Arizona Marijuana: Everything to Know About Marijuana Law in AZ

(THIS ARTICLE IS COURTESY OF FACEBOOK.COM)

 

Arizona Marijuana: Everything to Know About Marijuana Law in AZ

 6

Brandi Atkins, an Arizona resident and former dancer, was diagnosed in late 2015 with a rare autoimmune disease that made her joints and muscles swell, causing chronic pain. She popped in and out of the hospital with a cornucopia of prescription medications handed out to alleviate her pain, ease her symptoms, and navigate around her type 1 diabetes. These medications would often clash with her disease and cause her blood sugar to soar. In desperation, she turned to medical marijuana.

Almost immediately, Adkins noticed an improvement in balance, palatable reduction in pain, and (most importantly) hope for her future. The dispensary she visited took the time to understand her specific concerns, her goals, and the particulars of her health conditions. Thanks to medical marijuana, Adkins feels like she can dance again.

This hopeful scenario plays out in dispensaries across Arizona, where more than 100,000 patients suffering everything from epilepsy to chronic pain find relief through medical marijuana.

It’s an interesting situation: legalized medical marijuana and dispensaries in one of the United States’ most conservative territories. How do these conflicting events coexist? Have you ever wondered what exactly is the state of medical marijuana affairs in Arizona? Here’s our in-depth explanation of everything you always wanted to know about Arizona’s Medical Marijuana Laws (but were too afraid to ask).

The road to marijuana legalization in Arizona

When the federal government originally passed the Marihuana Tax Act of 1937, the predecessor to the Controlled Substances Act of 1970, all American states had criminalized cannabis in one way or another. It wasn’t until the mid-1990s that Arizona state legislators began listening to decades-long calls for marijuana law reform.

In 1996, Arizona passed Proposition 200, allowing doctors to prescribe medical marijuana (specifically, controlled substances) to treat diseases or relieve pain in seriously/terminally ill patients. In order for a patient to use medical marijuana, a doctor had to provide scientific evidence to prove marijuana’s usefulness along with a second doctor’s opinion to the Arizona Department of Health Services. This caused conflict between supporters and opponents of medical marijuana, and started a lengthy battle over the law’s lack of specificity in addition to the language “prescribe.” For a doctor to prescribe medicine, the substance must first undergo FDA trials and doctors must specify the exact dosage and consumption methods to be used. Unfortunately, this rendered Prop 200 illegal on a federal scope and a medical marijuana program never materialized. It did, however, protect first-time drug offenders from prison sentences, which was a step towards decriminalization.

Arizona tried once more to legalize medical marijuana in 2002 with Proposition 203, but the initiative failed, receiving 42.7% of the vote. A viable solution was not presented and approved until nearly a decade later.

In 2010, Arizonans voted to approve a much-revised version of Proposition 203, an initiative to legalize the medicinal use of marijuana. Proposition 203 authorized doctors to recommend cannabis as a therapeutic option, as opposed to prescribing a specific dosage of cannabis with strict consumption or application methods. This law also tasked the Arizona Department of Health Services (ADHS) to regulate the “Arizona Medical Marijuana Act.”

Arizona’s current marijuana policy

The ADHS had until April 2012 to establish a registration application system for patients and nonprofit marijuana dispensaries, as well as a web-based verification platform for use by law officials and dispensaries to verify a patient’s status as such. It also specified patients’ rights, qualifying medical conditions, and allowed out-of-state medical marijuana patients to maintain their patient status (though not to purchase cannabis).

On December 6, 2012, Arizona’s first licensed medical marijuana dispensary opened in Glendale.

In 2012, Arizona legislators amended the Arizona Medical Marijuana Act to include college and university campuses in their non-consumption list, even if the cardholder was over 21 years old. However, in April 2017, this ruling was overturned by the Arizona Court of Appeals, and though colleges can privately prohibit medical marijuana on campus, lawmakers cannot make campus cannabis use illegal.

The people of Arizona took advantage of the Department of Health’s qualifying condition appeal process in 2013 when they petitioned to include PTSD, migraines, and depression among the list of qualifying medical conditions. Following due process, the Director of the ADHS denied the petition.

prop 205 arizona

While it seemed like the Arizona population was becoming more tolerant of cannabis, it proved too soon to jump to recreational legalization. In 2016, Arizonans narrowly voted no on Prop 205 by a margin of 48:52, which would have legalized the adult use of marijuana. Ballotpedia attributes this loss to heavy early campaigning by opponents of recreational marijuana years before the election process. Opponents such as Insys, the creators of Fentanyl, lobbied heavily against recreational cannabis — their CBD medicine passed the first phases of FDA trials earlier in 2016. This loss resulted in a significant surge in new medical marijuana patients, many of whom were waiting to get their card only if the recreational law failed to pass.

Despite various lawmakers’ attempts to place limitations on Arizona’s medical marijuana law, the program is growing larger each year. As of late June 2017, there were 132,487 Arizona marijuana patients, 155 dispensary licenses (up from 124 at the law’s passage), and 881 patient caregivers.

The “Arizona Medical Marijuana Act”

The “Arizona Medical Marijuana Act,” or AMMA, empowers Arizona doctors to recommend medical marijuana as a viable treatment option for Arizona patients diagnosed with at least one qualifying medical condition. With this recommendation, a patient may apply for an Arizona Medical Marijuana Card, a card that allows patients to possess, purchase, and use medical marijuana.

