Thursday, July 18, 2019

Congressional Members Introduce the Medical Marijuana Research Act of 2019



Washington, DC – U.S. Representatives Andy Harris, M.D. (R-MD), Earl Blumenauer (D-OR), Zoe Lofgren (D-CA), H. Morgan Griffith (R-VA), Debbie Dingell (D-MI), and Rob Bishop (R-UT) on July 17th introduced the Medical Marijuana Research Act of 2019. This bill addresses burdensome processes that currently impede legitimate medical research on marijuana. This bipartisan piece of legislation would amend the Controlled Substances Act to establish a new, separate registration process to facilitate research with marijuana for medical purposes.

“As a physician who has conducted NIH-sponsored research, I cannot stress enough how critical this legislation is to the scientific community. Our drug policy was never intended to act as an impediment to conducting legitimate medical research. If we are going to label marijuana as medicine, we need to conduct the same rigorous scientific research on efficacy and safety that every other FDA-approved treatment undergoes. This legislation will facilitate that research by removing the unnecessary administrative barriers that deter qualified researchers from thoroughly studying medical marijuana,” said Dr. Harris.

“47 states have legalized some form of cannabis, yet the federal government is still getting in the way of further progress on the potential for research,” said Rep. Blumenauer. “We owe it to patients and their families to allow for the research physicians need to understand marijuana’s benefits and risks and determine proper use and dosage.”

“While the definitive medical benefits of marijuana remain largely uncertain, it is important we remove the bureaucratic barriers which stand in the way of legitimate research,” said Rep. Bishop. “Many important questions remain unanswered. This legislation allows scientists and researchers to get at those answers in a responsible manner that isn’t hindered by unnecessary roadblocks.”

“There is evidence of marijuana’s potential medicinal benefits in treating conditions including cancer, epilepsy, and glaucoma,” said Rep. Griffith. “In order to move forward in evaluating the medicinal value of medical marijuana and determining its accompanying side effects, it is critical that we remove barriers to research. To that end, I am pleased to join in reintroducing this bipartisan legislation. The Medical Marijuana Research Act constitutes common sense legislation that could open the door to treatment that can substantially improve the quality of patient care.”

“This common-sense legislation would take the necessary step of advancing the Federal government’s scientific and medical research into the potential benefits and harms of medical cannabis for patients who need it,” said Rep. Zoe Lofgren.

“We all know marijuana has medical benefits, but the Federal government has continued to get in the way of further medical research that would help us better understand the effects,” said Dingell. “Removing barriers that prevent research will help improve our understanding of medical marijuana and provide additional treatment options for millions of patients.”

Letters and quotes of support from a wide coalition of organizations can be found here.

The Medical Marijuana Research Act of 2019 addresses two major barriers currently faced by researchers who wish to conduct legitimate medical research with cannabis, a Schedule I drug. First, it creates a new, less cumbersome registration process specifically for marijuana, reducing approval wait times, costly security measures, and additional, unnecessary layers of protocol review. Second, once researchers have been approved to conduct this research, this bill makes it easier for those researchers to obtain the cannabis they need for their studies through reforms in both production and distribution regulations. To this end, the bill also allows for the private manufacturing and distribution of cannabis solely for research purposes. Currently, the only marijuana available to be used in research legally comes from a single contract the National Institute on Drug Abuse holds with the University of Mississippi.



Monday, July 15, 2019

Medical Cannabis Costs Rise, Patient Pools Shrink With Full Legalization in California and Other States

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When states legalize cannabis for all adults, long-standing medical cannabis programs take a big hit, in some cases losing more than half their registered patients in just a few years, according to a data analysis by The Associated Press.

Much of the decline comes from consumers who, ill or not, got medical cards in their states because it was the only way to buy cannabis legally and then discarded them when broader legalization arrived. But for people who truly rely on cannabis to control ailments such as nausea or cancer pain, the arrival of so-called recreational cannabis can mean fewer and more expensive options.

Robin Beverett, a 47-year-old disabled Army veteran, said she resumed taking a powerful prescription mood stabilizer to control her anxiety and PTSD when the cost of her medical cannabis nearly tripled after California began general sales. Before last year, an eighth of an ounce of dry cannabis flower cost her $35. Now it’s approaching $100, Beverett said.

“It’s ridiculous. The prices are astronomical,” said Beverett, who moved to Sacramento from Texas because medical cannabis is illegal there. “Going to the dispensary is just out of the question if you’re on any kind of fixed income.”

It’s a paradox playing out nationwide as more states take the leap from care-centered medical programs to recreational models aligned with a multibillion-dollar global industry.

States see a “massive exodus” of medical patients when they legalize cannabis for all adults — and then, in many cases, the remaining ones struggle, said David Mangone, director of government affairs for Americans for Safe Access.
“Some of the products that these patients have relied on for consistency — and have used over and over for years — are disappearing off the shelves to market products that have a wider appeal,” he said.

Cost also rises, a problem that’s compounded because many of those who stay in medical programs are low-income and rely on Social Security disability, he said.

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In Oregon, where the medical program shrank the most following recreational legalization, nearly two-thirds of patients gave up their medical cards, the AP found. As patients exited, the market followed: The number of medical-only retail shops fell from 400 to two, and hundreds of growers who contracted with individual patients to grow specific strains walked away.

Now, some of the roughly 28,000 medical patients left are struggling to find affordable medical cannabis products they’ve relied on for years. While the state is awash in dry cannabis flower that’s dirt cheap, the specialized oils, tinctures and potent edibles used to alleviate severe illnesses can be harder to find and more expensive to buy.

