Published: Sun, 23 Apr 2017 00:00:00 -0400
Last Build Date: Sun, 23 Apr 2017 01:27:05 -0400
Thu, 20 Apr 2017 09:45:00 -0400Yesterday West Virginia Gov. Jim Justice signed a bill that makes his state the 29th to allow medical use of marijuana. West Virginia is the sixth state to legalize medical marijuana in the last year and the third (along with Ohio and Pennsylvania) to do so through the legislature. In the other three states—Arkansas, Florida, and North Dakota—voters approved ballot initiatives authorizing medical marijuana last November. West Virginia's new law recognizes marijuana as a treatment for patients with terminal illnesses or any of 14 specified conditions, including cancer, HIV/AIDS, epilepsy, multiple sclerosis, Crohn's disease, post-traumatic stress disorder, and intractable pain. Patients whose doctors recommend marijuana will be able to obtain it in the form of pills, oils, gels, creams, ointments, tinctures, liquids, and vaporizable extracts from state-regulated dispensaries. The dispensaries will not sell buds for smoking or marijuana edibles, although patients can prepare their own at home. The law does not allow home cultivation, and patients can legally possess no more than a month's supply at a time. "This legislation is going to benefit countless West Virginia patients and families for years to come," says Matt Simon of the Marijuana Policy Project (MPP), a West Virginia native. "Medical marijuana can be effective in treating a variety of debilitating conditions and symptoms. It is a proven pain reliever, and it is far less toxic and less addictive than a lot of prescription drugs. Providing patients with a safer alternative to opioids could turn out to be a godsend for this state." One downside to West Virginia's law is a new standard for driving under the influence of marijuana that erroneously equates impairment with a blood THC level of three nanograms per milliliter. That's even lower than the unfair and unscientific five-nanogram cutoff that Colorado and Washington adopted when they legalized marijuana for recreational use. As MPP notes, West Virginia's DUID standard "could make it illegal for some patients to ever drive, since many patients have THC levels at this amount or greater many hours or days after last administering cannabis." West Virginia's rules put it on the less liberal end of a medical marijuana spectrum that ranges from highly permissive (e.g., California) to highly restrictive (e.g., New York). Eight of the 29 medical marijuana states also allow recreational use. Medical use was approved by ballot initiative in 14 of those states, beginning with California in 1996. In the rest, as in West Virginia, medical marijuana laws originated in the state legislature. Another 18 states have approved medical marijuana laws that MPP deems "ineffective because they are either unworkable or exceptionally restrictive." These laws allow use of specific cannabis products—typically low-THC, high-CBD extracts—and often do not provide a way to legally obtain them. But if you count those 18 states, MPP says, "only three states—Idaho, Indiana, and Kansas—have not approved any form of medical marijuana law." Although the federal government still does not recognize any legitimate use for marijuana, surveys find strong popular support for letting patients have access to it. A Quinnipiac University Poll conducted in February and a Marist Poll conducted last month put support for medical marijuana at 93 percent and 83 percent, respectively. In both surveys, large majorities of both Republicans and Democrats favored medical access, as does President Trump. Even his attorney general, arch-prohibitionist Jeff Sessions, concedes that "dosages can be constructed in a way that might be beneficial."[...]
Wed, 19 Apr 2017 17:15:00 -0400Pittsburgh Pirates outfielder Starling Marte was suspended Tuesday after testing positive for the testosterone derivative Nandrolone, an androgenic compound that increases lean body mass and strength, decreases fat mass, and expedites soft tissue repair. Prolonged use also causes left ventricular hypertrophy and high blood pressure, but it's the first set of effects that'll cause Marte to miss 80 games and render him ineligible for postseason play in the event the Pirates make it that far without him. Over at Yahoo!, MLB columnist Jeff Passan argues that Marte's suspension means we should revisit, for the millionth time, the MLB's policy on performance enhancing drugs. "The line between so-called PEDs and other drugs isn't thin. It just doesn't exist," Passan writes, citing the MLB's broad use of anti-inflammatories and other painkillers, which players can gobble without fear of getting their pay docked and being dragged through the mud. "The only reason PEDs are considered cheating is because federal drug policies stigmatized certain substances, and those now come with a scarlet S. Never mind that most players who take drugs today do so in order to deal with the rigors of a full season – of the grind, the travel, the responsibility to maintain playing shape in an environment that grows less conducive to it as the demands to do more increase." Baseball is America's most vengeful sport, governed by an esoteric code that allows victims of bat-flips and joyful baserunning to retaliate with violence, so it makes (some) sense that the reactions to Marte's rule-breaking have been Jeff Sessions-like, with one fellow MLBer suggesting that Marte's wages should be permanently depressed for the rest of his career: Historically, fans have been no more forgiving, at least when it comes to juice. Shortly after Pete Rose admitted to betting on games while managing the Reds, Gallup asked sports fans which offense was more serious. They chose PEDs by a mile: But I thought baseball was about rules! The MLB's drug policy is not uniquely stupid. Former players