Tag Archives: medical marijuana

Easing The Harms of Legalizing Marijuana In Minnesota

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I’m a strong supporter of legalizing marijuana in Minnesota, and nationally.  As I’ve written before, legalized marijuana “will make Minnesota a more sensible, just, fiscally sound, humane and free state.”  The evidence is overwhelming.

But let’s not be naive or dishonest here.  As with any vice, there are also huge problems associated with legalization that need to be alleviated.  To me, the most troubling downside of legalization is harms to minors, transportation users, and seriously ill patients.

Disadvantages of Ending Marijuana Prohibition

Damaging Minors’ Brains. First, credible researchers are finding that marijuana use by minors appears to be much more damaging than it is for adults. For an example, an article in an American Psychological Association publication reports numerous alarming research findings:

Heavy marijuana use in adolescence or early adulthood has been associated with a dismal set of life outcomes including poor school performance, higher dropout rates, increased welfare dependence, greater unemployment and lower life satisfaction.

Duke University psychologist Terrie Moffitt, PhD, and colleagues… found that persistent marijuana use was linked to a decline in IQ, even after the researchers controlled for educational differences. The most persistent users…experienced a drop in neuropsychological functioning equivalent to about six IQ points (PNAS, 2012). “That’s in the same realm as what you’d see with lead exposure,” says Weiss. “It’s not a trifle.”

There are some reasons to think that adolescents may be uniquely susceptible to lasting damage from marijuana use. At least until the early or mid-20s, “the brain is still under construction,” says Staci Gruber, PhD, a neuroscientist and director of the Cognitive and Clinical Neuroimaging Core and the Marijuana Investigations for Neuroscientific Discovery (MIND) Program at McLean Hospital/Harvard Medical School…

Also immature in teens is the endocannabinoid system. As its name implies, this system comprises the physiological mechanisms that respond to THC. That system is important for cognition, neurodevelopment, stress response and emotional control, and it helps to modulate other major neurotransmitter systems, says Krista Lisdahl, PhD, director of the Brain Imaging and Neuropsychology Laboratory at the University of Wisconsin, Milwaukee.

Repeated exposure to marijuana can dial down cellular activity in the endocannabinoid system. Such interference might be a bigger problem for immature brains, says Lisdahl. “That sets the stage for why adolescents may be more sensitive to the effects of repeated marijuana exposure, from a neuroscience perspective.”

So, should we oppose legalization of marijuana?  Not unless we also want to bring back alcohol prohibition, because alcohol also is extremely damaging to the brain and many other parts of the body, and alcohol leads to countless more deaths than marijuana.

Still, in the rush to legalize marijuana, these kinds of findings shouldn’t be shrugged off by legalization enthusiasts.  We need to shine a light on these findings to encourage young people to delay marijuana usage until later in life, and to encourage everyone to not overdo it.

More Traffic Fatalities.  Second, legalization of marijuana also will increase the number of impaired drivers, which will likely lead to more traffic injuries and fatalities. USA Today reports the expert findings from states where the drug is now legal:

According to research from the Insurance Institute for Highway Safety and the Highway Loss Data Institute, the frequency of collision claims filed to insurers were higher in four states where marijuana is legal: Colorado, Nevada, Oregon and Washington.

The Highway Loss Data Institute study focused on collision claims between 2012 and October 2017, and compared against four control states where marijuana remains illegal: Idaho, Montana, Utah and Wyoming.

A separate study conducted by the Insurance Institute for Highway Safety focused on police-reported crashes before and after retail marijuana was allowed found Colorado, Oregon and Washington saw a 5.2 percent increase in the rate of crashes per million vehicle registrations, compared with neighboring states.

Law enforcement officials and others are using these kinds of findings as a reason to oppose legalization.  That’s absurd.  No one, including law enforcement officials, wants to bring back alcohol prohibition because of the staggering number of serious drunk driving problems, so we shouldn’t keep marijuana illegal because stoned driving problems are in the mix.

At the same time, we also shouldn’t deny the existence of the problem, and be passive about harm reduction.

Destroy Medical Cannabis Program For Patients.  Finally, ending marijuana prohibition could inadvertently harm or destroy Minnesota’s fledgling medical cannabis program, and consequently harm the seriously ill Minnesota patients benefiting from it.

