Debate Forum: 4/19/16

One of the Top Ten woman of the year, Marsha Bonhart. One of the Top Ten woman of the year, Marsha Bonhart.

Marijuana, don’t you wanna?

National pot peer pressure
By Sarah Sidlow

Woah, weed.

Who knew one little leaf could be so polarizing, so political, so unbelievably complicated?

With (cough) 4/20 in the air, and state elections looming through the haze in November, let’s get an update on where we stand at the global, national and state levels.

The United Nations begins a three-day summit today in New York for a special summit on global drug policy. Cleverly named the United Nations General Assembly Special Session (UNGASS) on the World Drug Problem, the summit is the first of its kind since 1988, and specifically aims to address the state of global drug policies. Backers are hopeful that it will encourage suggestions on less strict marijuana policies from countries that have already done so. Looking at you, Uruguay. Unfortunately, with so many cooks in the kitchen, and all with a different idea of how drugs and their users should be regulated, taxed and/or punished, experts say the meeting “is unlikely to be the game changer in global drug policy that some are seeking.”

In D.C., the Supreme Court recently said “no thanks” to the opportunity to hear a case challenging Colorado’s legalization of recreational marijuana. The case: Colorado’s neighbors Nebraska and Oklahoma were essentially arguing that since marijuana is now legal in Colorado, it increases the likelihood of marijuana-related offenses taking place in Nebraska and Oklahoma—creating a law enforcement burden on those states. Though Justice Alito thought SCOTUS should hear the case, the Supremes’ ultimate denial demonstrates a definite disinterest in picking apart pre-existing marijuana laws.

Also, the Drug Enforcement Administration has sent a letter to senators saying it plans to decide whether marijuana should reclassified under federal law in “the first half of 2016.” Missed the memo? Basically, marijuana is currently classified as a Schedule I drug, alongside other serious drugs like heroin, MDMA and ecstasy. This makes it impossible for scientists to study, and also very, very bad if you have it where you shouldn’t. Re-scheduling marijuana to a lower classification wouldn’t legalize it, but it would make things a whole lot easier for a whole lot of people.

And President Obama recently commuted 61 drug sentences, bringing his total number of commutations to 248, for those of you keeping score. Though President Obama ended up being more moderate on many of his proposed criminal justice policies than Candidate Obama, this big number, with more to come, will help cement his legacy while adding to the national discourse about marijuana in our society.

And here in the Buckeye State, pot, this time of the medical variety, is back on the ballot, after the Medical Cannabis and Industrial Hemp Amendment has passed the initial stages. The amendment would allow adults to grow, possess and use marijuana for medicinal purpose and allow farmers to cultivate industrial hemp.

With all these moves being made at the state, national and international levels, people are having some honest-to-goodness conversations about the future of this lionized leaf. For the first time ever, recent polls indicate that over 50 percent of Americans approve the legalization of marijuana for medicinal and recreational purposes. Yet states still face challenges within their own infrastructure to pass marijuana reform laws. Moreover, states that have already legalized are still limited by federal restrictions. Is it time for common consensus to play a role in marijuana legalization?

Reach Dayton City Paper freelance writer Sarah Sidlow at SarahSidlow@DaytonCityPaper.com

Move on down, Mary Jane

By Michael Brice Keller

At this point in time marijuana is a Schedule I drug, meaning it is in the same category as heroin, LSD and ecstasy. According to the DEA, that means it has a high potential for abuse, has no currently accepted medical treatment use in the U.S. and there is a lack of accepted safety for use of the drug or substance under medical supervision.

In states where marijuana is legal, it is used to treat many conditions from epilepsy to multiple sclerosis, yet they say there is no accepted medical treatment use.  According to the DEA, marijuana is more dangerous than cocaine! There has never been a death from a marijuana overdose.  This is because you would have to consume 1,500 pounds of marijuana in about 15 minutes, which is impossible. It’s very clear that marijuana is in the wrong drug class, at the very least.

In the late 1800s and early 1900s, cannabis was a regular part of the U.S. Pharmacopeia. The Marijuana Tax Act of 1937 effectively banned uses and sales of marijuana through a strict tax, even though it was in many homes as an ingredient in numerous medicines! Marijuana was made illegal partly because testimony that was given created fear and panic among white people.  They said that marijuana made men of color become violent and solicit sex from white women.  Claims like these had a huge impact on the outcome. They struck fear into the people and it worked. They banned a plant that was already being used as medicine.

