Tag Archives: marijuana

Drug Information, Drug Legalization, Legislative Issues, Public

SAM Analysis of HHS Cannabis Rescheduling Rationale

01/19/2024 admin Leave a comment

Full Analysis: https://learnaboutsam.org/wp-content/uploads/2024/01/SAM-Analysis-of-HHS-Cannabis-Rescheduling-Rationale.pdf

Executive Summary On August 30th, 2023, the Department of Health and Human Services (HHS) announced it recommended the reclassification of marijuana to Schedule III to the Drug Enforcement Administration (DEA). Four months later, HHS released an unredacted version of its recommendation to reclassify the drug. The 252-page review had been hidden from the public and was only released after legal action was threatened against HHS. This HHS recommendation is based on cherry-picked data and represents a weak and intellectually dishonest argument to reschedule marijuana. This summary describes just a few of the many flaws in the HHS methodology and conclusions. SAM’s full report provides an in-depth analysis of what the HHS got wrong and how the process could have been strengthened. In years past, the FDA, an agency of the HHS in charge of approving medicinal drugs, used an established five-factor analysis in determining whether Schedule I drugs have “currently accepted medical use.” In the current report supporting the recommendation to reschedule marijuana, the FDA changed these criteria to get its desired answer. If marijuana had been held to the same standards as other drugs, it would not be deemed to have “currently accepted medical use,” due to the infeasibility of measuring all strains and the insufficient amount of existing research into its safety and efficacy. In fact, the FDA’s new two-factor test explicitly states that studies used to support marijuana’s accepted medical use do not need to be controlled, a standard that was required in the five-factor test (save an evaluation done by a consensus of experts). It is not clear why the FDA moved away from the five-factor test, unless the agency approached the rescheduling review with a pre-determined conclusion. The five-factor test has been used for decades by Republican and Democratic Administrations. Additionally, the United States Court of Appeals for the District of Columbia Circuit examined and validated the test in Alliance for Cannabis Therapeutics v. Drug Enforcement Administration. The marijuana industry petitioners in that case even conceded that the five-factor test had no flaws, as explained in the opinion for the court. The FDA now considers the existence of state medical marijuana programs as evidence that marijuana has currently accepted medical use. A drug’s popularity among the public has never been used as a standard to determine medicine. Supreme Court Justice Steven Breyer in Gonzalez v Raich (545 U.S. 1 (2005), a case involving a medical necessity for the use of marijuana, opined during oral arguments that “medicine by regulation is better than medicine by referendum.” The Court’s 6-3 decision, which Justice Breyer joined, upheld the prohibition of marijuana for medical use under the Controlled Substances Act (CSA). The FDA’s novel standard in recommending marijuana’s rescheduling is rooted in a logical fallacy: some people say that marijuana is medicine, so marijuana must be medicine. The FDA is delegating its authority to determine that medications are safe and effective to popular opinion, a practice that not only exceeds the statutory authority of the agency but makes a mockery of the congressional intent of the Food, Drug, and Cosmetic Act to protect the public health. Following the FDA’s logic, psychedelic drugs, which are seeing a popular push for medical legalization, could also be considered medicine and be rescheduled due to shifting public opinion. The FDA compares marijuana to a limited, hand-picked list of other controlled and noncontrolled substances (e.g., heroin, alcohol, cocaine), not all Schedule I drugs. In the recommendation, the FDA measured marijuana’s potential for abuse by comparing it to a hand-picked selection of Schedule I, II, and III drugs. For example, the FDA compared marijuana to heroin, another Schedule I drug. The recommendation claims that because marijuana has a lower abuse potential than heroin, it shouldn’t be in the same category. Yet the FDA failed to compare marijuana to other Schedule I drugs, such as LSD. Comparing marijuana’s abuse potential against all Schedule I drugs would have allowed for a more rigorous analysis, but it would not have allowed the FDA to conclude that marijuana belongs in Schedule III. To qualify for Schedule III, a drug or other substance must have “potential for abuse less than the drugs or other substances in Schedules I and II” (21 USC 812(b)). Fifty years of data published by HHS show that marijuana does not meet this standard. None of the studies used by the FDA to justify its claim that marijuana is medicine support that conclusion. The FDA determined that marijuana is acceptable for medical use for pain, nausea and vomiting, and anorexia. Only three studies were used to justify this claim. The first (University of Florida), concluded that results were “inconclusive or mixed.” The second (National Academies of Sciences & Medicine) relied primarily on a study for which the results were not statistically significant. For the third (Agency for Healthcare Research and Quality), the FDA concluded that the positive effects of marijuana in the study were small and that “the increased risk of dizziness, nausea, and sedation [from marijuana use] may limit the benefit” (page 27 of 252). Furthermore, some of these studies were with inhalable marijuana; prior FDA evaluations have excluded inhalable marijuana studies because of their unreliability and questionable practices.

Drug Information, Drug Legalization, Legislative Issues, Public

The Legalization of Marijuana; thoughts and opinions

06/13/2023 admin Leave a comment

Drew Horowitz, MA, LADC, LPCC, CIP
Owner & CEO, Horowitz Health

Minnesota Legalizing Marijuana Is a Big, Potentially Bad Deal
For those who are easily influenced, mentally shaky or predisposed to addiction, legalization is as good as an endorsement, one that’s more likely to harm than not.