According to Minnesota Department of Health (MDH) patient surveys, many Minnesota patients are benefiting from precisely dosed, tested, and customized cannabis-based capsules, oils, tinctures, and topicals. Across a wide variety of qualifying conditions, two-thirds of patients report significant benefits, while only 10% report little to no benefit.

When it comes to chronic pain patients, the MDH surveys show that 63% of patients who had been on highly lethal, addictive opioid medications were able to reduce or eliminate their use of opioids after moving to much less addictive, lethal cannabis-based pain relief medicine.

Many seriously ill patients desperately want to hold onto those successful medicines, but worry that the post-legalization availability of cheaper, unprocessed raw marijuana plant material will put the manufacturers of their precisely dosed and formulated medicines medicine out of business.

Many Minnesotans probably won’t care too much that those manufacturers would go out of business.  But the problem is, if they do go out of business, patients would suffer.  That is, patients who are currently benefiting from those precisely formulated and dosed medicines would be forced to use raw plant material that they and their caregivers consider to be less safe, pure and customized form of medicine.

Mitigating the Harm

We can’t wish these problems away.  Therefore, the law ending marijuana prohibition should set aside a reasonable amount — for the sake of argument, let’s say five percent to ten percent of the revenue raised from legalizing marijuana — for  a Marijuana Harm Reduction Fund.  The lion’s share of the revenue raised by legalizing marijuana still could be allocated however lawmakers and their constituents see fit.  But a mitigation fund could be used for harm reduction projects like:

  • Medicine Affordability Assistance. Some type of patient-friendly sliding scale subsidy to make precisely dosed, tested and formulated cannabis-based medicines available and affordable to all Minnesota patients who, according to medical caregivers, need them.
  • Youth Brain Impact Public Education Campaign. A multi-media public education campaign aimed at teens, young adults and parents to raise awareness about the heightened dangers of marijuana use at an early age.
  • Stoned Driving Public Education Campaign. A multi-media public education campaign aimed at raising awareness about the very real dangers of driving while under the influence of marijuana.

A couple of important caveats about this fund:

  • Evidence-based campaigns. The content of the public education campaign should be overseen by inter-disciplinary experts to ensure campaigns don’t become Reefer Madness-like misinformation campaigns, and are instead based on the consensus of the best available scientific evidence.
  • Subsidy oversight. The subsidies of patients using cannabis-based medicines should be monitored to ensure physicians are verifying that patients are benefiting from the medications and the amount of patient subsidies are kept at a reasonable level.

Again, cannabis is much less addictive and deadly than already legalized alcohol.  Again, marijuana prohibition has been horrific for communities. of color.  Again, marijuana prohibition is very bad, and legalization is much better.  Don’t get me wrong.

But that can’t be the end of the debate.  Citizens like me who are advocating to end marijuana prohibition must own these problems, and do what we can to reduce the associated harm.

Disclosure: The author is a public relations consultant who helps one of Minnesota’s two manufacturers of cannabis-based medicine share patient success stories with the news media.  He doesn’t lobby for that company, and the public policy opinions expressed here are his own, not the company’s.

Opioid Abuse Crusader To Crack Down On Safer Opioid Alternative

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The Affordable Care Act repeal, which will lead to 23 million Americans losing their health insurance protections, isn’t the only way the Trump Administration is endangering Americans. It’s proposal to ban patients from getting relief from cannabis-based medicines is just as ill-informed and cruel.

Trump’s states rights-loving Attorney General Jeff Sessions has asked Congress to restore the federal government’s ability to crack down on state-authorized medical cannabis businesses. Since 2014, Congress has prohibited the federal Department of Justice from using funds to prosecute these state authorized businesses.

In a letter to Congress, Sessions made his case:

“I believe it would be unwise for Congress to restrict the discretion of the Department to fund particular prosecutions, particularly in the midst of an historic drug epidemic and potentially long-term uptick in violent crime. The Department must be in a position to use all laws available to combat the transnational drug organizations and dangerous drug traffickers who threaten American lives.”

I can’t think of a delicate way to say this. This is moronic.  Trump and Sessions say they are making battling rising opioid addiction a high priority, but this move would prevent pain patients from transitioning from highly addictive and dangerous opioid pain relievers to much less addictive and dangerous cannabis-based pain medicines.