“Lots of people have started trying to figure out how to make these concentrates and edibles themselves in their kitchen,” said Travis MacKenzie, who runs TJ’s Gardens, which provides free medical cannabis to children with epilepsy. “There are things that we don’t really want people to do at home, but the market conditions are such that people are trying to do more at home.”

The numbers compiled by the AP through public records requests and publicly available documents provide a snapshot of the evolution of cannabis as more states — Michigan was last in the door, and Illinois is about to follow — legalize pot for all adults.

Ten states have both medical and recreational markets. Four of them — Oregon, Nevada, Colorado, Alaska — have the combination of an established recreational marketplace and data on medical patients. The AP analysis found all four saw a drop in medical patients after broader legalization.

In Alaska, the state with the second-biggest decline, medical cardholders dropped by 63% after recreational sales began in 2016, followed by Nevada with nearly 40% since 2017 and Colorado with 19% since 2014.

The largest of all the legal markets, California, doesn’t keep data on medical patients, but those who use it say their community has been in turmoil since recreational pot debuted last year. That’s partly because the state ended unlicensed cannabis cooperatives where patients shared their homegrown pot for free.

There is limited scientific data backing many of the health claims made by medical cannabis advocates, and the U.S. government still classifies cannabis in any form as a controlled substance like LSD and cocaine.

Still, the popularity of medical pot is rising as more states legalize it. There are 33 such states, including the politically conservative recent additions of Oklahoma and Utah. Oklahoma has among the more liberal guidelines for use and has approved more than 100,000 patient licenses since voters backed legalization last June.

Getting a precise nationwide count of medical patients is impossible because California, Washington and Maine don’t keep data. However, absent those states, the AP found at the end of last year nearly 1.4 million people were active patients in a medical cannabis program. The AP estimates if those states were added the number would increase by about 1 million.

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As more states legalize cannabis for all adults, some who have been using it medically are feeling disenfranchised.

In Michigan, where medical cannabis has been legal for over a decade, the creation of a new licensing system for medical dispensaries has sparked court challenges as the state prepares for the advent of general cannabis sales later this year. A cancer patient there filed a federal lawsuit this month, alleging the slow licensing pace has created a shortage of the products she needs to maintain her weight and control pain.

In Washington, medical patients feel they were pushed aside when that state merged its medical and general-use markets, which also is what’s happening in California.

Los Angeles dispensary owner Jerred Kiloh sells medical and recreational cannabis and said those markets are quickly becoming one, since few companies are going to produce products for a vanishing group of customers. He said his medical business has dipped to 7% of overall sales and is dropping month to month.

“It’s going to be gone,” said Kiloh, president of the LA trade group United Cannabis Business Association.

In Oregon, regulators are struggling to find a path that preserves the state’s trailblazing low-cost medical pot program while tamping down on a still-thriving black market. A special state commission formed to oversee the market transition put out a report earlier this year that found affordability and lack of access are major hurdles for Oregon’s patients.

“Patients have needs. Consumers have wants,” said Anthony Taylor, a medical cannabis advocate who sits on the Oregon Cannabis Commission. “Patients are in crisis right now.”

General legalization has “indelibly changed the medical market,” and regulators want to identify the patients most affected by the transition, said Steve Marks, executive director of the Oregon Liquor Control Commission, which oversees Oregon’s recreational cannabis program.

Lawmakers just passed a bill that includes language that will allow the commission to explore a pilot program for home delivery of medical cannabis to patients in underserved areas, he said.

Meanwhile, Oregon U.S. Attorney Billy Williams has demanded lawmakers get control of excess weed being trafficked out of state and cited the medical industry as a potential source of illicit cannabis.

As a result, lawmakers are “paring the medical program back to what it probably should have been from the outset,” said Ben Pirie, a cannabis law attorney in Portland.

“There are patients with legitimate needs, but there are many more growing way more cannabis than needed to address those needs — and what do you do with that?” Pirie said, adding “there is this sweet spot in the middle that’s difficult to hit.”

Oregon law allows medical patients to shop tax-free at general-use stores, and recreational stores can sell medical pot, although those products comprise just 8.5% of their sales.

Meanwhile, the rules that came with general legalization put lower caps on the potency of edibles. That means medical customers often pay more for the same dose they got before broad legalization.

Medical cardholders, for example, used to buy gummies or chocolate bars infused with 400 mg of THC, cannabis’s high-inducing element. Now, edibles are capped at 100 mg for medical patients but cost the same or more.

“Who, with any medical condition, needs to be eating 20 pieces of candy a day?” asked Erich Berkovitz, Oregon’s last remaining state-licensed medical cannabis processor.

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Patients can also grow a small number of plants, but that doesn’t address the needs of the many medical patients who don’t smoke and instead rely on cannabis-infused edibles or tinctures.

Bill Blazina, a Navy veteran, used the state’s medical program in 2013 when he was diagnosed with esophageal cancer. But the 73-year-old grandfather found the landscape had changed dramatically when he was diagnosed last year with a new cancer in his lung.

The highly concentrated cannabis oil he took before — and wanted to take again — was selling for $60 a gram, his daily dose. A two-month supply would cost thousands at a retail pot shop, so Blazina connected with what he calls a “compassionate grower” who sold him the same amount at cost for $750, a transaction that fell in a legal gray area.

“I didn’t even know his name,” said Blazina, sitting in a rocking chair in his home in the tiny coastal town of Waldport. “I met him … and he’d bring it to me and smile, and I’d give him money and say, ‘Thank you,’ and I’d be on my way.”

After surgery and chemo, his cancer is in remission, but he still swallows a tiny drop of the oil on a piece of tortilla twice a day. He’s learned how to make it himself: He and his neighbor combine their eight legal plants, pulverize a pound (0.45 kilograms) of cannabis flower, steep it in grain alcohol, strain it and then simmer the resulting mix of alcohol and plant juice in a rice cooker until only dark black oil is left.