are suing the NFL for pumping them full of painkillers and NSAIDs to keep them on the field, a vicious cycle that former NFL wide receiver Nate Jackson gruesomely documents in his memoir Slow Getting Up. Are fans outraged about guys playing hurt? Maybe, but I suspect they care far more about players being better than they should be, like that time people could not shut the hell up about allegations Peyton Manning used HGH after neck surgery. Meanwhile, the Buffalo Bills suspended a player last year for using medical marijuana, under a doctor's supervision, to treat Crohn's disease. Not even the NBA--arguably America's most socially liberal league (David Stern's racist dress code notwithstanding)--is above this nonsense. Last month, it suspended Knicks center Joakim Noah for 20 games after he used a research chemical to heal faster from an injury. There is no drug in existence that could make Noah worth the concrete boots of a contract he signed with the Knicks last summer, because there is nothing you can inject into a surgically repaired 32-year-old seven-footer that will make him less old, less tall, or less busted. (And besides, is suspending him really worse than making him play in front of the mouth breathers at Madison Square Garden, recently seen booing the best Knicks pick since Patrick Ewing?) Like Passan, I think it's time to revisit the PED standards for most sporting bodies, if only to bask in the dysfunction that's sweeping the globe. I speak of the Therapeutic Use Exemption (TUE), in which the MLB has been a two-faced pioneer. Back in 2005, when the MLB announced it was going to crack down on amphetamine use--as deeply ingrained a baseball tradition as beaning guys for enjoying the game--it did so by allowing players to medicalize said use. Now, when the the MLB Players Association releases its annual report on drug testing in the league, you see two or three folks test positive for prohibited amphetamines, while more than 100 players have[...]
Wed, 19 Apr 2017 07:30:00 -0400In a Meet the Press interview on Sunday, Homeland Security Secretary John Kelly said "marijuana is not a factor in the drug war," which is instead focused on methamphetamine, heroin, and cocaine. Apparently that dismissive comment got Kelly into trouble, because two days later, in a speech at George Washington University, he gave marijuana top billing in his description of the drug threat posed by "transnational criminal organizations." And lest anyone think Kelly does not take marijuana seriously, he added three paragraphs emphasizing that he does: Let me be clear about marijuana. It is a potentially dangerous gateway drug that frequently leads to the use of harder drugs. Additionally, science tells us that it is not only psychologically addictive but can also have profound negative impact on the still developing brains of teens and up through the early 20s. Beyond that, however, its use and possession is against federal law and until the law is changed by the U.S. Congress we in DHS are sworn to uphold all the laws on the books. DHS personnel will continue to investigate marijuana's illegal pathways along the network into the U.S., its distribution within the homeland, and will arrest those involved in the drug trade according to federal law. CBP will continue to search for marijuana at sea, air and land ports of entry and when found take similar appropriate action. When marijuana is found at aviation checkpoints and baggage screening TSA personnel will also take appropriate action. Finally, ICE will continue to use marijuana possession, distribution and convictions as essential elements as they build their deportation / removal apprehension packages for targeted operations against illegal aliens. They have done this in the past, are doing it today, and will do it in the future. No doubt Kelly's marijuana comment on Meet the Press annoyed Attorney General Jeff Sessions, an old-fashioned drug warrior who believes "good people don't smoke marijuana" and has hinted that he plans to ratchet up enforcement of the federal ban in states that have legalized pot. Before yesterday's conspicuous correction, Washington Post reporter Derek Hawkins claimed Kelly and Ashcroft had staked out "two vastly different positions on marijuana" and "could hardly be further apart." But it's not as if Kelly has ever expressed any doubt about the wisdom or fairness of pot prohibition. As head of the U.S. Southern Command in 2014, Kelly complained that marijuana legalization in Colorado and Washington had made foreign officials less keen to help him stop Americans from getting the drugs they want. He reiterated that complaint in a Military Times interview last November, during which he said he was, like Donald Trump, open to medical use of marijuana but against broader legalization. "It is a gateway," Kelly said. "There's no doubt." Sessions sounds only somewhat more skeptical about marijuana's medical potential, saying, it "has been hyped, maybe too much," although "dosages can be constructed in a way that might be beneficial." Even Kelly's statement about marijuana to Meet the Press host Chuck Todd seemed to be aimed at deflating the idea that anything good could come from legalization: Todd: Marijuana legalization, does that help your problem or hurt your problem? Kelly: Yeah, marijuana is not a factor in the drug war. Kelly's concern about marijuana's role as a "gateway" to "harder drugs," of course, implicitly concedes that marijuana is less dangerous than other illegal intoxicants. But such talk has been a staple of anti-pot propaganda since Harry Anslinger was running the Federal Bureau of Narcotics, and even Sessions concedes that marijuana is "slightly less awful" than heroin. In short, notwithstanding The Washington Post's hyperbolic take, there is not much daylight between Kelly and Sessons on this issue.[...]