Before you bust out your best adolescent weed jokes or Reefer Madness paranoia, give some serious consideration to recent peer-reviewed medical research on this topic, as summarized by Scientific American:

A 2016 survey from University of Michigan researchers, published in the The Journal of Pain, found that chronic pain suffers who used cannabis reported a 64 percent drop in opioid use as well as fewer negative side effects and a better quality of life than they experienced under opioids. In a 2014 study reported in JAMA The Journal of the American Medical Association, the authors found that annual opioid overdose deaths were about 25 percent lower on average in states that allowed medical cannabis compared with those that did not.

Marijuana can be habit-forming, at least psychologically, but the risks are not in the same league as opioids. A 20-year epidemiological review of studies concluded that more than nine out of 10 people who try marijuana do not become dependent on the drug. The review paper, published in 2014, said the “lifetime risk of developing dependence among those who have ever used cannabis was estimated at 9 percent in the United States in the early 1990s as against 32 percent for nicotine, 23 percent for heroin, 17 percent for cocaine, 15 percent for alcohol and 11 percent for stimulants.”

Also, unlike the case with opioids, it is virtually impossible to lethally overdose on marijuana—because a user would have to consume massive quantities in a prohibitively short time. The National Institute on Drug Abuse (NIDA) says such a fatal result is very unlikely. Meanwhile, heroin-related overdose deaths have more than quadrupled since 2010. The U.S. Centers for Disease Control and Prevention says that from 2014 to 2015 heroin overdose death rates increased by 20.6 percent—causing nearly 13,000 deaths in 2015.

This is no longer coming from some guy in a Grateful Dead t-shirt making vague anecdotal claims. This is now coming some of the foremost medical authorities in the nation.  For many people, cannabis-based medicines can ease their pain without the level of addictiveness and nasty side effects that unfortunately come with opioid pain relievers.

Beyond pain relief, cannabis-based medicines — often with the intoxicating component of cannabis oil (THC) removed when it isn’t medically necessary — also are helping Minnesota patients who have been diagnosed with a variety of diseases, such as cancer, Glaucoma, HIV/AIDS, Epilepsy, Tourette Syndrome, Multiple Sclerosis, ALS, Crohn’s Disease, and terminal illnesses.

In Minnesota, most patients with those ailments who have been using cannabis-based oils, tinctures and capsules report to officials at the state Department of Health that they are experiencing substantial benefits from using cannabis-based medicine. On a scale of 1 to 7, where 1 is “no benefit” and 7 is “great deal of benefit,” nearly two-thirds (64%) of patients chose a 6 or 7.

Meanwhile, no patients report being hospitalized with complications from the cannabis-based medicine, something that cannot be said for opioids and many other FDA-approved medications. Minnesota’s Commissioner of Health, Dr. Ed Ehlinger, looked at this data and concluded:

“Based on this evidence from the first year, Minnesota’s approach is providing many people with substantial benefits, minimal side effects and no serious adverse events.”

For years now, Americans have seen patients benefitting from medical cannabis, and an overwhelming number of them like what they see.  A February 2017 Quinnipiac University survey found that 93 percent support “allowing adults to legally use marijuana for medical purposes if their doctor prescribes it,” including 85 percent of Republicans.  Only 23 percent of Americans, and 36 percent of Republicans, support “the government enforcing federal laws against marijuana in states that have already legalized medical or recreational marijuana?”

All of this leaves me wondering, what exactly are Jeff Sessions and Donald Trump smoking?

 

Note:  I’m a public relations consultant who has in the past done work for one of two medical cannabis businesses licensed by the State of Minnesota.  I no longer work with that company, and this post reflects my personal views.

Five Reasons Minnesota Voters Should Legalize Marijuana in 2018

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state_marijuana_laws_in_2016_mapCitizens in Massachusetts, California, Maine and Nevada recently voted to join Colorado, Alaska, Oregon, the District of Columbia and Washington as states that have legalized the use of marijuana for recreational purposes. Minnesota should be next.

Minnesota doesn’t allow citizen-initiated ballot measures, but the 2017 Legislature could put a legislatively referred constitutional amendment on the ballot, so
Minnesota voters could decide in November 2018 whether to legalize marijuana. Here’s why they should:


LEGALIZED MARIJUANA WILL MAKE MINNESOTA MORE SENSIBLE. Currently, Minnesota law assumes that marijuana is far more damaging than alcohol.  A mountain of research says otherwise.

