Study: Per Se Drugged Driving Laws Have Little Or No Impact On Traffic Deaths

The imposition of so-called per se drugged driving laws, which create new traffic safety violations for drivers who operate a vehicle with the presence of trace amounts of certain controlled substances and/or their inert metabolites (byproducts) in their blood or urine, do not reduce incidences of traffic safety deaths.

That’s the conclusion of a just-published study by economists at the University of Colorado, Denver and Montana State University. The study is available from the Institute for the Study of Labor (IZA) in Germany as a Discussion Paper.

Since 1990, 11 states have passed so-called zero-tolerant per se drugged driving laws which make it illegal for one to drive with detectable levels of a controlled substance in his or her system. Five additional states have passed similar laws specifying non-zero limits for controlled substances or their metabolites. Fourteen (Arizona, Delaware, Georgia, Illinois, Indiana, Iowa, Michigan, Nevada, Ohio, Pennsylvania, Rhode Island, Utah, Washington, and Wisconsin) of these sixteen states impose these strict liability per se standards for cannabis. Recently, the White House Office of National Drug Control has recommended zero tolerant per se drug standards for all US states.

Using state-level data from the Fatality Analysis Reporting System (FARS) for the period 1990-2010, authors examined the relationship between the adoption of controlled substance per se thresholds and overall incidences of traffic fatalities. They found that the relationship is statistically indistinguishable from zero and concluded that there is no evidence that these limits reduced traffic deaths.

Authors reported: “Despite the fact that these laws have been touted by politicians and academics as an effective strategy for making our roadways safer, we find no evidence that they reduce traffic fatalities. … [W]e cannot determine why per se drugged driving laws do not work, and leave this issue to future researchers. However, our results clearly indicate that, as currently implemented, laws that make it illegal to drive with detectable levels of a controlled substance in the system have little to no effect on traffic fatalities.”

In November, Washington state voters approved Initiative 502, which legalizes the private use and retail sale of cannabis to adults, but also imposes a 5ng/ml THC/blood per se limit for drivers over the age of 21. In Colorado, where voters on Election Day similarly legalized cannabis, Democrat Gov. John Hickenlooper and Republican Senator Steven King are calling for the passage of nearly identical per se cannabis legislation.

NORML has consistently opposed the imposition of stand-alone per se limits for cannabinoids, arguing that the presence of THC in blood, particularly at lower levels, is an inconsistent predictor of behavioral impairment, particularly in more frequent consumers who may potentially test positive for trace, residual THC levels in their blood for periods of time exceeding any period of acute impairment.

Operation of a motor vehicle while under the influence of cannabis is already a criminal offense in all 50 states. However, in order for one to gain a criminal conviction under most state DUI laws, prosecutors must prove that a motorist recently ingested cannabis and that doing so prohibited him or her from driving safely.

Full text of the study, “Per Se Drugged Driving Laws and Traffic Fatalities,” is available online here. A separate paper previously published by the same authors reported that the passage of statewide medical marijuana laws is associated with decreased incidences of traffic fatalities.

Study: Vaporized, Low-Potency Cannabis Mitigates Neuropathic Pain

The administration of vaporized, low THC cannabis is associated with reduced pain in subjects with neuropathy, according to clinical trial data published online by The Journal of Pain.

Investigators at the University of California, Davis Medical Center conducted a double-blind, placebo-controlled, crossover study evaluating the analgesic efficacy of vaporized cannabis in 39 subjects, the majority of whom were experiencing neuropathic pain despite traditional treatment. Subjects inhaled cannabis of either moderate THC (3.53 percent), low dose THC (1.29 percent), or zero THC (placebo). Subjects continued to take all other concurrent medications as per their normal routine during the 3- to 4-week study period. Spontaneous pain relief, the primary outcome variable, was assessed by asking participants to indicate the intensity of their current pain on a 100-mm visual analog scale (VAS) between 0 (no pain) and 100 (worst possible pain).

Researchers reported: “Both the low and medium doses proved to be salutary analgesics for the heterogeneous collection of neuropathic pain conditions studied. Both active study medications provided statistically significant 30% reductions in pain intensity when compared to placebo.”