2.5 oz of cannabis, up to 12 plants, deliveries of marijuana, 25 miles from a dispensary

Arizona marijuana patients or caregivers may possess up to 2.5 ounces of marijuana at any given time, and obtain 2.5 ounces in a 14-day period from an Arizona medical marijuana dispensary. Patients can also be authorized to grow up to 12 marijuana plants for their own use, or otherwise, find a caregiver to grow cannabis for them if they reside more than 25 miles from the nearest medical marijuana dispensary.

Living as a medical marijuana patient

chronic pain, alzheimers, cachxia, cancer, crohn's disease, glaucoma, hepatitis c, muscle spasms, nausea, ptsd, sclerosis, seizures, two or more conditions

For Arizonans like Brandi Atkins — mentioned at the beginning of this article — who think medical marijuana might be right for them, patients must receive a recommendation to use medical marijuana from a licensed Arizona physician. The patient must have one of the below qualifying medical conditions, and their physician must determine that the patient indeed has a qualifying condition. The written certification would state the doctor believes, in their professional opinion, the patient would likely receive therapeutic benefit from medical marijuana use.

Arizona’s list of debilitating qualifying conditions

ALS, alzheimer's disease, cancer, glaucoma, hiv/aids, hepatitis c, cachexia/wasting syndrome, muscle spasms, nausea, seizures, severe and chronic pain

Once a patient has received their written certification from an Arizona doctor, they may apply to the ADHS for a Registry Identification Card, a card that grants patients and caregivers the authority to possess, purchase, and use medical marijuana legally.

To apply for a Registry Identification Card, patients must submit their written certification, the application fee, their personal information, and a statement declaring they won’t use their medical marijuana for nefarious purposes (i.e. sell it to kids). If a minor wants to be a medical marijuana patient, there are stricter rules to follow before they can qualify for their card. The ADHS website explains the application process in more detail.

The most “caring” of the bunch

Some patients in critical need of cannabis are unable to travel easily to purchase or even consume cannabis without some assistance. Arizona included regulations to cover the people who would take care of these patients, known as Caregivers, allowing them to assist patients (up to five) in the medical use of marijuana.

Whether taking care of a child or an elderly parent, this endeavor is a huge responsibility. Caregivers need to educate themselves on the different aspects of marijuana, like different strains, consumption methods, and their patients’ specific health needs. Arizona caregivers must follow all the same regulations as patients, including registering with the ADHS and carrying an ID card.

Don’t worry, the law protects you!

As federal law still classifies marijuana as a Schedule 1 drug (without medicinal value), Prop 203 and other medical cannabis laws were designed to protect citizens’ rights. Arizona medical marijuana patients are supposed to be treated like every other resident. The AMMA’s regulations protect the rights of patients and caregivers in certain circumstances:

  • A school or landlord may not refuse to enroll/lease to a qualifying patient unless failing to do so would incur ramifications under federal law.
  • Medical facilities cannot deny treatment to patients based on their status as a medical marijuana user.
  • Parental rights cannot be denied based on a parent’s status as an Arizona medical marijuana patient.

While these protections are essential, they do not provide for every eventuality. Employers may not discriminate against employees who are medical marijuana patients, and may not penalize them for a positive drug test. However, employees cannot use or possess marijuana during the hours of work. Employers may lawfully discipline and even terminate any employee who tests positive for marijuana if they used or possessed during work hours, even if the employee is a registered patient.

Despite nearly 20 years of progress toward decriminalization and regulation, Arizona is still one of the toughest states in the nation when it comes to marijuana. Even minor possession is a felony for those who aren’t medical marijuana patients, with a max sentence of 3.75 years and a $150,000 fine.

I’m a physician, what part do I play in medical marijuana?

“I have found in my study of these patients that Cannabis is really a safe, effective and non-toxic alternative to many standard medications.” -Philip Denney, MD, Testimony to the Arkansas legislature in support of House Bill 1303, “An Act to Permit the Medical Use of Marijuana,” Nov. 17, 2005.

Doctors are the gatekeepers to medical marijuana. In all medically legal states, doctors must fully evaluate their patients and determine whether cannabis is a fit for their medical needs and whether they have a qualifying condition. This places a lot of responsibility on doctors’ shoulders, which most Arizona doctors bear with professionalism and true concern for their patients. The physician must be a doctor of medicine, a doctor of osteopathic medicine, a naturopathic physician, or a homeopathic physician who holds a valid license to practice in Arizona.

medical marijuana doctors in arizona

Physicians meet patients, either in person or via telemedicine services, to determine if the patient has a qualifying condition before signing a written certification stating that, in their professional opinion, the patient has a qualifying condition and would likely receive therapeutic benefits from medical marijuana use.

However, Arizona courts have cracked down on some physicians who have turned their practices into “certification mills” due to their being no additional requirements for marijuana recommendations other than holding a valid license to practice medicine in Arizona.

Visiting from out of state?

Arizona allows non-Arizona medical marijuana patients the same rights and protections as Arizona citizens. This caveat makes sense … sort of.

The law states a Registry Identification Card, or its equivalent, issued by another state is valid in Arizona, except in that a visiting qualifying patient may not obtain marijuana from an Arizona marijuana dispensary.