Marijuana does create societal problems, such as risk of addiction and impaired driving. But research finds that the risks associated with marijuana pale compared to the risks our society very willingly accepts with legal alcohol products.

For instance, while the Centers for Disease Control (CDC) finds that 37,000 people per year die of alcohol abuse, none die from marijuana use. None.  Research also shows that marijuana is far less addictive than alcohol, and that the alcohol-related health costs are eight times higher than marijuana-related health costs.

cursor_and_cannabis_facts_for_canadians__essential_information_for_an_informed_debate_about_cannabis_policyGiven the facts, making alcohol legal and marijuana illegal makes absolutely no sense. Treating those two vices equally under the law will make Minnesota a more sensible and intellectually honest place.

cursor_and_how_does_cannabis_compared_to_other_drugs_-_google_search

LEGALIZED MARIJUANA WILL MAKE MINNESOTA MORE JUST. Marijuana prohibition has made Minnesota unjust. The New York Times describes the grotesque amount of damage that has been done by making marijuana use a crime and launching a multi-billion law enforcement war against it:

From 2001 to 2010, the police made more than 8.2 million marijuana arrests; almost nine in 10 were for possession alone. In 2011, there were more arrests for marijuana possession than for all violent crimes put together.

The public-safety payoff for all this effort is meager at best: According to a 2012 Human Rights Watch report that tracked 30,000 New Yorkers with no prior convictions when they were arrested for marijuana possession, 90 percent had no subsequent felony convictions. Only 3.1 percent committed a violent offense.

What makes the situation far worse is racial disparity. Whites and blacks use marijuana at roughly the same rates; on average, however, blacks are 3.7 times more likely than whites to be arrested for possession, according to a comprehensive 2013 report by the A.C.L.U.

Stop! This war on marijuana is destroying more lives than marijuana itself ever could. Legalization will  at long last end the madness.

LEGALIZED MARIJUANA WILL SAVE TAX DOLLARS.  Constantly chasing and punishing marijuana users and sellers has been extremely expensive for taxpayers. According to the American Civil Liberties Union (ACLU), enforcing marijuana costs more than $3.6 billion per year.  That’s billion with a “b.”  Beyond saving tax dollars, legalized marijuana should be taxed, just as we do with alcohol, and generate revenue to address pressing community needs.

LEGALIZED MARIJUANA WILL HELP ALLEVIATE SUFFERING.  Minnesota has a medical cannabis law that authorizes the use of precisely dosed cannabis-based pills and oils.  These medicines are customized for each medical condition to limit or eliminate side-effects, such as the “high” sensation.  For instance, children with seizure disorders are able to use precise doses of a purified formulation of cannabis oil that has no intoxication side effects whatsoever.  Minnesota has a medically responsible law, and a Minnesota Department of Health study finds that about 90% of Minnesota patients are benefiting from these medicines.

But producing these medicines is expensive, and insurance companies don’t cover them. So, too many ailing Minnesota patients simply can’t access the medicines to get relief from their suffering. Accordingly, some of the state revenue derived from legalizing marijuana for recreational use should be dedicated to reducing the cost of the medicines, so suffering Minnesotans could get the help they desperately need.

cursor_and_prohibition_ends_-_google_searchLEGALIZED MARIJUANA WILL MAKE MINNESOTA MORE FREE. Finally, just as ending alcohol prohibition made America a more free nation, ending marijuana prohibition will make Minnesota a more free state. If marijuana was legalized, I probably wouldn’t use it. But if some in the “land of the free” want to use something that is demonstrably safer than legalized alcohol, a free society should allow them to do so.

So, enough with the sophomoric Cheech and Chong jokes.  From a purely good government standpoint, legalized marijuana will make Minnesota a more sensible, just, fiscally sound, humane and free state.  It’s time.

CORRECTION:  The original post did not list Maine, District of Columbia, Alaska, and Oregon.  Those states should have been included and were added after the original posting.

