Tag: recreational marijuana

10/10/23

Goodblend is Closing Its Dispensaries in PA

Medical marijuana customers in Pennsylvania received some disappointing news when Goodblend PA, a subsidiary of Parallel Cannabis, announced the company was closing its operations in the state in order to serve “patients” in other more established markets. The Northside feed and grow operation is scheduled to close by September 15th 2023 and the dispensaries, located in Erie and on Baum Boulevard in Pittsburgh will close sometime in October. A planned dispensary in Cranberry Township will never open. Trib Live reported the company said in an emailed statement, “In connection with a strategic review, we have made the decision to withdraw from the Pennsylvania market in order to serve patients in our other, more established markets.” That could be good news for PA cannabis users in the long run.

Medical marijuana was legalized in Pennsylvania is 2016 and dispensaries began to open in the state in 2018. According to the National Conference of State Legislators, as of April 24, 2023, 38 states have legalized cannabis products for medical use, and 22 states have legalized the recreational use of marijuana. But so far PA has resisted the pressure to join the 22 states who legalized recreational marijuana. I’d encourage the Commonwealth to continue to hold out while research related to the potential problems associated with marijuana use is completed and published.

In PREPARING to Legalize Cannabis, I reviewed two recent studies. One suggested cannabis use had strong associations with adverse mental health and life outcomes in teens. Another one added to the growing evidence of a causal association between cannabis use disorder (CUD) and schizophrenia that was said to be “almost certain.” Now a study published on August 29, 2023, in The Journal of the American Medical Association Network Open, by Lapham et al, found that CUD was commonly found among primary care patients in Washington State. Washington legalized recreational marijuana in 2012.

The New York Times reported that 21 percent of people in the Lapham et al study had some degree of a CUD. These findings were similar to previous research by Leung et al. They quantified the prevalence and risk of CUD as cannabis abuse (CA) or cannabis dependence (CD). Among people who used cannabis, 22% have CUD; 13% have CA (8-18%) and 13% (10-15%) have CD. The risk of developing cannabis dependence increased to 33% (22-44%) among young people who use marijuana weekly or daily.

Cannabis users need to be informed about the risks of developing CUDs and the higher risks among those who initiate early and use frequently during adolescence. Future studies are needed to examine how changes in cannabis policies may affect the risks of CUDs in the population.

The Lapham et al study in Washington State was conducted with data from Kaiser Permanente, a large health system in Washington. 5,000 patients 18 years and older were randomly selected from 108,950 eligible patients with a record of completing a cannabis screen as part of their routine primary care. They were categorized by their stated reason for using cannabis during the past 30 days: medical use only, nonmedical use only, or both. DSM-5 symptoms for CUD were used to assess severity, with 2-3 symptoms = mild, 4-5 symptoms = moderate, and 6-11 = severe.

Patients were asked about all modes of cannabis use as well as the primary mode, including inhalation (ie, smoke, vape, dab), ingestion (ie, eat, drink), application (ie, lotion, ointment), or other modes. Questions also included the frequency of past-year use and typical number of days per week and times per day of cannabis use.

Among cannabis users, 42.4% reported medical use only; 25.1% reported nonmedical use only; and 32.5% reported both recreational and medical use. The prevalence of CUD was 21.3% and interestingly did not differ depending of their reasons for use (i.e., medical use only). The most prevalent CUD symptoms for all groups were tolerance, uncontrolled escalation of use and craving. Patients with nonmedical use only or both reasons for use were more likely to report “withdrawal, use in hazardous situations, continued use despite consequences, time spent on use, interference with obligations, and activities given up.” Patients who reported any nonmedical use were at the greatest risk of moderate to severe CUD, with the lowest risk was among patients reporting medical use only. Lapham et al concluded:

In this study, CUD was common (21%) among primary care patients who use cannabis in a state with legal recreational use, with patients using for nonmedical reasons most at risk of moderate to severe CUD. As legal recreational cannabis use among adults continues to increase across the US, the results here underscore the importance of assessing patient cannabis use and CUD symptoms in medical settings.

So, as legal recreational marijuana use increases across the US, there is a corresponding call to assess people’s cannabis use and symptoms of CUD into standard medical care and practice. Research is also coalescing around a causative connection between using marijuana and schizophrenia. Teenaged use of marijuana leads to future adverse health and life outcomes. But there is a problem between the rapid pace of marijuana legalization and state and federal policy changes. These policy changes are happening faster than the scientific research can be done on the medical benefits and adverse consequences of marijuana.

In October of 2022 President Biden asked the Secretary of Health and Human Services (HHS) and the Attorney General to review how marijuana is scheduled under federal law. He also pardoned all people convicted of simple marijuana possession under federal law and urged governors to take similar action. Then on August 29th 2023 Politico reported the HHS Assistant Secretary wrote a letter to the DEA recommending that marijuana be moved from Schedule I to Schedule III. The letter is the last step in the official review process initiated by the President last October. Significantly, the DEA is not required to follow HHS’s recommendation.

The HHS recommendation was the result of an almost yearlong federal review of all available marijuana research. But advocates for the legalization of recreational marijuana and some lawmakers didn’t think the recommendation went far enough. They wanted the president to completely remove cannabis from the Controlled Substances Act. A cannabis advocate told Politico, “Rescheduling cannabis from 1 to 3 does not end criminalization.” However, if approved, the rescheduling would permit cannabis businesses to take tax exemptions for business expenses like salaries and benefits, providing a huge benefit to the financially struggling industry.

The shift in federal cannabis policy would also make it easier to conduct research on the health effects of cannabis consumption and for pharmaceutical companies to bring cannabis-based drugs to market. Researchers have long chafed at restrictions that only allow them to procure cannabis from a single farm at the University of Mississippi that bears little resemblance to the high-potency products many consumers are purchasing in state-legal markets.

Both legalization advocates and anti-legalization advocates are not happy with the HHS recommendation. Pro-marijuana advocates say it does not end criminalization, but anti-legalization advocates see it as potentially detrimental to public health. They say the “addiction profiteers” have been exposed for their lies about the physical, mental and financial benefits of legalization in the wake of the cumulating evidence of the harm being done to millions of Americans. “It is regrettable that the Department of Health and Human Services move now appears to be a nod to those monied interests.”

In August, ABC News did a short, 7-minute video in their Group Chat on how the increase in marijuana use could affect federal legislation, the economy, and national health, “How the legalization of recreational cannabis use is on the rise.” It’s available on YouTube, here. One of the individuals participating in this “Chat” said there is a lot of money at stake here in the marijuana industry. “It’s estimated that the marijuana industry can pump a hundred billion dollars into the overall economy this year.”

The health concerns were mentioned with a reference to a CDC report on its effect on teen health and wellbeing. “There are a lot of unknowns about the long-term risk of any cannabis exposure to developing brains.” According to the CDC marijuana use beginning in teen years or younger can affect brain development, which may impair thinking memory, and learning.” There were mental health issues, including schizophrenia. “The association between marijuana and schizophrenia is stronger in people who start using marijuana frequently at an early age.”

The health expert went on to say he hears from both sides is that “policy changes seem to be happening faster than scientific research. Now potentially rescheduling this from a class one substance can actually help with that research, but there’s a lot more we need to know.” But until then, we know already that several states are growing more cannabis than they can sell because there aren’t enough legal retailers in the market. The impact is that “the illegal marijuana trade is actually stronger and outpacing legal sales in states where it is legal.” In California, where recreational marijuana has been legal for seven years, unlicensed marijuana sales were more than double that of licensed sales.

Returning to Parallel Cannabis closing down its Goodblend facilities in Pennsylvania, there’s more to it than just wanting to serve “patients” in other more established markets. In the Green Market Report, John Schroyer reported the Atlanta-based company Parallel Cannabis is closing its three Goodblend PA facilities and leaving the Pennsylvania medical marijuana market because financial troubles led to a lawsuit from its landlord, Innovative Industrial Properties Inc. Pennsylvania is not the only state Parallel has had problems paying its rent. Parallel also defaulted on its rent for a facility in Texas. Parallel is one of the largest privately held multistate cannabis operators in the US, with additional facilities in Florida, Massachusetts, and Nevada.

Goodblend is struggling to get its own shareholders to agree to liquidate the business, with another pending lawsuit filed by Surterra Holdings, a division of Parallel. That suit alleges that minority owner Medical Bloom, which holds a 25% stake in Goodblend, has refused to agree to a dissolution. Parallel is asking for a court order to force the liquidation in order to pay off Goodblend’s debts, given that the Pennsylvania subsidiary is insolvent, the Post-Gazette reported.

So, in Pennsylvania, let’s not be seduced by the lure of money in legalizing recreational marijuana. The federal government is poised to reschedule marijuana, which will help the cannabis industry without removing marijuana from FDA oversight as a drug. Let’s wait a few more years and see what the scientific research tells us about the benefits and adverse effects from marijuana use before we begin to craft our legalization policy at the state or federal level. And let’s slow down the marijuana lobbyists at the state level who seem to be trying to get a preponderance of states to legalize recreational marijuana before that research has a chance to be done and published. If it means some more companies like Goodblend leave the state for more profitable fields elsewhere—or go bankrupt—good riddance.

12/21/21

The Risks of Legalizing Marijuana in PA

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Attempts to legalize recreational marijuana in PA with Senate Bill 350, the “Adult-Use Cannabis Act,” failed. But efforts to do so have not stopped. In September of 2021, State Representatives Jake Wheatley and Dan Frankel sponsored  H.B. 2050, which would legalize adult-use recreational marijuana. Not to be outdone, State Senators Dan Laughlin and Sharif Street introduced Senate Bill 473 to legalize recreational marijuana in October of 2021. Laughlin and Street believe their bi-partisan bill has the best chance of ultimately legalizing recreational marijuana in Pennsylvania, and could generate between $400 million and $1 billion of new tax revenue. But what are the risks of such legislative action?

Larry Weigand, who was running for sheriff in Delaware County, said he understood that social views on marijuana use have changed and polls report most Pennsylvanians support legalization. “But the social views of intoxication and driving under the influence have not; to the contrary, they have become more stringent.” He thought the legislature needs to be considerate of both sides of the issues, considering all who would be affected, “including the non-users of marijuana and law enforcement.”

Negative Consequences in Colorado

Consider the negative consequences of legalization in Colorado reported in The New York Times, “Reefer Madness or Pot Paradise?” Legalization coincided with a 20 percent rise in violent crime rates in Colorado, while marijuana-related arrests fell by half. Although low-level marijuana charges dropped, racial discrepancies in drug arrests persisted. African-Americans were still being arrested on marijuana charges almost twice as often. One of the state legislators who endorsed the Colorado ballot measure that legalized recreational marijuana said: “You don’t see drug-addled people roaming the streets, but we haven’t created a utopia.”

Since recreational sales began in 2014, more people in Colorado are going to emergency rooms for marijuana-related problems. Hospitals report higher rates of mental health cases associated with marijuana. An emergency room physician and researcher with the University of Colorado Hospital, Andrew Monte, analyzed hospital data that showed more people were arriving at ERs for marijuana-related reasons. He said, “There’s a disconnect between what was proposed as a completely safe drug.”

