In response to a letter from seven U.S. Senators including Elizabeth Warren, the DEA has indicated it will review its classification of marijuana as a Schedule I substance within the first half of 2016.
“DEA understands the widespread interest in the prompt resolution to these petitions and hopes to release its determination in the first half of 2016,”
DEA said in a 25-page response.
Warren’s original letter asks the DEA to acknowledge the mainstreaming of medical marijuana. “While the federal government has emphasized research on the potential harms associated with the use of marijuana, there is still very limited research on the potential health benefits of marijuana — despite the fact that millions of Americans are now eligible by state law to use the drug for medical purposes.”
DEA drug scheduling, under the Controlled Substances Act, classifies substances based on their medical uses and potential for abuse. Currently, marijuana is grouped with heroin as a Schedule I substance, a category that is reserved for drugs deemed the most dangerous, highly addictive and of no medicinal value. Comparatively, methamphetamine, cocaine and most prescription painkillers that are currently part the opioid epidemic fall into the Schedule II category, a classification which permits doctors to prescribe them and researchers to access them for studies.
The Reschedule 420 smoke-in demonstration in front of the White House on April 2, 2016 (Photo by John Kagia/Whaxy).
While experts and advocates agree that cannabis should be de-scheduled completely, rescheduling the plant as a Schedule II substance would allow for more collaborative medical research and fewer criminal penalties for possessing marijuana. Currently, medical marijuana research is done on a small scale in the United States or in other countries with favorable legislation.
In their response to lawmakers, the DEA mentions that between 2000-2015, it provided marijuana to researchers at a rate of about 9 per year. The bureaucratic complexity of doing legal cannabis research has led many universities and organizations to abandon it all together.
“That number is totally insufficient to meet public health needs and to answer the number of [research] questions that pop up yearly,”
said John Hudak of the Brookings Institute. “People just aren’t applying because of all the headaches involved.”
While the DEA’s letter might be good news for marijuana advocates, acting DEA Administrator Chuck Rosenberg made clear last year that he has no intention of rescheduling marijuana, despite promising research, millions of people providing anecdotal evidence and legal medical marijuana programs in 23 states.
“If you want me to say that marijuana’s not dangerous, I’m not going to say that because I think it is. Do I think it’s as dangerous as heroin? Probably not. I’m not an expert,”
said Rosenberg. He later admitted that marijuana is not as harmful as heroin, a nod to the political agenda of drug scheduling. Similar proposals to reschedule cannabis made in 2000 and 2006 were also rejected by the DEA.
“Almost half the states in the country have medical cannabis laws and major groups like the American Nurses Association and the American College of Physicians are on board,” said Tom Angell of Marijuana Majority. He also suggested that the Obama Administration should use executive powers to reclassify marijuana as a Schedule II substance before he leaves office.
Hundreds of peaceful protesters who agree with Angell gathered in front of the White House for one of the largest smoke-in demonstrations in history on Saturday April 2 (click here to see photos from the rally).
Feature photo credit: John Kagia
In 1978, the federal government of the United States launched the Compassionate Investigational New Drug (IND) Program, an initiative intended to provide medical cannabis grown by the government to those with serious diseases and health issues — for life. The program, however, wasn’t launched as a result of a curiosity regarding the medicinal efficacy of cannabis on the part of the nation’s leaders. Rather, it was the culmination of two lawsuits by Robert Randall, a pioneering patient from Sarasota, Florida.
In 1976, Randall sued the government and won in a federal court the right to use medical cannabis to treat his glaucoma. A Federal District Court ruled that Randall’s use of marijuana was a necessity for his health. In fact, it was this case that established the precedent of medical necessity as a plausible legal defense for prosecuted patients. However, according to the New York Times:
“Two years later, the government cut off his access to the drug, but he sued for reinstatement and won.”
Randall’s second legal battle and victory resulted in the creation of the Compassionate IND Program, which — although it serves a very small number of patients — is still in effect today. Roughly 1,200 low-quality cannabis joints (cigarettes) are distributed to patients around the United States each month.
Although Randall died in June 2001, several other patients continue to each month receive large tins containing 300 low-grade pre-rolled joints from the federal government. The cannabis is grown on a farm at the University of Mississippi that has been managed by the National Institute on Drug Abuse (NIDA) since 1968. Unfortunately, the Bush administration closed enrollment to the IND Program in 1992. Existing participants, however, remain within the program until death and continue to receive their canisters of low-THC cannabis joints.
