In recent weeks, lawmakers in several states have moved forward with legislative proposals to permit specific strains and/or extracts of cannabis possessing high quantities of the cannabinoid cannabidiol (CBD), but otherwise maintaining criminal prohibitions on the whole plant.
But is this new direction in the best interest of patients? As I wrote in a recent column for Alternet.org (republished with permission by Cannabis Now under the title “Patients Ought To Be Skeptical Of Proposed CBD-Only Legislation — Here’s Why”), I believe the answer is ‘no.’
Ultimately, patients should not be unnecessarily forced to decide between either accessing the whole plant or its isolated components. They should have safe, legal access to both, and politicians, even well-intentioned ones, should not restrict patients’ right to choose the most suitable option.
Below are excerpts from my commentary. You can read the entire text here.
Patients Ought To Be Skeptical Of Proposed CBD-Only Legislation — Here’s Why
via Cannabis Now
[excerpt] If the plant ain’t broke, why fix it?
For longtime marijuana law reformers, the ongoing political conversation surrounding CBD is instructive. It makes it clear that many politicians’ public opposition to the idea of patients using marijuana therapeutically isn’t because of supposed unanswered questions surrounding the plant’s safety or efficacy. Rather, it is because lawmakers oppose the idea of some people getting high from a naturally growing herb. (The fact that patients can get equally high or even higher from FDA-approved synthetic THC has, for whatever reason, never been an expressed concern of either lawmakers or prohibitionists.) After all, the very same politicians who argue that marijuana isn’t medicine because it hasn’t been approved by the FDA or who allege that the substance hasn’t yet been subjected to sufficient scientific scrutiny utter no such public objections to the idea of legalizing patient access to CBD – a schedule I compound that hasn’t been reviewed, much less approved by the FDA, and that has been clinically studied far less than cannabis.
Perhaps most ironically is that were it not for the advent of legalized whole plant marijuana, a policy change publicly opposed by many present day CBD-only political advocates, lawmakers (and anti-pot groups like SAM) today wouldn’t be aware of CBD, much less advocating for it. The reality is that it was the stakeholders in medical marijuana states, and those who provide for them, who have done the most to explore and promote cannabidiol as a legitimate therapeutic agent. And they were able to do so because they, unlike most federally licensed medical researchers, had access to the whole plant.
We’ve been down this road before. Not long ago, lawmakers and anti-marijuana zealots were dismissing patients’ desire to access the marijuana plant because they alleged that the THC-pill Marinol could adequately meet patients’ needs. Patients and their advocates were skeptical of lawmakers’ claims then, and properly so. Now many of these same politicians are once again dismissing patients’ calls for whole plant medicine by claiming that products and strains containing CBD alone only will suffice. Patients and their advocates ought to be equally skeptical once again.
On Sunday February 16th, I bought legal weed for the first time from a recreational cannabis store in Denver, Co. I spent a few minutes speaking with some of the employees, as I was eager to hear how things were going under this newly sanctioned marijuana market. Unsurprisingly, business was great. Some items were selling quicker than others, but everyone was in agreement that the rollout of Colorado’s legal cannabis retail system had been a great success, except for one crucial component that was as unsettling as it was expected – we were standing in one of a few dozen high profile stores, well-known for having excessive amounts of cash on hand (in the first week of sales, businesses generated $5 million in cash-only transactions) and no where to put it, because the banks won’t take it.
Clearly, denying these pot stores the ability to safely deposit their earnings poses an imminent threat to public safety. These shops are easy targets for robbery and assault (as well as other forms of criminal activity), which puts customers and employees at serious risk. Some of these shop owners are considering banning backpacks or other large bags – others are arming their workers. Neither of these options are a viable solution.
This problem isn’t new however, nor is it going unnoticed. On February 14th, the Department of Treasury released a nonbinding memorandum, in conjunction with the Justice Department stating that banks may consider working with pot retailers without fear of prosecution – so long as they remain in compliance with state laws, and followed other instructions outlined in the memo. Though a truly historic and progressive action by the federal government’s leading financial regulatory body, these guidelines are largely symbolic, providing no actual legal protection to banks working with cannabis shops. As such, most financial companies remain skeptical about getting involved with a market existing under so many contradictory laws.
According to federal law, these banks could technically be found guilty of money laundering (among other offenses) for handling the proceeds of what the US government still considers an illegal drug. The Colorado Bankers Association rightly notes that the guidance issued by the Department of Justice and the U.S. Treasury “only reinforces and reiterates that banks can be prosecuted for providing accounts to marijuana related businesses.” The Association further criticizes these new guidelines, stating that “Bankers had expected the guidance to relieve them of the threat of prosecution should they open accounts for marijuana businesses, but the guidance does not do that. Instead, it reiterates reasons for prosecution and is simply a modified reporting system for banks to use. It imposes a heavy burden on them to know and control their customers’ activities, and those of their customers.”