It’s not going to be OK.

As someone who, substance-wise, has been there, done that; who founded and operates multiple Twin Cities substance abuse recovery programs; who as a clinical therapist and interventionist has helped more than 1,000 families steer their loved ones into treatment, I sound this ominous note from too much hard experience. Plenty of research (linked throughout) backs up that this isn’t just me being a naysayer—research that stands to become reality in Minnesota after recreational marijuana becomes legal August 1, 2023. Legalization sends the message, particularly to those most at risk—youth—that marijuana is safe enough to be legal just like alcohol and nicotine, never mind that those substances are ineffectively subject to the same age 21 limitation and are addiction mainstays. For many—especially, again, our youth—the state’s medical marijuana preestablished a luster around marijuana that, if it’s helpful and good for some, it’s helpful and good for anyone experiencing any pain or discomfort. Look where medical endorsement of opioids as painkillers led us. Apples to oranges? The point is people don’t ask questions when they’re seeking relief.

Promoting marijuana as a means of self-medication or, worse, a casual, “recreational” plaything will be extremely harmful to our community, and by “community” I don’t just mean the recovery community.

Here’s what I anticipate is coming and what we can do about it:

Increased marijuana use
“Why not? It’s legal!”Research in the Journal of the American Medical Association’s (JAMA’s) psychiatry publication showed that legalizing recreational marijuana in the U.S. has led to increases in cannabis use disorder in both adults and respondents ages 12 to 17 years, despite the legal age for use being 21. This early reliance sets the stage for marijuana-related mental health and substance use disorders.

Addiction and dependence
Although marijuana isn’t considered as physically addictive as, say, opioids, many individuals develop a psychological dependence on it. Some of the most horrifying cases I’ve faced professionally were those who classified as “chronic marijuana users.” If it alters your mood, it’s addictive, period. Research in Drug and Alcohol Dependence, an international journal on biomedical and psychosocial approaches, examined medical marijuana laws across the country and found that legalization increased dependence and addiction by almost 4 percent: a relatively significant jump, given the total population. Marijuana users are also more likely to consume alcohol compared to non-users, according to research published in the National Institute of Health’s National Library of Medicine.

Mental health impact
Marijuana use has been associated with an increased risk of mental health issues, particularly in vulnerable individuals. These conditions include 1) anxiety disorders, 2) depression, 3) psychosis and 4) an increased risk in predisposed individuals of developing schizophrenia. I’ve seen countless teens and young adults become psychotic from marijuana use. Worse is when they become isolated, paranoid and unable to function at a standard level. Preteens, teens and young adults don’t cognitively process risk and reward the way adults do, plus they’re more prone to experiment if substances are easy to come by and don’t have legal consequences. Trauma (known or repressed) survivors of all ages as well as individuals with existing anxiety disorders tend to become more symptomatic with marijuana use, opening the floodgates to ever-worsening conditions.

Impaired cognitive functioning
Heavy, prolonged marijuana use, especially during adolescence (defined as ages 10 through 24) when the brain is still developing, has been linked to cognitive impairments the likes of reduced intelligence, memory deficits (Lisdahl et al., 2012)and decreased attention span. Such diminishment can affect educational and occupational outcomes and may require interventions to support affected individuals. In my practice, I notice that many of the students and young adults who already struggle with academics/work demands, anxiety or low self-esteem appear to begin using marijuana to cope with these issues, only to discover that marijuana make them worse, which then causes more challenges: dependence, mental health problems and hopelessness.

Professional preparedness
Not only will legalization likely increase demand for mental health services and treatment, substance use disorder recovery programs will have to adapt their approaches and develop specialized programming. Marijuana users argue that its effects and impacts aren’t as harmful as stronger substances such as cocaine and heroin. Less lethal or not, it’s all relative when it comes to treating addiction, which is less about the drug’s strength than who can function or not function while using. Many of those in treatment for more harmful substances will agree to discontinue the bad stuff but continue to use the more widely accepted and now- legal marijuana. This will trigger an increase in relapse, which typically leads a person back to their substance of choice (the more lethal one). As it stands currently, marijuana is illegal and counselors are able to point to the fact that using illegal substances is highly discouraged and risky for continued sobriety. Counselors can certainly still point out that marijuana is a dangerous substance for those in recovery. Addiction, however, is an illness of justification, one that uses any angle possible to justify a return to use.

Concern about readiness to deal with more marijuana-related health issues isn’t limited to those of us who treat substance use disorder. It applies to physical health, too: Take organ transplants as Exhibit A. And it very much applies, as touched upon above, to mental health. The American Counseling Association has issued guidelines around the mixed messaging, i.e., marijuana may be legal in Minnesota but is still classified as a controlled substance federally. The Minnesota Psychiatry Society issued a statement not supporting legalization. And now?

As a professional at the nexus of the above considerations, I’m grateful that the consequences of marijuana legalization are still being studied; however, we’ve already crossed into a dangerous area: The Minnesota law is passed. Only with candid, widespread public education can its impacts defy the existing research.

To be totally transparent, I’m scared.
I’m scared for our children, teens and high schoolers who’ll gravitate toward trying a drug they never thought they would.