A pound of that flower at a retail store would be about $2,000, Blazina said.

“I think the regulations should go toward more access and how do we get more access, realistically, for the people who need it medically,” he said, before taking his afternoon dose. “It prohibits people who don’t have the ability to grow from getting the medicine they need because it drives the price up — and I don’t see that as being helpful at all.”


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BY ASSOCIATED PRESS, June 11th 2019

Wednesday, July 10, 2019

Safe Access New Mexico Public Comment on Proposed Rule Changes for New Mexico's Medical Cannabis Program (MCP)




Jason Barker
SafeAccessNewMexico@gmail.com



Wednesday, July 10th 2019


Andrea Sundberg
NM Department of Health
Medical Cannabis Program
P.O. Box 26110
Santa Fe, NM 87502-6110
MCP.comment@state.nm.us



Introduction: The Medical Cannabis Program Plant Count and Adequate Supply MUST be protected from and kept entirely separate from any future Recreational Cannabis law, and this should be written in the Rules in Regulations. A review of 15 medical cannabis producers menus shows that the medical cannabis program is not providing an adequate supply of cannabis derived CBD products for the over 80, 000 medical cannabis patients. This one day review of menus showed 919 Total THC Products to only 90 Total CBD Products available on that day. Another survey conducted by the Medical Cannabis Program exposed how 55% of producers said they have been unable to keep pace with patient demand for cannabis and related products. Doctors on the state’s Medical Cannabis Advisory Board and the program Medical Director could also be taking the time, at least once quarterly, to visit dispensaries to see what products are available to the patient community.

Public Comment For:
  • Revisions to nonprofit producer licensure requirements, including cannabis plant limits, licensing fee requirements, and the specification of certain quarterly reporting requirements;
[NMAC 7.34.4 - Medical cannabis licensing requirements for producers, couriers, manufacturers and laboratories. https://nmhealth.org/publication/view/rules/4987/]

Cannabis Plant Limits: Making revisions to the proposed licensing requirements for medical cannabis licensed producers with a plant count that sets a standard for the amount of cannabis CBD strains/plants to be grown per licensure requirement. Making revisions limiting use of the medical cannabis program LNPP’s licensure and plant count for that of the medical cannabis program and only the medical cannabis program. That is the Purpose of the Act.

Proposed Revision: A non-profit producer that operates a facility and, at any one time, is limited to a combined total of no greater than [2,500] 1,750 cannabis [mature female plants, seedlings and mature male] plants, with 17% (percent) of all cannabis plants grown being that of cannabis derived CBD plants; not including seedlings, and an inventory of usable cannabis and seeds that reflects current patient needs[, and that shall sell cannabis with a consistent unit price, without volume discounts or promotional sales based on the quantity purchased]. A non-profit producer may possess any quantity of seedlings, as defined in this rule. A non-profit producer shall not possess a quantity of cannabis [either mature female plants or seedlings and mature male] plants that exceeds the quantities authorized by their licensure and associated licensing fee. A licensed non-profit producer may sell and distribute usable cannabis to a person or entity authorized to possess and receive it. A licensed nonprofit producer may obtain plants, seeds and usable cannabis from other licensed non-profit producers. A licensed non-profit producer may only use the cannabis plant for the operations of the state’s medical cannabis program and can only be used in that medical cannabis program.
Or
Making revisions to licensing requirements for medical cannabis licensed producers with a plant count for patients and producers properly structured and increased: Medical cannabis CBD strains at ratio of; 1.5 thc(or lower) : 1 cbd (or higher) being removed from patient and producer allowable plant count.



Survey:A review of 15 medical cannabis producers menus shows that the medical cannabis program is not providing an adequate supply of cannabis derived CBD products for the over 80, 000 medical cannabis patients. This one day review of menus showed 919 Total THC Products to 90 Total CBD Products available.

Each and every qualifying health condition for the medical cannabis program requires the use of cannabis derived CBD in one form or another.

LNPP Menus Review of THC and CBD Products
Cannaceutics (Bernalillo) http://www.cannaceutics.org/ : Flower was 105 THC products and 5 CBD products; Extracts was 6 THC Products and 2 CBD Products; Edibles was 26 THC products and 8 CBD Products; Topicals was 3 THC products and 0 CBD products.

CG Corrigan (Bernalillo) https://www.cgoodinc.com/ (DoH has wrong web address listed) : Flower was 11 THC Products and 1 CBD product; Extracts was 12 THC products and 1 CBD product; Edibles was 28 THC products and 0 CBD Products.

Everest Apothecary (Bernalillo) https://everestnm.com/ : Flower was 5 THC products and 0 CBD products; Edibles was 9 THC products and 0 CBD products; Extracts was 9 THC products and 2 CBD products; Topicals was 1 THC product.

Ultra Health - NM Top Organics (Bernalillo) https://ultrahealth.com : Flower was 8 THC Products and 1 CBD product; Edibles was 9 THC products and 1 CBD product; Extracts was 4 THC products and 2 CBD products; Topicals was 1 THC product and 2 CBD products.

PurLife (Bernalillo) https://www.purlifenm.com/ : Flower was 39 THC and 2 CBD products; Extracts was 24 THC products and 0 CBD Products; Edibles was 31 THC products and 0 CBD products.

New Mexicann Natural Medicine (Santa Fe) https://www.newmexicann.com/ : 41 total THC products and 10 total CBD products.

Pecos Valley Production (Dona Ana) https://pecosvalleyproduction.com/ (DoH has wrong website listed): 37 total THC products and 10 total CBD products.

