical shape will be removed and destroyed; not resold or given away as part of a compassionate care program.

Parents should be held accountable if edibles fall into the wrong hands. Just like Tylenol, Xanax or Adderall, medications are not meant to be in places where children have open access to them. If Colorado is experiencing an issue with kids accidentally ingesting THC gummies, the parents should be at fault.

Flintstone vitamins are people shaped, but we don’t ever hear about children consuming mass amounts of those. Why? Because parents know enough to keep them put up and away. Unfortunately, lesser intelligent people can’t seem to do the same with their cannabis edibles, meaning all of Colorado must suffer from poor parenting.

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Medical marijuana legalized in Pa.

By Julia Terruso, Staff Writer
HARRISBURG - Hundreds of cheering families, legislators and patients watched Gov. Wolf sign a medical marijuana bill into law Sunday afternoon, many hopeful at last for relief from debilitating pain, seizures and other medical conditions.

Allie Delp watched from her mother's lap, purple sunglasses strapped around her wide blue eyes to protect them from the light. Large crowds are tough for Allie. The 4-year-old suffers from Dravet syndrome, a severe seizure disorder, and most days she stays in the dimly lit, cool comforts of her home to avoid triggers. Today was too important not to make the drive from Ford City, said Allie's mother, Amanda Delp.

"It feels like a dream. It really does," Delp said. "If you would have asked me four years ago if I would be advocating for medical marijuana, I would have told you it's just people wanting to get high. It took my daughter for me to open my eyes and realize it can save people."

A row away from Allie, Robert Billhime Jr., 45, sat with his girlfriend and 6-week-old napping son, Aspen. Multiple back surgeries left Billhime addicted to painkillers three years ago. He lost his job, his home. Addiction nearly cost him his life, he said. "If it wasn't for the cannabis I wouldn't be here. I won't go back. I won't be an addict," he said wiping a tear from his eye and looking down at his son.

Billhime called the day a huge step in the right direction but said discrimination and misunderstanding persist. "It's still not going to change the bigotry already in the legal system. If you're a cannabis user, legal or not, you're prejudged simply because you refuse to be an addict."

Billhime said he almost lost custody of his children because the family court judge ordered he take a drug test while he was using cannabis for back pain. He had supervised visitations for six months.

In the packed rotunda Sunday there were hundreds of stories like these. People trying to make it through their pain, determined, loving parents doing whatever they could - and then some for their kids. Wearing green for cannabis - and purple, for epilepsy awareness - they erupted in cheers as Wolf signed the bill into law.

Wolf thanked the advocates, particularly the mothers who brought their kids to rally at the Capitol to give a face to the people the legalization would benefit.

"When you have people who represent a cause as eloquently and in as heartfelt a way as the advocates for this has done, it shows we can get something done that means something," Wolf said. "We're not responding to a special interest here; we're not responding to someone who makes campaign contributions - we're responding to people who are telling us there is a real human need here in Pennsylvania."

There was much congratulating among legislators for bipartisan work on the bill.

"We won!" Sen. Mike Folmer (R., Lebanon), who rallied Republicans, said to a roar as he took the podium. "This is your day!"

Democratic Sen. Daylin Leach, who represents parts of Delaware and Montgomery Counties, recalled introducing a medical marijuana bill in 2010 and failing to find a single cosigner. "The pain of illness touches us all eventually and so we all united to defeat [pain] . . . We worked together, we studied, we begged, we cajoled and we argued - and we convinced our fellow legislators to join us."

The law allows people suffering from 17 specified conditions - including cancer, epilepsy, multiple sclerosis, and seizures - to access medical marijuana in pill, oil, or ointment form at dispensaries statewide.

The Department of Health is expected to oversee what will become a new industry in Pennsylvania, with dozens of dispensaries, hundreds of workers and potentially thousands of patients. Patients would use identification cards, after receiving a doctor's prescription, to access marijuana from one of 150 dispensaries statewide. All dispensaries would be licensed by the state and face intense regulation.

Getting the system up and running could take more than 18 months before a patient can actually access medical marijuana. A provision in the bill allows families with children under 18 to obtain medical marijuana from other states where it is legal without fear of prosecution.

Temporary regulations are also expected to be written to permit adults access if they can demonstrate they suffer from one of the 17 conditions listed in the legislation.