Other researchers in “Marijuana and acute health care contacts in Colorado” reported that marijuana-related ER patients were five times as likely to have a mental-health issue as those with other cases. “As more states legalize marijuana, it is important to address public education and youth prevention, and understand the impact on mental health disorders.” The most frequent primary diagnosis of ER visits with marijuana-related billing codes compared to those without marijuana-related billing codes was for mental illness.

Among primary diagnosis categories, mental illness was more prevalent in ED visits and hospitalizations with marijuana-related billing codes. Examination of the role marijuana plays in mental health driven healthcare encounters is critical given the relationship between drug use disorders and mental health disorders. While it is unclear whether this finding is reflective of changes due to a legal market, it clearly prioritizes the consequences of marijuana use within a mental health population as a priority area for further research.

Psychosis and Marijuana

While political rhetoric in favor of legalization is calling for the end of marijuana “prohibition,” scientific research is forming a consensus that THC, the psychoactive cannabinoid in marijuana, induces psychotic symptoms. A research article published in The Lancet Psychiatry, “Psychiatric symptoms caused by cannabis constituents,” included additional evidence for that consensus. The authors readily acknowledged that cannabis was one of the most widely used psychoactive substances worldwide, with 6-7% of Europeans and 15.3% of Americans using it each year. Decriminalization and legalization trends were happening globally, with Canada, Uruguay and a growing number of US state permitting the sale and recreational use of marijuana. However,

Given the projected increase in rates of cannabis use, the increasing potency of cannabis and cannabis-based products, and the burgeoning interest in the therapeutic potential of cannabinoids, it is timely to assess the psychiatric effects of cannabis constituents.

The researchers demonstrated that THC induced significant increases of symptoms as they were reported on psychiatric scales, the Brief Psychiatric Rating Scale (BPRS) and the Positive and Negative Syndrome Scale (PANSS). Positive symptoms included delusions and hallucinations; negative symptoms included blunted affect and amotivation; and general symptoms included depression and anxiety. Effect sizes were greater for positive symptoms than negative symptoms, but not for general symptoms. This finding suggested that THC induced positive symptoms like psychosis to a greater extent than negative symptoms.

Speaking with Healio Psychiatry in “THC linked to psychiatric symptoms with large effect sizes,” Oliver Howes, one of the co-authors, said: “These findings highlight a potential risk of taking THC-containing cannabis products, and, importantly, show that THC can lead to short-term psychotic symptoms even in people with no history of mental illness or other risk factors.” While there has been previous evidence for the association of positive psychiatric symptoms and marijuana, Howes said he was surprised that THC induced other psychiatric symptoms like social withdrawal.

In conclusion, these findings demonstrate that the acute administration of THC induces positive, negative, and general psychiatric symptoms with large effect sizes. By contrast, CBD does not induce psychiatric symptoms, and there is inconclusive evidence that it moderates the induction of psychiatric symptoms by THC. These effects are larger with intravenous administration than with inhaled administration, and tobacco smokers have less severe positive symptoms. These findings highlight the acute risks of cannabis use, which are highly relevant as medical, societal, and political interest in cannabinoids continues to grow.

In a related editorial published in the same issue of The Lancet Psychiatry, “THC: harmful even in low doses?”, Carsten Hjorthøj, and Christine Merrild Posselt said there was a growing scientific consensus that marijuana does have a causal role in the development of psychosis. And they thought the association seems to be bidirectional. “In some people, cannabis leads to incident psychosis, whereas in other people, psychosis leads to incident cannabis use.” However, they noted this consensus was not reflected in mainstream public discourses, “which have a major effect on the political agenda to decriminalize cannabis.”

Referring to “Psychiatric symptoms caused by cannabis constituents,” Hjorthøj and Posselt said finding large effect sizes for general psychiatric symptoms, even with low doses of THC, was “extremely important and worrying.”

Moreover, the authors failed to find any clear evidence that concurrent administration of cannabidiol (CBD) reduced these symptoms. Indeed, such an ameliorating effect was observed in only one of four included studies. This finding is notable because CBD in particular is being touted as a potential wonder drug with antipsychotic, anxiolytic, and other properties. . . As Hindley and colleagues have clearly demonstrated, there are at least transient psychiatric symptoms associated with even relatively low doses of THC. Of course, this result should not be extrapolated as meaning that single doses of THC will eventually lead to schizophrenia or other severe disorders. However, it might be prudent to extrapolate and paraphrase the words of Moore and colleagues from their 2007 meta-analysis to apply to both recreational and medicinal use of THC-containing cannabis: “there is sufficient evidence to warn people that using THC could increase their risk of developing psychiatric symptoms or even a psychotic illness”.

So, pointing to the potential for increased tax revenue, the opportunity for new jobs in the marijuana industry, and all the other supposed benefits of ending the so-called ‘prohibition’ of recreational marijuana is not enough. Pennsylvania also needs to consider the risks to its citizens if it legalizes recreational marijuana. And one of them is people who use cannabis increase their risk of experiencing psychosis and other psychiatric symptoms.

There are several other articles on the risk of psychosis with marijuana on this website, and the concerns for Pennsylvania if recreational marijuana is legalized in the Commonwealth. Here are a few: “Cannabis and Psychosis: More Reality Than Satire,” “Telling the Truth About Marijuana and Psychosis,” “The Business of Legalizing Marijuana in PA,” and “Should Pennsylvania Go ‘Full Colorado’ with Marijuana?” Part 1 and Part 2.

10/6/20

Should Pennsylvania Go ‘Full Colorado’ with Marijuana? Part 2

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In Part 1, we began to examine some of the potential impact to Pennsylvania if the state were to go “full Colorado,” unreservedly legalizing recreational marijuana as the state of Colorado has done. We started out with the September 3, 2020 call by Governor Tom Wolf for the legalization of marijuana use for adults in Pennsylvania. Lieutenant Governor John Fetterman, who stood beside him, also voiced his unreserved support of legalization. But as we looked at the hope for legalization in Pennsylvania, we saw the reality of what had already happened in other states that legalized recreational marijuana was dramatically different.

On the Facebook page for the “Pennsylvania Family Council” dated September 25, 2019, is a shot video that presents a quick series of sound bites and facts about going full-on Colorado: “Lt. Gov. Fetterman wants ‘full Colorado’ with marijuana.” He thinks the legalization of recreational marijuana is “the right thing for Pennsylvania.” You can also view the video on YouTube. We’ll look at most, if not all of the information that this short video throws at you. If there was something I failed to cover, it can be found within the links presented in either Part 1 or here in Part 2 of this article.

According to a 2018 state report, “Impacts of Marijuana Legalization in Colorado,” seizures of Colorado-sourced marijuana were most likely to occurs in states bordering or near Colorado: Kansas, Nebraska, and Wyoming. At least 3 made it to Pennsylvania. Seizure used to be almost exclusively marijuana flower, accounting for over 90% of the reported seizures in 2012. By 2017, 58% of seizures were for flower, 26% were for concentrates/hash and 16% were for edibles. See the following table from the report.

Overall crime rates for property remained stable from 2012 to 2017, but violent crime increased 20%. An increase in the number of aggravated assaults was primarily responsible for the increase in the violent crime rate while larceny was responsible for the increase in property crime rates. SAM (Smart Approaches to Marijuana) reported the crime rate in Colorado has increased 11 times faster than the rest of the nation since legalization. “Marijuana arrests of young African-American and Hispanic youth have increased since legalization (Colorado Department of Public Safety [CDPS], 2016).” See the table below.

SAM reported that in Colorado, the number of drivers intoxicated with marijuana and involved in fatal traffic accidents increased 88% from 2013 to 2015. “Driving under the influence of drugs (DUIDs) have also risen in Colorado, with 76% of statewide DUIDs involving marijuana” (Colorado State Patrol [CSP], 2017). Washington State had a doubling of drugged driving fatalities. In Oregon, 50% of all drivers assessed by drug recognition experts (DRE) in 2015 tested positive for THC. See “Driving Under the Influence of Cannabis” for more information on DUIDs.

The proportion of Colorado youth who reported marijuana use in the past 30 days was significantly higher than the national average. This held true from 2008/2009 through 2015/2016. Colorado was in the top 20% of states for youth marijuana use. See the following figure. Smart Approaches to Marijuana (SAM) reported that since legalization, Washington, Oregon Alaska and Washington, DC have had past-month use of marijuana above the national average among youth aged 12-17. See the chart below.

“Reefer Madness or Pot Paradise?” also noted how politics was infiltrated by marijuana legalization. With a new, marijuana-friendly governor in office, Colorado legislators passed six marijuana laws in 2019 that included approving marijuana-delivery services; out-of-state investment and publicly traded cannabis companies; the creation of pot lounges—“marijuana hospitality establishments”—where marijuana could be consumed without violating the state’ indoor clean-air laws. As the industry expands, some of marijuana’s earliest supporters and entrepreneurs have raised concerns about being left out as pot companies in the US and Canada chase billion-dollar projected incomes and hire powerful politicians like John Boehner, the former Speaker of the House.

Luke Niforatos, the Executive Vice President for Smart Approaches to Marijuana (SAM), said despite claims of states not allowing child-friendly pot products, marijuana shops sell products like “Pot Tarts,” “Kush Pop,” and pot-laced gummy bears. Edible and drinkable products are becoming the direction the marijuana industry is going. “How many people think this is for 21 and up?”

The industry has prospered in selling marijuana-infused “edibles” that come in the form of cookies, candy, ice cream, sodas, and other sweet treats that are particularly appealing to children. These edibles comprise approximately 20 to 50% of the market in legalized states (where data is available), thereby increasing their availability to children and youth who are normally unaware of consumption serving sizes and consequences (Colorado Department of Revenue, 2015; O’Connor, Danelo, Fukano, Johnson, Law, & Shortt, 2016).

So, where does this leave the supposed success of other states implementing marijuana legalization and what Pennsylvania can look forward to?

The concern expressed for the danger to children in PA from candy-like edibles was legitimate. But it does not seem in states where recreational marijuana is legal that the marijuana industry has any interest in attempting to limit or restrict the sale of edibles that could appeal to children. 53.5% of high school students in Colorado feel it would be easy to get marijuana if they wanted, not more difficult, as Sharif Street said would happen after legalization (see Part 1). Financial assistance for restorative justice programs and historically disadvantaged businesses is roughly 1.5% of the projected tax income from marijuana sales; .065% of the total state budget. It seems to be more of a political carrot to gain public approval than real restorative social justice.

As the marijuana industry expands, the economic benefit to legalization seems to be primarily to the cannabis corporations, not the small, locally owned and operated businesses which are concerned about being left out. “Reefer Madness or Pot Paradise” in The New York Times said marijuana is starting to look like the next Silicon Valley. Vehicular accidents and driving under the influence of drugs (DUIDs) increased dramatically in various states that legalized marijuana. Legalization has led to increased black-market activity, not less; especially in rural areas that border states where marijuana is still illegal. Drug trafficking organizations and Mexican cartels have begun growing marijuana illegally in the US.