I’m scared for the kid—the adult! —who’s depressed and withdrawn and who, instead of considering a true antidepressant medication or natural coping strategies, will use marijuana to address their issue.

I’m scared for addiction and mental health professionals. We’ll be on the receiving end of a massive influx in hospitalizations, people seeking treatment, high rates of relapse and substantially worsening mental health symptoms—this on the heels of COVID, during which we’ve seen a surge in mental health needs and massive spike in addiction. We simply are not prepared for this never-seen-before phase into which we’re being pushed.

The call now—and it’s a loud, urgent one—is for education, be it parents to their kids, teachers to their students, friends to their friends, counselors to their clients, doctors to their patients, recovery professionals to everyone who’ll listen: Marijuana may be legal, but it’s not without substantial risk.

Drug Legalization

Colorado marijuana industry experiencing ‘largest downturn that we’ve ever seen’

12/28/2022 admin Leave a comment

https://www.9news.com/article/money/colorado-marijuana-industry-experiencing-largest-downturn-ever-seen/73-dc6706ff-19ff-40dd-bcb4-5ff41cc7ca64

Many factors are leading to a decrease in revenue for an industry that’s only a decade old, and it’s threatening the funding of public projects.

Author: Marc Sallinger (9 News)

Published: 7:54 PM MST November 30, 2022

Updated: 10:32 AM MST December 5, 2022

DENVER — Colorado’s marijuana industry knows what it’s like to feel the high, but now the buzz is wearing off. Marijuana sales have declined for more than a year in the state, threatening public programs funded by the tax revenue the sales produce.

In an industry that’s built on getting high, marijuana sales are now seeing record lows.

“Right now, the Colorado marijuana industry is going through the largest downturn that we’ve ever seen,” said Truman Bradley, executive director of the Wheat Ridge-based Marijuana Industry Group. “Our industry is going through big time layoffs. Thousands of people have lost their jobs and small business owners are going under. Unfortunately, I expect that to continue into the coming year.”

So why is this all happening now? It starts with supply and demand. When everyone was sent home in 2020, let’s just say there wasn’t much to do. That resulted in a big spike in marijuana sales during the pandemic. Now that people aren’t stuck at home, they aren’t buying as much weed.

“The medical market is down about 47% statewide and the recreational market is down about 20%. Those are huge, huge, numbers,” Bradley said. “To put that into perspective, that means there is a hundred million dollars less in marijuana tax revenue than there was a year ago. What that means is critical programs that are funded by marijuana tax revenue are at risk.”

But that’s just one problem.

In Colorado, the wholesale price of marijuana is at a record low. Today, it costs $658 per pound. That’s half the price compared with this time last year, when it was selling for $1,316.

“The price of marijuana is at the lowest since the recreational marijuana was legalized in Colorado,” said Alex Padilla, professor and chair of economics at Metropolitan State University of Denver. “I believe that the decrease in price is a result of the increase of supply of marijuana.”

Revenue is also down. In September of 2022, stores made nearly $147 million ($146,880,577) worth of marijuana sales. That’s down from more than $181 million ($181,130,791) in September of 2021 and $206 million ($206,488,268) in the same month of 2020.

“What that means is when the state’s joint budget committee gets together this year to look at marijuana tax revenue, they’re going to be looking at a $100 million shortfall of marijuana tax money,” Bradley said.

Inflation is yet another potential cause for the downturn.

“With the increase in inflation, people are going to have to make choices,” Padilla said. “If we haven’t seen an increase in wages corresponding to an increase in inflation, people are going to have to make sacrifices.”

When people buy less weed, schools see less money.

Andy Stine is the director of capital construction with the Colorado Department of Education. Last fiscal year, the department’s Building Excellent Schools Today program, or BEST, took in $97 million in marijuana tax money to fund grants for school construction and renovation.

“Marijuana revenue excise tax is a large portion of the revenue that comes into the program,” Stine said.

The amount of money it brings in from marijuana tax revenue will likely go down this year.

“We would have to decrease the amount of grants that we are able to offer in the next fiscal year,” Stine said.

Marijuana tax revenue funds about 100 different programs around the state. Last year Colorado collected a record $423 million in taxes from cannabis. Programs like BEST have several revenue streams funding them, but if they get less money from marijuana taxes, they won’t be able to fund all the grants.

Drug Legalization

CDC Health advisory

09/14/2021 admin Leave a comment

Increases in Availability of Cannabis Products Containing Delta-8 THC and Reported Cases of Adverse Events

Distributed via the CDC Health Alert Network
September 14, 2021, 10:00 AM ET
CDCHAN-00451