Delp hopes to use that provision to get Allie cannabis oil in the near future. Her daughter has as many as 80 seizures a month, she said. One in five children with Dravet doesn't live to adulthood, Delp said. Many are mentally challenged and require care the rest of their lives.

"Cannabis not only gives us hope to help control the seizures, but there are children in legal states where it's been shown to help their cognition," Delp said. "Maybe she'll be able to catch up, lead a normal life."

Allie is an active tomboy (she did barefoot laps around the rotunda before the bill-signing got under way). She doesn't know to avoid triggers for the seizures that threaten her life.

"She loves riding her four-wheeler, chasing her sisters around, just being a kid," Delp said. "This - it won't solve everything - but it gives us hope, and we need hope."

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Massachusetts MMJ regulations; Less than ReaLisTic…

Proposed MA DPH regulations regarding medical-marijuana patients and caregivers

Posted by via

To:          Massachusetts Department of Public Health

From:     Andy Gaus

Re:         Proposed regulations regarding medical-marijuana patients and caregivers

Thank you for providing this forum to comment on the proposed DPH regulations on medical marijuana.

Two provisions in particular appear to make it virtually impossible for caregivers to provide the marijuana patients need while dispensaries are slowly organizing themselves:

1) Each caregiver must provide marijuana for only one patient.

2) The caregiver is not supposed to receive any compensation whatever from the patient for providing the marijuana.

Put these two provisions together, and very few people can practically step forward and become caregivers.

Bear in mind that growing marijuana indoors requires investing several hundred dollars in equipment to get started, paying high electrical bills in the ensuing months as well as ongoing costs for soil and fertilizer, and putting in hours of very real physical labor. If a patient grows for herself, these costs are repaid by the marijuana harvested and the relief it brings. But if a patient cannot grow for herself, the very considerable costs and burdens of producing the marijuana fall totally on the caregiver, with all compensation prohibited.  This isn't just unfair: it has the practical effect of making it virtually impossible to be a caregiver, which means no one can help the person who cannot grow for herself. If you wish to limit the ability of a caregiver to profit from their cottage industry, you could set a maximum number of patients (but not a maximum of one), or a maximum price per ouince, or both. A limit of, say, 20 patients per caregiver and $100 per ounce would keep caregivers and their homes from turning into for-profit dispensaries but would not leave patients with no one to turn to during a long period when cities and towns are enacting moratoriums and potential dispensary operators are clearing numerous legal hurdles.

The provision that a patient must have no more than two total sources of marijuana is also unnecessarily onerous. If all providers are supposed to use a common state database, any user of the database should be able to verify that the same patient isn't filling the same prescription multiple times at different locations. If a further check is needed, patients could be issued something like a ration book.

One senses in all these regulations the underlying assumption that a set of air-tight regulations is both necessary and sufficient to prevent  medical marijuana from being diverted to healthy recreational users, and that without such air-tight regulations, large-scale diversion is inevitable, with disastrous social consequences, particularly the increased availability to minors.

Let's be realistic: recreational users, including minors, already have total access to marijuana if they want it. Kids themselves, when surveyed, report that marijuana is easier to get than alcohol. Those who get their dope from dealers needn't fear being rejected as too young, and most of them get it, not from dealers, but from each other, in a vast informal network where everyone is both a user and a distributor. Likewise, almost all Massachusetts adults who wish to consume marijuana recreationally have found or could find a connection: marijuana prices have actually come down in recent years due to market saturation.

As officials responsible for public health, your first priority must be to make sure that patients who need marijuana for relief of painful and debilitating conditions can get it.

Minimizing diversion cannot be the main goal: it will never be effective for its stated purpose and is certain to cause unnecessary stress and pain for patients who need relief now and for the caregivers who would like to provide it .
Respectfully submitted,
Andy Gaus
Boston, MA

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By Jonathan Martin
Seattle Times staff reporter

Under a clear blue Southern California sky, four editors of Car and Driver magazine stepped on a closed driving course and got, as they later wrote, "stoned back to the bomb age."

It was all for a good purpose. There was little convincing science showing how — or how much — marijuana impaired driving ability. So they did a field test.

The editors found that they could physically operate a car even while very high, and fared well on driving tests. But their attention spans got so fragmented that they agreed getting behind the wheel was a lousy idea.

That was 1980. Thirty-two years later, scientific consensus about marijuana's effect on driving remains as foggy as the editors' brains.