Marijuana-related emergency room visits have increased drastically since legalization. According to the Colorado Department of Public Health and Environment, the rate of marijuana-related ER visits increased 35% between 2011 and 2015. SAM reported these ER visits included a growing number of Butane Hash Oil (BHO) burn victims. “BHO is a marijuana concentrate that yields a THC potency of 70–99% and is highly lucrative. Production involves forcing raw marijuana and butane into a reaction chamber, which creates a highly combustible liquid that easily explodes when introduced to an ignition source.” See: “A Little Dab Will Do Ya” for more on BHO.

There is a clear negative effect on teens and youth in states that have legal recreational marijuana, even though it has always been legalized for adults and not teens. SAM reported the average rate of regular teen marijuana use is 30% higher in Alaska, Colorado, Oregon, and Washington than the US rate as a whole. Almost one-third of all 18 to 25-year-olds in legalized states said they’ve used marijuana in the past month, up from around one-fifth 10 years ago. See the research of Stacey Gruber detailed in “From the Frying Pan Into the Fire with Recreational Marijuana in PA,” “Double Whammy of Teens Vaping Marijuana,” and “Listening to Marijuana Research” for further concerns with teens using marijuana.

The research into whether or not marijuana is a gateway drug is mixed, but it does seem to have been a “stepping stone” of sorts with individuals who go on to use other drugs. See “Marijuana as a ‘Gateway’ Drug” and “Rebirth of the Gateway Hypothesis,” for more on the gateway hypothesis.

Cannabis may be safer now, but its strength is increasing under legalization. SAM reported the average national THC potency of flower is 11.04%, but in Colorado it is 17.10% and it is 21.24% in Washington State. In the 1960s and 1970s, cannabis contained less than 4% THC. And there is emerging evidence of a strong link between high-potency marijuana and psychosis. “The odds of psychotic disorder among daily cannabis users were 3.2 times higher than for never users, whereas the odds among users of high potency cannabis were 1.6 times higher than for never users.” See “Gambling with Cannabis and Psychosis” and “Cannabis and Psychosis: More Reality Than Satire” and “Psychosis and Adolescent Marijuana Use” for more information on the link between marijuana and psychosis.

One final piece of information came in mid-September of 2020. The Pittsburgh Business Times reported that two of the largest Pittsburgh-area medical marijuana startups, Solevo and PurePenn, have been acquired by a Florida company, Trulieve Cannabis Corp., based in Tallahassee, Florida. Solevo ranks second on the The Pittsburgh Business Times’ list of the region’s largest medical marijuana dispensaries and growers/processors; PurePenn is fourth. In addition to Florida, Trulieve has operations in California, Massachusetts and Connecticut.

Do Pennsylvanians really want to go “full Colorado?”

09/29/20

Should Pennsylvania Go ‘Full Colorado’ with Marijuana? Part 1

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On September 3, 2020, Governor Wolf renewed his call for the legalization of recreational marijuana use for adults in Pennsylvania, which he originally announced his support of in September of 2019. Pointing to a presumed economic windfall such a legislative act would bring to the Commonwealth, he said: “Now more than ever, specially right in the middle of a pandemic, we have a desperate need for the economic boost that the legalization of cannabis could provide.” Lieutenant Governor John Fetterman also highlighted the economic impact to come from legalization. He said he could pitch marijuana legalization as a jobs bill. “Legalizing marijuana would create tens of thousands of jobs that require no subsidy.” This is a complete about-face from Wolf’s position two years ago, when he said, “I don’t think Pennsylvania’s actually ready for recreational marijuana.”

His rejection of legalization from August of 2018 was followed by a statement on Twitter in December of 2018 that signaled an evolving position, where Governor Wolf said more and more states were implementing marijuana legalization and we should keep learning from their efforts. “I think it is time for Pennsylvania to take a serious and honest look at recreational marijuana.” In an article I wrote in January of 2020, “From the Frying Pan Into the Fire with Recreational Marijuana in PA,” I said I hoped PA would learn from the long-term consequences of marijuana legalization in other states. We should not allow the political pressure to legalize marijuana to outpace learning from the consequences to other states and the science from research into marijuana.

Is the pressure to legalize recreational marijuana use in Pennsylvania a consequence of “more and more states successfully implementing marijuana legalization,” as Governor Wolf said in December of 2018? Let’s look at some of the claims that have been made about legalization, especially in Colorado, to see what this supposed successful implementation could mean for Pennsylvania.

In his most recent call for legalization, Governor Wolf said the revenue from legalization would benefit restorative justice programs and historically disadvantaged businesses. Another factor in the proposed legislation is reform to the criminal justice system and the uneven enforcement of marijuana laws against Blacks and Latinos. Fetterman said: “If you go over the span of decades we are talking nearly a quarter of a million Pennsylvanians that now have some affiliation with the criminal justice system for nothing more than consuming a plant that’s actually legal in 12 jurisdictions across this country.” State Senator Sharif Street of Philadelphia, one of the co-sponsors of the “Adult-Use Cannabis Act,” added that marijuana would economically benefit farmers, who could rotate it with corn. He added that regulation would also make it more difficult for dealers to sell to minors.

In addition to these claims made during the September 3rd announcement, there were the results from a May 2019 statewide “listening tour” by John Fetterman to hear people’s opinions as to whether or not they were in favor of or opposed to legalizing adult-use recreational marijuana. The most commonly stated reasons cited in support of legalization included in the Listening Tour Report were: a perceived economic benefit with increase funding for education and infrastructure, the expungement of past non-violent cannabis convictions and the belief that cannabis is safer than alcohol and opioids. Common reasons stated by those opposing legalization included concerns marijuana is a gateway drug, increased vehicular accidents and problems measuring a DUI level, and potential negative effects on youth.

The Listening Tour Report also found there was a 65-70% approval of adult-use cannabis legalization. Residents were overwhelming supportive of decriminalization and expungement of non-violent and small cannabis-related offenses. There was near-unanimous support for removing marijuana from its classification as a Schedule 1 drug. Many residents said that if legalized, marijuana should be grown on Pennsylvania farms and should create jobs in Pennsylvania. People were also concerned about an increase of people driving under the influence of marijuana. Most people were opposed to candy-like edibles because of their potential appeal to children.

A Franklin & Marshall College Poll in Mach of 2019 found that 59% of Pennsylvania voters supported legalization, a dramatic change since May of 2006 when only 22% supported legalization. There was a dramatic upshift of approval between 2015 (40%) and 2017 (56%), with Pennsylvania’s approval of medical marijuana occurring in 2016. Many polls reporting on whether or not marijuana should be made legal did as the Franklin & Marshall poll did, by asking an either-or, yes or no question: “do you think the use of marijuana should be made legal, or not?” But when polls distinguished between the recreational use and medical use of marijuana, support, support for legalization dropped. See the following compilation of survey results on PollingReport.com. Look at a 2014 question by the Pew Research Center that begins with: “Which comes closer …”

It seems a legitimate question of the reported percentages of Pennsylvanians supporting adult-use cannabis legalization is to ask to what extent was it influenced by the previous approval of medical marijuana? I previously raised the question of a possible strategy in the long-term goal of gaining national approval for recreational marijuana legalization was to pursue it one state at a time; initially concentrating on the supposed medical benefits from marijuana (See “Marijuana Peek-A-Boo” and “Eating the Elephant of Marijuana Legalization in PA”). These touted medical benefits are difficult to replicate or refute since marijuana is currently a Schedule I drug, which makes reliable research into its effects—good or bad—difficult to do.

Governor Wolf said recently the revenue from legalization would benefit restorative justice programs and historically disadvantaged businesses. However, the original “Adult-Use Cannabis Act” said $9 million would annually be distributed from the fund annually to the Department to carry out its duties, which include grants and loans to “low-income permittees.” These departmental duties include up to $2 million annually “to provide financial assistance to growers, processors, dispensers, and microgrowers who were harmed by effects of cannabis prohibition.” Interest-free loans could be granted to individuals with a prior cannabis-related criminal conviction, whose annual income was below $80,000, and who had successfully completed an educational program and passed an exam; again, up to $2 million annually.

95% of the remaining annual tax income (projected to be $581 million) was supposed to go to school districts. The projected income was calculated from the 17.5% tax rate that would be imposed on cannabis sold by licensed dispensaries. Yes, there would be some benefit to historically disadvantaged businesses and restorative justice programs, but that is out of merely 1.5% of the projected tax income. The governor’s rhetoric seems to be a bone tossed in reaction to the economic crisis of the COVID pandemic and the social justice issues that have been sweeping the country the past several months rather than a serious proposal. That is, if the roughly $539.6 million would really go towards schools. $581 million sounds like a significant figure, but it is actually 0.65% of the total operating budget for Pennsylvania for fiscal year 2020-2021.

The same 2019 Franklin & Marshall poll mentioned above also found that legalizing marijuana for recreational use was a top priority for only 5% of Pennsylvanians surveyed, while increasing state funds for public education (23%) and improving the state’s infrastructure (18%) were viewed as more important top priorities. Proposing to spend the anticipated income from legalization on schools sounds like a strategic political move to increase the chances of getting the Adult-Use Cannabis Act through the state legislature.

The same can be said about the inclusion of social justice reform actions in Senate Bill 350. Decriminalization and expungement can be accomplished independent of legislation that legalizes recreational marijuana. While changing the scheduling is popular in PA, there is nothing really that can be done, as that would take federal action. And as long as cannabis is a Schedule I controlled substance, selling, distributing, possessing and/or using marijuana or marijuana-derived products is a federal crime. JDSupra ended their article on the Adult-Use Cannabis Act with a disclaimer that said while federal policy may recommend enforcement discretion, “it is important to understand that compliance with state law does not equal compliance with federal law, and that federal marijuana policy may change at any time.”

A New York Times article in June of 2019, “Reefer Madness or Pot Paradise?” looked at what has happened in Colorado since they became the first-in-the-nation to experiment with legalizing recreational marijuana. Let’s look first at the social justice issue John Fetterman was concerned about. While low-level marijuana charges have fallen dramatically, the racial divide in drug arrests has continued. State data shows that African-Americans in Colorado are still being arrested on marijuana charges at twice the rate of white people. Jonathan Singer, one of two state legislators who endorsed the Colorado ballot measure that legalized their adult use recreational marijuana measure, said: “You don’t see drug-addled people roaming the streets, but we haven’t created a utopia.” Once known for its wide range of outdoor activities, now Colorado is known as the state that has “great weed.”

Colorado’s first-in-the-nation experiment has reshaped health, politics, rural culture and criminal justice in surprising ways that often defy both the worst warnings of critics and blue-sky rhetoric of the marijuana industry, giving a glimpse of what the future may hold as more and more states adopt and debate full legalization.