Minnesota Law Enforcement Lobbyists Move To Criminalize Abused Prescription Pain Drugs

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prescription_pain_killer_bustSaint Paul, Minn. —  A coalition of Minnesota law enforcement officials announced today that it will push to ban Minnesota patients from using a long list of dangerous prescription pain killers being sold on the streets by criminals.

At a news conference at the State Capitol today, the  Minnesota Law Enforcement Coalition (MLEC) called for legislation to ban codeine, morphine, methadone, fentanyl, oxycodone, hydrocodone, bitartrate, hydromorphone, oxymorphone, meperidine, and propoxyphene.  Law enforcement officials stressed that these prescription pain medicines all are dangerous when not used as prescribed, and are currently being sold by criminals on the streets, often to young people.

MLEC has taken the same stand against legislation to make marijuana available to Minnesota patients.  Because many seriously ill patients find that marijuana relieves pain and nausea, it has been legalized for medical use in 20 states.  But MLEC opposes making marijuana available to Minnesota patients, since it  can be harmful when abused, and is being sold illegally on the streets.

“We must do whatever we can to eliminate the abuse and criminal activity associated with these dangerous prescription pain killers,” said Wayne Krupke, Executive Director of MLEC.  “For the same reasons marijuana shouldn’t be given to patients, these prescription pain killers shouldn’t be given to patients.”

The advocacy organization Patients for Effective Pain Management (PEPM) maintains that drugs like marijuana, morphine and oxycodone relieve the pain of seriously ill patients, and the good that comes from that outweighs the harm caused by abusers of those drugs.

morphine_pump“It’s inhumane to deny a proven pain reliever to suffering patients, simply because abuse is possible,” said Mary Ann Wakefield, PEPM’s Executive Director.  “Many of the most effective pain meds can be abused or sold on the black market, but that doesn’t mean that we should turn our backs on patients helped by those drugs.”

However, Krupke maintains that the medical community has many other pain killers at their disposal, such as aspirin, acupuncture and meditation.  At the same time, he points out that the National Institute on Drug Abuse has found that approximately 16 million Americans reported using a prescription drug for nonmedical reasons in 2010.

“As with marijuana, no one can guarantee that drugs like morphine and oxycodone won’t be sold by drug dealers and abused by kids,” said Krupke.  “Until and unless they can provide such a guarantee, those pain killers must be outlawed for all, including patients.”

Meanwhile, Governor Mark Dayton pledged to support whatever the law enforcement lobby recommends.

“I will not compromise on this issue unless someone can convince the law enforcement lobby to compromise on it,” said Dayton.  “When it comes to what is best for patients in pain, I put my full confidence in the law enforcement lobby.”

Note:  This post is satire, and not an actual news story.  It was featured in Politics in Minnesota’s Best of the Blogs.

Dayton Needs To Reclaim Veto Power From Lobbyists

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Governor Dayton says he will veto any medical marijuana proposal unless legislators can reach a compromise with law enforcement group lobbyists.  The Associated Press reports:

Dayton repeatedly cites law enforcement concerns for his own opposition to medical marijuana. But in an interview today with the Associated Press, the Democratic governor says he’d probably sign a bill to legalize it if sheriffs, prosecutors and other law enforcement groups get behind it.

I support and admire this Governor, so let me say this as politely as I can:  Sir, may I please inquire as to WHAT ARE YOU SMOKING?

Governor Dayton, with all due respect, lobbyists were not on our election ballots.  You were.  Minnesota citizens didn’t give any lobbyists the most powerful tool in a democracy, the veto.  We collectively gave it to you, because we can hold you democratically accountable when we disagree with you.  We can’t do that with unelected, unaccountable lobbyists.

veto_stampWe voted for duly elected lawmakers to compromise with other duly elected lawmakers.  The Governor and legislators should certainly be informed by lobbyists on all sides of the issue, but the veto power shouldn’t effectively be handed to lobbyists, as Governor Dayton is doing on the medical marijuana issue.

Unfortunately, this is not all that uncommon in Minnesota State government.  From the left, education reforms too often don’t  get a fair debate if the teacher’s union lobbyists turn their mighty thumbs downward.   From the right, tax reform has become the impossible dream because a bevy of business lobbyists are effectively given a collective veto.