But it is now a big political issue as voters consider whether to make Washington one of the first states to legalize recreational marijuana sales. For the first time in our state, Initiative 502 would set a legal impairment level for THC, the psychoactive compound in marijuana.

Based on some studies, that level — 5 nanograms of active THC per milliliter of whole blood — may be equivalent to about 0.05 percent blood-alcohol level, less than the state limit for booze. But even the experts emphasize that establishing the cutoff point when crash risk rises is "preliminary" and could change, in part because marijuana research in the U.S. is hindered by the federal ban on the substance.

The proposal is complicated, legally and politically.

Initiative 502 sets a "per se" standard making it inherently illegal to drive with more than 5 nanograms of THC. But there are no handy charts showing the number of tokes it takes to reach that level, because marijuana varies in strength and affects novice and seasoned users differently. I-502 supporters describe the DUI provision as a political and law-enforcement necessity. "This is simple: Don't drive when you think you might be impaired," said Seattle City Attorney Pete Holmes, an I-502 sponsor.

But uncertainties about the DUI provision fuel strong opposition among some marijuana-legalization advocates. They predict a rash of DUI cases based on unsettled science, and object to a zero-tolerance level for drivers younger than 21, which is also prescribed in the new law.

That provision helped turn prominent DUI lawyer Jon Scott Fox of Seattle from a likely supporter into an opponent. "I think innocent people could be, and probably will be, prosecuted based on the per se aspect of the law," he said.

Setting a limit

About 10.5 million people — 4.2 percent of the country's drivers — reported in a 2009 federal survey that they drove under the influence of an illegal drug in the past year, with marijuana by far the most common drug. Among high-school seniors, one in 10 said they'd recently driven under the influence of marijuana, according to a University of Michigan survey.

Currently, there are plenty of DUI prosecutions for marijuana, and I-502 does not change legal standards for stopping or arresting drivers.

If something other than alcohol is suspected during a traffic stop, one of 217 "Drug Recognition Experts" — specially trained police officers throughout the state — are usually called in to do a 40-minute evaluation, said Washington State Patrol Sgt. Mark Crandall, who coordinates the program.

Based on that evaluation, the driver would be asked for a blood draw at a medical facility; a search warrant also can be obtained, and drivers with four previous DUIs must give blood. About a third of the blood tests in the past three years — 1,536 out of 4,581 — found marijuana, according to Washington State Patrol data.

Because there is no current cutoff for THC, even a positive blood test for any amount, alone, is not grounds for a DUI conviction. One Seattle driver was recently acquitted for DUI despite a positive blood test because of questions about the science.

Francisco Duarte, a defense lawyer specializing in DUI cases, said that makes prosecutors prone to plea-bargain marijuana DUI cases.

But I-502 would make DUI prosecutors' jobs easier. A driver with a blood test above 5 nanograms would be presumed impaired, just as drivers with 0.08 percent blood-alcohol levels are now.

"This definitely takes away a defendant's ability to argue what impairment really means," said Duarte.

The 5-nanogram level is based on tests for active THC, which usually dissipates within hours of use. Another marijuana compound, carboxy-THC — stored in fat cells for 30 days or more, often tripping up users in workplace drug tests — is not counted under I-502 as a basis for impairment.

State Rep. Roger Goodman, a Kirkland Democrat who champions stiffer DUI laws, believes the time required for a police officer to conduct a blood test — two hours or more — will deter unwarranted stops.

"We have no reason to expect police will start pulling people over with no evidence of impairment to have blood drawn," he said.

Crandall said I-502 would not change his officers' basic duty. "We deal with impairment. You have to go all the way back to the traffic stop: What happened for the guy to have his blood drawn?"

Evolving science

Thirteen other states have "per se" laws for THC, dating back to Arizona's 1990 zero-tolerance law. The Office of National Drug Control Policy has made "drugged-driving" an enforcement priority, expecting that it will lead to safer roadways. Paul Armentano, a DUI expert with the marijuana-advocacy group NORML, said there is no data supporting that premise. Nor is there a proven need to make prosecutor's jobs' easier, he said.

"When cases are brought now, it's highly likely that the state gets a guilty verdict," said Armentano, citing figures in Colorado and California, where about 90 percent and 79 percent of DUI cases, respectively, led to convictions.

The laws are based on evolving science. A 2011 analysis by the National Institute on Drug Abuse found that studies on driving under the influence of cannabis "vary considerably," and more research is needed.