Many are shocked to learn of this 37-year-old program and its participants. Upon first gaining knowledge of the program, it is easy to dismiss the story as an urban legend or internet clickbait. What is most problematic, however, is the hypocrisy illustrated by this effort. While government officials can arguably defend themselves by noting that it was a court decision that forced them to begin producing and delivering cannabis medicine to a small group of patients, the fact that cannabis continues to be categorized as Schedule I by the federal government is a blatant example of illogical and hypocritical public policy.
The FDA doesn’t reveal the number of patients participating in the IND Program, but some believe that between two and four remain. Two of these patients reside in Florida, including Irvin Rosenfeld, a 61-year-old stockbroker who has a tumor disorder, and Elvy Musikka, a 72-year-old glaucoma sufferer and cannabis legalization activist.
Rosenfeld began receiving cannabis under the program in 1982 and has written a book about his experience entitled My Medicine, the cover of which features him holding a large tin of low-grade government joints from the Compassionate IND program (grown on the NIDA-managed farm). He is probably the most publicized and interviewed of the participants. Echoing the perception that the government’s actions are hypocritical, Rosenfeld said:
“The United States federal government has been supplying me 10 marijuana cigarettes per day for almost 33 years, and in the same vein arresting people for possessing marijuana they give me for medical use.”
Rosenfeld uses cannabis to treat a rare bone tumor disease and has calculated his consumption of legal government cannabis over more than three decades, estimating that he has smoked more than 120,000 joints provided by the government’s pot farm at the University of Mississippi. Mussika, who has been highly critical of the IND Program and prohibition overall, notes that many federal lawmakers are completely unaware of this program.
“They’re very surprised — [most] didn’t know the government ever supplied anybody,”
Irvin Rosenfeld smoking one of the cannabis joints provided to him by the U.S. Government.
Until the government allows robust clinical research and human trials into the therapeutic benefits of medical cannabis, access to the drug for patients in states that have yet to legalize adult use will lag. It is currently the Schedule I status of cannabis that officially categorizes it as a highly addictive and dangerous drug with zero medical value (along with bath salts and heroin). Schedule II, a Controlled Substances Act category intended for less dangerous drugs, features methamphetamine and cocaine, both of which can be prescribed by a physician.
Because of its Schedule I status, doctors — even those in states with medical or adult use laws — cannot prescribe cannabis. Instead, they are limited to writing a recommendation. Many medical cannabis advocates are insisting on a Schedule III categorization, or lower, to ensure that ample research can be conducted that involves human trials and high-quality cannabis, such as that which can be purchased in states like Washington, Oregon, and Colorado.
Eventually, attrition will dwindle the patient population of the Compassionate IND Program to nothing and it will cease to exist. Although this will reduce the government’s hypocrisy, it will do little to provide safe access to cannabis medicine for millions of sick patients like Rosenfeld and Mussika.
“If I didn’t have my medical marijuana, most likely I’d be dead. If I was still alive, I’d be on disability and homebound. Instead, I’m a stockbroker here in Fort Lauderdale.”
Photo credit: wptv.com; philly.com
Patients who register with their state’s medical cannabis program typically become, literally, card carrying members. What many do not realize is that some states recognize the registrations of those from outside areas, something that is called reciprocity. While most states do not recognize out-of-state medical cannabis exemptions or qualifications, a few do. Of these, there are important differences of which millions of traveling patients should be aware.
The medical cannabis laws of most states do not allow reciprocity for one simple reason: It invites scrutiny by federal authorities, specifically those in the Drug Enforcement Administration, or DEA. The Justice Department is home to the DEA and exercises oversight for interstate commerce. It therefore has a vested concern to ensure that diversion (legal cannabis being delivered to illegal recipients) and other fraudulent activity is not involved. The issue becomes only more complex based on the fact that medical, and even recreational, cannabis is legal in some states, but all forms of cannabis are illegal at the federal level.
The federal government categorizes cannabis as Schedule I, meaning it is officially as “dangerous and addictive” as heroin and bath salts. In fact, both cocaine and methamphetamines, two truly addictive drugs that nearly any medical professional will testify are more dangerous than cannabis, both reside in less-restrictive Schedule II; they can even be prescribed by a physician.
Possession vs. Purchase
Four states with medical cannabis laws on the books allow visitors to legally possess and consume cannabis (within limits), but do not provide safe access via dispensaries to the medicine or related products (like concentrates, edibles, tinctures, and topicals).
States allowing registered patients from out-of-state to possess cannabis include:
- New Hampshire: Visiting patients are permitted to possess and consume cannabis, but cannot purchase or grow the herb.
- Arizona: Card-carrying patients from other states are permitted to possess and use cannabis, but not purchase it.
- Michigan: Visiting patients may possess and use. If driving with cannabis, the herb must be stored in a case in a locked trunk of the vehicle.