Summary
The purpose of this Health Alert Network (HAN) Health Advisory is to alert public health departments, healthcare professionals, first responders, poison control centers, laboratories, and the public to the increased availability of cannabis products containing delta-8 tetrahydrocannabinol (THC) and the potential for adverse events due to insufficient labeling of products containing THC and cannabidiol (CBD).
Background
Marijuana, which can also be called weed, pot, or dope, refers to all parts of the plant Cannabis sativa L., including flower, seeds, and extracts with more than 0.3% delta-9 tetrahydrocannabinol (THC) by dry weight. Any part of the cannabis plant containing 0.3% or less THC by dry weight is defined as hemp.1 The cannabis plant contains more than 100 cannabinoids, including THC, which is psychoactive (i.e., impairing or mind-altering) and causes a “high”.2 CBD is another active cannabinoid found in the cannabis plant that is not psychoactive and does not cause a “high”.
The term THC most often refers to the delta-9 THC isomer, which is the most prominently occurring THC isomer in cannabis. However, THC has several other isomers that occur in the cannabis plant, including delta-8 THC. Delta-8 THC exists naturally in the cannabis plant in only small quantities and is estimated to be about 50-75% as psychoactive as delta-9 THC.3,4 CBD can be synthetically converted into delta-8 THC, as well as delta-9 THC and other THC isomers, with a solvent, acid, and heat to produce higher concentrations of delta-8 THC than those found naturally in the cannabis plant.5 This conversion process, used to produce some marketed products, may create harmful by-products that presently are not well-characterized.
Delta-8 THC products are increasingly appearing in both marijuana and hemp marketplaces, some of which operate legally under state, territorial, or tribal laws.6 Most states and territories permit full or restricted hemp marketplaces that sell hemp and hemp-derived CBD products.7 Products sold as concentrated delta-8 THC are also available online. Delta-8 THC products are sometimes marketed as “weed light” or “diet weed.”
The health effects of delta-8 THC have not yet been researched extensively and are not well-understood. However, delta-8 THC is psychoactive and may have similar risks of impairment as delta-9 THC.4 As such, products that contain delta-8 THC but are labeled with only delta-9 THC content rather than with total THC content likely underestimate the psychoactive potential of these products for consumers. In addition, the sale of delta-8 THC products is not limited to regulated marijuana dispensaries in states, territories, or tribal nations where marketplaces operate under law. Rather, delta-8 THC products are sold by a wide range of businesses that sell hemp. As a result, delta-8 THC products may also have the potential to be confused with hemp or CBD products that are not intoxicating. Consumers who use these products may therefore experience unexpected or increased THC intoxication.
A wide variety of delta-8 THC-containing products have entered the marketplace, including, but not limited to, vapes, smokable hemp sprayed with delta-8 THC extract, distillates, tinctures, gummies,
chocolates, and infused beverages. In addition, because testing methods for products like synthetically derived delta-8 THC are still being developed, delta-8 THC products may not be tested systematically for contaminants such as heavy metals, solvents, or pesticides that may have adverse health effects.8
Recent increases in delta-8 THC-involved adverse events
In March 2021, the West Virginia Poison Control Center9 reported two cases of adverse events related to use of delta-8 THC products in adults. In both instances, individuals mistook the products containing delta-8 THC for CBD-like products. These exposures led to symptoms consistent with cannabis intoxication. The Michigan Poison Control Center10 also reported two cases of severe adverse events to delta-8 THC in two children who ingested a parent’s delta-8 THC-infused gummies purchased from a vape shop. Both children experienced deep sedation and slowed breathing with initial increased heart rate progressing to slowed heart rate and decreased blood pressure. The children were admitted to the intensive care unit for further monitoring and oxygen supplementation.
In 2021, The American Association of Poison Control Centers (AAPCC) introduced a product code specific to delta-8 THC into its National Poison Data System (NPDS), allowing for the monitoring of delta-8 THC adverse events*. From January 1 to July 31, 2021, 660 delta-8 THC exposures were recorded with the new product code, and one additional case was recoded as a delta-8 THC exposure from October 2020. Eighteen percent of exposures (119 of 661 cases) required hospitalization, and 39% (258 of 661 cases) involved pediatric patients less than 18 years of age.
Syndromic surveillance data from emergency departments participating in the CDC’s National Syndromic Surveillance Program (NSSP) show an increase in visits with a mention of delta-8 THC or some variation in the chief complaint text in recent months. More than 4,400 active emergency facilities that represent portions of 49 states and Washington, DC contribute data to NSSP, accounting for approximately 71% of all U.S. non-federal emergency departments. The first suspected visit associated with delta-8 THC in NSSP was observed in September 2020, with three additional visits observed through the end of 2020. Suspected visits have generally increased monthly in 2021 (three suspected visits were observed in January; six in February; 16 in March; 11 in April; 29 in May; 32 in June; and 48 in July 2021). The majority of these visits (73%, 109 of 149 visits) occurred in the Department of Health and Human Services’ Regions 4 and 6, which are composed primarily of Southern states that have not passed state laws to allow non-medical adult cannabis use.11 These numbers are likely an underestimate due to the potential for inaccurate and incomplete information about products used by consumers.
Several factors can influence both the type and severity of cannabis-related adverse events, including the type of cannabinoid ingested, concentration, route of exposure, and the individual characteristics of the person who consumed the cannabinoid such as their age, weight, and sex. Delta-8 THC intoxication can cause adverse effects similar to those observed during delta-9 THC intoxication10,12, and may include—
•Lethargy
•Uncoordinated movements and decreased psychomotor activity
•Slurred speech
•Increased heart rate progressing to slowed heart rate
•Low blood pressure
•Difficulty breathing
•Sedation
•Coma