Law enforcement officials say legalization caused the black-market cultivation of marijuana to expand and made the problem worse. While licensed growers harvest marijuana from fields and greenhouses, police and sheriff’s officers raid houses converted to illegal cultivations they say export marijuana to other states. People cover the windows of grow houses to have the glowing grow lights and rewire the electric and water lines to avoid the meters. In May of 2019 police and federal drug-enforcement agents raided 240 homes around Denver and Northern Colorado that were illegally growing marijuana. The US attorney in Denver said Colorado has become “The epicenter of black-market marijuana in the United States.”

Small rural, towns near Utah, Nebraska or New Mexico are opening marijuana shops and raising concern from officials about out-of-state trafficking. Smart Approaches to Marijuana (SAM) reported there has been a 50% increase in illegal grow operations across rural areas of the state. “In 2016 alone, Colorado law enforcement confiscated 7,116 pounds of marijuana, carried out 252 felony arrests, and made 346 highway interdictions of marijuana headed to 36 different U.S. states.”

Legalization has made it easier for the black market to thrive in rural areas due to the difficulties involved in distinguishing between legal and criminal marijuana farms. About $6.5 million worth of illegal marijuana was confiscated by federal agencies in the White River National Forest in Aspen, Colorado, and 9,200 illegal marijuana plants were found growing on islands in the middle of the Colorado River (Associated Press, September 29, 2017; Roy, 2017). The ability to hide black market activity in legalized states has encouraged drug trafficking organizations (DTOs) and Mexican cartels to begin growing marijuana illegally within the United States and there is now a strong presence of cartel activity in Alaska (ADPS, 2016).

Since recreational sales began in 2014, more people visited emergency rooms for marijuana-related problems and hospitals report higher rates of mental health cases tied to marijuana. Yet thousands of others make daily stops at dispensaries without any problems. Calls to poison centers rose 210% in Colorado after legalization. The annual rate of marijuana-related ER visits increased 35% between 2011 and 2015.

In Part 2, we will continue with our examination of whether Pennsylvanians can hope to successfully implement recreational marijuana legalization. There is a 2018 report by Colorado, “Impacts of Marijuana Legalization in Colorado” that has some interesting data on seizures of Colorado-sourced marijuana (some Colorado-sourced marijuana was seized in Pennsylvania). Violent crime increased, as did marijuana arrests of young African-American and Hispanic youth. Oh, and Colorado was in the top 20% of states for youth marijuana use.

01/21/20

From the Frying Pan Into the Fire with Recreational Marijuana in PA

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On September 25, 2019, Governor Tom Wolf announced he supports legalizing recreational marijuana. Wolf and Lt Gov. John Fetterman called for three specific actions at their press conference: 1) a bill to decriminalize non-violent and small cannabis-related offenses; 2) developing a way to expunge past convictions for non-violent and small cannabis-related offenses; and 3) consideration by the General Assembly of legalization of adult-use recreational marijuana. He said: “We now know the majority of Pennsylvanians are in favor of legalization, and that includes me.” He added that he looked forward to seeing what could be accomplished, especially the criminal justice reforms.

His endorsement represented an about-face from August of 2018, when he told KDKA Radio Morning News the time was not right to legalize marijuana for recreational use: “I don’t think the citizens of Pennsylvania are ready for it.” He recommended waiting on the longer-term results of legalization in states such as Colorado, Oregon, Washington, where their different approaches could be helpful as PA weighs its own options. Then in December of 2018, Wolf said in a tweet: “More and more states are successfully implementing marijuana legalization, and we need to keep learning from their efforts.” He added any change would require legislation. But he thought it was time for “Pennsylvania to take a serious and honest look at recreational marijuana.”

Wolf’s support for legalization came after the completion of Fetterman’s “Statewide Cannabis Listening Tour” on May 19, 2019. Key takeaways from those who attended the tour included: 65-70% approval for adult-use cannabis legalization; near unanimous support for decriminalization and mass expungement of non-violent and small cannabis-related offenses; if legalized, cannabis should be grown on Pennsylvania farms; the removal of cannabis from its current classification as a Schedule I drug; and a provision allowing for six to eight homegrown cannabis plants for personal use. More than 10,000 individuals attended Listening Tour meetings and the online portal received more then 44,000 comments. The September announcement of support for legalizing recreational marijuana was followed by the introduction of the “Adult-Use Cannabis Act,” Senate Bill 350, by Pennsylvania senators Daylin Leach and Sharif Street.

If passed, the bill would legalize adult-use cannabis for individuals 21 years of age and older, and establish a permitting process for growers, processors, and dispensaries; the current measure would not place a limit on the number of permits that could be issued. The bill would also allow for cannabis delivery, consumption (i.e., “bring your own” or BYO) lounges, and home grow. Under the proposed legislation, the Pennsylvania Department of Agriculture would oversee the adult-use program.

Two days after the Adult-Use Cannabis Act was introduced, Governor Wolf met with governors from New York, New Jersey and Connecticut at a “marijuana summit,” where they agreed to a set of core principles for legal cannabis programs they would pursue. This seems to be part of a continuing strategy for legalizing recreational marijuana in Pennsylvania that I said was like eating an elephant one bite at a time (See “Eating the Elephant of Marijuana Legalization in PA”). Let’s see if we can digest some of what we are hearing from the “Statewide Cannabis Listening Tour,” the Adult-Use Cannabis Act, and what we can learn from the states who have gone before PA in legalizing recreational marijuana.

The first key takeaway in the Executive Summary of the Listening Tour was that 65-70% of those who attended tour stops approved of adult-use cannabis legalization. This seems to be the source of Governor Wolf’s statement that “We now know the majority of Pennsylvanians are in favor of legalization.” We know that 65-70% of those who attended tour stops approved of adult-use cannabis legislation, not that 65-70% of Pennsylvanians approve of legalization. The 10,000 or so individuals who went to the Listening Tour stops are not representative of the Commonwealth as a whole, and surveys of them should not haven been presented as “the majority of Pennsylvanians” by the governor. The Executive Summary made the distinction, saying a majority of attendees supported legalization—why didn’t the governor?

The Adult-Use Cannabis Act would issue permits to applicants seeking to legally become a Grower, Homegrower, Microgrower, Processor, open a Dispensary to sell cannabis retail to consumers, become a Deliverer of cannabis from a dispensary to consumers, or operate “use lounges,” where individuals may use cannabis which they have brought to the space. Cannabis use in public, except use in these consumption lounges, would be prohibited. See the “Adult-Use Cannabis Act” link for a further description of these permits. There would be a 17.5 percent tax rate imposed at the point-of-sale on cannabis by dispensaries.

There was “near-unanimous” support for decriminalization and mass expungement of non-violent and small cannabis-related offenses, and for removing cannabis from its current classification as a Schedule I drug. These social justice concerns and the rescheduling of cannabis are laudable and can be legislated independent of legalizing adult-use of recreational marijuana. Were they bundled into the Adult-Use Cannabis Act in order to garner support in the General Assembly for legalizing recreational marijuana?

There was concern expressed for an anticipated increase of people driving under the influence of cannabis, which has in fact happened in other states. The National Institute on Drug Abuse said several meta-analyses found the risk of being involved in a crash increased significantly and in a few cases doubled or more than doubled. “Two large European studies found that drivers with THC in their blood were roughly twice as likely to be culpable for a fatal crash than drivers who had not used drugs or alcohol.”

A 2009 article in The American Journal on Addictions said detrimental effects of cannabis use varied in a dose-related fashion and were more pronounced with highly automatic driving functions than with more complex tasks that required conscious control. Impaired drivers tend to compensate effectively when driving, but combining alcohol and marijuana eliminates the ability to use such strategies “and results in impairment even at doses which would be insignificant were they of either drug alone.”

In Colorado, where recreational marijuana has been legal since 2012, there has been a sharp increase in the number of marijuana-related automobile fatalities each year from 2013 to 2016. There were 77 marijuana-related fatalities in 2016, 51 of those drivers had levels of THC above the threshold for cannabis impairment under Colorado law. According to a survey by the Colorado Department of Transportation, over half of marijuana users said they had got behind the wheel of a vehicle in the last 30 days within two hours of using the drug.

After recreational marijuana was legalized in Washington in 2012, the proportion of marijuana-positive drivers involved in fatal crashes increased from 8 percent to 17 percent in 2014, according to AAA. The majority of drivers who had detectable levels of THC also had alcohol and/or other drugs in their blood at the time of the crash. “Of all THC-positive drivers involved in fatal crashes over the study period, an estimated 34.0% were positive for THC only, 39.0% were positive for both THC and alcohol.” 16.5% were positive for both THC and one more other drug, but not alcohol; and 10.5% were positive for THC, alcohol, and one or more other drugs.

Research from the Insurance Institute for Highway Safety (IIHS) and Highway Loss Data Institute (HLDI) showed that crashes were up as much as 6 percent in Colorado, Nevada, Oregon and Washington when compared with neighboring states that haven’t legalized marijuana for recreational use: Idaho, Montana, Utah and Wyoming. IIHS-HLDI President David Harkey said legalizing marijuana was having a negative impact on the safety or our roads. “Despite the difficulty of isolating the specific effects of marijuana impairment on crash risk, the evidence is growing that legalizing its use increases crashes.”

The Adult-Use Cannabis Act seeks to take an illegal drug away from the black market and regulate its distribution through legislation and regulation. And hopefully develop a new revenue source for Pennsylvania. PA Auditor General Eugene DePasquale estimated legalizing marijuana would produce approximately $581 million in annual tax revenue. After funding a grant program ($2 million) and an interest-free loan program ($2 million) and $9 million to the Department of Agriculture to oversee the adult-use program, 95% of the remaining revenue would be distributed to school districts. Ironically, one of the top concerns noted in the “Statewide Cannabis Listening Tour” was the potential of negative effects on the development of youth and students.

The New York Times featured an article in April of 2019 on how the illegal marijuana market was booming in California despite legalization. The governor of California redeployed National Guard troops stationed on the border with Mexico to go after illegal cannabis farms in Northern California because the problem was getting worse, not better. In wildland areas, the California Department of Fish and Wildlife more than doubled its seizures of illicit marijuana in 2018, the first year recreational cannabis was legal.

Of the roughly 14 million pounds of marijuana grown in California annually, only a fraction — less than 20 percent according to state estimates and a private research firm — is consumed in California. The rest seeps out across the country illicitly, through the mail, express delivery services, private vehicles and small aircraft that ply trafficking routes that have existed for decades.This illicit trade has been strengthened by the increasing popularity of vaping, cannabis-infused candies, tinctures and other derivative products. Vape cartridges are much easier to carry and conceal than bags of raw cannabis. And the monetary incentives of trafficking also remain powerful: The price of cannabis products in places like Illinois, New York or Connecticut are typically many times higher than in California.

Politico also wrote about “How Legal Marijuana Is Helping the Black Market.” It said when Oregon legalized marijuana in 2014, the state tried to stifle its black market by making the path into the legal market was as easy as possible. “It did not limit licenses and it simplified regulations, creating a program with one of the lowest barriers to entry in the United States.” The strategy worked. An Oregon State Police Sergeant estimated there are more illicit marijuana growing in Southern Oregon than before legalization, with most of it going out of state. He said law enforcement is just inundated with illegal marijuana and exportation.