- Rhode Island: Like similar states, visiting qualifying patients may use and possess up to 2.5 ounces of cannabis, but cannot purchase from dispensaries in the state.
There are three states that practice full reciprocity and will legally allow, under certain circumstances, out-of-state patients to make purchases at licensed dispensaries. This is a way for those suffering a debilitating disease or condition, especially those who must medicate daily, to obtain medicine when they are traveling. It is not recommended that patients attempt to carry cannabis through an airport or on a flight. While many are successful, the legal ramifications in some states — or from federal authorities — simply are not worth the risk for the average patient.
It is legal for any patient possessing a valid medical cannabis card, from any state, to purchase, possess, and consume cannabis products at Nevada dispensaries. In fact, because reciprocity is practiced by so few states in the U.S., Nevada may become a destination for patients in other states who wish to vacation or meet business clients, but don’t desire to — or simply can’t — go without their medicine for the duration of their travel.
In Nevada, reciprocity is fairly straightforward. At their first dispensary visit, patients from out-of-state are asked to sign an affidavit testifying that they are currently a valid patient in another state. In addition, traveling patients are restricted to that initial dispensary for one month. Because most travelers, especially those vacationing in Las Vegas, will be staying a considerably shorter period of time than a month (a two to seven day span is more common), they are limited to a single dispensary for that particular trip. Las Vegas is significant, especially considering that 40 million people travel there each year (that’s the entire population of California, the most populous state in the nation).
Thus, patients visiting Las Vegas or Reno should be careful when selecting their initial dispensary. If their next trip to the Silver State is more than 30 days in the future, they will then be able to shop at the dispensary of their choice. Some have pondered if Nevada will pass recreational legalization via a ballot initiative in November 2016. If it does, Las Vegas could become the Amsterdam of the United States, being America’s legal adult playground for more than merely gambling and big-dollar magic acts.
The fact that Nevada is risking federal scrutiny to do what is best for patients is both relatively novel among states that have enacted medical cannabis laws, but also within the theme of Nevada’s tourism. If there are three states that understand the economic and cultural benefits of a robust tourism industry, it is Nevada, Colorado, and California. This spirit is finally being expressed within state laws affecting medical cannabis patients.
In Hawaii, patients from the mainland must simply register with the state. None of the details of this program are available, however, due to the fact that it will not go into effect until January 1, 2018. Patients traveling to this classic vacation destination of perfect temperatures and gorgeous beaches must remain patient for their opportunity to spend a few days in paradise while also remaining medicated to reduce or eliminate pain and nausea or deliver relief from inflammation-based diseases such as fibromyalgia, arthritis, and even cancer.
Maine requires that the recommending physician of visiting patients submit a form that testifies to the patient’s condition and eligibility in their home state. Visiting patients may designate a caregiver or dispensary in Maine, but not both. Surprisingly — in what seems to be an effort to accommodate those who relocate to Maine, not just visitors or vacationers — patients can have their doctor petition for their right to cultivate up to six mature plants.
Thus, patients who qualify for their home state’s medical cannabis program may visit or move to Maine and immediately request, via their recommending doctor, legal permission to consume and even cultivate cannabis.
Federal legality would eliminate the need for states to practice reciprocity in their recognition of registered medical cannabis patients from fellow states. However, this isn’t something that is on the political horizon in Washington, D.C. and a popular topic in Congress. Until true progress is made on Capitol Hill, patients will have to rely upon the handful of states that officially recognize the programs of those outside their own borders.
Alzheimer disease (also known as Alzheimer’s disease or simply Alzheimers) was discovered in 1906 by Dr. Alois Alzheimer, who diagnosed it following an autopsy on the brain of a person who died of an unknown mental illness.
Alzheimer’s actually begins damaging the brain up to a decade prior to the onset of any form of short-term memory loss. It is this memory loss that is the infamous first symptom of the disease.
Alzheimer’s is the sixth leading cause of death in the United States and plagues about five million Americans. It is a progressive neurodegenerative brain disorder and the most common form of dementia. In fact, it is estimated that Alzheimer disease causes 60 to 70 percent of all cases of dementia. One in three senior citizens will eventually die from this disease or another form of dementia.
2016 Israeli Study
While previous research has already revealed the benefits of cannabis in the treatment of neurological disorders, including Alzheimers and Parkinson’s, a new study confirms previous findings.