This is a bit paradoxical. How is an out-of-state patient to access medical marijuana without purchasing from a dispensary or bringing it over state lines, which is federally illegal? Here’s how:

Another registered Arizona patient or designated caregiver can offer and provide medical marijuana so long as nothing of value is given in return, and the recipient doesn’t end up possessing more than 2.5 oz. of marijuana. This works, though it may be simpler to become a resident of Arizona.

Medical Marijuana Dispensary basics, keeping patients safe, obeying laws

inside a dispensary

All Arizona marijuana dispensaries are nonprofit organizations, a philosophy similar to out-of-state patients: “nothing of value may be exchanged for the transfer of medical marijuana.” While medical marijuana isn’t free, dispensaries may charge for medical marijuana as part of the expenses incurred during business operations. Patients can purchase up to 2.5 ounces of marijuana every two weeks, either as flower or an equivalent amount in concentrate, edibles, or other cannabis product forms.

As marijuana is still federally illegal (and valuable), security remains a  top priority. Dispensaries are required to use the ADHS online verification system to confirm each Arizona marijuana patient’s status as a patient and the amount of marijuana purchased over the last 60 days. This system is password protected and will not allow any access through an unencrypted internet connection. This online system does not include patients’ addresses or other personal information.

Dispensaries are also required to have a strong security system for their facility, including a single secure entrance. Medicating on the premises is forbidden. These heavy requirements go hand-in-hand with Arizona officials’ concern that marijuana products will encourage theft, violence, or negligent/illegal use.

Don’t be afraid to ask about the future

Though Arizona’s medical marijuana laws are full of sticky, complicated red tape, the program’s existence is still a huge step forward in the crusade for national legalization. Suffering patients in Arizona can find medical relief with our favorite plant and still enjoy protection from the law. Hopefully, after reading our guide, you now understand the nuts and bolts of how medical marijuana regulations work in Arizona.

Still want more information? Check out the Arizona Department of Health Services website at www.azdhs.gov.


Sources:

https://azmarijuana.com/links/legal/

https://azmarijuana.com/news/proposition-203-arizona-medical-marijuana-act/

http://norml.org/legal/item/arizona-medical-marijuana

http://www.azdhs.gov/licensing/medical-marijuana/index.php

http://medicalmarijuana.procon.org/view.resource.php?resourceID=000881#Arizona

http://www.azcentral.com/story/news/politics/arizona/2017/04/06/ruling-overturns-law-banning-medical-marijuana-arizona-college-campuses/100145648/

http://blog.norml.org/2011/05/16/alternet-the-five-worst-states-to-get-busted-with-pot/

http://www.azdhs.gov/documents/licensing/medical-marijuana/debilitating/2013-july/medical-marijuana-debilitating-medical-condition-decision-form-jan-2014.pdf

https://ballotpedia.org/Arizona_Marijuana_Legalization,_Proposition_205_(2016)

https://www.nytimes.com/elections/results/arizona-ballot-measure-205-legalize-marijuana

http://azcapitoltimes.com/news/2017/01/24/lawmakers-act-to-change-medical-marijuana-rules/

https://www.washingtonpost.com/news/wonk/wp/2016/09/09/a-maker-of-deadly-painkillers-is-bankrolling-the-opposition-to-legal-marijuana-in-arizona/?utm_term=.7428039f5547

https://www.forbes.com/sites/theemploymentbeat/2014/12/02/medical-marijuana-and-the-workplace-what-employers-need-to-know-now/#3ff5578b66b8

http://medicalmarijuana.procon.org/view.source.php?sourceID=000593

http://www.phoenixnewtimes.com/news/arizonas-week-in-weed-pot-docs-cant-lie-on-forms-az-supreme-court-says-8277359

https://www.marijuana.com/news/2014/07/arizona-court-rules-that-medical-marijuana-patients-can-sell-weed-to-other-patients/

http://www.azdhs.gov/documents/licensing/medical-marijuana/reports/2016/2016-apr-monthly-report.pdf

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New York Health Dept. Proposes Medical Marijuana Improvements

(THIS ARTICLE IS COURTESY OF THE MPP WEBSITE)

 

New York Health Dept. Proposes Medical Marijuana Improvements

 Aug 10, 2017  


The New York Department of Health proposed additional changes to the state’s medical marijuana program today. While the official proposed regulations will not be released until August 23, the changes appear to be very positive. Once the rules are released, the public will have 30 days to comment.
New forms of medicine would be allowed, including topicals and chewable lozenges, as well as “[c]ertain non-smokable forms of ground plant material,” which will hopefully be clarified in the full text of the regulations. Having whole plant cannabis available for vaporization could dramatically reduce prices for patients, and we will seek to make sure it’s permitted.
Other changes would reduce burdens on medical professionals, hopefully encouraging more of them to participate. For more information and the complete list of proposed changes, you can read the Department of Health’s full announcement.

West Virginia Becomes the 29th Medical Marijuana State

(THIS ARTICLE IS COURTESY OF THE MPP WEBSITE)

West Virginia Becomes the 29th Medical Marijuana State

Apr 19, 2017 , , , , , , , ,, ,


Today, West Virginia officially became the 29th state to pass medical marijuana legislation!

Gov. Jim Justice signed the law today after the bipartisan bill passed both the Senate and House earlier this month.

