Medical Marijuana Update

Legal news, protests, etc.

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notsofasteddie
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Re: Medical Marijuana Update

Post by notsofasteddie » Sun 19th Mar 2017 08:30 pm

Weed works — and science proves why

By Emily Earlenbaugh |
March 16, 2017


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Cannabis extract is prepared at the Constance Therapeutics laboratory in Richmond.
Photo: By David Downs - Special To The Chronicle

You can’t blame patients and doctors for being skeptical about marijuana’s efficacy. First off, we don’t smoke any other modern medicine. And there are very few gold-standard clinical trials for marijuana. Plus, activists hype pot’s curative properties for everything under the sun.

Still, the evidence supporting the safety and efficacy of medical cannabis is plentiful (more than 20,000 studies have been completed on the topic) and the research continues to grow. And this year might be seen as a tipping point.

In a 2017 systematic review of medical studies, researchers from the National Academy of Sciences confirmed there is substantial evidence that cannabis is an effective option for many senior ailments. The landmark 395-page review by the country’s best physicians represents the most current medical conclusions on cannabis, summarizing 10,700 research studies and coming to 100 research conclusions.

Chronic pain, inflammation

The most common use of cannabis is as a pain reliever; surveys of state pot patient populations consistently show that chronic pain is the No. 1 reason people report using medical pot. The data back up the surveys as well. The NAS study reported, “There is conclusive or substantial evidence that cannabis or cannabinoids are effective for the treatment of chronic pain in adults.”

Cell, animal and human trials, as well as patient reports, all confirm cannabis’ efficacy for chronic pain relief. While the review looked at studies on many types of chronic pain (including neuropathy, arthritis, cancer pain, multiple sclerosis, musculoskeletal issues and chemotherapy-induced pain) cannabis was helpful for pain relief regardless of condition.

Cannabis’ broad efficacy is largely due to how it interacts with the “endocannabinoid system” — an electrochemical signaling system in our nerves. This system helps the human body regulate itself. The endocannabinoid system has receptors throughout the body: in the brain, connective tissues, organs, glands and immune cells. When something goes wrong, the endocannabinoid system responds. For example, when someone is injured, cannabinoids made by the body itself can be found at the injured area, decreasing activators and sensitizers in the tissue, calming immune cells to prevent pro-inflammatory substances from being released, and stabilizing the nerve cell to prevent excessive firing. These responses work to minimize pain and damage.

While endocannabinoid receptors are stimulated by the body's natural endocannabinoids, they also can be stimulated by plant-based cannabinoids, such as those found in cannabis. The main ones active in marijuana include tetrahydrocannabinol (THC) and cannabidiol (CBD). When patients use cannabis medicinally, their natural endocannabinoid system is stimulated by cannabinoids, resulting in reduced pain and inflammation.

These anti-inflammatory and pain-relieving properties make cannabis an option for ameliorating the daily suffering from common chronic pain conditions like arthritis and neuropathy, which decrease mobility and reduce quality of life.

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Dried cured bud, an indica strain called Cookies.
Photo: By David Downs - Special To The Chronicle

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Syringe of cannabis oil used to refill vape pens. Photo: By David Downs - Special To The Chronicle

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Purified extracts of cannabis oil for inhaling.
Photo: By David Downs - Special To The Chronicle

A safer alternative

Access to cannabis for pain management is especially important for seniors because the pharmaceutical alternatives can be deadly. Since 1999, the prescription opiate market has quadrupled in size, along with the death toll from opiate overdoses. Despite these troubling numbers, opiates are commonly prescribed for chronic pain conditions. Some studies are showing that opioids just don’t work for long-term pain management, even if people can avoid addiction issues.

Once patients start using opiates, they require increasingly larger doses to get pain relief. When safe doses no longer work, patients must live with the pain or risk overdose. Cannabis has no lethal overdose level, making it a safer alternative for patients hoping to avoid this cycle of opiate addiction. In areas where medical cannabis is legal, deaths from opiate overdoses have gone down by 25 percent, according to several peer-reviewed studies, including one in 2016 in JAMA Internal Medicine.

Wide range of treatments

Beyond relief from pain and inflammation, the National Academy of Sciences also supports the use of cannabis to treat spasticity from spinal cord injuries and other disorders, as well as nausea, lack of appetite, insomnia, anxiety, symptoms of multiple sclerosis, Tourette’s syndrome and post-traumatic stress disorder.

