Tag Archives: medicine

Small steps forward for medical marijuana in big ol’ Texas

Originally posted by Lauren L’Amie, April 4, 2017, here

 

The possibilities seem endless in a place as big as Texas—a state where you can you can buy guns and groceries in the same trip, or easily and legally purchase exotic animals.

Still, in all but one county, possession of two ounces or less of marijuana can result in a misdemeanor charge, up to 180 days in prison, or a fine of up to $2,000. Four or more ounces is a federal offense punishable by up to two years in prison. Could that soon change?

Police arrest an estimated 70,000 Texans annually for marijuana possession, usually in small amounts. But according to recent polls, 68 percent of Texans support reducing penalties for low-level marijuana possession.

Safe to say, it’s taken the legislators in the Lone Star State a little too long to catch up to public opinion. With the passage of new medical marijuana policy, however, the Texas legislature isn’t as far away from legalizing weed as it would seem.

In September 2017, the Texas Compassionate Use Act, Texas’s first small medical marijuana victory, is set to become viable law thanks to the exhaustive efforts of lobbying groups across the state.

The Compassionate Use Act allows patients with epilepsy access to low-THC marijuana and CBD oil, both of which have been proven to prevent seizures and replace other epilepsy drugs that come with nasty side effects. Texas Gov. Greg Abbott, who signed the bill into law in June 2015, said it would provide “healing and hope for children,” although he reiterated that its signing does not open the door for recreational marijuana use in Texas.

Heather Fazio, the Texas political director for the Marijuana Policy Project, said that despite Abbott’s show of support, the regulatory nature of this legislation does virtually nothing to help the very few patients that it claims to benefit.

“While the passage of this legislation was monumental in that the Texas legislature acknowledged cannabis as medicine, the existing program is unreasonably restrictive,” Fazio says.

According to the legislation, the state will only grant permission to patients who have “intractable epilepsy,” meaning they must have already exhausted two other prescription drug options with no success. Not only that, patients must also receive official prescriptions for cannabis from two state-licensed physicians before they can access treatment.

Medicinal cannabis has been proven to help adults and children by reducing seizure frequency regardless of whether their condition is “intractable” by the Texas definition. One study conducted this year showed a whopping 90 percent of epilepsy patients reported success using cannabis products rather than other seizure medication.

In the 28 other states where medical marijuana programs exist for patients, patients have to go through a formal process to be certified to use medical marijuana. Since it’s illegal under federal law to prescribe cannabis, patients can receive recommendations and certifications directly from a physician, enabling them to then seek out legal dispensaries. But under the Texas Compassionate Use, “recommendations” and “certifications” are not technically the same as a “prescription.”

For Fazio, the flawed language in the bill is perhaps the most problematic in that it doesn’t protect doctors. If the bill’s framing stays as it is now, Texas physicians are required to “prescribe” cannabis—which is both illegal and puts doctors in danger of losing their DEA registration.

“This is all legal semantics, and it’s kind of annoying,” Fazio says. “But it is important so that doctors have the confidence they need to move forward with getting their patients access to this medicine that can help them.”

Policy shifts in Texas tend to begin with smaller trial runs in pockets across the state alongside massive lobbying efforts, like those of Fazio and organizations like Texans for Responsible Marijuana Policy.

In recent years, Texas has had hints of tiny weed victories across the state—Houston’s Harris County, for instance, is currently the only county in the state that allows offenders caught with four ounces or less of the drug the option to take a $150 “cognitive decision” class rather than walk away with a misdemeanor charge on their record as part of new county legislation passed March 1.

In 2015, State Representative David Simpson (R-Longview) submitted HB 2165 in support of recreational marijuana use. A Tea Party-backed Republican, Simpson made a case for a traditionally liberal issue with a deeply conservative, unexpectedly religious backbone: weed, Simpson argued, was made by God. And a righteous God doesn’t make mistakes.

“I’m especially cautious when it comes to laws banning plants,” Simpson writes, “I don’t believe that when God made marijuana he made a mistake that government needs to fix.”

As the Compassionate Use Act’s Sept. 1 implementation date approaches, the state is required to issue a minimum of three cannabis business licenses by the end of April. Until then, two companion bills, HB 2107 and SB 269, are in committee pushing for the expansion of both the language and scope of the Compassionate Use Act. If passed, the bills will allow patients to access the medicine they need without a hitch while assuring that Texas physicians are protected.