Summary
The rise in delta-8 THC products in marijuana and hemp marketplaces has increased the availability of psychoactive cannabis products, even in states, territories, and tribal nations where non-medical adult cannabis use is not permitted under law. Variations in product content, manufacturing practices, labeling, and potential misunderstanding of the psychoactive properties of delta-8 THC may lead to unexpected effects among consumers. Adverse event reports involving products that contain delta-8 THC that resulted in consumers’ hospital or emergency department treatment have been described. Increased
reports of adverse events related to delta-8 THC, as well as preliminary reports of the emergence of other similarly produced products derived from cannabis warrant the continued monitoring and tracking of adverse events related to THC.
Recommendations for the Public and Consumers
•Consumers should be aware of possible limitations in the labeling of products containing THC and CBD even from approved marijuana and hemp retailers. Products reporting only delta-9 THC concentration, but not total THC may underestimate the psychoactive potential for consumers.
•Consumers should be aware that products labeled as hemp or CBD may contain delta-8 THC, and that products containing delta-8 THC can result in psychoactive effects. Delta-8 THC products are currently being sold in many states, territories, and tribal nations where non-medical adult cannabis use is not permitted by law. In addition, retailers may sell products outside of regulated dispensaries in states, territories, and tribal nations where cannabis use is permitted by law. This may provide consumers with a false sense of safety, as delta-8 THC products may be labeled as hemp or CBD, which consumers may not associate with psychoactive ingredients.
•Parents who consume edibles and other products that contain THC and CBD should store them safely away from children. Children may mistake some edibles that contain THC and CBD (e.g., fruit-flavored gummies containing delta-8 THC) as candy.
•If consumers experience adverse effects of THC- or CBD-containing products that are an immediate danger to their health, they should call their local or regional poison control center at 1-800-222-1222 or 911 or seek medical attention at their local emergency room and report the ingredients of ingested products to healthcare providers. Consumers are also encouraged to report adverse events to MedWatch.
•Consumers should be aware that the cannabis marketplace continues to evolve. Other cannabis-derived products of potential concern have emerged recently, such as those containing delta-10 THC and THC-O acetate. More research is needed to understand the health effects of products containing these compounds.
Recommendations for Public Health Departments and Poison Control Centers, including those in locations where laws only permit hemp marketplaces
•Release information to healthcare providers and the public about the psychoactive qualities andthe potential health implications of using products containing delta-8 THC and that productslabeled as hemp or CBD may contain delta-8 THC.
•Poison control centers have a new code available to identify delta-8 THC exposures. For patientsor providers reporting delta-8 THC consumption, poison control centers should use the AmericanAssociation of Poison Control Centers code 310146 or product code 8297130 to indicate delta-8THC exposure and aid in the continued surveillance of these exposures.
•States, territories, and tribal nations that have passed laws allowing non-medical use of adultcannabis or that may allow such use in the future may consider requiring the reporting of totalTHC content, including ingredients like delta-8 THC and other compounds that may besynthetically produced, on product labeling.
•Community-based organizations, such as Drug-Free Communities coalitions, can use informationfrom this report to raise awareness in their communities about the potential negative healtheffects associated with use of delta-8 THC-containing products, as well as the emergence ofother cannabis-derived products of potential concern.
Recommendations for Retailers Selling Cannabis Products
•Retailers selling cannabis products should provide information to consumers about thepsychoactive qualities of delta-8 THC.
•Retailers selling cannabis products should report total THC content on product labeling, includingingredients like delta-8 THC that may be synthetically produced to create a psychoactive effect.
Recommendations for Healthcare Providers
• Healthcare providers should be vigilant in observing patients presenting with THC-like intoxication symptoms who do not report an exposure to marijuana or history of use. Symptomatic patients should be questioned about their use of CBD or delta-8 THC products.
• There is no specific antidote for THC intoxication. Treatment is largely symptomatic and supportive care. The ability to detect delta-8 THC with laboratory tests that hospitals use to detect delta-9 THC currently is not fully characterized. Consult with your hospital’s medical toxicologist or local poison control center for toxicology consultations on treatment.

For More Information
• CDC Marijuana homepage: “Marijuana and Public Health”
• FDA Delta-8 THC Consumer Update: “5 Things to Know about Delta-8 Tetrahydrocannabinol”
• Visit CDC-INFO or call CDC-INFO at 1-800-232-4636
• CDC 24/7 Emergency Operations Center (EOC) 770-488-7100

References

1. Agriculture Improvement Act of 2018. H.R.2, 115th Cong. (2017-2018).

Rosenberg EC, Tsien RW, Whalley BJ, Devinsky O. Cannabinoids and epilepsy. Neurotherapeutics, 12 (2015), pp. 747-768.
Razdan RK. CHEMISTRY AND STRUCTURE-ACTIVITY RELATIONSHIPS OF CANNABINOIDS: AN OVERVIEW, Editor(s): STIG AGURELL, WILLIAM L. DEWEY, ROBERT E. WILLETTE, The Cannabinoids: Chemical, Pharmacologic, and Therapeutic Aspects, Academic Press, 1984, Pages 63-78. 4. Hollister LE, Gillespie HK. Delta-8- and delta-9-tetrahydrocannabinol comparison in man by oral and intravenous administration. Clin Pharmacol Ther. 1973 May-Jun;14(3):353-7
Kiselak TD, Koerber R, Verbeck GF. Synthetic route of sourcing of illicit at home cannabidiol (CBD) isomerization to psychoactive cannabinoids using ion mobility-coupled-LC-MS/MS. Forensic Sci Int 2020; 308:110173.
Brightfield Group. What’s the Fate of Delta-8? Consumer, Product, and Regulatory Trends. Published 2021. Accessed August 31, 2021.
National Conference of State Legislatures (2020, April 16). State Industrial Hemp Statutes.
Delta-8-THC, HB 3000, 2021 Oregon State Legislature Regular Session. Testimony of Steven Crowley.
West Virginia Substance Abuse Early Warning Network. Alert #WV003. Reported Cases of Adverse Reactions to Delta-8 THC Products in West Virginia. March 10, 2021.
Michigan Poison Center. Fact Sheet: Emerging Public Health Concern: Delta-8 THC. April 23, 2021.
National Conference of State Legislatures (2021, July 14). State Medical Marijuana Laws. 12. Grotenhermen F. Pharmacokinetics and pharmacodynamics of cannabinoids. Clin Pharmacokinet.2003;42(4):327-60.