They concluded: “Both the 1.29% and 3.53% vaporized THC study medications produced equal antinociception at every time point. … [T]he use of low doses could potentially be prescribed by physicians interested in helping patients use cannabis effectively while minimizing cognitive and psychological side effects. Viewed with this in mind, the present study adds to a growing body of literature supporting the use of cannabis for the treatment of neuropathic pain. It provides additional evidence of the efficacy of vaporized cannabis as well as establishes low-dose cannabis (1.29%) as having a favorable risk-benefit ratio.”

Previous clinical trials have indicated that inhaled cannabis can safety and effectively relieve various types of pain, particularly neuropathy — a hard-to-treat nerve condition often associated with cancer, HIV, spinal cord injury, diabetes, multiple sclerosis, and other conditions. These include the following double-blind, placebo-controlled (FDA gold-standard) studies:

Ware et al. 2010. Smoked cannabis for chronic neuropathic pain: a randomized controlled trial. CMAJ 182: 694-701.

Wilsey et al. 2008. A randomized, placebo-controlled, crossover trial of cannabis cigarettes in neuropathic pain. Journal of Pain 9: 506-521.

Ellis et al. 2008. Smoked medicinal cannabis for neuropathic pain in HIV: a randomized, crossover clinical trial. Neuropsychopharmacology 34: 672-80.

Abrams et al. 2007. Cannabis in painful HIV-associated sensory neuropathy: a randomized placebo-controlled trial. Neurology 68: 515-521.

Wallace et al. 2007. Dose-dependent Effects of Smoked Cannabis on Capsaicin-induced Pain and Hyperalgesia in Healthy Volunteers Anesthesiology 107: 785-796.

Separate clinical trial data also reports that inhaled “cannabis augments the analgesic effect of opioids” and therefore “may allow for opioid treatment at lower doses with fewer side effects.”

Since 1999, US sales of opiate drugs have tripled in number and in 2010, a record-setting 254 million prescriptions for opioids were filled in the United States — enough to medicate every American adult around the clock for a month. (In particular, the manufacturing of the drug Oxycodone has increased from 8.3 tons in 1997 to 105 tons in 2011, an increase of 1,200 percent.) Overdose deaths from the use of prescription painkillers are also now at record levels, totaling some 15,000 annually — more than triple the total a decade ago.

Full text of the study, “Low-dose vaporized cannabis significantly improves neuropathic pain,” appears in The Journal of Pain.

2012: The Year In Review — NORML’s Top 10 Events That Shaped Marijuana Policy

#1 Colorado and Washington Vote To Legalize Marijuana
Voters in Colorado and Washington made history by approving ballot measures allowing for the personal possession and consumption of cannabis by adults. Washington’s law, which removes criminal penalties for the possession of up to one ounce of cannabis for personal use (as well as the possession of up to 16 ounces of marijuana-infused product in solid form, and 72 ounces of marijuana-infused product in liquid form), took effect on December 6. Colorado’s law, which allows for the legal possession of up to one ounce of marijuana and/or the cultivation of up to six cannabis plants in private by those persons age 21 and over, took effect on December 10. Regulators in both states are now in the process of drafting rules to allow for state-licensed proprietors to commercially produce and sell cannabis.

#2 Most Americans Favor Legalization, Want The Feds To Butt Out
A majority of Americans support legalizing the use of cannabis by adults, according to national polls by Public Policy Polling, Angus Reid, Quinnipiac University, and others. A record high 83 percent of US citizens favor allowing doctors to authorize specified amounts of marijuana for patients suffering from serious illnesses. And nearly two-thirds of Americans oppose federal interference in state laws that allow for legal marijuana use by adults.

#3 Connecticut, Massachusetts Legalize Cannabis Therapy
Connecticut and Massachusetts became the 17th and 18th states to allow for the use of cannabis when recommended by a physician. Connecticut lawmakers in May approved Public Act 12-55, An Act Concerning the Palliative Use of Marijuana. The new law took effect on October 1. On Election Day, 63 percent of Massachusetts voters approved Question 3, eliminating statewide criminal and civil penalties related to the possession and use of up to a 60-day supply of cannabis by qualified patients. The law takes effect on January 1, 2013.

#4 Schedule I Prohibitive Status For Pot “Untenable,” Scientists Say
The classification of cannabis and its organic compounds as Schedule I prohibited substances under federal law is scientifically indefensible, according to a review published online in May in The Open Neurology Journal. Investigators at the University of California at San Diego and the University of California, Davis reviewed the results of several recent clinical trials assessing the safety and efficacy of inhaled or vaporized cannabis. They concluded: “Based on evidence currently available the Schedule I classification is not tenable; it is not accurate that cannabis has no medical value, or that information on safety is lacking.”