In a study published in January 2016, a team from Israel comprised of medical researchers from Tel-Aviv University and Bar-Ilan University, added medical cannabis oil to the treatment regimens of a small group of patients suffering from Alzheimer’s. Researches administered the medical cannabis oil to deliver THC to study participants. The objective of the study was to measure the efficacy and safety of cannabis oil as a supplement to traditional pharmacotherapy for the relief of “behavioral and psychological symptoms of dementia.”
Concluded the study:
“Adding medical cannabis oil to Alzheimer’s disease patients’ pharmacotherapy is safe and a promising treatment option.”
This study was conducted to further explore the previously proven background that “Tetrahydrocannabinol (THC) is a potential treatment for Alzheimer’s disease (AD).”
Cannabis has also been proven to provide relief from several other symptoms of aging experienced by seniors, including arthritis, chronic pain and loss of appetite. While initial studies are promising, the neuroprotective qualities of the plant should be explored further.
Until such research is permitted in the United States and Congress is willing to remove cannabis from Schedule I of the Controlled Substances Act, similar studies will be lacking in the States. As long as cannabis is legally considered as dangerous and addictive as heroin, methamphetamine, and cocaine, patients, caretakers, and physicians will lack the knowledge to apply the best strains of cannabis to a variety of diseases and conditions. Similarly, American cannabis breeders and cultivators will be left to rely upon anecdotal patient testimonies and research conducted outside the borders of the U.S.
With medical laws sweeping the nation, more and more patients are eligible for legal and safe access to cannabis — or at least the right to legally possess and consume it. As of June 2015, 14 states had passed “CBD-only” laws, programs designed to provide safe access to low-THC, high CBD (cannabidiol) cannabis oil for a limited set of diseases. In many states, including Iowa, Missouri, and Oklahoma, the only qualifying condition is epilepsy or debilitating seizures.
CBD-Only Laws Relatively Ineffective
Such laws are primarily motivated by childhood epilepsy and intended to curb the occurrence of seizures. Unfortunately, most are relatively ineffective and more a political stunt to gain reelection than an effort to truly help sick adults and children. Many of these patients gain no benefit from conventional pharmaceutical treatments. Many CBD-only states, however, are providing no safe access to an organic medicine that can easily be extracted into a concentrated form and given to children twice a day.
Often, such limited medical cannabis laws are given the name of a child patient who helped inspire them them or was cited as a reason to support the legislation, such as the Harper Grace Durval bill (Mississippi), the Haleigh’s Hope Act (Georgia), and the Alexis Carey bill (Idaho). Unfortunately, such laws serve a minority of childhood epilepsy sufferers. Current research and anecdotal evidence has revealed that CBD-only oils significantly reduce seizure activity in less than one-third of patients. Thus, seven out of 10 children with severe epileptic conditions like Dravet syndrome and Lennox-Gastaut syndrome do not gain effective improvement to their condition and a significant decrease in seizures from CBD only.
CBD-only states that limit the herbal extract to only epilepsy also discount the most common condition for which CBD oil is administered: Cancer. By allowing only patients suffering seizures or childhood epileptics to use CBD oil, politicians most intent on re-election discount a sizeable portion of their citizens and millions of sick people when they so tightly limit the scope of their state’s CBD law.
No Access to Medicine
Some experts have observed that a network of dispensaries that provide trained budtenders and sage advice to desperate patients is typically not available in most states that have implemented CBD-only medical cannabis laws. Laws that merely legalize and remove penalties from the possession or consumption of something like CBD oil, but that do nothing to provide safe access to medicine and consulting for patients are of little real help.
Some have opined that current CBD legislation in many states is merely a political ploy to satisfy medical cannabis and patient advocates and put up a roadblock to future legislation that is more comprehensive and less restrictive. In other words, the governors and legislatures of many conservative states have beaten cannabis activists and legalization groups like NORML and MPP (Marijuana Policy Project) to the punch with their own highly diluted, mostly ineffective laws.
Also, programs that cater to a single disease like epilepsy reach a very small portion of the overall patient population. According to the MPP:
“…only two percent of the registered patients in both Rhode Island and Colorado report seizures as their qualifying conditions.”
This reveals that CBD-only laws sometimes provide safe access to very few patients. Unfortunately, MPP reported that “The vast majority of [all medical cannabis] patients have symptoms that benefit from strains of marijuana that include more than trace amounts of THC.”
Critics and Lip Service
Vocal critics of CBD-only legislation include Paul Armentano, the Deputy Director of NORML. Armentano has called such laws “largely unworkable” and believes that this is due to the tight restrictions they place on doctors and patients. For example, Tennessee, Utah, and Florida provide access to CBD oil not via dispensaries and retail outlets like those in Portland, Seattle, Denver, and Los Angeles, but instead limit qualified patients to those participating in a special FDA clinical trial.