While the law isn’t perfect, it’s a great start toward providing safe and legal access to medical marijuana for qualifying patients. A summary is available here.

This achievement didn’t happen overnight. In fact, MPP, along with many other advocates, has been working tirelessly to get a medical marijuana bill passed for years.

MPP released the following in a press release:

“This legislation is going to benefit countless West Virginia patients and families for years to come,” said Matt Simon of the Marijuana Policy Project, who is a West Virginia native and graduate of West Virginia University. “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.”

Six states have adopted comprehensive medical marijuana laws in the past 12 months. Three of those laws, including West Virginia’s, passed through Republican-controlled legislatures. Lawmakers in Pennsylvania and Ohio approved them last April and June, respectively. The other three were approved by voters in November in states won by Donald Trump — Arkansas, Florida, and North Dakota.

“Intensifying public support and a growing body of evidence are driving the rapid growth in the number of states adopting medical marijuana laws,” Simon said. “Lawmakers are also learning about marijuana’s medical benefits from friends, family members, and constituents who have experienced them firsthand in other states. More than nine out of 10 American voters think marijuana should be legal for medical purposes. In light of this near universal support, it is shocking that some legislatures still have not adopted effective medical marijuana laws.”

Apr 19, 2017 , , , , , , , ,, ,


Today, West Virginia officially became the 29th state to pass medical marijuana legislation!

Gov. Jim Justice signed the law today after the bipartisan bill passed both the Senate and House earlier this month.

While the law isn’t perfect, it’s a great start toward providing safe and legal access to medical marijuana for qualifying patients. A summary is available here.

This achievement didn’t happen overnight. In fact, MPP, along with many other advocates, has been working tirelessly to get a medical marijuana bill passed for years.

MPP released the following in a press release:

“This legislation is going to benefit countless West Virginia patients and families for years to come,” said Matt Simon of the Marijuana Policy Project, who is a West Virginia native and graduate of West Virginia University. “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.”

Six states have adopted comprehensive medical marijuana laws in the past 12 months. Three of those laws, including West Virginia’s, passed through Republican-controlled legislatures. Lawmakers in Pennsylvania and Ohio approved them last April and June, respectively. The other three were approved by voters in November in states won by Donald Trump — Arkansas, Florida, and North Dakota.

“Intensifying public support and a growing body of evidence are driving the rapid growth in the number of states adopting medical marijuana laws,” Simon said. “Lawmakers are also learning about marijuana’s medical benefits from friends, family members, and constituents who have experienced them firsthand in other states. More than nine out of 10 American voters think marijuana should be legal for medical purposes. In light of this near universal support, it is shocking that some legislatures still have not adopted effective medical marijuana laws.”

Where Marijuana Is Legal: Opioid Deaths And Alcohol Sales Are Way Down

(THIS ARTICLE IS COURTESY OF HIGH TIMES MAGAZINE)

For many years, the biggest threat to marijuana legalization and fledgling legal cannabis businesses was the police.

Fears of DEA agents breaking down the front door at dawn, prosecutions in federal court with its accompanying mandatory minimums or warrantless visits from helicopter-riding police who merely cut down plant and leave—such things happen and are legal—was what kept people involved in cannabis up at night.

But now, with legalization sweeping the country and a vast majority of Americans in support of medical marijuana, the real enemy is revealing itself.

And as recent events in Arizona demonstrated, it’s Big Pharma.

In 2015, U.S.-based companies made up 40 percent of the global pharmaceutical trade, a market share worth $413 billion. These companies are well aware that cannabis is becoming an accepted treatment for chronic pain and many of the other lifelong afflictions now treated by highly profitable trademarked drugs—and some have proven willing and able to take steps to make sure marijuana stays out of the hands of law-abiding Americans in order to protect that enormous bottom line.

“Pharmaceuticals are going to run me down,” Dr. Gina Berman, medical director of the Giving Tree Wellness Center, a Phoenix, Arizona-based cannabis dispensary, told the Guardian. “We have a small business, and we can’t afford to fight Big Pharma.”

The most egregious case to date is Insys Therapeutics. Insys, is an Arizona-based drug manufacturer of pain drugs that contain fentanyl, the powerful synthetic opioid that’s been fingered in many fatal opiate overdoses (including the death of Prince).

Arizona was the lone state where a marijuana legalization initiative failed at the ballot in November—and one of the leading donors to the anti-legalization campaign, with a $500,000 check, was Insys. (Another was Trump-supporting casino magnate Sheldon Adelson, CEO of the Las Vegas Sands Corp. Here are the Vegas nightlife spots to boycott, forever.)

As the Intercept reported this fall, Insys executives openly recognized the threat to its market posed by marijuana. And in a devious twist, Insys identified marijuana as an existential threat and moved to keep it illegal, while developing a new drug based on synthetic THC.

On March 23, the DEA ruled that Insys’s new drug, called “Syndros,” could be marketed and sold as a Schedule II drug—meaning it could be prescribed to patients as soon as this fall.

So far, the FDA has approved Syndros for AIDS-related weight loss and vomiting and nausea associated with chemotherapy—two of the original applications for medical marijuana.

“It’s pretty absurd that federal law considers marijuana to have no medical value, but allows for the development of synthetic versions of the same substance,” Mason Tvert, a spokesman for the Marijuana Policy Project, which sponsored Arizona’s legalization measure, told the Guardian.