NAS researchers were hesitant to back up the reports that cannabis is an effective treatment for some conditions, including cancer and epilepsy. The NAS also found pot to be ineffective on glaucoma, one of the original reasons patients received the drug. Still, rather than rule out cannabis’ efficacy for these conditions, NAS researchers recommended controlled clinical trials to provide more robust evidence.

While the scientific research is starting to persuade seniors to try cannabis for their medical needs, many still worry about psychoactive side effects. But you don’t have to smoke pot or get high for it to work. Cannabis has many active components, and not all affect patients in ways that cause euphoria.

Research historically focused on THC, a cannabinoid with strong medicinal properties and psychoactive effects. While THC can leave patients feeling “high,” when it’s combined with enough CBD, the psychoactive effects disappear. This type of synergistic effect is called an entourage effect and happens when multiple cannabinoids or terpenes (cannabis’ aroma molecules) are combined. With hundreds of cannabinoids and terpenes, different varieties of cannabis provide an array of effects. Because of this variety, a cannabis specialist can be helpful for directing seniors to the types of cannabis that will work best for their needs.

While more research may expand our understanding of cannabis’ potential uses, the overall results are clear: Cannabis can safely help many seniors now.

Still, an education gap exists for seniors and the doctors who treat them. Doctors note that the endocannabinoid system is not yet taught in medical school. As the research continues to show cannabis’ medical efficacy, reliable cannabis education for doctors and their patients is essential.


sfchronicle


Emily Earlenbaugh is a cannabis patient consultant and wellness researcher. She is a former teaching assistant and adjunct instructor at UC Davis. Earlenbaugh has a doctorate in philosophy of science from UC Davis.

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Re: Medical Marijuana Update

Post by notsofasteddie » Fri 24th Mar 2017 12:23 am

The Best Recipe for Maximizing the Medical Effects of Marijuana

CBD-only preparations lack the synergies available when marijuana's other cannabinoids and its terpenes are kept in the game.

By Phillip Smith / AlterNet
March 22, 2017

CBD (cannabidiol) is getting a lot of attention these days as the medicinal cannabinoid in marijuana. CBD-only products are all the rage in the ever-expanding medical marijuana market, and CBD-only medical marijuana laws are becoming a favorite resort of red state politicians who want to throw a sop to those clamoring for medical marijuana, but are hesitant to actually embrace the demon weed.

But is CBD the miracle molecule on its own? Or would users benefit from using preparations made from the whole pot plant? Not to knock CBD, which even by itself clearly provides succor for many people, but advocates of "whole plant medicine" make a strong case.

That case is based on the entourage effect, which posits an interactive synergy between the components of the plant, and not just the major cannabinoids, such as THC and CBC, but also the lesser-known but still therapeutically active cannabinoids, such as CBG, CBN, THC-a, and THC-v, and even the terpenoids, the molecules that make pot plants smell and taste lemony (limonene) or piney (pinene), earthy (humulene) or musky (myrcene). The entourage effect suggests that if people want to unlock the full benefits of medical marijuana, they need to be using whole plant medicine.

"CBD and THC seem to work better together. They lessen each other’s side effects," said Eloise Theisen, RN, MSN, director of the American Cannabis Nurses Association.

"CBD has value, but its value can be enhanced with the whole plant and we can develop more individualized medicine," said Mary Lynn Mathre, RN, MSN, and president and co-founder of Patients Out of Time.

And again, it's not just the cannabinoids.

"THC seems to potentiate all the effects of CBD and conversely, CBD affects THC," explained Dr. Perry Solomon, chief medical officer for HelloMD. "Dr. Ethan Russo further supports this theory by demonstrating that non-cannabinoid plant components such as terpenes serve as inhibitors to THC’s intoxicating effects, thereby increasing THC’s therapeutic index. This ‘phytocannabinoid-terpenoid synergy,’ as Russo calls it, increases the potential of cannabis-based medicinal extracts to treat pain, inflammation, fungal and bacterial infections, depression, anxiety, addiction, epilepsy, and even cancer," he said.

"Terpenes act on receptors and neurotransmitters; they are prone to combine with or dissolve in lipids or fats; they act as serotonin uptake inhibitors (similar to antidepressants like Prozac); they enhance norepinephrine activity (similar to tricyclic antidepressants like Elavil); they increase dopamine activity; and they augment GABA (the 'downer' neurotransmitter that counters glutamate, the 'upper')," Solomon continued.