MJ Express-O/PurLife (Dona Ana) https://www.purlifenm.com/location/203-s-foch-st-t-or-c-nm-87901/ : 65 total THC products and Zero CBD products.

Verdes Foundation (Bernalillo) https://www.verdesfoundation.org/ : Flower was 7 THC products and 3 CBD products; Edibles was 9 THC products and 4 CBD products; Extracts was 7 THC products and 7 CBD Products.

R. Greenleaf (Bernalillo) https://rgreenleaf.com : Flower was 17 THC products and 3 CBD products; Edibles was 19 THC products and 13 CBD products; Extracts was 24 THC products and 4 CBD products; Topicals was 4 THC products and 0 CBD products.

Southwest Wellness Center (Taos) https://www.southwestwellnesscenter.com : Flower was 9 THC products and 1 CBD product; Extracts was 13 THC products and 1 CBD product; Edibles was 12 products and 0 CBD products.

New Mexico Alternative Care (San Juan) http://www.newmexicoalternativecare.com : 56 Total THC products and 2 total CBD products.

Minerva Canna Group (Santa Fe) https://minervacanna.com/ : 53 Total THC products and 2 total CBD products.

Sacred Garden (Dona Ana) https://app.trybaker.com/shop/1738?provider=1738 : 67 Total THC products and 5 total CBD products.

Organtica (Bernalillo) http://organtica.com/ : 45 total THC products and 7 total CBD products.

919 Total THC Products to 90 Total CBD Products
Source:
Medical Cannabis Licensed Non-Profit Producer List https://nmhealth.org/publication/view/general/2101/


Article: Surveys on medical pot detail New Mexico supply shortages | BY ASSOCIATED PRESS | Published: Tuesday, May 14th, 2019 at 8:14am | https://www.abqjournal.com/1315387/provider-says-medical-cannabis-sales-trail-enrollment-growth.html
  • “In results obtained Tuesday, 55% of producers said they have been unable to keep pace with patient demand for marijuana and related products.”
  • “Of the patients surveyed, about one in four said they were unable to purchase cannabis within the past 90 days because it was out of stock. Shortages were more pronounced in eastern New Mexico, with about four in 10 patients citing shortages.”
Why not use Hemp CBD?
Testing standards and safety protocols for Hemp derived CBD are non-existent in New Mexico and the serious lack of regulation poses a health risk for patients in the medical cannabis program.


Article: “Hemp Derived CBD vs. Cannabis Derived CBD”
“For many reasons, CBD-rich cannabis is a better source of CBD than industrial hemp. The only reason CBD derived from hemp is gaining any notoriety is as an attempted end-run around federal law. When cannabis prohibition is ended and cannabis is treated like any other agricultural product, CBD will be extracted from the best source of cannabidiol—CBD-rich cannabis. The need to derive CBD from industrial hemp will end.”
[https://culturemagazine.com/hemp-derived-cbd-vs-cannabis-derived-cbd/]



Conclusion:“Adequate Supply” can be achieved, if it is approached that the supply must be available if Every Patient ALL went out and purchased on the same day. And plants counts should be based on plant canopy and square footage instead of counting individual plants.

For ensuring safe access to all areas of the state of New Mexico and proper administering of the Lynn and Erin Compassionate Use Act, by the New Mexico State Department of Health, this can be achieved by opening applications for producer licensure specific to rural expansion in the state and by providing a new plant count structure to provide adequate supply as follows;

First, not all medical cannabis plants are the same. The cannabis plant contains dozens and dozens of cannabinoids. The most well known cannabinoid for a long time has been tetrahydrocannabinol (THC), but as more scientific research is conducted involving cannabis and its ability to be used as a medicine, more and more people are learning about other cannabinoids, in particular cannabidiol (CBD). Some plants have THC and others produce CBD, THC has psychoactive properties that affect your brain and give you a ‘runner’s high’ while CBD does not.

A plant count that is based on ratio of patients to serve with inclusion of empirical data for varying amounts cannabis plant material needed to manufacture different forms of medical cannabis medicine.

The Medical Cannabis Program Plant Count and Adequate Supply MUST be protected from and kept entirely separate from any future Recreational Cannabis law, and this should be written in the Rules in Regulations.

Issues such as access, police harassment, and the price and quality of medicine will still be relevant to the patient community despite the adoption of a policy of legalization for recreational use. The federal refusal to recognize the medical efficacy of cannabis causes more harm and difficulty for patients than any failure by local or state governments to adopt policies of legalization of cannabis for recreational use. Any system of recreational cannabis regulation should not be built on the backs of current medical cannabis laws.

The legalization of cannabis for recreational use is a separate issue from safe and legal access to cannabis for therapeutic use. We caution policy makers against letting the debate surrounding legalization of cannabis for recreational use obscure the science and policy regarding the medical use of cannabis.

The State’s Medical Cannabis Program expansion is now “Medically Necessary”and the State needs to allow the Department of Health to open the application process, the State needs to increase the Licensed Non Profit Producer plant count, add more licensed non-profit producers, in conjunction with other measures to ensure safe access to medicine and to be compliant with the law. Currently there is Less Than ⅓ of a cannabis plant per person in the medical cannabis program and 55% of Program LNPP’s can not meet patient demand.

For ensuring safe access to all areas of the state of New Mexico and proper administering of the Lynn and Erin Compassionate Use Act, by the New Mexico State Department of Health can be achieved with “adequate supply” as follows:
  • Adequate supply of medical cannabis properly defined, structured, and increased.
  • Maximum quantity of usable cannabis increased to 425.243 grams per 3 months ( 2.5 ounces every two weeks ).
  • Inclusion of empirical data for determining adequate supply for varying amounts cannabis plant material needed to manufacture different forms of medical cannabis medicine for proper dosage. 