But what about Insys Therapeutics? It’s a company straight out of a Superman comic. 

In December, Justice Department prosecutors took the “unusual” step of charging six former Insys executives, including former CEO Michael L. Babich, with racketeering for its “aggressive” marketing of a fentanyl-based pain drug called Subsys, the New York Times reported. Prosecutors alleged that in order to sell more Subsys, the company arranged lavish dinners and other events for doctors who prescribed “lots of” the drug, and when that didn’t work, the company resorted to kickbacks. 

One Connecticut nurse pleaded guilty in 2015 to accepting $83,000 in kickbacks from the company. Families of dead patients, prescribed Subsys despite prescriptions for other drugs that are fatal when combined, and despite no cancer diagnosis—the drug is only FDA-approved from cancer-related pain—have also sued the company.

In a statement, Carmen Ortiz, the-then U.S. attorney for Massachusetts (before she and many others were summarily fired by Trump administration officials earlier this year), pinned part of the blame for the country’s opiate epidemic squarely on “corporate greed.”

In January, Insys founder John Kapoor stepped down as chairman, a role he took over from the indicted Babich in late 2015. Kapoor’s exit came after Insys’s sales plummeted 40 percent, as Forbes reported. (Wonder if the alleged kickbacks had anything to do with the inflated numbers?)

It’s all very ominous, but in a real way, marijuana activists should let Insys try—and then fail, spectacularly, as they are primed to do.

Insys’s proposed product, called Syndros, is a solution of “oral dronabinol.” Dronabinol is the generic name for another synthetic version of THC that’s been on the market for quite some time, called Marinol—and if you know anyone who has used Marinol, you know what they think of it. Namely, it kind of sucks.

For many patients, fake weed simply doesn’t work. As one patient prescribed Marinol told CBS News, “It might as well have been M&M’s.”

This is almost certainly because as synthetic THC only, Marinol and Syndros both lack cannabidiol, or CBD, as well as dozens of others cannabinoids. And as per the “entourage effect” theory, proffered by luminaries like CNN’s Sanjay Gupta and many more, your body and brain need all of cannabis’s component parts in order for its medical “magic” to work.

But let’s say Insys strikes out with Subsys. It won’t end there.

This is a company accused, with enough evidence to indict in a federal court, of being willing to see people die in order to sell more drugs. And it won’t end with this company.

Big Pharma is scared of weed—terrified—and as any animal scientist will tell you, a cornered and frightened animal is the most dangerous. And that applies to humans.

You can keep up with all of HIGH TIMES’ marijuana news right here.

West Virginia Legislature Votes To Legalize Medical Marijuana ‘As Soon As Possible’

 

MPP Blog


WV Legislature Approves Medical Marijuana Bill

Posted: 07 Apr 2017 12:34 PM PDT

 West Virginia is on the verge of becoming the next state with an effective medical marijuana law!

The bill received final approval in the West Virginia Legislature on Thursday and is headed to the desk of Gov. Jim Justice. He has publicly expressed support for legal access to medical marijuana and is expected to sign the bill into law, making West Virginia the 29th state to adopt an effective medical marijuana law.

SB 386, titled the West Virginia Medical Cannabis Act, charges the Bureau of Public Health with regulating medical marijuana growers, processors, and dispensaries. Patients with specifically listed qualifying medical conditions will be allowed to use extracts, tinctures, and other preparations of marijuana, but not marijuana in flower or leaf form. This differs from the original version of the bill and the medical marijuana programs in most other states. A summary of SB 386 is available at http://bit.ly/2nbUAq3.

MPP issued the following statement in a press release:

“Some of the House amendments to the bill are concerning, but it still has the potential to provide relief to thousands of seriously ill WestVirginians,” said Matt Simon of the Marijuana Policy Project, who is a West Virginia native and graduate of West Virginia University. “We commend the Legislature for passing this compassionate and much-needed legislation, and we encourage Gov. Justice to sign it into law.

“This will be an important and, in some cases, life-saving program,” Simon said. “It is critical that the state implement it promptly. We are committed to working with officials to make sure the program is as effective as possible and to get it up and running in a timely fashion. Many patients cannot afford to wait much longer.

The post WV Legislature Approves Medical Marijuana Bill appeared first on MPP Blog.

Study: States with medical marijuana have lower prescription drug use—Plus Fewer Drug Overdoses And Deaths

 

Study: States with medical marijuana have lower prescription drug use—This Causes Fewer Drug Overdoses And Fewer Drug Related Deaths As It Is Impossible To Overdose (Die) From Marijuana Usage!

Prescription drug prices are up, making policy experts increasingly anxious. But relief could come from a surprising source. Just ask Cheech and Chong.

New research found that states that legalized medical marijuana — which is sometimes recommended for symptoms like chronic pain, anxiety or depression — saw declines in the number of Medicare prescriptions for drugs used to treat those conditions and a dip in spending by Medicare Part D, which covers the cost on prescription medications.

The study, which appears in Health Affairs, examined data from Medicare Part D from 2010 to 2013. It is the first study to examine whether legalization changes doctors’ clinical practice and whether it could curb public health costs.