The entourage effect makes whole plant medicine the preferred means of ingesting therapeutic marijuana, the trio agreed.

"I think that any whole plant medicine is more effective than any CBD-only product," said Solomon.

"Whole plant medicine is the only way to go," echoed Theisen.

"It's safer and more effective, and tolerance will develop more slowly—if at all," Mathre concurred.

The traditional method of consuming whole plant marijuana has been to smoke it, but that's not an especially favored route among medical marijuana advocates. And there are other options.

"Vaporization or tinctures of whole plants. Any sort of extraction method that isn’t going to deplete it," said Theisen.

"Delivery methods vary greatly in terms of their efficiency and their effects. I heard a colleague say that smoking a joint for therapeutic effect is akin to opening your mouth in the rain to get a drink of water," said Constance Finley, founder and CEO of Constance Therapeutics. "Our preferred methods are buccal (cheek) ingestion or sublingual ingestion, vaping from a vaporizer or vape pen whose hardware is safe to use with cannabis extracts, and topical for additional localized impact."

With whole plant superior to single-cannabinoid preparations, people living in states that have only passed CBD-only laws are not able to enjoy the full benefits of medical marijuana. That's a damned shame, said an exasperated Mathre.

"We have lawyers and politicians practicing medicine without a license—they don’t know what they are talking about," she said. "Clearly there may be some patients who need little to no THC, but the vast majority will benefit from it. Patients should have all of the options open to them and research needs to continue to help determine how to best individualize cannabis medicine."


AlterNet




Phillip Smith is editor of the AlterNet Drug Reporter and author of the Drug War Chronicle.

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Re: Medical Marijuana Update

Post by notsofasteddie » Sat 25th Mar 2017 12:39 pm

Medical Marijuana Update


by psmith,
March 22, 2017

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Busy, busy. Lawmakers in Arkansas and North Dakota try to "fix" medical marijuana initiatives, New York chronic pain patients can now use medical marijuana, a CBD compromise is reached in Georgia, and more.


Arizona


Last Thursday, the Court of Appeals upheld limits on PTSD recommendations. The state court of appeals ruled that the Department of Health Services was acting legally when it decided that doctors could only recommend medical marijuana for "palliative care" for PTSD. The department argued there was no evidence showing marijuana could actually cure people of PTSD. The department also limited recommendations to people who were already being treated for PTSD. An Arizona medical marijuana nurses group filed suit against the restrictions, but now the court has ruled against them.


Arkansas


Last Wednesday, a bill to ban edibles and public smoking won a committee vote. A bill that would bar medical marijuana patients from consuming edibles or from smoking their medicine in public was approved by the House Rules Committee. But the measure, House Bill 1400, faces an uphill battle to win final approval because any changes to the voter-approved medical marijuana law require a two-thirds vote to pass.

Last Friday, the bill passed the House. The House voted to approve House Bill 1400, which would prohibit the smoking of medical marijuana anywhere tobacco smoking is prohibited. The bill passed 88-0. Under the bill, knowingly smoking medical marijuana in the presence of a pregnant woman would be prohibited. The measure also prohibits those under 21 from smoking medical marijuana. A bill that would have banned smoking medical marijuana at all has already died in the Senate.

On Monday, the House killed a bill banning edibles. The House voted 52-40 to kill House Bill 1991, which would have banned the commercial production of medical marijuana edibles in the state. Bill sponsor Rep. Robin Lundstrum (R-Springdale) argued that patients could make their own and that medical marijuana is medicine, not candy, but her arguments failed to sway her peers.


Georgia


Last Thursday, url=http://www.ajc.com/news/state--regional ... P9s712m6HJ]lawmakers reached a compromise on a CBD cannabis oil bill[/url]. Lawmakers appear to have reached an agreement that would add six illnesses and conditions to the state's list of qualifying medical conditions, allow the use of CBD cannabis oil in hospice care, and keep the allowable level of THC in cannabis oil at 5% or less. That means Senate Bill 16 should now be able to pass out of the House Human Services Committee and head for a House floor vote.