Wed, 19 Apr 2017 00:05:00 -0400You can't pick up a newspaper, turn on the TV or radio, or access any online news source without encountering headlines screaming "opioid epidemic." There is the alarming rise in the number of chronic pain patients who have become addicted to opioids. And the explosion, in recent years, of opioid prescriptions by health care providers now under government pressure to curtail their prescribing. This pressure has driven many opioid addicts to the illicit drug market to avoid the pains of withdrawal. There, according to the Centers for Disease Control and Prevention (CDC), they often find opioid heroin cheaper and sometimes more readily available despite a 50-year "War on Drugs." Thus they become heroin addicts. Media hysteria begets calls to action. Politicians and the administrative state devise new laws to control this "evil plague." As a surgeon who regularly prescribes painkillers for patients suffering from postoperative pain or painful conditions, I see a painful cognitive dissonance. Begin with US policy towards heroin. Originally developed in the 1870s, diacetyl-morphine was marketed under the brand name Heroin, by the Bayer pharmaceutical company. Despite pleas by the Surgeon General and the American Medical Association to keep it legal, Heroin was banned in the US in 1924 because political leaders believed it the drug corrupted an individual's moral character. Meanwhile, dilaudid, 3 to 4 times more potent than morphine, is legal and is routinely administered for pain both as an oral and an injectable agent. Fentanyl, or Duragesic, is legal, too, although it is more than 50 times the potency of morphine. There is even greater cognitive dissonance with methadone, the powerful opioid approved for use in the US in 1947 and commonly used in this country to treat addiction to heroin and other opioids. Chronic users of opioids develop a tolerance, requiring ever-increasing doses to achieve the desired effect. A low, oral dose of methadone binds with enough of a person's opioid receptors to prevent withdrawal symptoms yet not produce the euphoric effects. The idea behind "methadone maintenance" programs is to transfer the addiction from heroin or another opioid. Because they do not experience the euphoria and "escape" of their chosen opioid, methadone addicts can resume a normal, productive—even conventional—life. Some can be tapered off from methadone and "detoxified." But many remain on methadone, sometimes for their entire lives. To put things in proper perspective, chronic alcohol use is much more dangerous. Chronic use can cause cirrhosis of the liver, cardiomyopathy (heart failure from damaged heart muscle), encephalopathy and dementia, chronic pancreatic inflammation, and has been linked to cancer of the stomach and the esophagus. In addition, one can overdose on alcohol as well—which may cause a person to stop breathing, become hypoxic, and die. And here's where the cognitive dissonance comes in: it is perfectly acceptable and permissible—even public policy—to allow people to be chronically addicted to the opioid methadone. The side-effects of prolonged use are considered serious yet tolerable. But it is unacceptable and counter to public policy for a person to be chronically addicted to any other opioid, even if that person self-doses to prevent withdrawal while avoiding the "high" in order to lead a peaceful and productive life. The concept of "harm reduction" as an approach to substance abuse has gained increased acceptance by health care practitioners as well public health and government authorities. Harm reduction approaches chemical dependency in a non-judgmental and realistic way, leaving drug prohibition in place. The strategy seeks to ameliorate the most destructive effects of prohibition on the individual drug user and addict. The health care practitioner focuses on minimizing the addict's self-inflicted harm. Clean needle-exchange programs to prevent the spread HIV and hepatitis are a part of harm reduction. Met[...]
Tue, 11 Apr 2017 15:15:00 -0400
(image) Pennsylvania's Tom Marino, a three-term member of the House of Representatives and a former prosecutor, will likely be Trump's nominee to head the Office of National Drug Control Policy, CBS reports. More:
A source familiar with personnel moves in the White House says that Marino is in the final stages of completing his paperwork and an official announcement is forthcoming. When asked for comment, the White House said it had no personnel announcements at this time. Marino's office had no comment.
Marino, who is serving his third term representing Pennsylvania's rural 10th congressional district, was appointed to serve on the House's bipartisan committee combating the opioid epidemic in 2016 after the enactment of two bills he introduced on drug control.
Marino spent 10 years as District Attorney of Lycoming County before President George W. Bush nominated him in 2002 as the U.S. Attorney for the Middle District of Pennsylvania, where Marino says he prosecuted "a wide range of federal offenders, from violent criminals and drug dealers to white collar businessmen who cooked the books."
As a member of the House, he's also voted against pretty much every piece of marijuana reform legislation:
New Trump drug czar voted NO on all medical marijuana amendments, including limited CBD and veterans ones. https://t.co/CCCfo2dEph— Tom Angell (@tomangell) April 11, 2017
While the Trump White House declined to comment, marijuana prohibitionist Kevin Sabet told CBS News, "My understanding is that Tom has a deep understanding of the issue and is excited to get started."
Tom Angell, the most dogged reporter of marijuana policy news I know, is currently combing through Marino's record of drug policy statements. Here's a taste:
"One treatment option I have advocated for years would be placing nondealer, nonviolent drug abusers in a secured hospital-type setting under the constant care of health professionals," he wrote. "Once the person agrees to plead guilty to possession, he or she will be placed in an intensive treatment program until experts determine that they should be released under intense supervision. If this is accomplished, then the charges are dropped against that person. The charges are only filed to have an incentive for that person to enter the hospital-slash-prison, if you want to call it."
More from Angell here.