There is no reasonable logic that says marijuana should be classified as one of the most harmful drugs.  It is way less addictive than drugs in the same class as well as drugs in lower classes, it has shown many different medical uses in states where it is legal and you simply cannot overdose from it.  Common sense should tell us this couldn’t possibly be one of the drugs that need the most dangerous ratings.

The Supreme Court overturned the Marijuana Tax Act of 1937 in 1969 but the Nixon administration and Congress passed the Controlled Substance Act.  Marijuana was temporarily put in Schedule I as a holding place until they could review it and decide where it belonged.  The commission studied marijuana and then advised the administration where it should be placed.  The commission found that marijuana was indeed a less serious threat to public health.  The commission thought that each person should be permitted to possess a small amount of marijuana at that time without consequence but it should still remain illegal.  The Nixon administration wanted to be “hard on drugs,” ignored these recommendations and set the stage for further escalation of the drug war.

The U.S. government has a patent on marijuana, noting its neuro-protective qualities.  The time of denying medical benefits of cannabis is rapidly coming to a close and the DEA even has recently published a letter in which they suggest rescheduling may be coming in the first half of 2016.  There are presently 23 medical marijuana states and Pennsylvania is soon to be 24.

Gov. Kasich (noted legalization opponent) has even cited that it is “incumbent” on him to consider medical marijuana.  Now with the introduction of medical marijuana legislation in Ohio, it could be just months away from law, and hopefully the 25th medical marijuana state.  Cannabis is a leading contender in the fight against cancer, yet is sidelined in illegality and stigma.  Government interference with medical access is the worst part of the story.

The focal point for the informed is quite simply this: Marijuana is best controlled with a model similar to tobacco or alcohol. The federal policy is far more advanced than many states and has been “states’ rights” for years. Considering the “Cole” Memo, full legalization in four states and a recent Supreme Court declination, this bolsters the “laboratories of democracy” model.

The governor has suggested that it’s not state policy to target consumers.  Local decriminalization efforts in Ohio and efforts across the nation are on the horizon.

The best approach is clearly to remove marijuana from DEA’s list of controlled substances.  De-scheduling is most appropriate, with most states treating marijuana similar to alcohol.  A half measure of just “reducing” to Schedule II would certainly be progress, but far from the prompt action we need in this area. A vast majority of the harms associated with marijuana are because of the criminal labeling.  Alcohol is a noted contributor to violence and marijuana, a noted contributor to chilling.

It is time to de-schedule cannabis now.

Michael Brice Keller is a disabled veteran and Dayton based defense attorney who works on the Appointed Counsel Rosters in Southwest Ohio. He believes current marijuana laws are unjust, costly and cause significant harm, particularly to minorities. He and his network partners advocate for marijuana legalization, as it is objectively safer than alcohol and pharmaceuticals. Discover more at GreenFightOhio.com, BriceKellerLaw.com, or call 937-5400-LAW.

Mean marijuana

By Dave Westbrock

Our old friend cannabis is back. Now the argument is not so much a libertarian one in favor of the general freedom to smoke weed, but of the great advantages to the general public in favor of the medicinal qualities of Mary Jane. In the first place the objective evidence for schwag is very limited. The major argument is the rare individual with drug-resistant seizure disorder. Epidiolex of GW pharmaceuticals (cannabidiol) is a cannabinoid derivative (not available as flammable
Mr. J) which is being studied for treatment of a rare form of epilepsy known as Dravet Syndrome (DS) and Lennox-Gastaut Syndrome (LGS). Both syndromes have been shown to have significantly reduced seizures in early clinical trials of affected patients and currently are under Fast Track and Orphan Drug Designation by the FDA. LGS is a form of severe epilepsy that usually presents prior to age 4, associated with recurrent severe seizures, impaired intelligence and developmental delay. There is no current cure or a single drug that is effective therapy. Similar conditions apply to DS, and both are associated with sudden unexpected death in epilepsy (SUDEP). The important message here is that these disorders are uncommon and are not shown to respond to smoking grass.