Now, Oregon is an easy place to find high-quality, cheap, legal marijuana. There are more than 650 licensed marijuana dispensaries in the state, or three times the number of McDonald’s restaurants (205). If you’re an Oregonian living in a town or county with legal pot and you want to buy marijuana, there is no reason to shop illegally.

Even The Motley Fool weighed in with “5 Reasons the Marijuana Black Market Won’t Go.” They noted how the legalization of recreational marijuana in Canada and U.S. states has not stopped black market cannabis, as initially expected. “In California, the largest legal weed market in the world by annual sales, illicit marijuana sales are projected to outpace legal pot sales in 2019 by a significant margin: $8.7 billion to $3.1 billion.” Estimates by Scotiabank are that the black market would be responsible for 71% of total cannabis sales in Canada in 2019. The problem noted by the Motley Fool included supply issues in Canada, tax issues in select US states, a slow dispensary approval process, jurisdiction issues, and spotty regulatory enforcement.

Staci Gruber, who is the director of the MIND (Marijuana Investigations for Neuroscientific Discovery) project, has published a series of studies that confirmed the heavy use of marijuana lowers the level of white matter in the corpus callosum region of the brain; and the earlier the age of marijuana use was associated with lower levels of white matter. White matter affects learning and brain functions, modulating the distribution of action potentials and acts as a relay and coordinates communication between different brain regions. Not surprisingly, marijuana smokers were also found to have higher levels of impulsivity. Adolescent marijuana users are also vulnerable to reduction in grey matter, which is responsible for information processing and decision making. See “Listening to Marijuana Research,” “Marijuana Policy Has Run Ahead of Science” and “Double Whammy of Teens Vaping Marijuana” for more on these concerns.

The Motley Fool noted where cannabis had been one of the fastest-growing industries on the planet. After sales more than tripled worldwide between 2014 and 2018, Wall Street forecasted a 5-fold to 18-fold increase in global annual revenue by 2030. But since May of 2019, many marijuana stocks have seen their share price cut in half or worse. Our neighbor to the north, Canada, hasn’t stomped out the black market as expected and supply shortages have been a persistent problem. And the regulatory enforcement designed to drive the black market out of business hasn’t been working. “Based on data from the United Cannabis Business Association, via an audit that was recently turned into California Gov. Gavin Newsom (D-Calif.), 2,835 of the 3,757 listings of marijuana sellers in California on website WeedMaps were unlicensed.”

Hopefully the core principles for legal cannabis programs the governors of Connecticut, New York, New Jersey and Pennsylvania agreed they would pursue at the so-called “marijuana summit” included a continued “wait and see” option. Legalizing recreational marijuana does not seem to have solved problems it was predicted to solve and seems to have generated new ones that weren’t anticipated or predicted. Let’s follow Governor Wolf’s older advice about waiting to see the longer-term consequences of marijuana legalization in Washington, Oregon, Colorado and California. If we acted on his endorsement in favor of legalization now, wouldn’t we be jumping from the frying pan into the fire?

01/14/20

Eating the Elephant of Marijuana Legalization in PA

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On December 19, 2018, PA Governor Tom Wolf tweeted more and more states were successfully implementing marijuana legalization, and PA needed to keep learning from their efforts. Change would take legislation. “But I think it is time for Pennsylvania to take a serious and honest look at recreational marijuana.” Then on January 3, 2019 Pittsburgh state Representative Jake Wheatley proposed the commonwealth legalize recreational marijuana, saying House Bill 50 would provide for social justice reforms, incentivize cannabis businesses to partner with PA farmers, and well as invest in student forgiveness, after school programs and affordable housing. We need to do what is best for the people of Pennsylvania and legalize cannabis this Legislative Session.”

Governor Wolf said: “I’m just trying to be a realist, that this is something we really ought to be taking a look at in a way that maybe we haven’t before.” But he didn’t intend to make it a priority of his second term. However, he also thought Pennsylvania shouldn’t hide her head in the sand and say things aren’t happening in other states in the region.

I’m just saying I’m going to look at what’s going on in the neighboring states and see if we can continue to learn from them and other states that have, through referendum and legislative action, legalized it, and see what maybe we ought to be doing. I’m just keeping my eyes open.

The Republican-controlled chambers of the General Assembly are opposed to the bill. Senate Majority Leader Jake Corman called the idea “reckless and irresponsible,” while his counterpart in the House, Majority Leader Bryan Cutler, opposed the medical marijuana passed in 2016.  Corman said, “As long as I as leader, I will do everything in my power to prevent legalization of recreational marijuana.” He added that it gives the wrong message to our youth.

Then on September 25th Governor Wolf announced that he was now in favor of legalizing marijuana for recreational use. Lt. Governor John Fetterman, who had spent months on a statewide recreational marijuana listening tour, stood beside him. Governor Wolf said, “I think it’s time for the General Assembly to sit down and craft a bill that actually recognizes that Pennsylvania is ready for this, and also takes advantage of what we’ve learned from other states in terms of what to do and what not to do.” On October 15th, 2019, two state senators introduced Senate Bill 350, which would allow for home delivery and the expungement of many previous criminal convictions related to marijuana. See the link for key high lights of the Bill.

Some have doubts that the proposed Adult-Use Cannabis Act will pass this year, especially in its current form, as there are no Republican co-sponsors at this time. The bill also faces an uphill battle in Pennsylvania’s Republican-controlled Senate, although Senators Leach and Street have indicated that they are optimistic the bill will pass and that many of their Republican colleagues will end up supporting the measure. Generally, the legislation is thought to stand a better chance than prior efforts in light of the Lt. Governor’s listening tour and the Governor’s recently announced support of legalization. With that said, in response to Gov. Wolf’s comments promoting legalization, House Republican leaders issued a statement less than one month ago criticizing Gov. Wolf’s position and stating that “[o]ur caucus has no plans or interest in legalizing recreational marijuana.” It is also worth noting that Senator Leach also co-sponsored Pennsylvania’s medical cannabis legislation, which reportedly also lacked any Republican co-sponsors initially.

Pennsylvanians are facing a purposeful and strategic scheme to get recreational marijuana legalized in their state. It began with Governor Wolf signing Senate Bill 3, legalizing medical marijuana on April 17, 2016. Initially, the approved conditions were limited to 17 “serious medical conditions.” Those conditions have expanded from 17 to 23 since then, as seen on the PA website, under Qualifying Conditions. Anxiety, Dyskinetic and spastic movement disorders, opioid use disorder, terminal illness and Tourette syndrome have been added; and a few have been relaxed, such as Cancer now has added “including remission therapy.”

At first, dried leaves, plant material and edibles were strictly prohibited. Only those forms of medical marijuana listed in Act 16 were permitted. They included: 1) a form medically appropriate to administer by vaporization or nebulization; 2) pills; 3) topical forms, including gels, creams or ointments; 4) tinctures; 5) liquids; or 6) oils. Also, a licensed practitioner or medical professional determined which form is appropriate for the patient.

At the World Medical Cannabis Conference & Expo held in Pittsburgh in April of 2017, Daylin Leach said he expected medical marijuana would be available in plant form (dry leaf, flower) in 2018. He said a section of Senate Bill 3 authorized an advisory board to make recommendations about whether to change the permissible forms of the drug. During a panel discussion at the Expo, he said the following about the advisory board:

But they will [approve sale of the plant form of marijuana], because we’re appointing people to do that,” Leach said as the crowd laughed. “They will recommend that at latest by April 17 (2018), which means when dispensaries open, it is likely that they will have whole plant on their shelves from day one.

On April 16th, 2018 Governor Wolf announced he supported changes to the existing state medical marijuana program that would allow dispensaries to sell dry leaf marijuana or “flower,” and the PA Health Secretary, Rachael Levine, announced she approved the recommendation from the state’s advisory board to permit the sale of dry leaf “for patients with a qualifying medical condition.” The rationale was their desire to offer a lower-cost option to the forms permitted in Act 16. PA law still prohibited smoking medical marijuana or using it in edible form, but it was unclear how that rule would be enforced once the marijuana was purchased and taken home. Cannabis consumer advocate Chris Goldstein said: “I’m sure patients are going to go home and smoke it, and there’s nothing wrong with it. . .  This is how humans have used cannabis for 10,000 years and it’s how people should have access to it in Pennsylvania.”

Now there are six forms of medical marijuana available for consumption in PA: pills, extracts, liquids, topicals, patches, and flower. “Dry leaf/flower” went on sale at PA dispensaries on August 1, 2018. Daylin Leach was off on his time table, but accurate on his prediction that flower would be for sale in the first year.

In its first full year, Pennsylvania collected $2 million in tax revenue from growers and processors. Dispensaries reported $132 million in sales. Dr. Rachael Levine said: “Our goal for the next year and beyond is to increase the number of grower/processors and dispensaries operating, to register even more physicians and to continue the growth of our scientific, medically based program.” There are currently an estimated 72 medical marijuana dispensaries in Pennsylvania, with around 283 more applications for potential dispensaries as of the end of November, 2019. Writing for Law.com, Patrick McKnight said:

Pennsylvania’s medical marijuana program is noteworthy for its promotion of scientific testing. As part of the program, the state certifies eight academic clinical research centers. The mission of the clinical program is to conduct, “Research on the therapeutic or palliative efficacy of medical marijuana limited to the serious medical conditions defined by the act and the temporary regulations.” The state also has four approved laboratories for quality testing and sampling.

There are some serious researchers, like Staci Gruber, who are investigating the medical benefits of cannabis. She is an associate professor of psychiatry at Harvard Medical School and the director of MIND (Marijuana Investigations for Neuroscientific Discovery). She has done research on the effects of both recreational and medical marijuana. In an interview with The Harvard Gazette, Dr. Gruber said the science on the health effects of marijuana is not yet settled. “When we think about legalization we always like to have science inform policy. In this particular case, it seems to me that policy has outpaced science.”

Gruber said there is a lot we don’t know about the effects of marijuana. Most of what we do know comes from studies of “chronic, recreational marijuana users.” There are differences between recreational and medical marijuana use, with regard to what they use and how they use. She said there has been well-founded excitement about the potential for medical cannabis use. “[But] there’s a striking paucity of research on the use of medical cannabis.”

Dr. Gruber said her goal as a scientist was to provide truthful information so all people, regardless of their recreational or medical status, can understand what is in their cannabis. In pursuit of this goal, Dr. Gruber and her colleague Kelly Sagar continued a discussion of their research with “Marijuana on the Mind?” in Policy Insights from the Behavioral and Brain Sciences. You can also watch an archived webinar by Gruber and Sagar on the same subject, “Marijuana on the Mind: A Primer for Policymakers” on the website Social Science Space, where there are also written answers to some of the questions from the webinar. The presentation exists as an independent YouTube video as well. The audio cuts out a few times, but returns if you continue with the video.