Thu, 06 Apr 2017 07:00:00 -0400
(image) On Tuesday night California Gov. Jerry Brown unveiled proposed legislation aimed at reconciling Proposition 64, the 2016 ballot initiative that legalized cannabis for recreational use in that state, with the medical marijuana regulations that state legislators approved in 2015. The bill generally favors the more liberal rules of Proposition 64, a.k.a. the Adult Use of Marijuana Act (AUMA), over the more restrictive provisions of the Medical Cannabis Regulation and Safety Act (MCRSA), which is good news for entrepreneurs and consumers.
California officials plan to start distributing marijuana licenses by next January, but first legislators have to decide how that will work. The MCRSA requires independent marijuana distributors, similar to the state-appointed middlemen who have the exclusive right to distribute alcoholic beverages in most states, and restricts other licensees (growers, manufacturers, transporters, and retailers) to no more than two categories. The AUMA does not require independent distributors and imposes no restrictions on vertical integration, except that testing companies cannot hold other licenses.
Brown thinks the latter approach makes more sense. "Overly restrictive vertical integration stifles new business models and does not enhance public and consumer safety," he says. "Allowing for a business to hold multiple licenses including a distribution license will make it easier for businesses to enter the market, encourage innovation, and strengthen compliance with state law."
Brown also favors the AUMA's narrower definition of cannabusiness "owners" who are required to undergo background checks. The AUMA sets the threshold at a 20 percent ownership stake, compared to 5 percent under the MCRSA.
Brown's bill preserves the MCRSA's limit on the number of midsized growers "in furtherance of the intent of Proposition 64 to prevent illegal production and avoid illegal diversion to other states." It also prohibits medical and recreational retailers, who will collect different taxes and enforce different age restrictions, from operating under the same roof. That separation might help the Trump administration, which according to White House Press Secretary Sean Spicer supports medical marijuana but frowns on recreational use, target some cannabusinesses while leaving others alone.
The Drug Policy Alliance (which backed the AUMA), the California Cannabis Industry Association, the United Food and Commercial Workers Western States Council, and the California Cannabis Manufacturers Association are pleased with Brown's proposal. The Teamsters, who represent the employees of state-mandated alcohol distributors and hoped to represent the employees of state-mandated cannabis distributors, are not. "We're going to fight that part of it really hard," Teamsters lobbyist Barry Broad told The Sacramento Bee. "It raises really significant anti-trust issues that we don't think are accounted for....It's quite conceivable that the entire market can be owned by someone who also controls distribution and access to the market. It's a big problem."
For the Teamsters, yes. For the rest of us, not so much.
Wed, 05 Apr 2017 17:41:00 -0400The United States is currently home to zero facilities where users of illicit intravenous drugs can get high under a doctor's supervision. Seattle and King County, Washington recently announced plans to open two such facilities, called supervised injection sites. Later this month, the Massachusetts Medical Society will vote to ask their state to do likewise. "It's about trying to get individuals into an environment, where they have a much better chance of surviving their substance use disorder, to a point in time where they actually are able to make progress in recovery," Dr. Dennis Dimitri tells Boston's WBUR. "We felt that the ethics of doing this were justifiable, that putting a program such as this in place would do more benefit than any harm." The trustees will ask their members to vote in favor of a supervised injection site pilot later this month. Vancouver's Insite, a supervised injection site opened in 2003, has had 3.5 million visits, 5,000 overdoses, and zero deaths. (Seattle Mayor Ed Murray visited Insite, and it cemented his decision to bring the model to his city.) The Sydney Medically Supervised Injecting Centre in Sydney, Australia, opened in 2001. In the intervening decade and a half, it's received 860,000 visits during which 4,397 people have overdosed and zero have died. Supervised injection sites, in other words, are really good at keeping heroin and opioid users alive. They're staffed by medical professionals and stocked with clean needles and the overdose reversal drug Naloxone. People who want to quit can talk to addiction experts about their options, like medication-assisted therapy. People who don't want to quit can use without dying, or contracting and spreading diseases like HIV and hepatitis. These facilities work so well that even Iran uses them. And yet the U.S., which consumes more prescription opioids than any nation on Earth, has zero. "I just don't think that that's the direction we ought to be going in," Norwood Police Chief William Brooks told WBUR, of the Massachusetts Medical Society statement. "It does feel like we're giving up, we're throwing our hands up, and I don't think we should do that." Brooks is not a bad guy. He applauded Massachusetts Attorney General Maura Healey's deal with Amphastar Pharmaceuticals to subsidize the purchase of Naloxone for Massachusetts first responders, saying it was in "keeping with our core mission to protect human life." But there are echoes of Maine Gov. Paul LePage in his reluctance to get on board with a safe injection site. This time last year, LePage vetoed a bill that would allow pharmacies to sell Naloxone without a prescription, saying access to the drug "serves only to perpetuate the cycle of addiction." In a way, LePage was right: Keeping an overdose victim alive increases the odds that person will get high again, because their odds of ever using again are zero if they're dead. In a similar way, Brooks is right: Giving users a safe place and clean equipment is a concession to the reality of drug addiction. More policymakers should make that concession, because the relevant policy questions are these: 1.) What keeps users alive? 2.) What curtails the spread of communicable diseases associated with illicit drug use? 3.) What brings problem users into contact with people who can help them? 4.) What treatments work for people who want to quit? Right now, people are dying from drug overdoses because policymakers have allowed their distaste for aberrant behavior to supersede globally recognized best practices. Brooks, and others like him, can continue to hate heroin and Oxy and fentanyl, to despise the toll of addiction, to mourn the design flaws of the human brain. But it is unacceptable for harm reduction skeptics to block such efforts while decrying overdose deaths. We can have a living drug war, or living drug users. It should be clear by now that we can't have both.[...]