This obviously greatly limits participation and access, delivering help to very few actual patients after the hype of national press releases and photo opps has passed. In addition, patients in such states are shown no respect in terms of their desire or right to choose their own variety and brand of cannabis medicine from the retail outlet of their choice. Such limited access results in programs that are more lip service than actual help for millions of patients, their caregivers, and their families. In essence, many such programs are a monumental societal-level taunt, inviting very sick patients and desperate parents to participate in programs with very little actual effectiveness.
Patients are increasingly seeking high-CBD varieties of cannabis for treatment of many diseases and conditions, most notably cancer, epilepsy, multiple sclerosis, pain, and anxiety. There is also evidence that adult seizure patients, especially females, have a greater need for THC than other sufferers. Even if most states were actually providing safe, reliable access to high-quality, laboratory tested CBD oil containing no THC, the latest research indicates that such a limited approach that disregards the benefits of whole plant therapy helps few children — and actually increased seizure activity for some.
One study published in 2014 and conducted by Dr. Kevin Chapman involved 58 children, with an average age of seven, with “catastrophic forms of epilepsy.” It found that less than 30 percent of children treated with CBD-only oil containing very little or no THC experienced a reduction in seizures of 50 percent or greater. When THC is added to the mix, the majority of patients begin to experience a reduction in seizure activity. It is also estimated that many patients who gain marginal or even good efficacy from CBD-only oil would experience even greater therapeutic benefits if their medicine also contained some THC, even in small amounts or maybe at a 1:1 ratio with CBD.
A 2015 CBD Patient Survey conducted by Care by Design surveyed 2,495 patients between March and August of 2015. One of the survey’s key findings was the fact that CBD oils lacking THC are not as therapeutic or effective as those containing between 20 and 35 percent THC. Concluded the survey:
“THC matters. A higher ratio of CBD to THC does not result in better therapeutic outcomes. Patients using the 4:1 CBD-to-THC were the most likely to report a reduction in pain or discomfort….”
The survey goes on to note that patients who use an oil featuring a 2:1 CBD-to-THC ratio reported “the greatest improvement in overall wellbeing.” This confirms other research that has discovered that CBD and THC interact synergistically to enhance the therapeutic effect of the other, an example of the entourage effect.
Anecdotal Patient Testimonies
Many desperate parents of children with epilepsy have experimented with CBD oil. Unfortunately — as research has indicated — for the majority of them, oils high in CBD, but low in THC, do not work best for their children. Jason David has been treating his seven-year-old son, Jayden, an epilepsy sufferer with Dravet syndrome, with medical cannabis in one form or another since 2011. Dravet is one of the worst manifestations of epilepsy and does not respond to conventional treatments. Said David:
“I wish Charlotte’s Web [a CBD-only oil from Colorado] worked for all epileptic kids, but it doesn’t. The worst seizures Jayden ever had on medical cannabis was while we were using Charlotte’s Web.”
Brian Wilson, a former East Coast resident, moved to Colorado in 2014 because of its medical cannabis law. He is another parent of a child suffering from Dravet syndrome. In an interview with Ladybud in 2014, Wilson said:
“CBD is a very important part of the mix, but only part. We saw minor seizure control and developmental progress with CBD alone, but we didn’t see real seizure control until we added measurable levels of THC to the mix.”
Wilson also noted that the acidic precursor to THC, THC-A, provides significant therapeutic value to some patients. “This is highly individualized medicine. There is no magic bullet,” he added.
Some medical cannabis advocates believe that vague CBD-only bills “betray the science behind cannabis medicine.” Patients are finding that CBD, without any THC, is simply not effective or is marginally effect, when clearly superior solutions exist. In fact, several cases like that of Jason David and his son Jayden have been reported in which CBD only increased seizure disorders, often during times of illness, stress, or hormonal change.
More Research Necessary
Unfortunately, until cannabis is removed from Schedule I of the Controlled Substances Act of the federal government — which considers it as dangerous and addictive as heroin and bath salts — human trials and detailed research will fail to occur in the United States. Even cocaine and methamphetamine, truly addictive and dangerous drugs, are categorized as Schedule II and can be prescribed by a doctor.
Until Congress commits to comprehensive research into the medical efficacy of cannabis for a wide variety of diseases and ailments, tens of millions of patients throughout the country will needlessly suffer. More must be understood about the delicate and nuanced interplay of cannabinoids and terpenes and how they benefit patients with a variety of conditions. Until this happens, a naturally occurring herb that could be helping a sizable portion of the patient population will continue to be outlawed, denying the sick safe access to a 10,000-year-old organic medicine.