In “Marijuana on the Mind?” Gruber and Sagar gave a helpful review of the history of medical use of marijuana, noting how it was included in the U.S. pharmacopeia (a list of medicinal drugs with their effects and directions for their use) until 1942. They also documented several areas of concern with marijuana, including its adverse effects on cognition, especially executive function and memory; brain development among adolescents; and safety concerns related to the frequency and magnitude of marijuana use as well as its potency. Based upon their discussion, policy recommendations given by Gruber and Sagar include:

  1. age restrictions based upon evidence highlighting the developmental trajectory of the adolescent brain;
  2. restrictions on targeting youths in advertisements;
  3. safe packaging guidelines to prevent the accidental ingestion of edible MJ products by children;
  4. place limits on THC potency as well as minimums for potentially beneficial cannabinoids in marijuana, like CBD;
  5. more research on the impact of medical marijuana, which will likely require a lessening of marijuana as a Schedule I substance

PA medical marijuana research would do well to partner with researchers like Gruber and her organization. Let’s allow research and not rhetoric guide the medical uses of the cannabinoids in cannabis. But is Pennsylvania’s commitment to scientific testing real or just window dressing?

Over four years ago in “Marijuana Peek-a-Boo” I suggested a strategy for legalizing recreational marijuana would eat the elephant one bite at a time. Keep the battles going state-by-state and simultaneously keep the federal government out of the fight. Legislatures within the states where marijuana is not yet approved should hear about the income and health benefits of legalizing marijuana, but not the existing problems where it has been approved. Information on the different kinds of cannabinoids in marijuana and their varying medical benefits—some greater than others—needs to be suppressed. Let them think the medical benefits are all or nothing with marijuana and not contingent upon specific cannabinoids within marijuana. The known health problems from smoking marijuana should be minimized or ridiculed.

Gruber and Sagar’s policy recommendations should be seriously considered and implemented by Pennsylvania. Lawmakers should read “Marijuana on the Mind?” and/or watch “Marijuana on the Mind: A Primer for Policy Makers.” They could also read, “Marijuana Policy Has Run Ahead of Science,” which is a discussion of Gruber and Sagar’s article. The scientific testing and research of marijuana by the Commonwealth needs to be seriously and aggressively pursued. The benefits and problems with cannabinoids like THC and CBD need to be researched and described. So far it seems there are limited health benefits from THC. See “Listening to Marijuana Research”  or “Marijuana & Adverse Health Effects” for more information on this. Then there are two previous articles I wrote on marijuana legalization in Pennsylvania: “Keep Marijuana Medical in PA” and “Marijuana Stepping Stones In PA?”

09/12/17

Trouble in Plumas County

© Natallia Yeumenenka | 123rf.com; “Plumas” is Spanish for feathers.

Situated in the Sierra Nevada region of California, Plumas County is an attractive recreational destination for a wide variety of activities, including boating, camping, fishing, hiking, skiing, hunting and others. The Explore Plumas County webpage says it is “a Wilderness of Wonders,” where the wilderness is untouched. “Natural beauty is etched in the snow-capped peaks and towering pines.” It is said to be a four-season travel destination with fresh mountain air and pristine, blue waters. You are encouraged to explore the mountain ranges and wilderness, where there is “something new to discover with each experience”—including illegal marijuana growers.

I’m not a resident of Plumas County. But as I was completing another article (“Pot Market Getting a ‘Black’ Eye”) on the problems with how the expanding recreational marijuana has helped the black market for marijuana to flourish instead of weakening it, I ran across the current debate over marijuana in Plumas County. Looking closer at the issues in this small, rural county helps to illustrate some of the problems that come with the political and cultural pressures to legalize marijuana.

The photos on the Explore Plumas County webpage are seductively beautiful. I want to go visit; maybe for a very long time. The county is in the northern end of the Sierra Nevada range. The entire county population is only 20,007, as of the 2010 census. But Plumas County is in the midst of a political and culture war over whether or not there should be a greater presence of marijuana in the county. Cannabusiness Law noted currently there is a ban on the retail sales of marijuana as well as manufacturing. Current zoning codes do not permit commercial marijuana growing, but the codes are under review. The webpage also provides you with information to contact local officials and let them know you oppose the bans … or approve them, I’d add.

On November 8, 2016, California voters approved Proposition 64, the Adult Use of Marijuana Act (AUMA). Beginning in 2018, it allows “the sale of marijuana for adult use in licensed stores under regulations to be established by the state Dept. of Marijuana Control (DMC) in conjunction with local governments.” The possession and use of up to one ounce of marijuana (or 8 grams of concentrates) and personal use cultivation of up to six plants is also legal. It also reduces fines for most illegal cultivation, sale, transport and possession for sale offenses from felonies to misdemeanors—with possible exceptions for violent or repeat offenders. See the California NORML website for the following quote and more information on Proposition 64 and other California marijuana laws.

Commercial sale, cultivation, and production of marijuana are allowed only by licensed providers. Illegal sale, transport, manufacture, cultivation, or possession with intent to sell are generally punishable as misdemeanors, with felony enhancement allowed for special circumstances and three-time offenders. Minors under 18 are in no case subject to imprisonment, but may be punished by drug education and community service.

Medical marijuana has been legal in California since 1996 with Proposition 215, the Compassionate Use Act. And it is because of the fallout from that change that many of the current problems in Plumas County have occurred. The Los Angeles Times reported that four weeks before the 1996 general election where Proposition 215 was approved, Senator Diane Feinstein said “you’ll be able to drive a truckload of marijuana through the holes in it.” The devil is in the details, and she said this particular bill lacked details. Nevertheless, the assessment of the author of the LA Times article was it had been an incredible success, despite its vague wording and instances of abuse. Read on before you accept that statement.

After the approval of Proposition 215, the cultivation of marijuana took off in the so-called Emerald Triangle, consisting of the counties of Mendocino, Humboldt and Trinity, along the northern coast of California. Plumas County is on the opposite, eastern side of the state, at the same latitude as the Emerald Triangle counties. The Emerald Triangle has been estimated to produce 60% of America’s marijuana. As was noted above, Plumas County previously banned the retail sales and manufacturing of marijuana, and had zoning restrictions for the cultivation of marijuana. Nevertheless there have been serious problems with illegal activities involving marijuana within the county.

In July of 2015, Plumas County authorities reported that along with Forest Service law enforcement, they recovered about 23,000 marijuana plants at two separate locations. The estimated value of the plants was in excess of $10 million. Officers from Plumas County SWAT, the Forest Service and California Fish and Wildlife took part in the eradication raids. Two suspects were encountered near one site, but they avoided capture in the brushy steep terrain. Residents were encouraged to contact authorities if they saw any signs of marijuana gardens, such as drip lines, gardening tools, bags of fertilizer or pesticides, trash piles or remote campsites.

In August of 2016, John Bartell reported for KXTV how the Plumas National Forest was plagued with illegal grows. Reportedly, teams were finding illegal grows on a weekly basis. One local cattle rancher said he lived next to an illegal marijuana grow. “They had pit bulls running free and they attacked 2 cows and bit their ears off.” A Plumas County detective said they regularly encounter a number of individuals who are not residents of the United States cultivating the gardens. Often they turn out to be Mexican nationals. “Some are out here for 3 or 4 months and are promised $10,000 or $20,000 to grow.” There have been instances of hunters wandering into fields where they were killed. Safety in the Plumas National Forest is now a serious concern.

This is not simply an isolated problem for Plumas County. In Yosemite National Park, park rangers are regularly discovering and destroying large marijuana growing operations, attributed to the same Mexican cartels. Here is a video report on this problem from the Travel Channel. A park ranger is quoted as saying the park has had several marijuana growing plantations located within its borders. Some of these growing plantations have been worth as much as $14 million. “These are not simply a few people that want to have a garden and grow something for their use.”

There is a “Plumas People Opposed to Commercial Cannabis” Facebook page with multiple articles describing issues from the illegal marijuana grows. Banned pesticides are showing up in California water. A Reuters article, appearing on US News & World Report, noted toxic chemicals from illegal marijuana farms are found in California’s rivers and streams feeding the state’s water supply. The chemicals have turned thousands of acres into toxic waste dumps. Law enforcement officers who have inadvertently touched plants and equipment have been hospitalized. ”Scores of animals have died.”

A New York Times article noted that despite the promise of a legal market, many growers are not signing up. Hezekiah Allen, the executive director of the California Growers Association, estimated only about 11% of growers in the Emerald Triangle have applied for grow permits. The paperwork to obtain a permit, the fees and the taxes are given as reasons for not doing so. Lori Ajax, the chief of California’s Bureau of Cannabis Control said there are folks who have been operating for a long time with minimal local oversight or no oversight at all. She thought it was going to take some strong enforcement to bring people into the regulated market.

California, which by one estimate produces seven times more marijuana than it consumes, will probably continue to be a major exporter — illegally — to other states. In part, that is because of the huge incentive to stay in the black market: marijuana on the East Coast sells for several times more than in California.

The drastically reduced legal consequences in Proposition 64 for most of the illegal offenses related to the cultivation, sale, transport and possession of illegal marijuana from felonies to misdemeanors, at least for the first couple of offenses, means there is very little motivation for illegal growers to enter the legal market. The Mendocino County district attorney said people living in the urban centers of California, like San Francisco, Los Angeles, and San Diego don’t realize the crime rate in the rural areas where marijuana is being grown.

Among the cases he is handling are a robbery and slashing death of a grower; the murder of a man at a marijuana farm by a co-worker wielding a baseball bat; an armed heist in a remote area by men who posed as law enforcement officers; and a robbery by two men and a juvenile who were invited to a barbecue and then drew guns on their hosts and fled with nine pounds of marijuana.

There was a meeting of the Plumas County Cannabis Working Group on the afternoon of Thursday, September 7th, 2017. The Facebook page for the Plumas People Opposed to Commercial Cannabis Facebook page related some of the concerns expressed by residents. One concerned resident noted how the drafted ordinance document was written by a pro commercial growing committee, “whose members stand to make large amount of money.” She also raised the issue of the potential environmental impact of water, pesticides and drainage into their creeks and rivers. Another person during the meeting raised a concern that approving commercial grow operations would lead to less county and/or state support to address the anticipated increase in local crime. A pro grower responded by saying high fences, guard dogs and private security forces would keep criminals in check. The concerned individual responded: “Yes, that’s JUST what we want here.”

In an open letter to the Plumas County Supervisors, another Plumas county resident noted how some individuals said the best way to improve Plumas County was to bring in the anticipated influx of cash from approving commercial growing. “They urge us to look for the money, trust them for a higher standard of character and compliance than has been reported elsewhere, and trust the free market.” But that isn’t happening in other areas. See “Pot Market Getting a ‘Black’ Eye.”

