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medical cannabis

  • by Paul Armentano, NORML Deputy Director June 13, 2013

    Republican Gov. Brian Sandoval has signed legislation, Senate Bill 374, authorizing the creation of up to 66 not-for-profit [correction: facilities may be for profit] medical marijuana dispensaries.

    Under the new law, state regulators are tasked with overseeing the creation of licensed establishments to produce, test, and dispense cannabis and cannabis-infused products to authorized patients. Nevada voters enacted a state constitutional amendment in 2000 mandating state lawmakers to allow for physicians to authorize qualified patients to consume and grow cannabis. However, that law did not provide for facilities where patients may obtain medicinal cannabis.

    Approximately 3,800 Nevadans are presently authorized to grow and/or consume cannabis under state law.

    Senate Bill 374 imposes limits on the home cultivation of cannabis if patients reside within 25-miles of an operating dispensary. However, patients who are cultivating specific strains of cannabis not provided by a local dispensary may continue to engage in the home cultivation of such strains. Patients who have an established history of cultivating medical cannabis prior to July 1, 2013, also may continue to do so until March 31, 2016.

    The bill also amends possession limits from one-ounce to two and one-half ounces and increases plant cultivation limits from three mature plants to twelve.

    Medical marijuana products dispensed by state-licensed facilities will be subject to standard state sales taxes as well as a 4 percent excise tax, of which 75 percent will be directed to education and 25 percent will be directed toward implementing and enforcing the regulations.

    Arizona, Colorado, New Jersey, Maine, and New Mexico have state-licensed medical cannabis dispensaries up and running. Similar dispensary outlets are in the process of opening in Connecticut, Massachusetts, Rhode Island, Vermont, and Washington, DC.

  • by Paul Armentano, NORML Deputy Director June 10, 2013

    Preclinical study data published online in the scientific journal Nutrition & Diabetes reports that tetrahydrocannabivarin (THCV) — a naturally occurring analogue of THC — possesses positive metabolic effects in animal models of obesity.

    British researchers assessed the effects of THCV administration on dietary-induced and genetically modified obese mice. Authors reported that although THCV administration did not significantly affect food intake or body weight gain in any of the models, it did produce several metabolically beneficial effects, including reduced glucose intolerance, improved glucose tolerance, improved liver triglyceride levels, and increased insulin sensitivity.

    Researchers concluded: “Based on these data, it can be suggested that THCV may be useful for the treatment of the metabolic syndrome and/or type 2 diabetes (adult onset diabetes), either alone or in combination with existing treatments. Given the reported benefits of another non-THC cannabinoid, CBD in type 1 diabetes, a CBD/THCV combination may be beneficial for different types of diabetes mellitus.”

    Last month, Harvard Medical School researchers published observational data in The American Journal of Medicine reporting that subjects who regularly consume cannabis possess favorable indices related to diabetic control as compared to occasional consumers or non-users of the substance. Writing in an accompanying commentary, the journal’s Editor-in-Chief stated: “These are indeed remarkable observations that are supported, as the authors note, by basic science experiments that came to similar conclusions. … I would like to call on the NIH and the DEA to collaborate in developing policies to implement solid scientific investigations that would lead to information assisting physicians in the proper use and prescription of THC in its synthetic or herbal form.”

    Observational trial data published in 2012 in the British Medical Journal previously reported that adults with a history of marijuana use had a lower prevalence of type 2 diabetes and possess a lower risk of contracting the disease than did those with no history of cannabis consumption, even after researchers adjusted for social variables such as subjects’ ethnicity and levels of physical activity.

    Previously published preclinical data also indicates that the administration of cannabidiol (CBD) halts the development of type 1 (juvenile) diabetes in mice genetically predisposed to the condition.

    Full text of the study, “The cannabinoid ?9-tetrahydrocannabivarin (THCV) ameliorates insulin sensitivity in two mouse models of obesity,” is available online here.

  • by Paul Armentano, NORML Deputy Director June 7, 2013

    Democrat Gov. John Kitzhaber on Thursday signed legislation, Senate Bill 281, into law to allow patients with post-traumatic stress to be eligible to engage in the therapeutic use of cannabis.

    The new Oregon law expands the state’s existing medical marijuana program, initially enacted by voters in 1998, to include post-traumatic stress as a state-qualified illness for which marijuana may be recommended.

    To date, only three states – Connecticut, Delaware, and New Mexico – specifically allow for the use of cannabis to treat symptoms of post-traumatic stress.

    Clinical trial data published in the May issue of the journal Molecular Psychiatry theorized that cannabinoid-based therapies would likely comprise the “next generation of evidence-based treatments for PTSD (post-traumatic stress disorder).”

    Post-traumatic stress syndrome is an anxiety disorder that is estimated to impact some eight million Americans annually. To date, there are no pharmaceutical treatments specifically designed or approved to target symptoms of PTSD.

  • by Paul Armentano, NORML Deputy Director May 22, 2013

    A Michigan traffic safety law that prohibits the operation of a motor vehicle by persons who possess any presence of THC in their blood, regardless of whether or not they are behaviorally impaired by the substance, may not be strictly applied to state-qualified medical cannabis patients. So decided the Michigan Supreme Court on Tuesday in the case People v Koon.

