As we enter the second decade of state-authorized medical cannabis the growing pains are evident and the maturing industry is entering a time of reckoning. Having millions of Americans legally using cannabis, medically or otherwise, is a true victory but, frankly, the time has come for a bit of reform within the industry. Those of […]
Two decades ago, in 1989, the administrator of the Drug Enforcement Administration rejected the findings of his agency’s chief administrative law judge who had ruled that marijuana has accepted medical value in the U.S. and should be rescheduled. In dismissing the judge’s decision the administrator stated that anyone who supported medical marijuana was perpetrating a “cruel hoax” on the American public.
Those words came back to me as I read the news of North Carolina’s medical marijuana law that was signed on July 3, 2014. North Carolina became the tenth state to enact the so-called “CBD only” medical marijuana law. (The other nine states are Alabama, Florida, Iowa, Kentucky, Mississippi, South Carolina, Tennessee, Utah and Wisconsin.) While the intent of lawmakers may have been compassionate the result is, in my opinion, a cruel hoax.
These laws have tremendous appeal to the lawmakers. Pressure for passage of such laws has come from the parents of young children who are stricken with rare forms of epilepsy. When all conventional medications fail, and they often do, parents have found success with CBD oil, derived from the cannabis, or marijuana, plant. The results can be breathtakingly dramatic as you can see in this video. https://www.facebook.com/photo.php?v=721753387847681&set=o.1423068877953424&type=3&theater
So in passing these bills lawmakers are showing their compassion for seriously ill, especially the young, while tackling the tricky political question of legalizing marijuana for medical purposes. “But wait,” the lawmakers say, “we aren’t legalizing ‘pot’ we are legalizing CBD, one of the ingredients in marijuana. And CBD doesn’t get you ‘high’ so drug abuse is impossible.”
Okay, CBD doesn’t get the patient ‘high’ but CBD is just one of the ingredients in the cannabis plant and the North Carolina law, like several others, still prohibits growing marijuana to obtain the CBD. So, just how exactly are the North Carolina patients going to obtain this needy medication?
You might think these states could simply turn to those states which have legalized the entire plant for medicinal purposes and buy the needed medicine. Simple, right?
Wrong. Marijuana, on the federal level, is still illegal, still a Schedule I drug. That’s what the DEA administrator decided it should be when he over-ruled his chief administrative law judge back in 1989, calling anyone who promoted the medical use of marijuana a “snake oil salesman.” As long as marijuana remains in Schedule I it cannot be shipped inter-state. So the ten CBD-only states cannot simply import marijuana from states where it is already legal for medical purposes.
So, just where do those ten states propose to get their CBD-only supplies? Well, I’m not privy to all their plans but I think a little hint was dropped in the coverage of WBTV in Raleigh.
“For now, it’s not sure how natural CBD oils made from actual marijuana plants in Colorado will get to North Carolina. Until that’s figured out, legislators say a pharmaceutical company making a trial CBD oil, called Epidiolex, will be rolled out immediately. ‘
Oh, I see. We’re going to “immediately” roll out a new pharmaceutical drug that has not yet been approved by federal officials so that we do not have to grow a plant that has a 5,000 year history of medical use or adjust its current standing in the federal drug hierarchy.
But wait, there’s more.
“All kids who sign up for this trial will be part of a study. That data will then be used to learn more about how the medicine works best.”
Okay, so your child also needs to be part of a research study. Well, that may not have been what the parents’ wanted when they started lobbying for the bill but it looks like that may be the only way to obtain the legal CBD trial drug. Does this mean the children may be exposed to placebo doses of CBD? Will there be double-blind, randomized testing which guarantees that some children will not receive the real CBD?
Do you see why the expression “cruel hoax” may have come to mind?
Postscript: To the parents in these states — I am very happy that your state has enacted a law that recognizes your child’s need but the battle is not yet won. You cannot let your guard down or expect that bureaucrats will resolve all the problems. It was your voice and those of friends and activists that passed this law and you cannot go silent now.
Recently I read A New Leaf: The End of Cannabis Prohibition by Alyson Martin and Nushin Rashidian. I was initially puzzled by the title. To paraphrase Mark Twain, reports of the death of cannabis prohibition have been greatly exaggerated. During a recent trip to several of the states that have legalized cannabis for medical purposes I heard plenty of reports that confirmed to me the cannabis prohibition is still alive and very well in the U.S.A. But title nit-picking aside this is really an excellent book that every cannabis activist should read.