Another resident also voiced her concerns that every member of the Cannabis Work Group was someone in favor of commercial cultivation. The Work Group was “not a balanced representation.” She noted where the issue of odor was minimized. See the above linked New York Times article for a report that a police reconnaissance helicopter could smell pungent marijuana plants from 800 feet above an illegal grow. Concerns over an increase in crime, homelessness and changes in the community culture have been largely unanswered, she said.

credit: Sierra REC Magazine

People move to or visit Plumas County for the natural beauty, rural lifestyle, recreational opportunities, the mountain air, the open vistas, to raise families, to escape the culture and crime of the city. All of these would be changed in some degree by widespread cannabis cultivation. High fences would predominate, along with heavily secured tall hoophouses. The oft-referenced Mexican Cartels are unlikely to simply pack their suitcases and go home; what will they do here instead? Who will buy up properties and small farms and lease acreage for this lucrative crop? What large commercial interests may impact land use, local politics, ecological concerns, the small town culture? How does greed divorced from responsible citizenship change a community?

The decision on commercial marijuana growing in Plumas County isn’t finalized yet. The next scheduled meeting of the Cannabis Working Group is Thursday September 14th, starting at 10 AM PDT. There are a number of issues it seems; these are only a few. Will the façade of an unbalanced work group be addressed? What about the impact on local crime and the environment? If this is supposed to bring money into the county, how will that work when already California produces multiple times the amount of cannabis that can be consumed in the state? And it will be illegal to send any cannabis grown in Plumas County out-of-state. Doesn’t that set the county residents up for an explosive increase in illegal grows if commercial marijuana growth is approved? That is what happened in Colorado, which was better prepared enforcement-wise for recreational marijuana than California seems to be.

I live in Allegheny County, Pennsylvania, in a township whose population in the 2010 census was over 8,000 more than the entire population of Plumas County. My home state approved the Pennsylvania Marijuana Act (for medical marijuana) on April of 2016. There aren’t any dispensaries open yet; the state has just begun to register practitioners. In June of 2017 twelve companies were awarded growing licenses, including one in western PA fronted by Jack Ham, a former linebacker for the Pittsburgh Steelers. Growing will only be done in warehouses.

The only types of medical cannabis allowed initially are pills, oils, gels, creams, ointments, tinctures, liquid, and non-whole plant forms for administration through vaporization. Given the issues noted above in Plumas County and other counties in California, I hope residents of my home state will work together, as the residents of Plumas County are currently doing, to prevent similar concerns from developing in Pennsylvania. Residents of other states that have started down the road to legalization, be forewarned and learn from the current trouble in Plumas County.

If you sympathize with those Plumas County residents opposed to commercial marijuana growth in their county, give them some encouragement on the “Plumas People Opposed to Commercial Cannabis” Facebook page.

09/8/17

Pot Market Getting a “Black” Eye

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On April 3, 2017 the governors of four states with legalized recreational marijuana—Alaska, Colorado, Oregon and Washington—sent a letter to Attorney General Jeff Sessions. They asked that the Trump administration “engage” with them before making any changes to the existing federal regulatory and enforcement systems. Their particular concern was potential revision to the “Cole Memo,” an Obama-era policy that attempted to strike a balance between federal interests and state sovereignty in the growing legalization of marijuana. The governors said the Cole Memo provided guidance to the foundation of state regulatory systems and was “vital to maintaining control over marijuana in our states.” They warned that overhauling it could produce unintended consequences such as diverting “existing marijuana product into the black market and increase dangerous activity in both our states and our neighboring states.”

On July 24, 2017, Attorney General Sessions replied individually to the governors who signed the April 3rd letter. You can review copies of the letters sent to Governor Brown of Oregon and Governor Inslee of Washington. Each letter pointed to documents from the respective states that raised serious questions about the efficacy of marijuana “regulatory structures” in that state. He then directed their attention to the concluding paragraph of the memo that said it “does not alter in any way the Department’s authority to enforce federal law, including federal laws relating to marijuana, regardless of stat law.”

Among the specific concerns for Oregon Sessions highlighted was that only 30% of the marijuana market in Oregon was compliant with state marijuana laws. There was a “pervasive illicit cannabis cultivation in the state,” which was trafficked out-of-state. Law enforcement was said to be unable to keep pace with out-of-state diversion. “The reality of legalization is that it has provided an effective means to launder cannabis products and proceeds.” Individuals were said to be exploiting legal mechanisms to obscure their products’ origin and their true profits.

Among the concerns he highlighted for Washington was the lack of regulation and oversight of the medical marijuana market has “unintentionally” led to a growth of the black market. “Since legalization in 2012, Washington State marijuana has been found to have been destined for 43 different states.” The recreational marijuana market is incompletely regulated. One of the leading regulatory violations has been the failure to use and/or maintain the traceability of marijuana products.

Writing for The Washington Post, Christopher Ingraham said the Sessions’ letter indicated he remained deeply skeptical of efforts to legalize recreational marijuana. But for now, Justice Department actions will be dictated by the Cole Memo. Federal non-interference seems to hinge on whether there is evidence of a public health or safety threat. John Hudak, a drug policy expert with the Brookings Institution, said the Sessions letter is an important indicator that Sessions is serious about enforcing marijuana law under the Cole Memo. He also expressed concerns with the accuracy of the data Sessions cited. He said reports compiled by law enforcement authorities were “notorious for cherry-picking data and failing to put data into context.” He suggested the Attorney General was drawing conclusions on incomplete data or data taken out of context.

Reporting for the Associated Press, Andrew Selsky said Governor Brown responded to Attorney General Sessions, noting the document he cited to her on Oregon marijuana problems was invalid and had incorrect data and conclusions. She went on to say new laws, including the tracking of all marijuana grown for legal sale, will help cut down on diversion into the black market. She added that she had recently signed legislation making it easier to prosecute the unlawful import and export of marijuana products. A Washington state official similarly said Sessions made claims about the situation in the state of Washington that were “outdated, incorrect, or based on incomplete information.”

Pause for a moment here. There isn’t denial that diversion occurs, just that the data the reports were based on was incorrect, outdated, incomplete. The thinking seems to be that more legalization will lessen the black market problem. Oregon Congressman Earl Blumenauer said: “”The more that we go down the path of legalization, regulation and taxation, diversion becomes less and less of a problem.” But is this just wishful thinking, rhetoric expressed to encourage the ongoing march towards nationwide legalization?

In a different article, Selsky noted the movement in several states, including Oregon, Colorado and California to implement tracking systems for marijuana and marijuana products. “The tracking system is the most important tool a state has,” according to Michael Crabtree. But as the systems rely on user honesty, they aren’t fool-proof. ““We have seen numerous examples of people ‘forgetting’ to tag plants.”

In California, recreational pot sales become legal in January of 2018. The Emerald Triangle area of northern California is the largest cannabis-producing region in the U.S. It is estimated to produce 60% of America’s marijuana. Although growers have been cultivating marijuana in the area since the 1960s during San Francisco’s Summer of Love, the industry really took off when Proposition 215 legalized medical marijuana in 1996.

Senator Mike McGuire, who represents the Emerald Triangle region, thought California’s tracking program would help limit the cannabis black market. But implementing a fully operational legal market in California could take years. “In the first 24 months, we’re going to have a good idea who is in the regulated market and who is in the black market.”

Anthony Taylor is a licensed marijuana processor and lobbyist. But as far back as the 1970s, he was growing cannabis illegally in an area east of Portland. He said it is easier to grow marijuana illegally these days because authorities don’t have the resources to uncover every operation. Growers who risk selling outside the state can earn thousands of dollars per pound, according to Taylor.

The Los Angeles Times reported that Hezekiah Allen, the executive director of the California Grower’s Association, warned that California growers are in for a “painful downsizing curve” when new laws go into effect in January of 2018. “We are producing too much.” He estimated the state cannabis growers produce eight times the amount of marijuana the citizen’s of the state can consume. He expects that some growers will stay in the black market and continue to illegally send marijuana to other states. Some growers may stop growing cannabis, but he expects others simply just won’t apply for state permits.

Lori Ajax, chief of California’s Bureau of Medical Cannabis Regulation said: “For right now, our goal is to get folks into the regulated market, as many as possible.” But, “There are some people who will never come into the regulated market.”

A Denver Grand Jury indicted 62 people and 12 businesses for operating the largest illegal marijuana uncovered in Colorado since Colorado legalized recreational marijuana in 2012. The drug bust, known as Operation Toker Poker, executed almost 150 search warrants at 33 homes and 18 warehouses and storage units in Denver. Seizures included 2,600 illegally cultivated marijuana plants and 4,000 pounds of marijuana. The ring operated from 2012 to 2016 and brought in an estimated $200,000 a month. The operation produced more than 100 pounds of cannabis monthly and shipped it to Kansas, Texas, Nebraska, Ohio, Oklahoma and other states.

Read original articles on Operation Toker Poker here at: The Denver Post, U.S. News, and the Daily Mail.

The DEA and State Patrols for Kansas and Nebraska participated in the investigation. Barbara Roach, special agent in charge of the DEA’s Denver field office, said since 2014 there has been an influx of organized criminal groups coming to Colorado in order to produce marijuana to sell in other states. “The marijuana black market has increased exponentially since state legalization.” Colorado Attorney General Cynthia Coffman said: “The black market for marijuana has not gone away since recreational marijuana was legalized in our state, and in fact continues to flourish.”

Andrew Freedman, a cannabis regulation consultant, said he is hopeful that state legislation passed in 2017 will make it more difficult for criminal to grow quantities of marijuana for the so-called “gray market,” while using a legal interest in the business as a cover. “

 I do think the experiment is under the microscope, . . . Anything negative that happens will be a national story. This was a weakness in our system, and I’m hopeful the legislation shores up that weakness, but it is something the story will be judged on.

So it seems the expectation that ongoing legalization of recreational marijuana will make diversion less of a problem is wishful thinking. It may even be rhetoric to calm the fears of individuals who are unsure about where they stand on the issue. What does seem clear from the information above is that legalizing recreational marijuana in Colorado hasn’t made diversion go away; and officials seem to think it has been “flourishing.” At least one California official expects state regulation will not be followed by all the instate cannabis growers when the new laws go into effect. Even cannabis supporters acknowledge there will be a time lag of perhaps years before the regulatory machinery can get a handle on illegal cannabis growers.

08/19/16

Head-in-the-Sand

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© andreykuzim | 123rf.com

Within the U.S. the legalization of medical and recreational marijuana has rapidly increased over the past few years, but not without some disturbing trends. One of these is the rise in THC potency within cannabis. The 2016 World Drug Report (2016 WDR) indicated that cannabis THC potency in the U.S. has been increasing over the past thirty years. It went from less than 3.4% in 1993 to 8.8% in 2008. Bloomberg reported that more recent data suggests that THC potency in cannabis increased to 12.6% in marijuana seized by authorities in 2013. In states where recreational marijuana is legal, such as Colorado and Washington, some samples have reached as high as 30%, with the average around 17%, according to the 2016 WDR.

Mehmedic et al. published an article in the September 2010 edition of the Journal of Forensic Sciences that also concluded the increasing potency of THC in cannabis. While there was the above noted increase of THC in cannabis seized by authorities, the CBD concentration increased only slightly, from .3% to .4%. The cannabinoid with the greatest known medical potential in marijuana is CBD, not THC. The researchers concluded not only was cannabis more potent, the market share for higher-potency products was increasing. “The question now becomes: What are the effects of the availability of high-potency products on cannabis users?”