Example revisions to licensing requirements for the medical cannabis program LNPP’s & PPL's :
  • Plant count for patients & producers properly structured and increased.
  • Cannabis CBD strains at ratio of; 1.5 thc (or lower) : 1 cbd (or higher) not counted against patient/caregiver or LNPP allowable plant count.
  • Clones and Cuttings provided to qualified patient / caregiver with a PPL by a LNPP’s not counted against LNPP allowable plant count.
  • Plant Count that is based on ratio of patients to serve AND inclusion of empirical data for varying amounts cannabis plant material needed to manufacture different forms of medical cannabis medicine. 
  • Patient / Caregiver PPL plant count increased to allow for 6 immature seedlings /clones / cuttings, 6 plants in vegetative stage, and 6 plants in flowering stage for a total of 18 cannabis plants.
  • The addition of Cooperative/Collective PPL’s (Example Below)Washington State Medical Cannabis Program Cooperatives (Established 7/2016) Medical cannabis cooperatives allow up to four medical cannabis patients or their designated provider to join together to grow cannabis for the patients’ personal use. Every member must be entered into the medical cannabis authorization database and have a medical cannabis recognition card. The total number of plants authorized for the participants may not exceed 60 plants. Cooperatives must register with the Washington State Liquor and Cannabis Board (WSLCB) and follow all regulations. Cooperative members may ONLY:Be in a cooperative if they have a valid medical cannabis recognition card. Form a four member cooperative. Participate in a cooperative if they are at least 21 years of age. Grow up to the total number of plants authorized, with a maximum of 60 plants. Belong to one cooperative. Grow plants in the cooperative and not anywhere else. Use the cannabis and its products, and not sell or give away cannabis or cannabis products to anyone who is not in the cooperative.  A cooperative must be: Located at one of the member’s homes or personal property. Limited to one cooperative per tax parcel. Enclosed by an 8-foot fence, if outdoors, and cannot easily be seen or smelled. Learn more with Washington’s Collectives: A Patient's Guide to Medical Marijuana Cooperatives (PDF).


“Section 2. PURPOSE OF ACT.—The purpose of the Lynn and Erin Compassionate Use Act is to allow the beneficial use of medical cannabis in a regulated system for alleviating symptoms caused by debilitating medical conditions and their medical treatments.”

The focus on cannabis policy in 2019 should be on the medical cannabis program expansion, education about medical cannabis and the program, and protecting the program like Governor Lujan Grisham promised.

Medical cannabis patients in New Mexico deserve safe access to their medicine at ALL schools before the state legalizes cannabis for other people to party with in a recreational market.

Medical cannabis patients in New Mexico deserve safe access to medical cannabis in hospitals and medical facilities, like little kids going through the horrors of cancer treatment at UNM, before the state legalizes recreational cannabis use.

Medical cannabis patients in New Mexico deserve safe access to medical cannabis in hospice care facilities and senior retirement communities before the state legalizes cannabis for other people to have fun with recreationally.

Our Military Veterans and First Responders deserve safe and equal access to medical cannabis before the state legalizes cannabis for other people to party with.

Any state educational institution of higher learning should have safe access to research medical cannabis and the state’s medical cannabis program before legalization ruins that potential research.

All doctors and prescribing medical professionals in the State of New Mexico should have safe access to recommend the use of medical cannabis to their patients or patient's caregiver before recreational cannabis legalization. 



Proposed Rules Hearing Public Comment - Part II

Introduction: New Mexico medical cannabis patients are denied restrocity participation in other state programs (ie. D.C.) due to language stating the medical cannabis cards are valid only to “engage in the intrastate possession and administration of cannabis for the sole use of the qualified patient.”

Public Comment For:• Various revisions and additions to definitions in all three rule parts.
NMAC 7.34.3 - Medical cannabis registry identification cards.
https://nmhealth.org/publication/view/rules/4986/

Proposed Revision: “Registry identification card”: The Registry identification card shall be valid for use in New Mexico and other state medical cannabis programs with valid reciprocity and participation for out of state qualified patients. 

From Page 3 https://nmhealth.org/publication/view/rules/4986/ : 
SS. [RR.] “Registry identification card” means a document issued and owned by the department which identifies a qualified patient authorized to engage in the use of cannabis for a debilitating medical condition or a document issued by the department which identifies a primary caregiver authorized to engage in the intrastate possession and administration of cannabis for the sole use of the qualified patient. The Registry identification card shall be valid for use in New Mexico and other state medical cannabis programs with valid reciprocity and participation for out of state qualified patients. 

References:DC Health List 
https://dchealth.dc.gov/sites/default/files/dc/sites/doh/page_content/attachments/Reciprocity%20Chart%20-%20Functionally%20Equivalent%20-%204-11-18.pdf

State Medical Cannabis Laws from National Conference of State Legislatures
(Updated) 7/2/2019
Table 1. State Medical Marijuana/Cannabis Program Laws with details on which states recognizes Patients from other states
http://www.ncsl.org/research/health/state-medical-marijuana-laws.aspx




The public comment provided above for plant counts was derived from the following Sources:Petition: Medical Treatment; Adequate Supply: LNPP Plant Count Increase | http://lecuanmmcpmcabpetitions.blogspot.com/2017/09/petition-lnpp-plant-count-increase.html | By Safe Access New Mexico

Petition Introduction: Requesting for the Medical Treatment; Adequate Supply: Remove CBD from Plant Count | http://lecuanmmcpmcabpetitions.blogspot.com/2017/03/petition-introduction-requesting-for.html | By Safe Access New Mexico