The American Association of Poison Control Centers (AAPCC) maintains the National Poison Data System (NPDS), which houses de-identified case records of self-reported information collected from callers during exposure management and poison information calls managed by the country’s poison control centers (PCCs). NPDS data do not reflect the entire universe of exposures to a particular substance as additional exposures may go unreported to PCCs; accordingly, NPDS data should not be construed to represent the complete incidence of U.S. exposures to any substance(s). Exposures do not necessarily represent a poisoning or overdose and AAPCC is not able to completely verify the accuracy of every report. Findings based on NPDS data do not necessarily reflect the opinions of AAPCC.
The Centers for Disease Control and Prevention (CDC) protects people’s health and safety by preventing and controlling diseases and injuries; enhances health decisions by providing credible information on critical health issues; and promotes healthy living through strong partnerships with local, national, and international organizations.

Categories of Health Alert Network messages:
Health Alert Requires immediate action or attention, highest level of importance
Health Advisory May not require immediate action; provides important information for a specific incident or situation
Health Update Unlikely to require immediate action; provides updated information regarding an incident or situation
HAN Info Service Does not require immediate action; provides general public health information

This message was distributed to state and local health officers, state and local epidemiologists, state and local laboratory directors, public information officers, HAN coordinators, and clinician organizations

Drug Information, Drug Legalization

New HHS Data Shows Significant Youth Drug Use Increases in Legalized States

12/21/2020 admin 1 Comment

(Alexandria, VA) – Today, state-level data from the National Survey on Drug Use and Health, the most authoritative study on drug use conducted by the Substance Abuse and Mental Health Administration (SAMHSA), found significant increases in youth marijuana use in several recently legalized marijuana states versus last year. At the same time, mental illness indicators worsened across the country while alcohol, cocaine, and tobacco use dropped, especially among young people. “Once again, marijuana is the stubborn outlier – the only drug significantly going up in several areas across the country and across several different age groups,” said Dr. Kevin Sabet, president of Smart Approaches to Marijuana (SAM) and a former senior drug policy advisor to the Obama Administration. “Weed normalization and commercialization has consequences, and unfortunately we are being hit hard while for-profit pot companies continue to enrich themselves.” According to the data, adolescents aged 12-17 using marijuana in the past year significantly increased versus last year in the legalized states of Nevada, Oregon, and California. All other legal states showed increases as well, but versus last year they did not reach statistical levels of significance. There were large increases not witnessed in non-legal states: Nevada experienced a 17.4% increase, while Oregon and California witnessed increases of 15.4 percent and 14.5 percent, respectively.

The data additionally show a statistically significant, 25.5 percent increase in past-month use in California among those aged 12-17.

The data also show us that youth use in states that have “legalized” marijuana far outstrips use in states that have not. Past-month marijuana use among young people aged 12-17 in “legal” states is 54.5 percent higher than past-month marijuana use among 12-17-year-olds in “non-legal” states (10% versus 6.47%). Past-year marijuana use among this age group in “legal” states is 41 percent higher than that of 12-17-year-olds in “non-legal” states (17.12% versus 12.14%).

Finally, the data also show that Washington D.C. has catapulted to the top of the list for youth first-time use, closely followed by Vermont. This is concerning given that Vermont’s legislature just recently passed a bill allowing for commercial sales. Maine and Nevada also witnessed statistically significant increases in this metric as well.Versus ten years ago, legal Vermont, DC, and Maine show significant increases in past month adolescent use, while non-legal states levels are flat across the U.S. as a whole. Use among young adults aged 18-25 skyrocketed, especially in legal states. In non-legal Virginia and New York, adolescent past year marijuana use significantly fell, as it did in the non-legal Southern region of the United States.At the same time, mental health indicators, including major depressive episodes, suicidal thoughts, and serious mental illness have worsened.”Today’s data further cements the need to hit pause on the rush to expand the commercialization of marijuana,” said Sabet. “We call on state lawmakers across the nation to halt all efforts to legalize marijuana and we urge Congress to pass a bill to streamline the process for research on the potential health & safety impacts of marijuana. With the year over year increases in use, we cannot afford to continue this misguided approach to drug policy – an approach that puts profits over our youth.”###
About SAM:
Smart Approaches to Marijuana (SAM) is the nation’s leading nonpartisan, non-profit public health alliance of concerned citizens and professionals who oppose marijuana legalization and support science-backed marijuana policies. SAM and its 30+ state affiliates have successfully prevented marijuana legalization in dozens of state legislatures and at the ballot box.
For more information about marijuana use and its effects, visit www.learnaboutsam.org

Drug Legalization

Not good for minnesota

03/13/2020 admin Leave a comment

Editor’s Note: The following position paper opposing the legalization of recreational marijuana was written by Dakota County Attorney James C. Backstrom and Dakota County Sheriff Tim Leslie.