A partial explanation for the increased potency in legal commercial markets like Colorado is the popularity of edible cannabis products made with cannabis extract-based concentrates such as oil, “wax,” or “shatter.” The THC potency of these extracts can be up to 80-90 percent. In 2014, edible products accounted for an estimated 35% of retail sales of recreational marijuana in Colorado. This makes it difficult to determine the dose or amount of THC ingested in an edible, leading to potential over-intoxication. “With edible products, the slower onset and longer duration of intoxication could increase the risk of over-intoxication, especially for new or inexperienced users.”

One way of regulating this concern has been to implement stringent labeling and packaging requirements. Washington and Colorado require edibles to have a 10mg serving size of THC. Alaska and Oregon have drafted legislation to set the serving size at a maximum of 5 mg of THC. The increasing potency has not been the only concern within states where marijuana is now legal.

Since the legalization of recreational marijuana in Colorado and Washington, incidents of accidental ingestion of cannabis among young children have been increasing. The Washington Poison Control center reported the number of cannabis exposure calls for people under 20 doubled from 2010 to 2014. In Colorado, within one year of legalization there was a 29% increase in the number of marijuana-related ER visits and a 38% increase in the number of cannabis-related hospitalizations.

More people using marijuana recreationally means an increase in the number of individuals driving under the influence of marijuana. The 2016 WDR said studies suggested that although cannabis seemed to be less hazardous than alcohol with regard to driving impairment, it is much more dangerous when used in combination with alcohol. In both Colorado and Washington there have been increases in the percentages of crashes and fatal crashes of drivers who tested positive for marijuana from 2012 to 2015.

Not surprisingly, the number of arrests and court cases with cannabis-related offences dropped substantially in state that have legalized marijuana. But data on other marijuana-related offences such as citations or warnings for public consumption were not readily available. See the following chart taken from the 2016 WDR.

chartHowever, there has been a ripple effect of drug concerns in the states adjacent to states where recreational marijuana is legal. In December of 2014, Nebraska and Oklahoma sued Colorado, requesting that the U.S. Supreme Court reverse Colorado’s decision to legalize marijuana, as it had led to an increase in trafficking marijuana in these neighboring jurisdictions. Attorneys for Colorado and the Obama administration asked the Supreme Court not take up the lawsuit. But as it turned out, the Court was also reluctant to take on the dispute as well.

The Supreme Court justices spent more than a year pondering whether to take the case. The proposed lawsuit was scheduled and re-scheduled five times for a closed-door conference, where the justices would debate the merits of taking the case.

In March of 2016 the Supreme Court declined by a vote of 6-2 to hear their complaint against Colorado. But the vote did not rule out future challenges. The Colorado Attorney General said that while the state has had several legal victories in federal lawsuits surrounding Amendment 64 legalizing recreational marijuana, Nebraska and Oklahoma’s concerns will not disappear. Doug Peterson, the Nebraska Attorney General was quoted by the Denver Post as saying: “The Court’s decision does not bar additional challenges to Colorado’s scheme in federal district court.” The Oklahoma Attorney General, Scott Pruitt said:

The fact remains — Colorado marijuana continues to flow into Oklahoma, in direct violation of federal and state law. Colorado should do the right thing and stop refusing to take reasonable steps to prevent the flow of marijuana outside of its border. And the Obama administration should do its job under the Constitution and enforce the Controlled Substances Act. Until they do, Oklahoma will continue to utilize every law enforcement tool available to it to ensure that the flow of illegal drugs into our state is stopped.

The federal government cannot continue to sit on the sidelines while recreational marijuana laws take hold state-by-state. The medical potential needs to be scientifically delineated and a step towards that is rescheduling marijuana as a Schedule II controlled Substance. The adverse effects of increased THC potency should be investigated, monitored and ultimately regulated. The collateral harm in neighboring states where marijuana is not legal should be dealt with cooperatively between states or result in federally mediated changes. Continuing a head-in-the-sand approach at the federal level is no longer a viable option.

The United Nations Office on Drugs and Crime (UNODC) publishes a yearly report giving a global overview of the supply and demand of various drugs and their impact on health.  This is one of a series of articles discussing information from the 2016 World Drug Report.

04/20/15

Medical Reform or Medicinal Con?

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© lightwise | 123RF.com

In my home state of Pennsylvania, the legislature is considering the legalization of medical marijuana. At least one activist believes it will happen in 2015: “We have the votes for it. It’s going to happen this term.” Jon Delano of KDKA cited Jay Costa, the Democratic Senate leader, as saying the medical marijuana bill is likely to be approved this spring. Legislation has been introduced in the Senate and gone to committee. “And it is very likely over the course of the next couple of months it will pass through the Senate and make its way over to the House.”

The new governor, Tom Wolfe, has publically said he would support medical marijuana in PA: “I believe that doctors who can now prescribe some of the most potent drugs in the world should be able to prescribe medical marijuana.” The problem seems to be in the State House, which is currently holding hearings on its own legislation. Tony Romeo with CBS Philly reported that law enforcement stressed the need for strict regulatory control if medical marijuana was legalized. Republican Matt Baker, chair of the House Health Committee said:

I am very cynical and skeptical about moving forward with this. And I think there are a lot of unresolved issues, and when you talk with the medical groups and the scientific community, they’re very, very concerned about us putting on white coats and trying to play doctor here.

Polls indicate that most Americans support the legalization of medical marijuana. More than half of the US population now lives in a state where marijuana in some form (medical or recreational) is legal. But take some time to really review this compilation of surveys on marijuana legalization on PollingReport.com. Several polls by organizations like the Pew Research Center, Gallup, and CBS News show a changing trend of Americans over time to agreeing that marijuana should be legalized, when the question is put as: “Do you think the use of marijuana should be made legal, or not?” All three organizations reported results that were essentially the same as the October 2014 Gallup poll—51% said yes to legalization; 47% said no to legalization.

But now look further down at a nationwide poll by the Pew Research Center taken in February of 2014, when the question answers had more options. There the question was: “Which comes closer to your view about the use of marijuana by adults? It should be legal for personal use. It should be legal only for medicinal use. OR, It should not be legal.” The results were: 39% said marijuana should be legal for personal use; 44% said it should be legal for medicinal use; 16% said it should not be legal; 2% were unsure or refused to answer.

Then the Pew Research Center published their newest poll on legalizing marijuana on April 14, 2015. This survey reported that 53% of Americans favored legalization, while 44% opposed legalization. Millennials (18-34) had the strongest support for legalization, with 68% in favor and 29% opposed. Among those who said marijuana should be legal, 78% did not think the federal government should enforce federal laws in states that allow its use. Conversely, among those who think marijuana should be illegal, 59% said there should be federal enforcement.

The most frequently cited reasons for supporting legalization are its medicinal benefits (41%), the belief that it is no worse than other drugs (36%) and its potential for tax revenue (27%). The most frequently mentioned reasons why people oppose legalization were that it hurts society and is bad for individuals (43%), and it is a dangerous, addictive drug (30%). So it seems that the Pew Research polls suggest there is more support for the use of medicinal marijuana than recreational marijuana.

Returning now to the compilation of results on Pollingreport.com there are some further interesting results in two other polls. In a CNN/ORC Poll done in January of 2014 the legal, not legal dichotomy gets most Americans saying marijuana should be legalized. And there is support for decriminalization measures as well. However, there are two other interesting results. 88% percent of the people polled think that marijuana should be able to be legally prescribed for medical purposes by their doctor. When asked if Colorado’s legalization of recreational marijuana was a good idea, a bad idea, or if you want to wait and see what happens before deciding, 33% thought legalization was a good idea; 29% thought is was a bad idea; and 37% wanted to wait and see what happens before they decide!

A Fox News Poll taken in February of 2013 asked if you thought that most people who smoke medical marijuana truly need it for medical purposes or just want to smoke marijuana; 30% said they truly needed it; 47% thought they just wanted to smoke it; 12% said it depended upon the person; 11% were unsure. Although there aren’t many well-accepted medical uses for marijuana as this point in time, there are some.

A 2007 study in the journal Neurology showed that marijuana is effective in reducing neuropathic pain in HIV patients. Live Science also reported marijuana, when combined with opiates, led to dramatic levels of pain relief. It has been helpful in reducing stiffness and muscle spasms in MS (Multiple sclerosis). It appears useful for reducing nausea induced by chemotherapy. Medical marijuana has been touted as a treatment for glaucoma, but other drugs are more effective.

Legalizing medical marijuana now will not just legitimize its medicinal use for these generally accepted conditions, it would permit the medicinal use of marijuana whenever the individual has been given a prescription for it by a doctor. Without reliable, scientifically replicated studies of the claims for medical marijuana efficacy, we would be returning to the times of patent medicine, where medical marijuana is claimed to treat almost anything and everything. The CNN polled opinion that medical marijuana users didn’t really need it, but just wanted to smoke it would then come true.

Sensible use of medical marijuana should follow the established procedures for all medicinal substances—approval by the FDA. As the medical usefulness of marijuana for a condition is demonstrated through this process, it would then become a FDA approved medicine.  I realize that once marijuana reaches this bar of approval, it would then be available for off label use for other medical conditions. But it would also then be REGULATED like all other medical treatments. The current process of state-by-state legislative approval of marijuana for medical purposes circumvents this regulative process. It was established to protect American citizens from the fiascos of past medical treatments that turned out to be ineffective at best and harmful at worst.

Reform must start at the federal level. Given that marijuana has been a Schedule I controlled substance, its availability for the kind of medical research needed to gain FDA approval has to be increased. So a first step would be changing its status from a Schedule I controlled substance to that of Schedule II. The reclassification would make it easier to do the needed research on its legitimate medical uses. I’d suggest delaying the approval of medical marijuana in Pennsylvania and the other states where it is not yet legal until research demonstrating its medical usefulness has gone through the FDA clinical trial process. This would delay the approval of medical marijuana, but it would establish a more stable path forward for the legitimate medical use of marijuana. Debates for the off label medical use could occur alongside those now going on for other classes of FDA approved drugs such as antipsychotics and antidepressants.

Incidentally, there was a bill introduced in the U.S. Senate to reclassify marijuana from Schedule I to Schedule II, the Compassionate Access, Research Expansion and Respect States (CARERS) Act. While it is gaining support, key leaders in both parties have reservations. As the Motley Fool pointed out, the proposed loosening of federal restraints comes just as a new study of the effects of heavy marijuana use on long-term memory in adolescents was published. I hope that if ongoing research demonstrates the need for further restrictions on the medicinal use of marijuana, there would be public and legislative support for that as well.

I suspect this suggestion would not be acceptable for many medical marijuana activists because their final goal is not just the medicinal legitimization of marijuana. Acceptance of medical marijuana may be the first steppingstone towards the legalization of recreational marijuana. As the polls show, there seems to be wider support for the medical use of marijuana than for the recreational use of marijuana. So press for the medical use of marijuana now, and then recreational approval at a future date.