Recently, cannabis has received attention for treatment of the symptoms associated with multiple sclerosis. This severe and chronically disabling disease affecting the central nervous system and spinal cord is associated with progressive weakness, paralysis, muscle spasms and sensory deficits. Studies have shown cannabis having a beneficial effect on stiffness, spasms and pain. Two forms of oral synthetic cannabis are available as controlled agents, dronabinol and nabilone. Side effects include hallucinations, dizziness, cognitive dysfunction and depression. No clinical study using incendiary wacky weed has been done, although some benefit has been shown in uncontrolled studies. Although anecdotal evidence is available, a prominent researcher once stated, “There is no antidote for an anecdote.”

Other effective uses of cannabis (oral form – marinol, spray form – sativex) in patients on chemotherapy include pain relief related to its hallucinogenic properties and as an anti-nauseant and orectic (appetite stimulant).

There are multiple proponents, including physicians, who advocate legalizing weed primarily to study its therapeutic benefits. Cannabis as an immune modulator is used to decrease the activity of the immune system, which effect is increasing inflammatory responses in, for example, joint tissue (rheumatoid arthritis), gut tissue (Crohn’s disease and ulcerative colitis) and lupus. No clinical studies have been shown to ameliorate the consequences of these or other immune inflammatory disorders. Cannabis affects the so-called CB-2 cell receptor. In chronic weed smokers, it can depress cell-mediated immunity (T cells – diseases of such associated with AIDS and leukemias). On the other hand, humoral immunity (B cell receptors) may be enhanced, and although asthma treatment has been proposed for cannabis, there are growing reports concerning the growing problem of allergy to weed. A clinical trial using incendiary cannabis is currently underway.

Of course, the major problems associated with chronic use of marijuana have been noted in previous debates. They include addiction, psychosis (particularly in the developing brain), mood disorders; including lack of motivation, depression, and effects on several brain regions including motor activity, hormonal regulation and pain perception. Marijuana may cause impotence (erectile dysfunction). Several studies have shown a decrease in sperm production in chronic users. Further research shows a depressed cortisol (adrenal steroid) response. In terms of lung problems, a Yale study showed a significant increase in bronchitis (preliminary requirement for COPD), sputum production and wheezing. Long-term studies require several years to relate cannabis smoking to chronic lung disease, but expect it and an association with lung cancer after years of use. Although different from ordinary cigarettes, when replacing nicotine with tetrahydrocannabinol (THC) there is just as much tar and 50 percent the carcinogen load in marijuana. No, smoking weed does not protect you from lung disease.

The real tragedy of marijuana and medical marijuana is the effects on newborns and infants of mothers who are chronic users. Although weed use has become cavalier in certain states and social groups, the long-term ill effects on children have been inadequately publicized. Four percent of pregnant women in the U.S. use recreational drugs. Seventy-five percent use marijuana. THC is associated with low birth weight of offspring and stored in large percentage in breast milk of users. There is also a higher rate of childhood leukemia. Such studies show increase incidence of microcephaly (small head size), problems with release of several hormones including prolactin (milk hormone), thyroid and cortisol release. Tested children of users show reduced memory and cognition as well as deficits in planning and task integration.

Given all this evidence and the unknown future of children, adolescents and adults with chronic cannabis use, can there be any question that marijuana use is simply abuse. Certain analogs of cannabis may be effective for both rare disorders as well as indications in a very limited population but would require strict regulation and not just a simple doctor’s prescription. For these reasons, marijuana should not be changed from its current  Schedule 1 classification. In view of the multiple pressures on physicians, including patient satisfaction surveys (see 4-13 opinion piece in WSJ), a significant number of doctors will give prescriptions to patients demanding cannabis if it is medically legal despite the significant societal, medical and public health consequences of legalization. Not discussed, given the consequences of weed use, are the potentially staggering, inevitable long-term care costs of affected children, disability claims and effects on the economy.

But despite the evidence the marijuana beat goes on.

Dr. Westbrock has been in private medical practice for 35 years. He was the Republican candidate for the U.S House of Representatives in 1994 and 1996. He has written and lectured extensively on the subject of healthcare reform and healthcare policy. He can be reached at Dave.Westbrock@DaytonCityPaper.com.

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Reach DCP editor Sarah Sidlow at SarahSidlow@DaytonCityPaper.com.

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