MSANI opposes the legalization of recreational marijuana in Minnesota as do the Minnesota Sheriffs Association, the Chiefs of Police Association, the Minnesota Police and Peace Officers Association and the Minnesota County Attorneys Association.

By James C. Backstrom and Tim Leslie

Legalizing the recreational use of marijuana would not be good for Minnesota.

Restricting marijuana use to just those ages 21 or older will not keep underage youth safe. In fact, one in four 12th-graders report that they would try marijuana, or that their use would increase, if the drug were legalized.

Chemical addiction and illegal drug use are the largest contributor to crime. The proponents of legalization don’t want to acknowledge that marijuana is an addictive substance. Unfortunately, most people in America are unaware of this, but it is a fact that cannot be ignored. The marijuana available today is much more potent (and consequently more addictive) than the marijuana smoked in the 1960s.

Marijuana can directly worsen symptoms of anxiety, depression, and schizophrenia. A recent marijuana study has also linked its use to higher risk of stroke and heart failure.

Marijuana is a gateway drug for many to the use of other illegal drugs… methamphetamine, heroin and cocaine. Studies have confirmed that the use of marijuana lowers inhibitions about drug use and exposes users to a culture that encourages the use of other illegal drugs.

While some initial studies in the scientific literature concluded that marijuana legalization reduces opioid use, subsequent studies have exposed flaws in those prior studies debunking these findings. These more recent reports in fact show the opposite trend… that recreational marijuana will increase opioid abuse.

America’s prisons are NOT filled with low-level, nonviolent marijuana users. Pro-marijuana advocates have spread this misinformation, but that is a fallacy. The actual statistics are:

Less than half of one percent of individuals in Minnesota prisons are there for a marijuana offense – and 70 percent of those individuals had prior felony convictions.

The reality is that you don’t go to prison for a marijuana offense unless you are in possession of or dealing large quantities of this controlled substance.

Many prosecutors regularly refer non-violent drug offenders to drug courts and diversion programs for low-level drugs, allowing them to obtain dismissals of their criminal charge if they complete treatment, attend counseling and stay sober. These types of common-sense efforts are designed to keep drug offenders out of jail and prison and help address their drug addictions, which are destroying their lives and adversely impacting public safety.

Lowering the criminal penalties for marijuana use is a completely different topic from legalization of this substance. The Minnesota Legislature reduced criminal penalties for low-level drug offenders, including marijuana users, four years ago.

Legalization would not reduce the burden of the criminal justice system, nor would it curb drug-related violence.

It is a complete fallacy to believe that legalizing marijuana will eliminate black market sales of this controlled substance by drug dealers and cartels. Black market activity has increased, not decreased, in states where recreational use of marijuana is legal. Black market sales of marijuana in Colorado have never been higher. Highway seizures of illegal marijuana in that state have increased by 39 percent since recreational marijuana was legalized.

One of the most serious and fastest growing crime problems in states that have legalized marijuana use is vehicle crashes. Since recreational marijuana was legalized in Colorado in 2013, marijuana-related traffic deaths have increased 151 percent — an increase of 83 traffic deaths every year. And the number of persons seriously injured in marijuana-related crashes far exceeds that number.

In the state of Washington, drivers involved in fatal car crashes who tested positive for marijuana doubled in the five-year period after legalization. One in five drivers involved in fatal car crashes in 2017 tested positive for marijuana. Recent research study shows that frequent marijuana users are dangerous drivers even when sober. Legalization of marijuana in Minnesota will result in more traffic deaths and injuries than occur from impaired driving today.

Commercializing marijuana increases public health and public safety costs beyond any economic tax benefits projected to be gained from legalization of the substance. The negative social and health costs of marijuana use far outweigh any anticipated tax revenues from commercialization. For every dollar gained in tax revenue from legalized sales of marijuana in Colorado, it is estimated that over $4.50 was spent to mitigate the social costs of legalization.

Legalizing marijuana in Minnesota would likely increase its use among teens, lead to more addiction, cause more traffic deaths and injuries, lead to more mental health problems, and increase the use of other illegal drugs.

We should not be legalizing this dangerous and addictive substance and encouraging more people to use it.

Drug Legalization

Ten Talking Points about the Cannabis Debate

01/23/2020 admin Leave a comment

SAM MN (OCTOBER 2019)

1. Cannabis is NOT a safe drug.
a. Cannabis is NOT a harmless drug; the part of the plant that gets you high, THC, is addictive (between 9% to 30% may develop a cannabis use disorder), and the THC potency these days is much stronger than in the past.
b. THC contributes to many health problems (e.g., mental illness, learning and memory impairment and impaired driving)
c. We have enough problems already with the two legal “recreational” drugs (nicotine and alcohol); adding a third legal intoxicant is a bad idea.