The findings add context to the debate as more lawmakers express interest in medical marijuana. Ohio and Pennsylvania have this year passed laws allowing the drug for therapeutic purposes, making the practice legal in 25 states, plus Washington D.C. The question could also come to a vote in Florida and Missouri this November. A federal agency is considering reclassifying it under national drug policy to make medical marijuana more readily available.

Medical marijuana saved Medicare about $165 million in 2013, the researchers concluded. They estimated that, if the policy were nationalized, Medicare Part D spending would have declined in the same year by about $470 million. That’s about half a percent of the program’s total expenditures.

That is an admittedly small proportion of the multi-billion dollar program. But the figure is nothing to sneeze at, said W. David Bradford, a professor of public policy at the University of Georgia and one of the study’s authors.

“We wouldn’t say that saving money is the reason to adopt this. But it should be part of the discussion,” he added. “We think it’s pretty good indirect evidence that people are using this as medication.”

The researchers found that in states with medical marijuana laws on the books, the number of drug prescriptions dropped for treating anxiety, depression, nausea, pain, psychosis, seizures, sleep disorders and spasticity. Those are all conditions for which marijuana is sometimes recommended. Prescriptions for other drugs treating other conditions, meanwhile, did not decline.

The study’s authors are separately investigating the impact medical marijuana could have on prescriptions covered by Medicaid, the federal-state health insurance program for low-income people. Though this research is still being finalized, they found a greater drop in prescription drug payments there, Bradford said.

If the trend bears out, it could have meaningful public health ramifications. As doctors and public health experts grapple with the consequences of excessive prescription painkiller use, medical marijuana could provide an alternate path. Experts say abuse of prescription painkillers — known as opioids — is in part driven by high prescribing. In states that legalized medical uses of marijuana, painkiller prescriptions dropped — on average, the study found, by about 1,800 daily doses filled each year per doctor. That tracks with other research on the subject.

Questions exist, though, about the possible health harms or issues that could result from regular use.

It’s unlike other drugs, such as opioids, in which overdoses are fatal, said Deepak D’Souza, a professor of psychiatry at Yale School of Medicine, who has researched the drug.

“That doesn’t happen with marijuana,” he added. “But there are whole other side effects and safety issues we need to be aware of.”

“A lot of people also worry that marijuana is a drug that can be abused,” agreed Bradford. “Just because it’s not as dangerous as some other dangerous things, it doesn’t mean you want to necessarily promote it. There’s a lot of unanswered questions.”

Meanwhile, it is difficult to predict how many people will opt for this choice instead of meds like antidepressants or opioids.

Because the federal government labels marijuana as a Schedule I drug, doctors can’t technically prescribe it. In states that have legalized medical marijuana, they can only write patients a note sending them to a dispensary. Insurance plans don’t cover it, so patients using marijuana pay out-of-pocket. Prices vary based on geography, but a patient’s recommended regimen can be as much as $400 per month. The federal Drug Enforcement Agency is considering changing that classification — a decision is expected sometime this summer. If the DEA made marijuana a Schedule II drug, that would put it in the company of drugs such as morphine and oxycodone, making it easier for doctors to prescribe and more likely that insurance would cover it.

To some, the idea that medical marijuana triggers costs savings is hollow. Instead, they say it is cost shifting. “Even if Medicare may be saving money, medical marijuana doesn’t come for free,” D’Souza said. “I have some trouble with the idea that this is a source of savings.”

Still, Bradford maintains that if the industry expanded and medical marijuana became a regular part of patient care nationally, the cost curve would bend because marijuana is cheaper than other drugs.

Lester Grinspoon, an associate professor emeritus of psychiatry at Harvard Medical School, who has written two books on the subject, echoed that possibility. Unlike with many drugs, he argued, “There’s a limit to how high a price cannabis can be sold at as a medicine.” He is not associated with the study.

And, in the midst of the debate about its economics, medical marijuana still sometimes triggers questions within the practice of medicine.

“As physicians, we are used to prescribing a dose. We don’t have good information about what is a good dose for the treatment for, say pain,” D’Souza said. “Do you say, ‘Take two hits and call me in the morning?’ I have no idea.”

Kaiser Health News (KHN) is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation.

Israel Wakes Up To Reality That Marijuana Is A Medical Gift From God For Mankind

(This article is courtesy of the Times of Israel News Paper)

As hundreds of medical professionals, farmers, patients and cannabis activists descend on Israel this week for the Cann10 International Medical Conference from September 11 to 13, Israeli scientists are plowing ahead with new clinical trials in order to approve cannabis use for a wider variety of diseases.

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Israel is a well-known internationally as a pioneer in medical cannabis. This summer, the government approved a plan initiated by Health Minister Yaakov Litzman (United Torah Judaism) to relax some of the medical cannabis requirements. The plan will expand the number of doctors who can issue cannabis prescriptions, remove limits on the number of marijuana growers, make cannabis available at approved pharmacies, and possibly eliminate the requirement for a permit from the Health Ministry so that just a doctor’s prescription will be sufficient.

“There’s no reason why someone who needs cannabis for medical reasons should suffer and confront unnecessary red tape, and therefore the present situation must be changed,” Litzman said in June, the Haaretz daily reported.

The Health Ministry’s move to make medical marijuana even more accessible is part of the country’s tolerance and even support for marijuana, especially in a medical context.