I’ve been involved in the cannabis reform issue for almost forty years. I am not unique in that regard. There are many fine people who have been slogging away at this issue for quite some time. Martin and Rashidian do an excellent job of paying homage to the “pioneers” while skillfully taking the reader rather quickly to the current scene, a period of time that covers the past fifteen years. It has been a terrifically exciting time as more than twenty states enacted medical marijuana laws and two states, Colorado and Washington, have legalized adult, social use of cannabis.
But legalizing cannabis—either for medical or social use—is not a simple matter of clicking your ruby heels and making the bad old prohibition disappear. It has taken a tremendous amount of hard work, lots of money and there have been some failures. The authors do a fine job of dissecting the failures as well as the victories. For anyone even remotely involved in cannabis reform this information is critical. Just as the ruby heels do not make prohibition disappear neither will Andy-Hardy-enthusiasm and a-barn-for-the-play make the ballot initiatives pass. Everyone knows the prohibition violates numerous civil liberties but screaming as much on a street corner doesn’t cut it. Meticulously learning the issue, being ready to compromise, and creating a well-thought out plan are the essentials. And passing a law is only the first step. The real trick is implementing the will of the people. The result may be a utopia like Colorado or a political quagmire like New Jersey.
There are twenty-two state laws recognizing marijuana’s medical value. The genie is way out of the bottle at this point but the issue is far from being resolved. The patchwork of different approaches in each state is unsettling, offering an erratic level of patient care. The maddening interference of the federal government is particularly well characterized in The New Leaf. The refusal of federal officials to honestly confront the legitimacy of cannabis as medicine is a particularly dark blight on our government. Explaining the duplicity is not an easy task but Martin and Rashidian do a commendable job.
I recommend this book to anyone with the slightest interest in the cannabis issue. For those already engaged it is mandatory reading.
It was another fun day touring Denver’s legal marijuana scene. My guide, the wonderful Marcie Cooper, took me to Mary’s Medicinals where entrepreneurship is once again paving some wonderful new directions. Mary (not her real name) has figured out how to make transdermal patches with a variety of different ingredients, all from the cannabis plant, of course. A transdermal patch, for those non-nurses in the audience, is like a nicotine or fentanyl patch. The medicine is in the patch and releases over time to the body. For many people it is an optimum delivery agent. For many medical cannabis patients I believe it will become the delivery method of choice.
In the picture above you can see the packaging for three of her products. There are the transdermal patches, in this case a THC Sativa and a CBD patch. Mary can also provide CBN, THCa, THC Indica, and THC Hybrid. If you are wondering what all those different types of patches might be used for I suggest you visit the www.marysmedicinal.com website where she has provided a very helpful anatomy map.
Above the patches you’ll see the CBD topical application pen. Click on it and you receive a dose of 2mg THC or CBD in topical lotion form. Rub the lotion into the skin and you have medication.
Coming from a nursing background I found this application protocol to be very exciting. No smoking or ingesting, a simple and dose-regulated administration system. Baby, we have come a long way.
This week I have the extreme pleasure to be visiting Denver, Colorado. Weather aside (it has been windy and cold) it has been a great visit thus far. I’ve been touring the marijuana dispensaries and clinics including a great visit at River Rock founded by Tony Verzura. River Rock is not just a grow center and dispensary, it is a philosophy and the future.
The picture accompanying this piece shows me in one of the many grow rooms at River Rock. Tony was very impressive in rattling off the statistics about his growing facility. Unfortunately I was still in a shock at what I was seeing so most of the stats went through my head. Take my word for it, there is a lot of cannabis growing. All the major varieties (sativa and indica) were there, many of them in brilliant flower.
What impressed me even more was Tony’s commitment to the medical marijuana issue, including a new project he is launching called Advanced Cannabinoid Therapy Guide or A.C.T. Now. It is a wonderful piece of software. Its goal is to standardize patient enrollment and collect information on the cannabis therapies that River Rock and the patient’s doctor recommend. Look upon it as the first EMR (electronic medical record) for medical marijuana patients. What excited me about A.C.T. Now was the possibility of collecting enough data to actually write scientific papers. They will be poo-pooed by federal agencies but, truth be told, the feds squandered their capital in medical marijuana a long time ago. They no longer have standing in the issue–only power to wreck more lives as they have for decades. The future is in companies and organizations like River Rock. The future is now.