2. Cannabis may or may not be a medicine that helps Vets (or non-Vets).
a. It is too early to say if the marijuana plant is effective medicine in treating pain or PTSD, although there are many studies underway.
b. Current research showed insufficient evidence to draw conclusions about the benefits and harms. One study showed it was significantly associated with worse outcomes for PTSD.
c. Smoking marijuana is not medicine. d. MN has a medical marijuana program that could be improved. We do not need to commercialize it to improve this program.

3. Marijuana does not replace opioids for pain
a. February 1, 2019 study showed low strength evidence that marijuana alleviated neuropathic pain and that marijuana as an efficacious treatment for opioid use was even weaker.
b. New study reverses finding of 2014 study and found an increase of 23% in opioid deaths

4. The state will not benefit from sizeable tax revenues.
a. Commercialization backers rarely discuss the costs associated with widespread use of the drug on health care, mental health services, law enforcement, businesses and consumers.
i. Estimated health and social costs per dollar of tax revenue
1. Alcohol $13
2. Tobacco $9
3. Estimated marijuana $4.5
b. California’s pot-related tax revenue missed projections by more than 50 percent, and the former governor of Colorado has said tax revenue from pot won’t solve fiscal challenges faced by states and municipalities.

5. Adolescent use will likely increase because the minimum legal age will be 21.
a. The US Surgeon General just stated “No amount of marijuana use during pregnancy or adolescence is known to be safe.”
b. Recent data indicate an overall higher rate of underage cannabis use in commercial cannabis states vs non-commercial cannabis states.
c. If history is informative, the rate of drug use by adolescents eventually increases if that drug becomes more accessible.
d. How is the minimum legal age of 21 for alcohol working?

6. Cannabis users have been unjustly punished by law enforcement.
a. Commercializing cannabis has not resolved social injustice issues. African Americans are twice as likely to be arrested for marijuana in commercialization states of Colorado and Washington. Denver: cannabis stores are clustered in minority neighborhoods, similar to liquor stores in low income areas.
b. Minnesota: Possession of less than 1 ½ ounces is a petty misdemeanor.
c. A very small percent of Minnesotans are incarcerated for cannabis use, and many of those had prior felony convictions.
d. We support decriminalization not commercialization

7. The black Market will not be eliminated.
a. The opposite is occurring in legalization states. In 2018 CA grew 15 million pounds of pot but only sold 2.5 million.
b. The black market is expanding as they undercut the retail price.

8. Cannabis is not commonly used.
a. Most Minnesotans older than 25 do not use cannabis (~11% report prior year use); the majority of users are in the 18-25year-old range (~37% report prior year use).
b. These MN rates are similar to the national average.

9. Legalization is not necessarily inevitable.
a. 10 states in the past two years have applied the brakes to full legalization efforts (CT, FL, MN, ND, NH, NJ, NM, NY, WI, VT).
b. What does legalization mean? When poll questions are properly asked, only about one-third of Americans favor full, commercial legalization.

10. Prohibition was not a failed policy.
a. Governments legislate all kinds of “prohibitions” in the name of public health and public safety and they work (e.g., indoor smoking restrictions)
b. The prohibition on alcohol decreased liver disease, domestic abuse and public drunkenness
c. We have enough problems with the two legal recreational drugs – nicotine and alcohol. We do not need another one added to the legal list. d. Should we lift the prohibition on all illicit drugs?

References

www.nationalacademies.org/cannabishealtheffects
Volkow, N. D., Swanson, J. M., Evins, A. E., DeLisi, L. E., Meier, M. H., Gonzalez, R., … & Baler, R. (2016). Effects of cannabis use on human behavior, including cognition, motivation, and psychosis: A review. JAMA Psychiatry, 73(3), 292-297.
https://www.ncbi.nlm.nih.gov/pubmed/28806794
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6258013/
https://www.pnas.org/content/116/26/12624
https://learnaboutsam.org
https://learnaboutsam.org Costs
http://alcohol-psr.changelabsolutions.org/alcohol-psr-faqs/alcohol-taxes-faq/alcohol-tax-revenues-social-and-health-costsgovernment-expenditures/#sec3q7
https://www.sciencedaily.com/releases/2014/12/141210121403.htm and https://www.cdc.gov/tobacco/data_statistics/fact_sheets/economics/econ_facts/index.htm
https://learnaboutsam.org/new-report-cost-of-marijuana-legalization-far-outweighs-tax-revenues/
https://www.hhs.gov/surgeongeneral/reports-and-publications/addiction-and-substance-misuse/advisory-on-marijuana-use-anddeveloping-brain/index.html
National Survey of Drug Use and Health. (2017). https://www.samhsa.gov/data/nsduh/reports-detailed-tables2017-NSDUH
https://www.mjfactcheck.org/potency
https://learnaboutsam.org Lessons Learned Social Justice
MN Department of Corrections Fact Sheet: Drug Offenders in Prisons, 2018
https://learnaboutsam.org Lessons Learned Black Market
National Survey of Drug Use and Health. (2017). https://www.samhsa.gov/data/nsduh/reports-detailed-tables2017-NSDUH 18 https://learnaboutsam.org/wp-content/uploads/2019/02/ECP_SAM_National_Poll_20190218-2.pdf