In setting a new level for impairment, I-502 cites data from nearly 3,400 fatally injured drivers in Australia, which found the risk of crash began to rise between 3.5 and 5 nanograms. But other studies undercut a clear correlation between car crashes and marijuana use.

When would an occasional user hit that level? One federal study found recreational users' THC levels fell below 5 nanograms within hours of smoking a one-gram joint. But that study used government-grown pot; the typical cannabis sold at Seattle medical-marijuana dispensaries is quadruple that strength.

Roger Roffman, a respected marijuana researcher and I-502 supporter, acknowledges that the research is preliminary. But a legalized marijuana market should also come with a warning, he said.

"We need to be mindful of what the public is told," said Roffman, a professor emeritus at the University of Washington "The initiative needs to say this is risky, because we are at a sea-change moment."

Effect on chronic users

At a recent I-502 debate at the University of Washington, medical-marijuana entrepreneur Steve Sarich warned students they could be arrested for a DUI a week after smoking a joint. "There goes your Pell Grant, there goes your college," said Sarich, who is organizing opposition to I-502.

His prediction distorts a majority of research, which finds active THC dissipates in casual users within hours.

But it can linger in frequent users, such as medical-marijuana patients. One study of such users — smoking up to 10 big joints a day — found active THC in their blood even after six days of abstinence.

I-502 makes no exemption for heavy users, including chronic pain patients.

Alison Holcomb, campaign manager for the initiative, is sympathetic to them, but said a DUI law should not be dictated by relatively rare cases. "We don't establish public policy based on outliers," she said.

The Car and Driver magazine editors, back in 1980, knew impairment when they felt it. One editor, a former race-car driver named Patrick Bedard, found his driving times improved slightly — when he "could muster the concentration."

But the higher he got, he felt less inclined to do so. "I'm a vegetable, inert, wordless, focused inward, contemplating the rapture," he wrote at the end of the experiment. "Every once in a while, I snap to and can't figure out where we are. But who cares?"

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New Jersey: Gets the Go-Ahead!

New Jersey's first medical-marijuana dispensary wins clearance to begin selling

By Jan Hefler
Inquirer Staff Writer

New Jersey's first medical marijuana dispensary has been cleared to begin selling the drug to patients who register with the state Department of Health.

After weeks of setbacks, Greenleaf Compassion Center received a permit Monday to open for business in a former drug paraphernalia shop in Montclair, Essex County. The nonprofit organization will be allowed to offer only strains with reduced potency.

Health Commissioner Mary O'Dowd said Greenleaf had passed its final inspections, but could not say when the dispensary would open for business. Asked if it would do so before the end of the year, she said: "I would expect that."

In August, when patients could begin signing up, O'Dowd had anticipated that Greenleaf would start dispensing marijuana in September. On Monday, she would say only that Greenleaf would open when it was ready.

Greenleaf chief executive Joe Stevens and his partner, Julio Valentin Jr., did not return calls seeking comment.

In August, Stevens also said he expected an early-September launch, but later explained that Montclair officials had told him it would take a few weeks to issue a certificate of occupancy after the building was renovated. He also said he did not know the Health Department would require laboratory testing of the marijuana before granting final approval.

O'Dowd said photo ID cards would be mailed to the 190 patients who registered with the Health Department after their doctors certified that they had medical conditions that can be alleviated by marijuana. An additional 130 patients are still going through the registration.

More than a year ago five other nonprofit companies received preliminary approval to open dispensaries, but they have been stymied by the lengthy process.

New Jersey is one of 17 states to allow medical marijuana despite a federal ban on the use of the substance. Federal officials have told the states they will not enforce the ban if marijuana is dispensed only to sick people and if state regulations are obeyed.

O'Dowd said her agency wanted to make sure New Jersey's program could withstand legal challenges and had taken the time to put together regulations to protect the public as well as patients. One of the challenges in implementing the program, she said, is that "the federal government views this as an illegal product."

Some dispensary owners and patients believe the state has been overly cautious and restrictive, causing patients to needlessly suffer.

Compassionate Care Foundation, one of the two nonprofits that plan to open a dispensary in South Jersey, has had to push back its estimated opening date many times in the last year because of problems getting local and state approvals. Its principal officers have had to undergo more than eight months of background checks, including extensive scrutiny of their finances.

William J. Thomas, the dispensary's chief executive, said last month that his company might be forced to abandon its plans if the background checks are not finalized soon.