#5 Marijuana Arrests Decline, But Still Total Half Of All Illicit Drug Violations
Police made 757,969 arrests in 2011 for marijuana-related offenses, according to the Federal Bureau of Investigation’s annual Uniform Crime Report. The total marked a decline from previous years. Of those charged in 2011 with marijuana law violations, 663,032 (86 percent) were arrested for marijuana offenses involving possession only. According to the report, approximately 43 percent of all drug violations in 2011 were for cannabis possession.

#6 Long-Term Cannabis Exposure Not Associated With Adverse Lung Function
Exposure to moderate levels of cannabis smoke, even over the long-term, is not associated with adverse effects on pulmonary function, according to clinical trial data published in January in the Journal of the American Medical Association. Investigators at the University of California, San Francisco analyzed the association between marijuana exposure and pulmonary function over a 20-year period in a cohort of 5,115 men and women in four US cities. They concluded: “With up to 7 joint-years of lifetime exposure (e.g., 1 joint/d for 7 years or 1 joint/wk for 49 years), we found no evidence that increasing exposure to marijuana adversely affects pulmonary function. … Our findings suggest that occasional use of marijuana … may not be associated with adverse consequences on pulmonary function.”

#7 Cannabis Use Associated With Decreased Prevalence Of Diabetes
Adults with a history of marijuana use have a lower prevalence of type 2 diabetes and possess a lower risk of contracting the disease than do those with no history of cannabis consumption, according to clinical trial data published in the British Medical Journal. Investigators at the University of California, Los Angeles assessed the association between diabetes mellitus (DM) and marijuana use among adults aged 20 to 59 in a nationally representative sample of the US population of 10,896 adults. Investigators concluded, “Our analysis of adults aged 20-59 years … Showed that participants who used marijuana had a lower prevalence of DM and lower odds of DM relative to non-marijuana users.”

#8 Medical Cannabis Dispensaries Not Associated With Neighborhood Crime
The establishment of medical cannabis dispensaries does not adversely impact local crime rates, according to a federally funded study published in the July issue of the Journal of Studies on Alcohol and Drugs. Researchers reported: “There were no observed cross-sectional associations between the density of medical marijuana dispensaries and either violent or property crime rates in this study.”

#9 Rhode Island Becomes The 15th State To Decriminalize Pot Possession Penalties
Governor Lincoln Chafee signed legislation into law in June amending marijuana possession penalties for those age 18 or older from a criminal misdemeanor (punishable by one year in jail and a $500 maximum fine) to a non-arrestable civil offense — punishable by a $150 fine, no jail time, and no criminal record. The decriminalization law takes effect on April 1, 2013.

#10 Cannabis Reduces Symptoms In Patients With Treatment-Resistant MS
Cannabis inhalation mitigates spasticity and pain in patients with treatment-resistant multiple sclerosis (MS), according to clinical trial data published online in May in the Journal of the Canadian Medical Association. Investigators at the University of California, San Diego assessed the use of inhaled cannabis versus placebo in 30 patients with MS who were unresponsive to conventional treatments. “Smoked cannabis was superior to placebo in symptom and pain reduction in patients with treatment-resistant spasticity,” authors concluded.

Florida Attorney General ‘Just Says No’ To Medical Marijuana

Please find below a recent memo from Florida Attorney General’s office rejecting activist’s petition to reschedule marijuana for medical access. This is notable because Florida is a top five political bellwether state, with an aging population, NORML receives more requests from Florida residents than anywhere else in the country to reform local medical cannabis laws.

Unfortunately, Florida Attorney General Pam Bondi’s office has rejected a petition from the Cannabis Action Network to reschedule cannabis so that sick, dying and sense-threatened medical patients with a doctor’s recommendation can possess and use it legally. As often is the case at the state level, the Attorney General is deferring to federal laws and Congressional intent.