Thu, 30 Mar 2017 17:53:00 -0400
(image) The best part of moral panics is that the people succumbing to them don't realize it. Those Salem Witch Trial perpetrators? They knew that witches abounded (read this excellent biography of Samuel Sewall, a judge who literally wore sackcloth and ashes in penance for his role in executing people). Same thing with the folks behind scares over ritual satanic child abuse in the 1980s (hello, Janet Reno) and so many other bizarro scares.
The latest chapter in this comes courtesy of Sens. Dianne Feinstein (D-Calif.) and Chuck Grassley (R-Iowa), who have introduced "The Protecting Kids from Candy-Flavored Drugs Act of 2017" because...
There are many instances of drug dealers altering flavor and packaging of cocaine or methamphetamines to appeal to children.— Sen Dianne Feinstein (@SenFeinstein) March 30, 2017
The legislation would:
- Provide an enhanced penalty when a person manufactures, creates, distributes, dispenses, or possesses with intent to distribute a controlled substance listed in Schedule I or Schedule II that is:
- Combined with a beverage or candy product,
- Marketed or packaged to appear similar to a beverage or candy product, or
- Modified by flavoring or coloring to appear similar to a candy or beverage product.
(image) Which is to say that it would take aim not so much at coke or meth—we await still the introduction of Sour Kids Meth and Nerds (Now With Even More Cocaine)!—but at various marijuana-laced edibles for sale in states that legalized recreational and medical marijuana. Indeed, despite claiming "many instances" of the pusher man wooing innocent boys and girls to the pleasures of coke and meth, Feinstein and Grassley provide no examples in their press releases or legislation. And while it's true that some (legal) pot peddlers have marketed candy-bar-looking products for adults, legalization in Colorado has not increased marijuana use by adolescents.
But why ruin a bad piece of bipartisan legislation being pushed by two senators whose collective age is 166 years old by insisting that they prove their case? If this bill protects just one kid from a candy-flavored drug, it will be worth it. Especially to Feinstein and Grassley.
Related: Buzz Bowl I: Four Loko vs. Joose!
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Tue, 28 Mar 2017 09:30:00 -0400Some U.S. military veterans received unpleasant news last week when they tried enrolling in a clinical trial conducted by the Department of Psychiatry and Behavioral Science at Johns Hopkins University. Upon calling a widely circulated hotline number intended to connect former servicemembers to researchers conducting a study on the efficacy of smoked cannabis as a treatment for post-traumatic stress disorder, they learned the study wasn't happening. Not at Hopkins, anyway. "If you are calling about the PTSD study, please know we are no longer participating in that study," the voicemail greeting said as of Monday morning. While the message has been playing since at least last week, neither Johns Hopkins University nor the psychiatry department had formally announced withdrawing from the study as of yesterday. That's why Sean Kiernan, president of the Warriors for Weed Project, sent a letter to Johns Hopkins University Ron President on Monday demanding that the university publicly explain why it was no longer participating in the study, which is sponsored by the Multidisciplinary Association for Psychedelic Studies (MAPS). "We're upset with Hopkins," Kiernan told me by phone today. "Something is going on there." A clinical trial measuring the efficacy of smoked marijuana as a treatment for PTSD has been in the works since 2014, when the Department of Health and Human Services approved MAPS' request to purchase research cannabis from the National Institutes on Drug Abuse. NIDA holds a monopoly on legally growing and providing marijuana for research purposes, and a clinical trial is the first step in having whole-plant marijuana moved from Schedule I of the Controlled Substances Act to Schedule II, where it can be legally prescribed for therapeutic purposes. (Currently, doctors may recommend marijuana under state laws, but they may not prescribe it under federal law.) The trial was slated to take place at both the University of Arizona and Johns Hopkins, but was briefly delayed when the University of Arizona fired researcher Sue Sisley, allegedly to avoid the wrath of Arizona lawmakers who opposed her work on medical marijuana. In 2016, Sisley announced she would continue her portion of the trial at the Scottsdale Research Institute. Sisley, along with Johns Hopkins professor Ryan Vandrey, would study whether various doses of smoked marijuana could help reduce the symptoms of treatment-resistant PTSD, using a $2 million grant MAPS received from the Colorado Department of Public Health and Environment. While Sisley's work will continue, Vandrey, of the Johns Hopkins Behavioral Pharmacology Research Unit, confirmed to me in an email on Monday that his team "has withdrawn its participation in the MAPS study." He referred me to a university spokesperson for additional information. On Tuesday, a university spokesperson released the following statement: "It is Johns Hopkins' mission to conduct high quality scientific research and save lives. Johns Hopkins elected to withdraw from the MAPS study of cannabis in veterans with PTSD prior to any participant enrollment because our goals for this study weren't in alignment. Johns Hopkins remains dedicated to helping military veterans, finding improved treatments for PTSD, and conducting innovative research to enhance our understanding of both the risks and benefits of cannabis/cannabinoids." "Johns Hopkins wanted to remain focused on clinical research, and MAPS wanted to focus on the science as well as on the policy issues surrounding the science related to the NIDA monopoly on marijuana for research," Brad Burge, communications director for MAPS, wrote in an email. "We still have an exceptionally strong research team, including the researchers at the University of Pennsylvania and the University of Colorado, as well as the Scottsdale Research Institute in Phoenix. We thin[...]