A Tikun Olam pharmacist metes out a patient's monthly medical marijuana prescription at the Tel Aviv dispensary on September 1, 2016. (Melanie Lidman/Times of Israel)

A Tikun Olam pharmacist metes out a patient’s monthly medical marijuana prescription at the Tel Aviv dispensary on September 1, 2016. (Melanie Lidman/Times of Israel)

“This is the second [marijuana] conference in Israel in six months and it is evidence that Israel and the world are starting to wake up to what Israel can contribute to the cannabis industry,” said Clifton Flack, chief marketing officer for iCAN Israel-Cannabis, a private equity fund that focuses on cannabis.

“Our key contribution has been and will be research,” Flack added. “The story of the Israel cannabis industry began with research, with Prof. [Raphael] Mechoulam. For the past 50 years we’ve contributed to research. You are going to find that, under the hood, a big percentage of the global cannabis products or industry will somewhere have something Israeli.”

Today, there are approximately 23,000 patients who have medical marijuana prescriptions in Israel, up from 10,000 in 2012. That number will continue to rise as marijuana is approved to treat more ailments, with scientists racing to run high-level, double-blind clinical trials exploring medical uses of cannabis that can be published in major medical journals.

Currently, cannabis is undergoing clinical trials or approved for use to treat tinnitus, colitis, Crohn’s disease, some of the spastic symptoms of cerebral palsy pediatric patients, severe epilepsy in children, Tourette’s syndrome, Parkinson’s disease, Inflammatory Bowel Disease, autism symptoms like insomnia or aggressiveness, and some of the side effects of cancer treatment. Future trials include testing cannabis for the treatment of rheumatoid arthritis, post-traumatic stress disorder and eye inflammations.

Professor Raphael Mechoulam, previously at the Weizmann Institute and now at Hebrew University, is largely credited as the father of medical cannabis for identifying and identifying tetrahydrocannabinol (commonly known as THC) in 1964. THC is the active compound in marijuana that produces the “high” sought after by recreational users. Another main active compound in marijuana is cannabidiol (CBD), which has medical benefits, including anti-inflammatory properties.

Professor Raphael Mechoulam in his lab in Hebrew University's Ein Kerem campus on September 1, 2016. (Melanie Lidman/Times of Israel)

Professor Raphael Mechoulam in his lab at Hebrew University on September 1, 2016. (Melanie Lidman/Times of Israel)

It took years for the rest of the medical establishment to begin paying attention to his work with medical marijuana, Mechoulam said.

“There was a therapeutic importance for epilepsy that we identified, and although we published, no one was interested in epilepsy,” he said. “There are one and two-year-old’s with epilepsy and there is no other medication that works. Only in the last few years have they discovered our work. Up to 60 percent of the kids with epilepsy are helped.”

But the 85-year-old scientist, who still oversees a lab at Hebrew University’s Ein Kerem campus, feels that the cannabis field is on the precipice of a breakthrough, and hundreds of uses of the plant are just waiting to be discovered.

“In the last few years, compounds related to cannabinoids are acting on things that we didn’t expect, like osteoporosis,” he said. He noted that cannabis may also reduce the amount of brain damage after a head trauma by relaxing constricted blood vessels.

Medicinal marijuana in the pre-cookie stage (photo credit: Abir Sultan/ Flash 90)

Medicinal marijuana in the pre-cookie stage (Abir Sultan/Flash 90)

Mechoulam has watched the field of cannabis research come a long way in the past decades. When he first started his research at the Weizmann Institute in the 1960s, his first challenge was to obtain a large amount of cannabis. “The administrative head of Weizmann called someone he knew in the police and just asked for cannabis,” Mechoulam recalled.

“I heard from the other side [of the conversation], ‘Is he reliable?’ and the person from the Weizmann Institute said ‘Of course he’s reliable!’ so they said, ‘Have him come over.’ So I went to the police, I got five kilo’s of hashish, I signed for it, and I put the five kilo’s of hashish in my bag. Then I went on a bus and went to the lab. Now, in the bus there was a lot of cannabis smell; nobody knew what it was.”

“Then it turned out that we had broken the law and I should go to prison and the policeman had broken the law and he should go to prison, because it was the Health Ministry that has to approve these things,” Mechoulam continued. “I went to the Health Ministry and said ‘I apologize, I’m sorry, next time we’ll do it that way.’”

Christine Haj, a post-doctoral student in Mechoulam's lab, holds a beaker of pure THC in the Hebrew University lab on September 1, 2016. THC, the principal psychoactive constituent of cannabis, can be an amber or gold colored glassy solid when cold, and becomes viscous and sticky if warmed. (Melanie Lidman/Times of Israel)

Christine Haj, a post-doctoral student in Mechoulam’s lab, holds a beaker of pure THC in the Hebrew University lab on September 1, 2016. THC, the principal psychoactive constituent of cannabis, can be an amber or gold-colored glassy solid when cold, and becomes viscous and sticky if warmed. (Melanie Lidman/Times of Israel)

The US National Institutes of Health has supported Mechoulam’s cannabis research for decades, since American scientists had much more difficulty obtaining cannabis for study. He was awarded a NIDA (National Institute of Drug Abuse) Discovery Award in 2011. Mechoulam said that while the US and Israel had similar laws governing cannabis research, Israel’s culture of personal connections, colloquially called  enabled the research to progress much faster here.