Is it any surprise then that these guidelines – which include a multi-tiered labeling structure and a requirement for banks to maintain ‘suspicious activity reports’ – have left many financial institutions with cold feet? Two of Colorado’s largest banks, Wells Fargo and FirstBank have already announced they won’t work with weed-related enterprises. In fact, most financial trade associations have widely rejected these latest overtures because there are no tangible, legal policies in place.
Despite the skepticism held by many federal administration officials and other politicians, the government can and should be doing much more to enable the success of this new, legal market. Unfortunately, many are sitting on their hands, and holding their breath – hoping to quietly ride out this growing wave of support for legalization, which shows no sign of subsiding. Over 50% of the US population supports a regulated marijuana retail system for adults.
Its time for these officials to concede to the will of the electorate, and address the legitimate needs of this new industry. Lawmakers now have an opportunity to show true leadership in this changing political landscape by supporting legislation that would give states and businesses the resources necessary to enable a responsible and successful implementation of this new “great experiment.” Specifically, they should get behind the “Marijuana Businesses Access to Banking Act,” introduced by Colorado representative Ed Perlmutter. This bill (HR 2652), already endorsed by the Colorado Bankers Association, would alter various banking laws to protect banks providing services to marijuana-related businesses from the threat of federal prosecution and other penalties.
Financial institutions don’t operate off good-faith statements (including non-binding memorandums) – even those from the Department of Treasury, or any other enforcement agency. They operate under explicit legal authorization. Only when the laws change will the banks truly be free to provide the services these businesses so desperately need, and their communities rightly deserve.
Contact your representative today and tell them to support HR 2652
CNN Chief Medical Correspondent Dr. Sanjay Gupta is “doubling down” in his advocacy for patients to have legal access to cannabis as a therapeutic agent.
In a commentary featured on the CNN website today, Gupta writes: “I am more convinced than ever that it is irresponsible to not provide the best care we can, care that often may involve marijuana. I am not backing down on medical marijuana; I am doubling down.”
Last August, Gupta authored a commentary apologizing for his past opposition to medical cannabis, stating, “We have been terribly and systematically misled for nearly 70 years in the United States (in regards to cannabis), and I apologize for my own role in that.”
In today’s editorial, Gupta acknowledges, “Marijuana is classified as a Schedule I substance, defined as (one of) the most dangerous drugs with no currently accepted medical use. Neither of those statements has ever been factual.”
He criticizes President Obama for acknowledging that cannabis poses less harm than alcohol while failing “to remove marijuana from the list of the most tightly controlled substances in the country.” Dr. Gupta also questions how the US government can possess a patent on the therapeutic application of cannabinoids yet still deny that the compounds possess medical utility.
Ultimately, cannabis prohibition is a “Draconian system where politics override science,” Gupta concludes.
Gupta’s forthcoming documentary on the plant, entitled “Weed 2: Cannabis Madness: Dr. Sanjay Gupta Reports,” at 10 p.m. ET on Tuesday, March 11.
Members of the Washington DC City Council gave final approval today to legislation reducing the District’s marijuana possession penalties to a fine-only violation.
District lawmakers voted 10 to 1 in favor of “The Simple Possession of Small Quantities of Marijuana Decriminalization Amendment Act of 2013,” which amends District law involving the possession or transfer of up to one ounce of marijuana from a criminal misdemeanor (punishable by up to 6 months incarceration and a maximum fine of $1,000) to a civil violation (punishable by a $25 fine, no arrest, no jail time, and no criminal record). Democrat Mayor Vincent C. Gray said that he intends to sign the measure into law.
Offenses involving the public consumption of cannabis remain classified as a criminal misdemeanor under DC law, punishable by up to six-months in jail and a $500 fine. The possession of cannabis-related paraphernalia will be re-classified as a violation, not a criminal offense.
Once signed into law, the measure faces a 60-day review period by members of Congress.
The District measure is similar to existing ‘decriminalization’ laws in California, Connecticut, Maine, Massachusetts, Nebraska, New York, Oregon, Rhode Island, and Vermont where private, non-medical possession of marijuana is treated as a civil, non-criminal offense.
Five additional states – Minnesota, Mississippi, Nevada, North Carolina, and Ohio – treat marijuana possession offenses as a fine-only misdemeanor offense.
Three states – Alaska, Colorado, and Washington – impose no criminal or civil penalty for the private possession of small amounts of marijuana.