Fri, 24 Mar 2017 17:00:00 -0400The state of Illinois enacted in 2013 a pretty blatantly unconstitutional law forbidding businesses engaged in (legal) medical marijuana sales or growing from contributing to political campaigns, in effect either directly or via a PAC (though only the latter was literally codified). But since candidates were also barred from accepting such contributions, the real legal effect was on direct contributions as well. Two Libertarian Party candidates, Claire Ball and Scott Schluter, sued over this, with the help of the Pillar of Law Institute and the Liberty Justice Center. I reported on the suit in the case of Ball v. Madigan back in June. This week, Ball and Schluter won a victory in U.S. District Court for the Northern District of Illinois, eastern division, in a request for summary judgment for them and against Illinois. ("Madigan" is Illinois Attorney General Lisa Madigan.) Quoting from the decision from Judge John Z. Lee, which considers the notion whether this law must face "strict scrutiny" as a possible First Amendment violation based on content, or the looser "intermediate scrutiny" applying to most campaign finance law: By singling out medical cannabis organizations, § 9-45 [the law being challenged] appears to reflect precisely...a content or viewpoint preference. Although Buckley and its progeny permit the government to regulate campaign contributions to some extent, surely the First Amendment does not give the government free rein to selectively impose contribution restrictions in a manner that discriminates based on content or viewpoint..... § 9-45 fails to pass constitutional muster even under Buckley's less rigorous intermediate standard. The Court therefore need not decide whether the statute would survive the more demanding standard of strict scrutiny, if that standard were to apply..... Since the only reasonable government purpose Judge Lee would accept, based on precedent, for these restrictions is "preventing quid pro quo corruption or its appearance," he finds Illinois failed to: point to any legislative findings raising concerns about corruption or the appearance of corruption in the medical cannabis industry. Nor do they point to any instances of actual corruption involving any medical cannabis cultivation center or dispensary. Rather, they rely solely upon Illinois's general history of political corruption scandals.... Still, the Judge is lenient on Illinois so far, writing that that thin evidence: nevertheless substantiate[s] Defendants' claim that the media and the public have perceived a risk of corruption relating to the medical cannabis pilot program. This is all the more true given that cannabis distribution and use were legally banned in Illinois until the passage of the Medical Cannabis Act. Although thin, such evidence is sufficient under governing law to establish an important government interest for purpose of this analysis. But that's not enough for Illinois to win: they must further demonstrate that § 9-45 is "closely drawn" to this important government interest. For the reasons that follow, they fall short of doing so..... Several features of § 9-45 render it plainly disproportional to the government's interest in preventing quid pro quo corruption or its appearance. First, § 9-45 is a disproportionate measure in that it imposes an outright ban on contributions, rather than a mere dollar limit on contribution amounts.... Defendants in this case have failed to explain why a flat prohibition is proportionate to the government's interest in avoiding the risk of actual or perceived corruption that arises when donors from the medical cannabis industry make monetary contributions to political campaigns. They assert that a wholesale ban is appropriate on the ground that medical cannabis cultivation centers and dispensaries "reap profits fro[...]
Tue, 21 Mar 2017 17:02:00 -0400
(image) The anaesthetic ketamine has been a popular party drug for decades due to its ability to put users in a blissful mood. Earlier this month, the American Psychiatric Association released a consensus statement acknowledging that the drug might also be a breakthrough treatment for severe depression.
The statement authors write that seven studies--all placebo-controlled, double-blind, and randomized--provide evidence that ketamine therapy is a "rapid and robust, albeit transient" response to severe clinical depression. The treatment is effective within hours, while conventional antidepressants generally take weeks to work. The transient nature of the drug, meanwhile, suggest it works best with twice-weekly dosing.
Ketamine hasn't been approved for treating depression, but Yale psychiatrist Gerard Sanacora succinctly explained to NPR why the drug's off-label status hasn't deterred him:
Sanacora says other doctors sometimes ask him, "How can you be offering this to patients based on the limited amount of information that's out there and not knowing the potential long-term risk?"
Sanacora has a simple answer.
"If you have patients that are likely to seriously injure themselves or kill themselves within a short period of time, and they've tried the standard treatments, how do you not offer this treatment?"
It certainly seems that the long-term risks of ketamine therapy, regardless of how severe they may be, are preferable to the short-term risk of a successful suicide attempt.