“Patient's Guide to CBD”. The Patient’s Guide to CBD is a comprehensive resource that covers a wide range of topics, including, available forms for use, what to look for on package labels, how to read a certificate of analysis, how CBD interacts with the endocannabinoid system, the current state of research, the compound’s legal status, and how to talk to one’s doctor about CBD. [https://www.safeaccessnow.org/patientscbd]

Americans For Safe Access [http://www.safeaccessnow.org/policy_shop]

Stith, S. S., Vigil, J. M., Brockelman, F., Keenan, K., & Hall, B. (2018). Patient-reported symptom relief following medical cannabis consumption. Frontiers in Pharmacology, 9, 96. [https://www.frontiersin.org/articles/10.3389/fphar.2018.00916/full]

Colorado Medical Marijuana Program [https://www.colorado.gov/pacific/cdphe/medicalmarijuana]

Colorado Department of Revenue- An assessment of physical and pharmacokinetic relationships in marijuana production and consumption in Colorado [https://www.colorado.gov/pacific/sites/default/files/MED%20Equivalency_Final%2008102015.pdf]

Cannabis Yields and Dosing by Chris Conrad (court qualified cannabis expert) [http://chrisconrad.com/],

Hawaii Medical Cannabis Program-Medical Marijuana Dispensary Task Force Study 2015 [http://files.hawaii.gov/auditor/Reports/2014/14-12.pdf]




Sunday, July 7, 2019

How to Talk to Your Doctor About Medical Cannabis Use



Have you had a bad experience disclosing cannabis use to a doctor? Did a doctor's attitude toward cannabis impact the quality of care you received? You're not alone.

Unfortunately, a prevailing stigma, lack of exposure to current cannabis research, and confusion about the legality of discussing cannabis with patients are still barriers within the medical community that keep doctors from treating their cannabis-using patients accurately and fairly.

One thing medical and non-medical cannabis users have in common with the rest of the world is that all need access to medical care. So what is a cannabis user to do?

To answer this question, Weedmaps News spoke with two experts on the subject. Dr. Bonni Goldstein is a Medical Director of Canna-Centers, a medical cannabis evaluation service in Lawndale, California, and a medical adviser to Weedmaps. Ted Chan is the CEO of CareDash, a fast-growing healthcare review website.

Both Goldstein and Chan have consulted with thousands of patients, many of whom report a variety of poor experiences disclosing cannabis use to doctors. Based on their respective years of research, and field experience in the subject, here are some key words of advice to keep in mind when talking to your doctor about 
cannabis.

Be Transparent (and Prepare for a Negative Response)
The first thing both adult users and medical cannabis patients should realize when disclosing to a physician is that they're likely to be met with either prejudice, ignorance, or both.

Goldstein has seen thousands of medical cannabis patients, many of whom have reported frustrating conversations with their doctors about using cannabis as medicine.

“Unfortunately, most doctors know nothing about cannabis as medicine or about the endocannabinoid system (ECS). There is no formal education about these topics in the majority of medical school or residency programs.” Goldstein said. 

“Only about 9% of medical schools even mention cannabis as medicine in their curriculum. And the reality is that we as doctors are taught that cannabis is a drug of abuse.”

Goldstein added that those who disclose non-medical cannabis use to doctors are likely to be lectured or even diagnosed with cannabis use disorder, a clinical impairment of control over cannabis use despite harmful or adverse effects.

Even with these systemic biases within the medical community, it's ultimately better to err on the side of full disclosure with a physician.

For all the potentially in the therapeutic properties 
cannabis, there are risks involved in mixing it with other medications. Drug.com lists 612 drugs that interact with cannabis, 129 of which have major interactions.Recent findings suggest that cannabis users need more than twice the usual amount of anesthesia before undergoing endoscopic surgery. It's also possible to be allergic to cannabis, and experience symptoms typical of other food, skin, or airborne allergies. The more your doctors know, the better chance they have of giving you proper care. 

That's why Chan recommends being completely transparent about your patterns of cannabis use. “If you use a little, say that,” Chan said. “If it's daily, recreational, or to manage a specific symptom, don't be afraid to say it.”

According to Chan, full transparency is not only a way to increase your chances of getting the medical care you need, but also a quicker route to finding out the doctor's attitude toward cannabis. Just be prepared to find out you know more than your doctor about cannabis and how it affects your body.



Be Proactive in Gauging Your Doctor's Reaction
Since most doctors you're likely to encounter either know nothing or have a professional bias against cannabis, it's important to be proactive and gauge how your doctor responds when you disclose cannabis use.

As CEO of CareDash, Chan has read thousands of reviews of doctors made by their patients, and talks to many patients personally. He considers patient advocacy a central role at CareDash. There's no shortage of reviews on the site describing incidents where a patient was either misdiagnosed or denied the care they needed based on physicians' bias against cannabis as a drug of abuse.

“We have 160,000 reviews on the site, and I'd say about 100 involve negative experiences around 
cannabis impacting patient experience,” Chan said.

In states where medical cannabis is legal, CareDash reviewers have described incidents where doctors seem convinced that the patient is trying to scam them for a medical 
cannabis recommendation. Reviewers often express surprise that their physician seemed to have no working knowledge of medical cannabis research.

A New York patient reported seeing a neurologist who immediately dismissed her for “seeking medical cannabis” after the woman expressed a desire to use cannabidiol (CBD) oil for her foot neuropathy instead of a pharmaceutical prescription. A patient in Nebraska who went to an emergency room with the flu reported being misdiagnosed as having a rare disease the doctor claimed was from smoking too much 
cannabis. According to the patient, the visit was during flu season, and the doctor refused to test the patient for the flu, and made the diagnosis only after the patient had disclosed cannabis use to the nurse.

If your doctor has an overtly negative reaction when you tell them you use cannabis, Chan recommends seeking a second opinion.