A 2012 analysis published by the American Civil Liberties Union of Maryland reported that the District possesses the highest percentage of marijuana possession arrests per capita in the nation.
(Dr. Mitch Earleywine was elected as the Chairman of the NORML Board of Directors in February 2014)
A recent headline reads: “Can Marijuana Kill You? German Scientists Say Yes.” The article focuses on a study of two (count ‘em, two!) young men who died while they had detectable levels of THC in their blood. I take a lot of pleasure in this kind of melodrama. If prohibitionists are stooping this low, we must really be frightening them. (It’s not completely pharmacologically ridiculous. Marijuana does increase heart rate. In fact, it can jack up heart rate almost as much as an espresso or energy drink. Maybe if you already had a weak heart and a coffee and a bong hit, well, something might happen.)
But I want to point out that we should actually expect literally thousands of reports like this. We should hear about lots of people who have heart attacks on the same day that they commune with the plant. It’s not because cannabis causes heart attacks. It’s simple chance.
I hate for my first blog as Chair of The Executive Board to be this nerdy, but I’ve been teaching statistics for more than 20 years. If that doesn’t make me a nerd, I’m not sure what would. But given how many people use cannabis daily and how many heart attacks occur in the United States, it’s actually a miracle that we haven’t heard about this kind of thing before. We also should expect to hear it a lot more often.
According to the National Survey on Drug Use and Health, roughly 7,600,000 Americans (over age 12) used marijuana daily or near daily in 2012. In addition, the Center for Disease Control suggests that about 715,000 of us have heart attacks in a year. (Let’s assume those under age 12 are probably not grabbing their chests with a myocardial infarction too often.) In addition, let’s guess that the United States has about 280 million people over age 12. It’s hard to know the exact number, but that’s probably in the ballpark.
With this in mind, we can predict how many people should have a heart attack the same day that they used cannabis simply by chance. That is, even if these two things had nothing to do with each other, we should expect some folks to have a heart attack the same day that they used cannabis just by accident.
Okay. It’s going to get nerdy here, but this is comparable to asking simpler questions. If I had a dime and a nickel, I might want to know what the chances are that I’d flip heads on both. I flip heads 1 out of 2 times on average for the dime, for a probability of .5. Then I flip heads on the nickel 1 out of 2 times on average, also for a probability of .5. So the chances of flipping heads on both is .5 * .5 for .25. So we’d expect to get heads on both coins about 1Ž4 of the time. If I flipped both coins 100 times, I’d get around 25 pairs of heads. Note that there’s nothing causal here. The nickel doesn’t know what the dime did. It doesn’t want to be like the dime. It’s not that the dime caused the nickel to flip heads.
So it’s the same deal for the cannabis-related heart attacks. If 7.6 million people use cannabis daily out of 280 million relevant Americans, that’s a probability of .0271. And if 715 thousand of 280 million have heart attacks, that’s a probability of .0026. Multiply these the same way we did with the probabilities for flipping heads (.0271 * .0026 = .00007). Now .00007 is a dinky number. If there were only 100 people in the country, we wouldn’t expect any of them (well, .007) to have a heart attack and smoke cannabis on the same day. But we’re talking about 280 million people here. So we’d expect .00007 * 280,000,000, = 19,600. That’s over 19,000 heart attacks.
So the question isn’t, “How did these two guys die of a heart attack with THC in their blood?” It should be, “Where are the other 19,598 guys who should have had heart attacks with THC in their blood?” In fact, the absence of this many cannabis-related myocardial infarctions inspired my wife to ask, “Does cannabis protect the heart?”
If we repeal prohibition, we’ll get to find out.
Go AS, Mozaffarian D, Roger VL, Benjamin EJ, Berry JD, Borden WB, Bravata DM, Dai S, Ford ES, Fox CS, Franco S, Fullerton HJ, Gillespie C, Hailpern SM, Heit JA, Howard VJ, Huffman MD, Kissela BM, Kittner SJ, Lackland DT, Lichtman JH, Lisabeth LD, Magid D, Marcus GM, Marelli A, Matchar DB, McGuire DK, Mohler ER, Moy CS, Mussolino ME, Nichol G, Paynter NP, Schreiner PJ, Sorlie PD, Stein J, Turan TN, Virani SS, Wong ND, Woo D, Turner MB; American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics—2013 update: a report from the American Heart Association. Circulation. 2013 Jan 1;127(1):e6-e245.
Substance Abuse and Mental Health Services Administration, Results from the 2012 National Survey on Drug Use and Health: Summary of National Findings, NSDUH Series H-46, HHS Publication No. (SMA) 13-4795. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2013.