The APA paper closes with the hunch that "economic factors make it unlikely that large-scale, pivotal phase 3 clinical trials of racemic ketamine will ever be completed," which means patients with treatment-resistant depression who'd like to give ketamine a shot will need an appointment at one of a handful of clinics offering ketamine treatment. Or, they can apply for enrollment in a philanthropic or federally funded ketamine study, of which there don't appear to be many.
This is a rather strange fate for a drug that the APA says has "generated much excitement and hope for patients with refractory mood disorders and the clinicians who treat them," but it's also an indictment of the Food and Drug Administration's regulatory process. Ketamine is off patent, which means no pharmaceutical company is going to spend several million dollars per phase to get approval for a drug formulation that any company could turn around and sell, no matter how many lives it might save.
Mon, 20 Mar 2017 00:01:00 -0400Illicit drug use is an old phenomenon, and Jeff Sessions has an old solution: take off the gloves. "We have too much of a tolerance for drug use," the attorney general complained to an audience of law enforcement officials Wednesday, promising more aggressive policing. "Our nation needs to say clearly once again that using drugs is bad," he declared. "It will destroy your life." That claim will fall on a lot of deaf ears among the 100 million Americans who have used marijuana—most of whom found it did not destroy their lives and some of whom found it made their lives better. He is right, though, that tolerance is rampant. A Gallup Poll last year showed that 60 percent of Americans think pot should be legalized for recreational use—as eight states and the District of Columbia have done. Medical marijuana is allowed in 28 states and D.C. But in his prepared remarks, Sessions insisted cannabis is "only slightly less awful" than heroin. Oh, please. The nation is in the midst of an epidemic of overdose deaths involving heroin and other opioids. In 2015, 32,000 Americans died of such overdoses. Compare that with the number of people who died from ingesting an excess of marijuana: zero. Pot, in fact, appears to be saving lives. A 2014 study published in JAMA Internal Medicine found that states allowing medical marijuana had 25 percent fewer deaths from prescription drug overdoses than states forbidding it. People often use opioids to relieve pain. But "individuals with chronic pain and their medical providers may be opting to treat pain entirely or in part with medical marijuana, in states where this is legal," said Johns Hopkins University professor Colleen Barry, the lead author. Sessions made a point of commenting on this unwelcome scientific data: "Give me a break." He paid lip service to "treatment and prevention," but don't expect much there. The Affordable Care Act, which the Trump administration and congressional Republicans have vowed to repeal, has been "the largest expansion of drug treatment in U.S. history," according to Stanford University psychiatry professor Keith Humphreys. If they have their way, we can expect the largest contraction of drug treatment in U.S. history. Promoting treatment goes against the approach long preferred by hard-line politicians. The most effective remedy for opioid addiction is medication-assisted treatment, or MAT, with drugs like methadone and buprenorphine. But if you'd like to stop shooting heroin, you may search in vain for help. The Drug Policy Alliance reports that "access to MAT is severely limited by extensive federal and state regulations and restrictions. A scant 12 percent of individuals with opioid dependence receive methadone, and only nine percent of substance abuse treatment facilities in the United States offer specialized treatment of opioid dependence with MAT." Among the people who could most benefit from this sort of treatment are prison inmates. But a DPA survey found no state correctional systems that provide it—even though a report last year from the surgeon general compared it to giving insulin to diabetics. Upon release, opioid-prone offenders are particularly susceptible to dying of an overdose, apparently because addicts' physical tolerance diminishes while they are locked up. Zealous drug warriors bridle at anything except prohibition and abstinence. Closing down "pill mills," where physicians allegedly overprescribe opioids, is a favorite option. Such lifesaving measures as facilitating access to sterile syringes and naloxone, which is used to reverse overdoses before they kill, are inherently suspect. The criminalization of opioid use often has fatal consequences, because it leaves addicts to obtain supplies from street dealers rather than pharmacists. T[...]