    In a unanimous opinion, the Court determined that legal protections extended to state-qualified patients under the Michigan Medical Marihuana Act, enacted by voters in 2008, supersede the state’s zero tolerance, internal possession law. As a result, the Court determined that state prosecutors must establish that authorized patients charged under the statute are actually impaired by their cannabis use in order to gain a DUI criminal conviction.

    According to the syllabus of the Opinion:

    “The MMMA [Michigan Medical Marihuana Act] does not define what it means to be ‘under the influence,’ but the phrase clearly contemplates something more than having any amount of marijuana in one’s system and requires some effect on the person. Thus, the MMMA’s protections extend to a registered patient who internally possesses marijuana while operating a vehicle unless the patient is under the influence of marijuana. The immunity from prosecution provided under the MMMA to a registered patient who drives with indications of marijuana in his or her system but is not otherwise under the influence of marijuana inescapably conflicts with MCL 257.625(8) [the state’s zero tolerance per se DUI law], which prohibits a person from driving with any amount of marijuana in her or system.”

    The state’s zero tolerance per se drug law remains applicable to non-patients. Under such laws, motorists are guilty per se (in fact) of a criminal traffic safety violation if they engage in the act of driving while detectable levels of certain controlled substances or, in some cases, their inert metabolites (byproducts) are present in the defendants’ blood or urine. Proof of actual impairment is not a requirement for a conviction under the law.

    To date, ten states — Arizona, Delaware, Georgia, Illinois, Indiana, Iowa, Michigan, Rhode Island, Utah, and Wisconsin — have enacted legislation imposing zero tolerance per se thresholds for the presence of cannabinoids and/or their metabolites. (State-authorized medical cannabis patients in Arizona and Rhode Island are exempt from prosecution under these per se statutes unless the state can provide additional evidence of psychomotor impairment.)

    Five additional states impose non-zero-tolerant per se thresholds for cannabinoids in blood: Montana (5ng/ml — law takes effect on October 1, 2013), Pennsylvania (1ng/ml), Ohio (2ng/ml), Nevada (2ng/ml) and Washington (5ng/ml). Most recently, Colorado lawmakers approved legislation stating that the presence of THC/blood levels above 5ng/ml “gives rise to permissible inference that the defendant was under the influence.” State-qualified patients in Colorado, Montana, and Nevada are not provided legal exemptions from these statutes, although legislation is presently pending in Nevada to do so.

    NORML believes that it is inadvisable to infer behavioral impairment based on the presence of blood/cannabinoid levels alone — a position that we outline here, here, and in public testimony here.

    Such caution is similarly expressed by the United States National Highway Transportation and Safety Administration, which acknowledges: “It is difficult to establish a relationship between a person’s THC blood or plasma concentration and performance impairing effects. … It is inadvisable to try and predict effects based on blood THC concentrations alone.”

    A 2013 review of per se drugged driving laws and their impact on road safety found “no evidence that per se drugged driving laws reduce traffic fatalities.”

  • by Paul Armentano, NORML Deputy Director February 22, 2013

    The National Organization for the Reform of Marijuana Laws is pleased to announce that it is now providing educational content to the editors of The Answer Page, Inc. The Answer Page, Inc. is an online medical educational resource founded in 1998 that provides daily education to healthcare professionals in 120 countries. TheAnswerPage (online at TheAnswerPage.com) uses the Socratic question-and-answer teaching method. The content for the website is primarily written by academic clinicians respected in their fields. All content is peer-reviewed and referenced from current texts and recent literature.

    TheAnswerPage now features educational content in the area of medical marijuana. The editorial team of TheAnswerPage states: “Medical marijuana may be controversial, but it is now an important area of study in healthcare. Doctors and healthcare professionals must understand the medical, legal, social and political issues to best respond to their patients’ questions and attend to their needs.”

    The medical marijuana ‘lecture series’ begins with an introductory primer to the cannabis plant. The following week focuses on five distinct cannabinoids and their therapeutic potential.

    “NORML recognizes that physicians and health care professionals desire balanced information regarding the safety and efficacy of cannabis as a potential therapy,” NORML’s Deputy Director Paul Armentano said. “NORML is pleased to provide its expertise to TheAnswerPage to assist health care professionals better understand and navigate this important public health issue.”

    Subscribers to TheAnswerPage receive continuing medical education (CME) credit by reading the content and completing an industry-unique Interactive Crossword Puzzle. The clues are structured to reinforce the educational material, and links are provided to the related content. Subscribers have personal educational accounts that organize their earned CME credit and allow clinicians to download, email or print CME certificates for credentialing and licensing.

    TheAnswerPage.com has over 50 interactive crossword puzzles posted, for earning CME credit. New content and crosswords are posted daily.

    TheAnswerPage‘s medical cannabis content is available at the ‘syllabus;’ select the pull down menu option: “Medical Marijuana — Medical, Legal, Social, and political Issues.” Free registration to the site is required.

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