PAM BONDI
ATTORNEY GENERAL
STATE OF FLORIDA
OFFICE OF THE ATTORNEY GENERAL

Administrative Law Bureau

Edward A. Tellechea
Chief Assistant Attorney General
PL-01, The Capitol
Tallahassee, FL 32399-1050
Phone (850) 414-3300
Fax (850) 922-6425

December 12, 2012

Jodi James
Director, Cannabis Action Network
Melbourne, FL

Ms. James:

Thank you for your petition wherein you request that the Attorney
General temporarily reschedule cannabis. I have been asked to
respond on the Attorney General’s behalf.

Section 893.0355, Florida Statutes, delegates to the Attorney
General the authority to temporarily reschedule controlled
substances set forth in Section 893.03(1), Florida Statutes, by rule
and addresses what factors shall be considered when making such a
determination. The statute reads in part as follows:

(3) In making the public interest determination, the Attorney
General shall give great weight to the scheduling rules adopted by
the United States Attorney General subsequent to such substances
being listed in Schedules I, II, III, IV, and V hereof, to achieve
the original legislative purpose of the Florida Comprehensive Drug
Abuse Prevention and Control Act of maintaining uniformity between
the laws of Florida and the laws of the United States with respect
to controlled substances.

The above quoted statutory language makes it very clear that when
determining whether a controlled substance should be rescheduled the
Attorney General must give great weight to the current drug
scheduling under federal law. In addition, Florida law also strongly
encourages uniformity in Florida and federal drug scheduling.

The Attorney General does not believe that it is in the best
interest of the public for her to use her authority to temporarily
reschedule cannabis, particularly given the legislative preference
for uniformity with federal drug laws and the fact that cannabis
remains a Schedule I drug under federal law.

Sincerely,

Edward A. Tellechea
Chief Assistant Attorney General

Study: Cannabis Is A “Potential Exit Drug To Problematic Substance Use”

Three quarters of medical cannabis consumers report using it as a substitute for prescription drugs, alcohol, or some other illicit substance, according to survey data published in the journal Addiction Research and Theory.

An international team of investigators from Canada and the United States assessed the subjective impact of marijuana on the use of licit and illicit substances via self-report in a cohort of 404 medical cannabis patients recruited from four dispensaries in British Columbia, Canada.

Researchers reported that subjects frequently substituted cannabis for other substances, including conventional pharmaceuticals. Authors reported:

“Over 41 percent state that they use cannabis as a substitute for alcohol (n=158), 36.1 percent use cannabis as a substitute for illicit substances (n=137), and 67.8 percent use cannabis as a substitute for prescription drugs (n=259). The three main reasons cited for cannabis-related substitution are ‘less withdrawal’ (67.7 percent), ‘fewer side-effects’ (60.4 percent), and ‘better symptom management’ suggesting that many patients may have already identified cannabis as an effective and potentially safer adjunct or alternative to their prescription drug regimen.”

Overall, 75.5 percent (n=305) of respondents said that they substitute cannabis for at least one other substance. Men were more likely than women to report substituting cannabis for alcohol or illicit drugs.

Authors concluded: “While some studies have found that a small percentage of the general population that uses cannabis may develop a dependence on this substance, a growing body of research on cannabis-related substitution suggests that for many patients cannabis is not only an effective medicine, but also a potential exit drug to problematic substance use. Given the credible biological, social and psychological mechanisms behind these results, and the associated potential to decrease personal suffering and the personal and social costs associated with addiction, further research appears to be justified on both economic and ethical grounds. Clinical trials with those who have had poor outcomes with conventional psychological or pharmacological addiction therapies could be a good starting point to further our under- standing of cannabis-based substitution effect.”

Previous studies have similarly demonstrated cannabis’ potential efficacy as an exit drug. A 2010 study published in the Harm Reduction Journal reported that cannabis-using adults enrolled in substance abuse treatment programs fared equally or better than nonusers in various outcome categories, including treatment completion. A 2009 study reported that 40 percent of subjects attending a California medical cannabis dispensary reported using marijuana as a substitute for alcohol, and 26 percent used it to replace their former use of more potent illegal drugs. A separate 2009 study published in the American Journal on Addictions reported that moderate cannabis use and improved retention in naltrexone treatment among opiate-dependent subjects in a New York state inpatient detoxification program.

Full text of the study, “Cannabis as a substitute for alcohol and other drugs: A dispensary-based survey of substitution effect in Canadian medical cannabis patients,” appears online in Addiction Research and Theory. NORML Advisory Board Member Mitch Earleywine is a co-author of this study.