Tue, 14 Mar 2017 13:25:00 -0400Federal judges continued to hand down fewer mandatory minimums for drug offenses in 2016, according to data released Monday by the U.S. Sentencing Commission. The trend, which began with the launch of the Justice Department's Smart on Crime initiative in 2014, is a result of federal prosecutors bringing less onerous charges. Of the 19,787 federal drug sentences handed down in 2016, 55 percent were guideline sentences, rather than mandatory minimums. In fiscal year 2010, only 35 percent of more than 24,000 federal drug sentences were not mandatory minimums. The Smart on Crime initiative clearly had an impact. But it was small and will likely be short-lived. Attorney General Jeff Sessions is reportedly preparing a memo to federal prosecutors regarding drug charging. Sessions has blamed the increase in heroin use on the decline in the Bureau of Prisons population, so I'm guessing his forthcoming memo will instruct prosecutors to resume bringing the maximum charge in federal drug cases. That means more mandatory minimums. The USSC's data reveals another noteworthy trend: Federal methamphetamine offenders continue to see very little benefit from the last decade's worth of various criminal justice reforms: (Charts made using Infogr.am with data pulled from the 2009-2016 USSC sourcebooks) To summarize those charts: Federal drug sentences, both mandatory minimums and guidelines, are falling for every drug but meth. But you wouldn't know it from the national conversation we're currently having about drugs. It's useful to compare crack and meth in particular. Both have fancier siblings that tend to get less panicky coverage (powder cocaine and prescription amphetamines, respectively); both are used and sold largely by low-income people; and both--up until 2010--required incredibly small quantities to trigger their corresponding mandatory minimums. Starting in 1986, five grams of crack cocaine triggered the same federal five-year mandatory minimum prison sentence as five grams of pure methamphetamine or 50 grams of a mixture containing any amount of methamphetamine. With the passage of the Fair Sentencing Act in 2010, the minimum quantity of crack cocaine necessary for a five-year mandatory minimum was raised to 28 grams; the minimum quantity for methamphetamine remains five grams. (Five grams, as my former colleagues at Families Against Mandatory Minimums like to point out, is the equivalent of five packets of sugar.) Why did we change the law for crack but not meth? Well, sentences for crack and powder cocaine had--still have, in fact--a gross disparity. An offender needed 500 grams of powder cocaine, which is sold by every race of offender, to trigger the same sentence as five grams of crack cocaine, which continues to be sold mostly by black offenders. Congress reduced that gap in 2010 to bring some racial justice to the federal criminal code. And that's good. I'll cheer for mercy by any means. But no legislator has campaigned for extending the same consideration to meth offenders, even though many of the people who sell meth do so to pay for their habits, and we are supposedly living in an era of treatment, not punishment. This is why I cringe a little when critics claim that legislators are responding to opioids more compassionately than they did to crack because opioids are a white drug and crack is a black drug. There is much truth to that observation, but let's not forget that meth--despite its rising popularity as a party drug among gay urbanites--remains a very white and rural drug, and we are taking pounds of flesh from the people who sell it. From the late 1990s through the late 2000s, every big media outlet probably ran at least one story decrying the meth epidemic. While you don't see as many[...]
Sat, 11 Mar 2017 13:45:00 -0500
"It didn't resemble cannabis. It didn't smell like cannabis."
So says Sue Sisley, who is pissed, and with good reason. She didn't get ripped off by an illegal dealer or a legal dispensary. No, she got screwed by the federal government, which seems incapable of growing good-quality marijuana. Sisley is an Arizona-based primary-care doctor who was awarded a grant to study the use of pot to treat post-traumatic stress disorder (PTSD) in military veterans. It took Sisley and her colleagues two years to get the shipment from the "12-acre farm at the University of Mississippi, run by the National Institute on Drug Abuse (NIDA)...[which] since 1968...has been the only facility licensed by the DEA [Drug Enforcement Administration] to produce the plant for clinical research."
Working with Multidisciplinary Association for Psychedelic Studies (MAPS), Sisley and her colleagues tested the pot and found that it was contaminated with mold and not at the right potency for their research. Your tax dollars at work, growing schwag that doesn't even rise to the level of reggie.
From a PBS account of the story:
Rick Doblin, MAPS' director, says this recent episode "shows that NIDA is completely inadequate as a source of marijuana for drug development research."
"They're in no way capable of assuming the rights and responsibilities for handling a drug that we're hoping to be approved by the FDA as prescription medicine," he says.
Via Twitter feed of Mike Hewlett.
Watch "Transplant Denied: How Medical Marijuana Policy Kills Patients," a powerful Reason TV video from 2012. Not for the faint of heart.
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Tue, 07 Mar 2017 16:49:00 -0500
(image) Attorney General Jeff Sessions laid out a three-pronged approach to combatting illicit drug use today at the New Hampshire Youth Summit on Opioid Awareness.
"There are three main ways to fight back against this problem," Sessions said in his prepared remarks. "Prevention, criminal enforcement and treatment."
In contast with federal drug officials under Obama, Sessions doesn't seem too keen on treatment:
Treatment is also important, but treatment often comes too late. Individuals have already lost their jobs and flunked their tests. Then the struggle to defeat addiction can be a long process – and it can fail. Experts will tell you that recovery is not certain. For many, addiction can be a death sentence.
I have seen families spend all their savings and retirement money on treatment programs for their children—just to see these programs sometimes fail.
Ramped-up enforcement, however, is something he's much more enthusiastic about: "The President has issued an Executive Order to the Department of Justice to dismantle these organizations and gangs. We are going to get rid of them. Of that you can be sure."
Sessions also called for a revival of late 80s/early 90s anti-drug marketing, the most famous example of which is former First Lady Nancy Reagan's "Just Say No" campaign:
The most effective solution in the 1980s and early '90s—when, for example, we saw a significant decline in teen drug use—was the Prevention Campaign. People began to stop using drugs. Drug users were not cool. Crime fell dramatically, and addiction fell too.
The National Institute for Drug Abuse reported this past December—as in, three months ago—that past-year use of illicit drugs among eighth, 10th, and 12th graders "continu[es] to decline to the lowest level in the history of the survey." Meanwhile, buckets of studies have shown that Just Say No-era anti-drug programming doesn't work.