You may also encounter a physician who seems reluctant to even address the subject of cannabis use when you disclose. According to Goldstein, most physicians don't know they are free to discuss medical cannabis with their patients. Many think that because it is federally illegal, they can get in trouble for speaking to patients about it.

“In 2002, the 9th U.S. Circuit Court of Appeals held that the federal government could not punish or threaten to punish a doctor for telling a patient that his or her use of medical 
cannabis use is proper,” Goldstein noted. “The relationship between physician and patient is special and protected, so physicians have free speech as long as they tell the truth about the science. No physician has been punished federally due to this protection.”



Ask Your Doctor How They Feel About Cannabis
If you find an appropriate time to do so, Goldstein recommends that medical patients ask their doctor how they feel about cannabis as medicine.

“I tell patients who are nervous about bringing up medical cannabis use with their physician to first ask 'What do you think about the use of medical cannabis for ... (Insert ailment)?' This way you are not sharing info that you may not be ready to share and you are feeling out the physician's attitude toward cannabis.”

If You Have a Good Relationship with Your Doctor, Consider Sharing Medical Information
If you find your physician negative or dismissing of medical cannabis, Dr. Goldstein recommends following up via email or in person with a scientific article or two about medical cannabis for the ailment in question, or about the ECS.

“Everyone says there is not enough research [about medical cannabis] and this is true, but there is lots of research on medical cannabis for the more common ailments. And it can be accessed easily on the internet through Google Scholar or PubMed,” Goldstein said. “Giving your physicians published research in a non-threatening way is a good way to start the conversation.”

According to Chan, an overwhelming majority of doctors are quite averse to accepting medical research from patients. So if you're going to try sharing cannabis information with your doctor, it might be best to wait until you've established an amicable relationship with them. Both Chan and Goldstein highly recommend elevating the conversation with technical and scientific terms (saying “cannabis” instead of “weed,” for example). If you're a medical cannabis patient, refer to cannabis as medicine and emphasize how it helps you.

Don't Be Afraid to Switch Doctors
According to Chan, there's a growing pool of 
cannabis-friendly doctors who understand the science and respect medical and responsible adult use of cannabis. Though they may still be few and far between, Chan says their ranks are growing, and cannabis users should seek them out when possible.

“Patients have a choice. It is their right to have a primary care physician who is understanding and supportive of their lifestyle choices,” Chan said. “It is in the interest of both the doctor and the patient to be aligned.

“I view it as more of a dating situation. As you might be on a date that doesn't work out,” Chan continued, “be friendly, but don't be afraid to shop around the next time you need a checkup and find a physician who is more aligned with your choice to use 
cannabis.”

If one is available in your area, Goldstein recommends seeing a cannabis specialist in addition to your doctor visits. “If you are asking your physician for medical cannabis advice, you will likely be disappointed as, again, most don't know anything. Seeing a cannabis specialist is likely going to be much more beneficial if you are looking for specific advice about cannabinoids, product, and dosing.”



Related Article: 
Talking to Your Doctor About Medical Cannabis | Americans For Safe Access | https://www.safeaccessnow.org/talking_to_your_doctor_about_medical_marijuana



Source: Andy Andersen ∙ June 23, 2019   6:00 am PDT  https://news.weedmaps.com/2019/06/how-to-talk-to-your-doctor-about-cannabis-use/

Thursday, July 4, 2019

Why Do We Call Cannabis Marijuana? How Language Matters...

Image result for Cannabis vs Marijuana word history
Credit: The Stranger

There is no such thing as a "Marijuana" plant, Cannabis is the plant's actual name. The plant name Cannabis is derived originally from a Scythian or Thracian word, which loaned into Persian as kanab, then into Greek as κάνναβις (kánnabis) and subsequently into Latin as cannabis according to the Etymology Dictionary.


From the standpoint of a botanist , cannabis is a genus of plant, and comes in various species such as sativa, indica and ruderalis (or sativa, indica and afghanica depending on the research you reference) and thus ‘cannabis sativa’ and ‘cannabis indica’ (or ‘c. indica and c. afghanica) are the correct names when dealing with the various forms of the “cannabis” plant — not ‘marijuana.’

Language is important because it defines our ideas. Words have a power that transcends their formal meaning. When we change words, we can also change the thoughts that underlie them. By changing the words we use to describe cannabis and herbal medicine, we can help our fellow citizens understand the truth about it, and see through the decades of propaganda.

That understanding will convert cannabis opponents into supporters, and bring closer the day when all our prisoners go free, and nobody else is ever again arrested for using or possessing “marijuana”. 

We prefer to use the word cannabis, because it is a respectful, scientific term that encompasses all the many different uses of the plant and true history of the sacred plant.

The word "marijuana" or “marihuana” is an emotional, pejorative term that has played a key role in creating the negative stigma that still tragically clings to this holistic, herbal medicine. Most cannabis users recognize the "M word" as offensive, once they learn its history.

Harborside, which is among the oldest and largest dispensaries in California, says on its website: “‘Marijuana’ has come to be associated with the idea that cannabis is a dangerous and addictive intoxicant, not a holistic, herbal medicine ... This stigma has played a big part in stymying cannabis legalization efforts throughout the US.”

The word marihuana used in the title of a 1936 drug exploitation film


The “marijuana” term started off life as a Mexican folk name for cannabis, but was first popularized in the US by the notorious yellow press publisher, William Randolph Hearst. Hearst was a racist, as well as being committed to the prohibition of marijuana, which threatened his timber investments. He used his control of hundreds of newspapers to orchestrate a vicious propaganda campaign against cannabis, which featured lurid (and false) stories about black and brown men committing outrageous acts of murder and mayhem. That campaign played on then-predominantly racist public opinion to make cannabis illegal at the federal level in 1937. Since then, “marijuana” has come to be associated with the idea that cannabis is a dangerous and addictive intoxicant, not a holistic, herbal medicine for helping people deal with the effects of cancer, AIDS, wasting syndrome and other conditions. This stigma has played a big part in stymying cannabis legalization efforts throughout the U.S.