O'Dowd said Monday those checks had not been completed. Thomas did not return a call and e-mail seeking comment.

Patients also have been getting anxious, especially those who paid the state's $200 registration fee in August and were expecting to receive their medicine last month.

"As each day passes, there's someone new who is suffering and someone new at risk of being prosecuted for self-medicating" by purchasing marijuana on the black market, said Rich Caporusso, a Medford man who was among the first patients to register.

He has Crohn's disease. He said his doctor believes his pain can be controlled by marijuana without the side effects of stronger drugs. In April, he sued the Health Department, saying it was stalling and ignoring patients' pain.

The medical marijuana law that then-Gov. Jon S. Corzine signed in January 2010 was supposed to be implemented that summer. But when Gov. Christie took office a few weeks after the signing, he wanted a full review of its provisions and also assurances from the federal government that there would be no prosecution.

The Health Department also took months to craft stringent regulations to limit the drug to patients with terminal illnesses, multiple sclerosis, and other serious ailments.

Jay Lassiter, an AIDS/HIV patient from Cherry Hill, said the Health Department's announcement was "wonderful news." He said he hoped there were no more snags.

He said the news was bittersweet because it came too late for Diane Riportella, a friend and patient activist who had testified at hearings, urging the Health Department to stop the delays in implementing the program.

She died last month of ALS (Lou Gehrig's disease). "She should have been first in line," Lassiter said.

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Obama // Romney // Legalization?

Ads running to legalize marijuana in three states
By Carl Marcucci

In November, voters in Colorado, Washington and Oregon will consider legalizing marijuana for recreational use. Although similar initiatives have failed in the past, this time the groups fighting to legalize pot are well-organized, professional and backed by high-dollar donors willing to outspend the competition, reports Raycom News Network.

In Colorado, the Campaign to Regulate Marijuana Like Alcohol (CRMLA) has produced several ads that say marijuana is healthier than alcohol. The campaign’s website points to medical studies that claim marijuana, unlike alcohol, has not been linked to cancer, brain damage, addiction or high healthcare costs.

CRMLA was given nearly $1.2 million from the Marijuana Policy Project, a DC-based lobbying group, as well as more than $800,000 by Peter Lewis, the founder and chairman of Progressive Insurance. Lewis has been a vocal proponent of marijuana legalization for several years and donated millions to legalization efforts around the country.

In an online video ad campaign, CRMLA has young adults explaining to their parents they prefer marijuana to alcohol. In one of the ads, titled Dear Mom, a 20-something woman tells her mother marijuana is “better for my body, I don’t get hung-over and honestly I feel safer around marijuana users.”

In Washington, rather than comparing marijuana to alcohol, New Approach Washington (NAW) is focusing on legalization, arguing outlawing cannabis does more harm than good, by wasting tax dollars on law enforcement while letting gangs control the money. She describes the possible benefits of legalization through saved law enforcement dollars and extra tax revenue.

The TV spot has a professional/executive looking woman, “I don’t like it personally, but it’s time for a conversation about legalizing marijuana. It’s a multi-million dollar industry in Washington state, and we get no benefit.”

These efforts appear to be working. In Washington, 50% of voters say marijuana should be legal while 38% say it should not, according to an Elway Research poll. And in Colorado, a Denver Post poll showed 51% of Coloradans were in favor of legalization, while 41% opposed it.

In Washington, the effort to legalize marijuana is being fought with a bankroll of between $4 and $5 million, according to the Raycom News Network story. NAW used those funds to put $1 million into television advertising during August, and hope to put triple that amount into the weeks preceding the November vote.

In total, groups in Colorado fighting to get marijuana legalized have a war chest of $2.5 million.

The campaigns are especially targeting women ages 30 to 55, whom tend to be less supportive of legalization and regulation than men.

The only visible group opposing the marijuana ballot, SMART Colorado, has been given less than $200,000 – most of it from Save Our Society, a Florida-based anti-drug group.

RBR-TVBR observation: Interesting that the Chairman of Progressive Insurance is donating so much money in this legalization effort. Perhaps legalizing it would create fewer accidents/injuries from police chases and save the insurance industry money? We doubt drivers with the stuff in their car would try to flee if it’s no more illegal than a pack of cigarettes. Who knows, but Progressive is a big corporation and Lewis seems to not be concerned about sticking his neck out on this.

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