Too often, legislators aren’t crafting legislative compromises inside legislative hearing rooms and chambers.  Instead the compromises are being formulated by the most politically powerful lobbyists in hallways and bars, and are then rubber stamped by legislators eager to please the lobbyists who decide which legislative candidates’ campaign war chests get filled.

I’m not a simplistic lobbyist basher.  Lobbyists are here to stay, and that’s actually a very good thing. Though campaign finance laws should limit their influence on the electoral process and less powerful interests need to have better access to lobbyists of their own, I know lobbyists can improve the legislative decision-making process with the specialized information that they bring.

Moreover, I’m not convinced the law enforcement position is all that unreasonable.  My understanding is that they could accept a proposal in which the active ingredient in marijuana (THC, Delta-9-Tetrahydrocannabinol) is delivered to patients through pills, oils and vapor.  Their concern apparently is with allowing patients to smoke unprocessed leaves, either home grown or commercially grown, because they think having more legal leaves floating around Minnesota would make it more difficult to enforce criminal marijuana laws.  Though I support decriminalizing recreational use of marijuana, I am encouraged that law enforcement isn’t saying “never” to these patients.  And they certainly have a right to their position.

But they don’t have a right to veto.

So, Governor, please do what we elected you to do.  Do the hard work of listening to all sides of the medical marijuana issue, and negotiating with them.  At the end of those negotiations, let us know whether YOU believe there is a reasonable policy position, and explain YOUR reasoning for YOUR decisions.

Governor Dayton’s Medical Marijuana Blindspot

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Imagine a man so obsessed with eliminating useless, harmless clutter from his attic that he fails to hear the cry of a suffering relative just a few feet away from him.

Recent news coverage conjures that image for me.

In one part of the news, we have ever-earnest Governor Mark Dayton sorting through the cluttered statutory attic to find useless laws.  Downsizin’ Dayton is finding lots of regulatory rubbish, such as a law requiring the capture of wild boars in the Twin Cities.  (Don’t worry, legislators, that’s “boars” with an “a.”)

medical_marijuana_patient_Photo_by_Raw_Story-2Elsewhere in the news, we have Minnesotans in severe pain pleading Governor Dayton and legislators for a law to allow them to use medicinal marijuana to relieve severe pain and nausea, as 20 other states already do.  To be clear, we’re not talking Cheech or Spicoli here.  We’re talking about people suffering and dying.

The Governor is no stranger to pain, and has proven throughout his career to be a very compassionate guy.  But for whatever reason, he doesn’t seem to be hearing the cries of these victims. Instead, he’s fixated on getting Boar Laws to the dumpster, and blindly following law enforcement officials who are so obsessed with chasing potheads that they can’t think straight about this very different issue.

Don’t get me wrong.  I am not now, nor have I ever been, a Boar Law sympathizer.  Like the Governor, I stand steadfastly against the Boar Law, and other forms of legislative hoarding.  Moreover, I recognize that some of Dayton’s “Unsession” proposals are very meaty, such as speeding up the environmental permitting process.  That’s extremely worthwhile reform work, and I hope the Legislature follows the lead of Governor Dayton and his Un-Lieutenant Tony Sertich.

But let’s face it, much of Dayton’s initiative to eliminate 1,000 laws falls firmly into the category of “nice to have,” rather than “must have.”  He is cleaning harmless clutter, and most of us function just fine with harmless clutter in our midst.

Practically speaking, no Minnesotan violating the Boar Law, or similar antiquated laws, is  in danger of being busted and imprisoned.   But a Minnesotan trying to buy marijuana to ease the pain of a loved one is in very real danger of being busted and imprisoned.  That’s bananas.

To the Minnesotans suffering from deadly illnesses, and their loved ones frantic to help them, medical marijuana is much more than a “nice to have.”   Former U.S. Surgeon General Jocelyn Elders explains the type of relief that Minnesota lawmakers are denying suffering citizens:

“The evidence is overwhelming that marijuana can relieve certain types of pain, nausea, vomiting and other symptoms caused by such illnesses as multiple sclerosis, cancer and AIDS — or by the harsh drugs sometimes used to treat them. And it can do so with remarkable safety. Indeed, marijuana is less toxic than many of the drugs that physicians prescribe every day.”

“Huh, Surgeon General Elders, did you say something?  I can’t hear so well up here in the statutory attic.”

– Loveland

Note:  The photo is from Raw Story.