“It’s allowing them access to this medicine that can greatly improve their quality of life and decrease suffering,” Fazio says. “And ultimately, give them the medicine that can help them in lieu of the pharmaceutical drugs that for many have proven to be dangerous and addictive.”

Would legalizing medical marijuana help curb the opioid epidemic?

Originally published by Ronnie Cohen Mon Mar 27, 2017 | 4:46pm EDT here

(Reuters Health) – In states that legalized medical marijuana, U.S. hospitals failed to see a predicted influx of pot smokers, but in an unexpected twist, they treated far fewer opioid users, a new study shows.

Hospitalization rates for opioid painkiller dependence and abuse dropped on average 23 percent in states after marijuana was permitted for medicinal purposes, the analysis found. Hospitalization rates for opioid overdoses dropped 13 percent on average.

At the same time, fears that legalization of medical marijuana would lead to an uptick in cannabis-related hospitalizations proved unfounded, according to the report in Drug and Alcohol Dependence.

“Instead, medical marijuana laws may have reduced hospitalizations related to opioid pain relievers,” said study author Yuyan Shi, a public health professor at the University of California, San Diego.

“This study and a few others provided some evidence regarding the potential positive benefits of legalizing marijuana to reduce opioid use and abuse, but they are still preliminary,” she said in an email.

Dr. Esther Choo, a professor of emergency medicine at Oregon Health and Science University in Portland, was intrigued by the study’s suggestion that access to cannabis might reduce opioid misuse.

“It is becoming increasingly clear that battling the opioid epidemic will require a multi-pronged approach and a good deal of creativity,” Choo, who was not involved in the study, said in an email. “Could increased liberalization of marijuana be part of the solution? It seems plausible.”

However, she said, “there is still much we need to understand about the mechanisms through which marijuana policy may affect opioid use and harms.”

An estimated 60 percent of Americans now live in the 28 states and Washington, D.C. where medical marijuana is legal under state law.

Meanwhile, the opioid epidemic – sparked by a quadrupling since 1999 in sales of prescription painkillers such as Oxycontin and Vicodin – kills 91 Americans a day.

Shi analyzed hospitalization records from 1997 through 2014 for 27 states, nine of which implemented medical marijuana policies. Her study was the fifth to show declines in opioid use or deaths in states that allow medical cannabis.

Previous studies reported associations between medical marijuana and reductions in opioid prescriptions, opioid-related vehicle accidents and opioid-overdose deaths.

In a 2014 study, Dr. Marcus Bachhuber found deaths from opioid overdoses fell by 25 percent in states that legalized medical marijuana.

Since last year, when New York rolled out its medical marijuana program, Bachhuber has included cannabis in a menu of options he offers his patients who suffer chronic or severe pain from neuropathy and HIV/AIDS, he said in a phone interview. Bachhuber, a professor at the Albert Einstein College of Medicine and Montefiore Medical Center in the Bronx, was not involved in the new study.

Many of Bachhuber’s patients ask for help quitting highly addictive opioids, and some have used marijuana to taper off the prescription painkillers, he said.

Nonetheless, a 1970 federal law puts cannabis in the same category as heroin, Schedule 1 of the Comprehensive Drug Abuse Prevention and Control Act, and finds it has no medicinal value. Consequently, doctors can only recommend, not prescribe, marijuana, and physicians who work for the federal government cannot even discuss the weed.

Federal prohibition also has led to severe limitations on marijuana research.

In January, a National Academies report found conclusive or substantial evidence that cannabis can effectively treat chronic pain, chemotherapy-induced nausea and spasticity. The report, written by an independent panel of medical experts, found no evidence of cannabis overdose deaths.

It did, however, find links between cannabis use and an increased risk of vehicle accidents as well as the development of schizophrenia or other psychoses, particularly among the most frequent users.

Bachhuber lamented the dearth of research on the best ways to use marijuana as medicine.

“We have information that it works based on the National Academies’ report,” he said. “But we don’t know who it works best for, at what dosage, for how long.”

Last week, U.S. Attorney General Jeff Sessions, the nation’s top cop, reiterated his concerns about marijuana and heroin, an illegal opioid.

“I am astonished to hear people suggest that we can solve our heroin crisis by legalizing marijuana,” he told law enforcement officers in Virginia, “so people can trade one life-wrecking dependency for another.”

SOURCE: bit.ly/2mRVepg Drug and Alcohol Dependence, online February 21, 2017.