Pot probably comes from the Mexican ‘potiguaya,’ which is a word for seeds, which may come from the expression ‘potacion de gauays,’ which would mean ‘a sorrow soup,’ which was some kind of concoction involving marijuana.. How it got shortened to ‘pot’ is unclear, but it was probably around the 1930s that Americans started using that word. (1)

And yes Hemp is part of the Cannabis plant family, Cannabaceae.  Cannabaceae is a small family of flowering plants. As now circumscribed, the family includes about 170 species grouped in about 11 genera, including Cannabis (hemp), Humulus (hops) and Celtis (hackberries). 



Language is important because it defines our ideas.


Related Articles To Read: 

The Word "Marijuana" Versus the Word "Cannabis" | APR 13, 2016 | The Stranger | by Tobias Coughlin-Bogue | https://www.thestranger.com/news/2016/04/13/23948555/the-word-marijuana-versus-the-word-cannabis

Here’s Why We Should Probably Say ‘Cannabis’ Instead of ‘Marijuana’ | July 23, 2016 | AlterNet | by April M. Short | https://www.alternet.org/2016/07/word-marijuana-has-ugly-history/

Marijuana: is it time to stop using a word with racist roots? | Mon Jan 29 2018 | The Guardian | Alex Halperin | https://www.theguardian.com/society/2018/jan/29/marijuana-name-cannabis-racism


(1) -  (Source : Geoffrey Nunberg, a linguist at UC Berkeley and NPR "Fresh Air" contributor.)


Monday, July 1, 2019

New Mexico Cannabis Decriminalization Law Goes Into Effect Today


What does this mean as New Mexico becomes the 23rd state to decriminalize cannabis, decriminalization is not the same as legalization of cannabis. Decriminalization means that the state of New Mexico has amended its laws to make certain acts criminal, but no longer subject to prosecution. In the cannabis context, this means individuals caught with small amounts of cannabis for personal consumption won’t be prosecuted and won’t subsequently receive a criminal record or a jail sentence. In many states and cities, possession of small amounts of cannabis is treated like a minor traffic violation.

The effective date of the provisions of the new cannabis decriminalization law is July 1, 2019.

Senate Bill 323, Decrease Cannabis Penalties, Introduced by Senator Joseph Cervantes.


Senate Bill 323 amends Section 30-31-23 NMSA 1978, within the Controlled Substances Act, to provide the following penalties for possession of cannabis:
  • Up to one-half ounce of cannabis: penalty assessment misdemeanor, up to $50 fine
  • More than one-half ounce but less than one ounce:  
    • First offense: petty misdemeanor, fine of not less than $50 or more than $100, and imprisonment for not more than 15 days 
    • Second or subsequent offense: misdemeanor, fine of not less than $100 or more than $1,000, or imprisonment for definite term of less than one year, or both
  • More than one ounce but less than eight ounces: misdemeanor, fine of not less than $100 or more than $1,000, or imprisonment for definite term of less than one year, or both
  • Eight ounces or more: fourth degree felony pursuant to Section 31-18-15 NMSA 1978
SB 323 also amends Section 30-31-25.1 NMSA 1978 to provide a $50 penalty assessment misdemeanor for use of or possession with intent to use drug paraphernalia.

SB 323 enacts a new statutory section within Chapter 31, governing criminal procedure, to provide that payment of a fine pursuant to a penalty assessment citation shall not be considered a criminal conviction. The new Section 3 contains requirements upon and authority granted to an officer issuing a penalty assessment citation under the criminal code, requirements upon the person to whom the penalty assessment citation is issued, and requirements for the magistrate or metropolitan court to which the penalty assessment citation is submitted. SB 323 provides that penalty assessments collected by a magistrate court or metropolitan court pursuant to Section 3 shall be transferred to the Administrative Office of the Courts (AOC) for credit to the Magistrate Drug Court Fund. (Legislative Analysis)


Karen O'Keefe, state policies director for the Marijuana Policy Project wasted no time in criticizing the Governor's action telling Forbes, “But it’s a shame that only one piece of the war on marijuana is ending in New Mexico this year." MPP state policies director further went on to say,"Voters support regulating, taxing, and legalizing cannabis for adult-use, and the Senate should have heeded their call,” O'Keefe said.

Decriminalization States 
According the National Conference of State Legislatures there are twenty-three (23) states and the District of Columbia have decriminalized small amounts of cannabis. States that have decriminalized small amounts of cannabis include:

Alaska (also now with legal provisions)
California (also now with legal provisions)
Colorado (also now with legal provisions)
Connecticut
Delaware
Illinois
Maine (also now with legal provisions)
Maryland
Massachusetts (also now with legal provisions)
Minnesota
Mississippi
Missouri
Nebraska
Nevada (also now with legal provisions)
New Hampshire
NEW MEXICO
New York
North Carolina
Ohio
Oregon (also now with legal provisions),
Rhode Island
Vermont (also now with legal provisions)
Washington (also now with legal provisions)
District of Columbia (also now with legal provisions).

Of the states above, Minnesota, Missouri, Nevada, North Carolina and Ohio designate it as a low-level misdemeanor, with no possibility of jail for qualifying offenses. The other states with decriminalization policy have specified small amounts of cannabis as a civil infraction, or the like.


Related articles on getting your New Mexico Medical Cannabis Card: