Vol. 5, Number 4 April 1, 2013 cheryl riley, editor & writer Dr. David Bearman, writer Gradi Jordan, writer Ed Glick, writer Paul Armentano, writer Sunil K Aggarwal, writer Amanda Reiman, writer Arthur Livermore, writer |
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Does the Drug War Protect Our Kids? - Dr. David Bearman One of the most commonly heard justifications for having a war on certain drug users (but hey, not Charlie Sheen with his suitcase of cocaine, Rush Limbaugh with his Oxycontin problem or Cindy McCain with her heavy use of opiates to relieve her migraine pain) is to protect our kids. Let's examine that concern a bit. It suggests that laws are an effective strategy at limiting teenage use of drugs. As the late William R. Buckley, conservative pundit and host of Firing Line for 33 years said, "Because alcohol is regulated and marijuana is not, it is easier for most junior high students to get marijuana than alcohol." The U.S. has some of the harshest drug laws in the world and Holland some of the most liberal, yet 19% of U.S. high school age students use marijuana, while only 13% of Dutch high school age students use cannabis. There was a big lie that surfaced around 1913. This was the invention of so-called "soldiers disease." The allegation was that many Civil War veterans were addicted to morphine. The Civil War did not herald in large numbers of wounded veterans as opiate "addicts." This is just one more myth perpetuated by prohibition. Mandell and other drug policy historians have documented, there was little written contemporaneously in the post Civil War period regarding the soldiers disease." No it wasn't until 50 years after the Civil War in 1913 that we began to see articles written about this so-called phenomenon. It begs credibility that if this condition were a real and significant problem amongst Civil War veterans that almost nothing was written about this contemporaneously. Now it is true that opium was readily available in patent medicine nostrums like Lydia Pinkham's Vegetable Compound, for the treatment of women's unmentionable ills. This was a euphemism for PMS, menstrual cramps and menopause. Who was using this? Studies show that far and away the typical opium user was not a young adult, not a Chinese worker, but a white woman in her 30s or 40s. At the turn of the 19th to the 20th century we had a high rate of opiate habituation. 75% were middle-age women. There was little or no crime associated with this use as opiates were readily available in many patent medicines and use amongst teenagers was not one of the reasons given for the Harrison Narcotics Tax Act.
Well, who cares and what does this have to do with today? Well, plenty if we're serious about assessing the effectiveness of todays drug policies. A review of adolescent drug use in countries with harsh drug laws vs. liberal drug laws demonstrates that harsh laws don't discourage use nor do liberal laws promote it. Portugal, Spain and Holland are cases in point. Making Drugs Illegal, Threatens Our Freedom and Doesn't Work More and more Americans are beginning to question whether having a drug be illegal really protects our children. First, most high school kids find it easier to buy marijuana than alcohol. Why? Alcohol is regulated. A store owner doesn't want to lose his or her license. Sellers of illicit substances have no such license or concern. This gives them license to sell to whoever has the money for their product. Further, our children are very bright. They recognize that alcohol and tobacco are dangerous and legal and THC, according to numerous articles, and such authorities as the FDA and the Canadian Government is not as dangerous. The current drug laws, especially those affecting marijuana, foster disrespect for education, government and law.
"While it is not possible with existing data to determine conclusively that state medical marijuana laws caused the documented declines in adolescent marijuana use, the overwhelming downward trend strongly suggests that the effect of state medical marijuana laws on teen marijuana use has been either neutral or positive, discouraging youthful experimentation with the drug."
Robert J. Barrow, Harvard University economist, wrote of damage caused by our drug policies in his paper 'Getting It Right: Markets and Choices in a Free Society'. He says, "The experience with drug enforcement shows that prohibitions of recreational drugs drive up prices, stimulate illegal activity, have only a moderate negative effect on consumption, and impose unacceptable costs in terms of high crime, expansion of prison populations, and deterioration of relations with the foreign countries that supply the outlawed products." Kurt Schmoke, citing former New York Governor Mario Cuomo, makes the distinction between an idea that sounds good and a good idea. He takes the liberal view that giving government the power to make drugs illegal sounds like a good idea. Schmoke's position is that "The current war on drugs is an idea that sounds good, but it is not a good idea that is sound. After hundreds of billions of dollars spent trying to stop the supply and demand of drugs, after the break-up of thousands of families because of the arrest of a non-violent drug offender, after eight decades of failure, how much longer will the war on drugs continue?" (Source: "The War on Drugs is Lost," National Review Editorial, 2/12/96) We are spending a ton of money and sending lots of Blacks and Hispanics to jail The enormous expenditure of funds to continue our proven dysfunctional drug policy is only getting worse. As we get harsher and harsher sentencing guidelines, such as 'three strikes, you're out,' "a disproportionate number of young Black and Hispanic men are likely to be imprisoned for life under scenarios in which they are guilty of little more than a history of untreated addiction and several prior drug-related offenses ... States will absorb the staggering cost of not only constructing additional prisons to accommodate increasing numbers of prisoners who will never be released but also warehousing them into old age." (Source: Craig Haney, Ph.D., and Philip Zimbardo, Ph.D., "The Past and Future of U.S. Prison Policy: Twenty-five Years After the Stanford Prison Experiment," American Psychologist, Vol. 53, No. 7 [July 1998], p. 718.) It is our judgment that the war on drugs has failed, that it is diverting intelligent energy away from how to deal with the problem of addiction, that it is wasting our resources, and that it is encouraging civil, judicial, and penal procedures associated with police states. We all agree on movement toward legalization, even though we may differ on just how far. (The War on Drugs is Lost, National Review Editorial, Feb. 12, 1996) Adequate and Well-Controlled Studies Proving Medical Efficacy of Cannabis Exist but Are Ignored by Marijuana Schedulers - Sunil Kumar Aggarwal and Amanda Reiman After a 40-year battle over the placement of marijuana in Schedule I, the U.S. Court of Appeals, DC Circuit, ruled in January on the most recent petition to reschedule marijuana in the case of AMERICANS FOR SAFE ACCESS (ASA) v. DRUG ENFORCEMENT ADMINISTRATION (DEA). The court ruled that the DEA had not acted arbitrarily and capriciously when it denied ASA's petition filed 9 years earlier to remove marijuana from Schedule I. Schedule I drugs have "no currently accepted medical use in treatment in the United States" and "a lack of accepted safety for use under medical supervision" -- a classification that holds marijuana more dangerous than cocaine, morphine, or methamphetamine, all listed in Schedule II with accepted medical uses. The court ruled that the research needed to move marijuana out of Schedule I does not exist. We respectfully beg to differ. The DEA's argument, stated in a 2006 report from the US Department of Health and Human Services (HHS), is that there are no "adequate and well-controlled studies" proving marijuana's efficacy. Though they noted a number of U.S.-based small-to-medium sized randomized, double-blind, placebo-controlled studies of inhaled marijuana for severe pain, spasticity, and wasting syndromes, all showing valid medical benefits, they felt these were not big enough. What DEA wants to see are akin to Phase III clinical trials -- large studies, involving hundreds of subjects, comparing marijuana to placebo in a double-blind, randomized fashion for a specific indication -- exactly what the Food and Drug Administration (FDA) wants when evaluating interstate drug marketing applications. Here's the rub: those kinds of studies have been done and are published in the peer-reviewed scientific literature and yet neither the DEA, nor the HHS, nor the Court took notice. Large, multicenter, randomized, double-blind, placebo-controlled studies involving hundreds of patients in America and abroad that are in some cases a year in duration have been published in U.S. National Library of Medicine indexed journals showing that marijuana, orally administered in extract form, can treat intractable pain in cancer and improve mobility and symptom control in multiple sclerosis. What is arbitrary and capricious is federal agencies have chosen to ignore these studies because they have been done mainly in the private pharmaceutical drug development sector where marijuana-infused products are produced, tested, and sometimes strategically renamed. This hide and seek game has resulted in rigorous research having little to no bearing on public scientific understanding of the medical use of marijuana. In the case of GW Pharma Ltd (GWP) of Wiltshire, England, it is a mouth spray directly extracted with liquid carbon dioxide from the flowers of two strains of marijuana plants grown in UK-licensed company greenhouses from a worldwide marijuana seed collection that resided in the Netherlands until the late 1990s. In the case of the non-profit Institute of Clinical Research (IKR) of Berlin, Germany, it is a capsulated alcohol extract made from marijuana flowers grown in Switzerland and extracted in Germany. Marijuana extracts have been produced for millennia for consumption, and the public has an overriding interest and right to know that these marijuana studies exist and that their results should logically have bearing on how we as a society understand, utilize, value, and ultimately classify marijuana. So why do the feds not include marijuana resin extract studies when weighing marijuana's evidence base? Sometimes it is as simple as a name game. Congress's definition of marijuana -- unchanged since 1937 -- has always included any compound, extract, or manufactured mixture containing a detectable amount of marijuana resin. If marijuana resin has been extracted and dissolved into a solvent or otherwise concentrated, that new substance is still called marijuana, hash, or hash oil, and this form of marijuana often carries stricter penalties, such as the life sentence penalty recently adopted by Oklahoma in 2011 for first-offense hash production. Millions have been punished under this full definition of marijuana via their possession or distribution of marijuana-infused edibles such as brownies or hash oil. Marijuana medicines made by GWP and IKR are concentrated forms of the marijuana plant with marijuana resin as a base. GWP's lead product, imported for U.S. trials under DEA license, was named "nabiximols" (Sativex®) and not marijuana by the United States Adopted Names Council, a body composed of organized medicine and pharmacy with FDA backing. In IKR's case, the company chose the name Cannador® for their marijuana extract seemingly without any regulatory oversight. Cannabis, marijuana's proper name, is a commonwealth medicinal plant belonging to no government or private entity. Licensed producers of marijuana extracts in the private sector have a rare and coveted wide latitude of scientific freedom to explore and discover, in a rigorous way, many of the medicinal benefits inherent to cannabis. Does the government have the right to ignore rigorous peer-reviewed published evidence about marijuana's medical utility accumulated in the pharmaceutical sector which enjoys privileged access to marijuana for research and development? Does private industry have the right to demand, as GWP once did, that marijuana not be rescheduled based in part on their collected data, which they recently achieved in the UK, presumably to protect company market share and pricing by avoiding competition from future marijuana producers who would be empowered by a rational reclassification of marijuana in federal law? Cannabis should not be cordoned off for the sake of private patents, monopolies, or FDA drug marketing applications. In the U.S., federal agencies have set-up onerous roadblocks that limit researchers' abilities to access marijuana -- the very impetus for private marijuana research to get started overseas, licensed by friendlier governments. A DEA judge actually ruled that the U.S. marijuana supply monopoly was not in the public interest in 2007, but this decision has been ignored. Many major medical societies want marijuana rescheduled or are urging a scheduling review be undertaken, including the American Medical Association, the American College of Physicians, and the Massachusetts Medical Society, publishers of the New England Journal of Medicine. In fact, there has been ongoing resistance to marijuana's placement in Schedule I ever since Congress first attempted it in 1970. When drafting the law, Congress sought input from Dr. Roger Egeberg, Assistant Secretary of Health at HHS and former personal physician to General MacArthur. He testified that "our recommendation is that marihuana be retained within schedule I at least until the completion of certain studies now underway to resolve the issue", referring to the comprehensive "National Commission on Marihuana and Drug Abuse" study being undertaken at that time. His recommendations were echoed in a Congressional Committee report which stated "the recommendations of this Commission" would be "of aid" in determining "the appropriate location of marihuana within the schedules of the bill." When the Commission reported in 1972 that the public threat of marijuana had been greatly exaggerated and recommended that its classification be lowered so that it was no longer on par with heroin, no one took responsibility and marijuana was left in Schedule I. Immediately afterwards, citizens filed the first of several petitions to reschedule marijuana. After 16 years, the first petition was favorably viewed by a DEA judge who concluded after an extensive, two-year evidentiary hearing, that "marijuana, in its natural form, is one of the safest therapeutically active substances known to man. By any measure of rational analysis marijuana can be safely used within a supervised routine of medical care." He ruled that marijuana be rescheduled to Schedule II, with painkillers and anesthetics, and that to not do so would be "unreasonable, arbitrary, and capricious." His decision was overruled by the politically appointed DEA head who said that data were inadequate. Forty years later, the ASA v. DEA case, now on appeal, is the latest major legal challenge to marijuana's schedule I status, and new rescheduling bills have been filed in Congress. We cannot let the federal government play fast-and-loose with science on marijuana research any longer--cannabis in all forms must be down-scheduled and de-scheduled. The public health justice imperative to stop curtailment of scientific inquiry and free medical professionals to explore alternative treatments like marijuana with patients is paramount. There are too many lives at stake, not to mention scientific integrity and a burgeoning field of medical discovery requiring much freer access to the marijuana plant. Sunil Aggarwal, M.D., Ph.D. and Amanda Reiman, Ph.D., M.S.W.
Dr. Aggarwal is a board member of Americans for Safe Access Foundation and a resident physician at a large academic medical center in New York City. Dr. Reiman is a California policy manager for the Drug Policy Alliance and a Lecturer in the School of Social Welfare at the University of California, Berkeley.
Alabama: Considering a medical marijuana law.
Arkansas: Considering a medical marijuana law. Florida: Medical marijuana petition drive underway. Idaho: Considering a medical marijuana law.
Illinois: Considering a medical marijuana law.
Indiana: Considering a medical marijuana law. Iowa: Considering a medical marijuana law.
Kansas: Medical marijuana petition drive underway.
Maryland: Considering a medical marijuana law.
Minnesota: Considering a medical marijuana law.
Missouri: Considering a medical marijuana law.
New Hampshire: Considering a medical marijuana law. New York: Considering a medical marijuana law.
North Carolina: Considering a medical marijuana law.
Ohio: Considering a medical marijuana law.
Pennsylvania: Considering a medical marijuana law.
South Carolina: Considering a medical marijuana law. South Dakota: Medical marijuana petition drive underway. Tennessee: Considering a medical marijuana law. Texas: Considering a medical marijuana law.
Wisconsin: Considering a medical marijuana law.
Featured Recipe - Chuey’s Chewy Oatmeal/Raisin Delight OK, so who is Chuey? Soy el doctor Chuey (Jessie). Jessie is the closest thing you get to Jay down where I live. Nurse Nancy Wife and I made these oatmeal raisin cookies to help our Canny Bus Trip Kit driver recover from a recent illness. Cannabis cookies are great when you are laid up. They stimulate appetite, fight the nausea of chemotherapy or narcotics, reduce pain, and are very nutritious. We made these cookies strong. They’d be chewier if we used dairy butter in the mix but we went with potency as these cookies are truly medical. Nancy and I also looked for the most organic ingredients possible as these treats were for a sick friend and she doesn’t need any preservatives. Ingredients:
¾ cup (12 tablespoons) Better Bud Butter (room temperature) Directions: Preheat the oven to 300 degrees. Coat a baking pan with butter or canola oil. Combine the dry ingredients (flour, salt, cinnamon, baking soda). Cream together the softened bud butter and sugar until smooth. Beat in eggs and vanilla. Fold the mixed dried ingredients into the creamed mixture. Stir in the oats, raisins, currants, and pecans. Chill the dough in the refrigerator for at least one hour. Chuey likes to take golf ball size (well to tell the truth baseball size) chunks of dough, roll them into a ball and slightly flatten them in the palm of your hand, place on baking pan and squish down just a bit more. Don’t crowd the cookies. Baking time at 300 degrees: Bake approximately 18 minutes depending upon the size of the cookies. Be careful not to overcook as these treats will dry up a bit as they cool. Cool the cookies on a rack and keep them in an airtight container for storage. Yield: How many cookies you get depends upon what size you make them. Smaller cookies (three to five dozen) will cook much faster than large cookies (two to three dozen). One large cookie produced day long relaxation and pain relief for one medical patient with chronic muscle spasm. Note to diabetics: You can substitute most of the sugar with a combination of fructose and other sweeteners. Portion control of the normal recipe will insure no nasty blood sugar peaks. Recommended Beverage: Summer- home made lemonade, Winter- Double lattes |
April 26-28, 2012 Tucson, AZ USA
Contribute to the AAMC Legal Fund here: Medical Marijuana States Alaska Arizona * California Colorado Connecticut Delaware District of Columbia Hawaii Maine * Massachusetts Michigan * Montana * Nevada New Jersey New Mexico Oregon Rhode Island * Vermont Washington * States with reciprocity law
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