Still, there have been many challenges along the way, especially because cannabis is a natural compound that must be grown rather than produced.

“Clinicians don’t like to work with marijuana or hashish because it’s not consistent, and that’s not the way modern research is done,” said Mechoulam.

The smallest changes in growing techniques, weather, or watering can affect the chemical make-up of the plant. “THC amounts can vary even within the same plant,” said Dr. Keren-Or Amar, business development manager at Shizim, another cannabis investment company.

“One of the concerns the FDA [US Food and Drug Administration] has expressed is that when you use a plant you cannot secure the right dosage in every batch,” said Doron Ben Ami, chief strategy officer of Therapix Biosciences Ltd., a company that is developing cannabis-based drugs to treat neurological disorders such as Tourette’s syndrome and mild cognitive impairments.

“In pharmaceuticals, you need to be sure you know exactly what your patient is getting,” he said.

Medical marijuana at the Tikun Olam dispensary in Tel Aviv on September 1, 2016. Along with guidance from Tikun Olam's specially trained nursing staff, patients can decide to purchase their prescription in flower form, pre-rolled joints, pills, or tinctures. (Melanie Lidman/Times of Israel)

Medical marijuana at the Tikun Olam dispensary in Tel Aviv on September 1, 2016. Along with guidance from Tikun Olam’s specially trained nursing staff, patients can decide to purchase their prescription in flower form, pre-rolled joints, pills, or tinctures. (Melanie Lidman/Times of Israel)

Therapix and other pharmaceutical companies are working with the chemical production of THC, or synthetic THC. This allows the company to monitor the exact ratio of the active compounds that will be in the developed drugs.

But as additional strides have been made in producing synthetic cannabis, scientists are also getting better at manipulating strains of marijuana to have higher levels of THC or CBD depending on what disease they are treating.

Tikun Olam, the largest and oldest cannabis dispensary in Israel, now has 15 marijuana plant strains, which are cultivated to have a specific ratio of THC to CBD. Its Avidekel strain has 18% CBD compared to just 0.8% THC, meaning that it is safe for children and won’t produce the high commonly associated with marijuana. Tikun Olam treats more than 200 children with epilepsy with this strain.

Tikun Olam started 10 years ago with 10 patients in Israel, growing a few plants on Birya, a small moshav near Safed. When its list of patients grew to 1,000, it had to move to commercial fields whose location is closely guarded.

Next up: More markets, more diseases

Today, there are currently about 23,000 patients in Israel who have medical marijuana licenses granted by the Health Ministry. Tikun Olam treats 7,000 people per month. Except for patients with Tourette’s syndrome, patients must prove they have tried at least four alternative methods for managing their pain or illness before receiving a medical marijuana license, which is utilized as a last resort.

“The problem for us is that people want to believe that cannabis is going to cure them, but we don’t have the research yet,” said Professor Zvi Bentwich, a professor of medical biology at Ben Gurion University and the chief scientist at Tikun Olam. Bentwich was a pioneer in the Israeli fight against HIV/AIDs, and he became interested in medical cannabis after observing the positive effects that marijuana use, though illegal, had on his patient’s in dealing with nausea and loss of weight.

“In the 1990s, I advocated for my patient’s to use cannabis illegally, and then I helped get the government to legalize cannabis,” he said. “Previously, marijuana has not been studied clinically. Well-created, legal, clinical studies didn’t exist.”

A cancer patient shows his concentrated marijuana pills in the Tikun Olam guidance center in Tel Aviv on September 1, 2016. (Melanie Lidman/Times of Israel)

A cancer patient shows his concentrated marijuana pills in the Tikun Olam guidance center in Tel Aviv on September 1, 2016. (Melanie Lidman/Times of Israel)

Now Bentwich works with Tikun Olam to design clinical studies for various diseases. “We doctors are reluctant to use cannabis unless evidence is brought forward to prove it. In Israel, we are in a position to do pioneering work that has not been done anywhere.”

“The industry is exploding, but it is a fraction of what it is going to be in 10 years,” added Flack, the equity fund chief marketing officer. “In 10 years you are going to see cannabis everywhere. In Israel we add vitamin D to milk. We should be adding CBD. It doesn’t get you high. The body requires CBD, the brain produces it naturally and taking CBD every day in small amounts only does you good. I think within 10 years we will see Yotvata milk with CBD.”

Market potential could be huge. Cannabics Pharmaceuticals, an Israeli company that developed a marijuana capsule for cancer sufferers, estimates that the medical marijuana market has the potential to reach $3.6 billion in the US alone by 2019. This would make it larger than the organic food market.

“I think in 10 years every single accelerator or incubator in Israel will have at least one business, one startup doing something for cannabis,” said Flack. “It could be a medical device, or a tracking system, but in the startup world it will be everywhere. You are going to see a significant export industry, not of the flower, but of medical products.”

Exporting the buds may not be far behind. Agriculture Minister Uri Ariel announced in August that Israel would begin exporting medical marijuana, possibly within the next two years.

Scientists stress that the real key toward making marijuana more useful to patients is clinical tests that can systematically prove that cannabis is safe and effective for human use for specific diseases.

“I can cure a lot of diseases in mice [with cannabis],” said Amar, a former scientist now with the cannabis investment group. But without clinical trials, she said, “there’s no benefit to humans.”

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