Massachusetts

Last Thursday, bills to protect patients' employment rights filed. Even as the state Supreme Court heard a case on employment rights for medical marijuana patients, two bills alive in the state legislature would do just that. Rep. Frank Smizik (D-Brookline) has introduced House Bill 2385, which would explicitlyprotect the rights of a medical marijuana patient to use the drug without facing discrimination in hiring, firing or terms of employment. The bill would also protect medical marijuana patients from discrimination in education, housing and child welfare and custody cases. That bill is currently before the Committee on Marijuana Policy. A similar bill was filed last sessions, but didn't pass. A second bill, House Bill 113, is aimed mostly at updating state law to bring it in line with the Americans With Disabilities Act, but one provision clarifies that employers cannot take adverse employment action against someone for using medical marijuana. That bill is before the Joint Committee on Children, Families, and Persons with Disabilities.


Nebraska

Last Wednesday, a medical marijuana bill got a charged hearing. At a hearing in the Judiciary Committee, law enforcement, the state attorney general's office, and the state's top doctor all came out in opposition to a medical marijuana bill, Legislative Bill 622, but legislators also heard emotional testimony in favor of the bill from Army veterans and others who said they would benefit from access to medical marijuana. Five of the bill's sponsors sit on the eight-member Judiciary Committee, so the bill is likely to make it to a House floor vote, where opposition has killed similar measures in past years.

Last Friday, the bill headed for a floor vote. The legislature's Judiciary Committee voted 6-1to advance Legislative Bill 622, which would bring medical marijuana to the Cornhusker state. The bill would authorize cultivation, manufacture, and distribution of medical marijuana products, but would ban smoking the herb or allowing patients to grow their own. The bill is opposed by Gov. Pete Ricketts (R), as well as the state's law enforcement establishment.


Nevada

On Monday, a bill was filed to let medical marijuana patients carry guns. State Sen. Kevin Atkinson (D-Las Vegas) filed Senate Bill 351. That measure would allow medical marijuana users to possess a firearm and a concealed carry permit. Current state law requires sheriffs to deny such permits for medical marijuana users.


New Hampshire

On Monday, a Senate committee approved the use of medical marijuana for Ehrlers-Danlos syndrome. The Senate Health, Human Services, and Elderly Committee has approved a bill that would add Ehlers-Danlos syndrome to the state's list of qualifying conditions for medical marijuana. The measure now heads for a Senate floor vote. If it passes there, the House will take it up.


New York

Last Thursday, the Health Department said New Yorkers suffering chronic pain will be able to use medical marijuana starting this week. After announcing in December that it planned to add chronic paid to its list of qualifying conditions for medical marijuana, the Health Department said patients could start getting recommendations for chronic pain beginning Wednesday. The department also announced that physicians' assistants can now recommend medical marijuana. “Improving patient access to medical marijuana continues to be one of our top priorities, as it has been since the launch of the program,” Health Commissioner Howard Zucker said in a statement. “These key enhancements further that goal."


North Dakota


On Tuesday, advocates threatened a lawsuit or new initiative in the face of legsialtive meddling. The head of the committee that ran the state's successful medical marijuana initiative campaign warned legislators that they could face a legal challenge or even another initiative campaign if they don't back away from changes contemplated in Senate Bill 2344, which has already passed the Senate. That measure bars patients and caregivers from growing their own plants and restricts the use of smoked medical marijuana to cases where a physician attests that no other form of marijuana would be effective. The comments came from Rilie Ray Morgan as he testified before the House Human Services Committee.


Tennessee

On Tuesday, a medical marijuana bill was prounounced dead. Rep. Jeremy Faison (R-Crosby) said that his medical marijuana bill, House Bill 495, is dead because senators were afraid to vote for it. "The Senate, bless their heart, are just scared to death of their voters," Faison said Tuesday after the House Health Committee shelved the bill and instead approved a non-binding marijuana-related resolution to study the issue over the summer.


Utah

On Tuesday, advocates announced plans for a 2018 initiative. Medical marijuana advocates are gearing up to try to put an initiative on the state's 2018 ballot. They said they would begin the process of signature gathering next month, and they cite promising polling. The state legislature has so far thwarted efforts to create a robust medical marijuana program.


Virginia


Last Thursday, the governor signed a bill legalizing pharmacy distribution of CBD and THC-A oil. Gov. Terry McAuliffe (D) signed Senate Bill 1027 into law. The bill allows for companies to manufacture and provide CBD cannabis oil and THC-A oil for the treatment of epilepsy and provides for its distribution through pharmacies.


[For extensive information about the medical marijuana debate, presented in a neutral format,visit MedicalMarijuana.ProCon.org.]


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