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Psychologists Group Slams Barriers To Marijuana Research

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The U.S.’s largest organization of psychology professionals is urging the federal government to stop making it so hard for researchers to study marijuana.

“Major barriers to research are preventing scientists from pursuing the full range of research that is needed to understand the impacts of recreational and therapeutic use of cannabinoids,” the American Psychological Association (APA) said in a recent advocacy briefing. “Marijuana and its constituent compounds are categorized as Schedule I (having no Food and Drug Administration-approved therapeutic use), and all research conducted with marijuana requires that investigators register with the DEA.”

APA, which represents more than 115,000 scientists, clinicians and educators, pointed out that the process to register to study cannabis “can take more than a year to complete and creates administrative burdens that serve as significant disincentives to pursuing research” and that Drug Enforcement Administration (DEA) oversight “involves redundant scientific protocol review.”

The Controlled Substance Act’s Schedule I — the most restrictive category — is supposed to be reserved for drugs with no medical value and a high potential for abuse. Researchers have long complained that marijuana’s classification there creates additional hurdles that don’t exist for studies on other substances.

Heroin and LSD are also in Schedule I alongside cannabis, yet cocaine and methamphetamine are classified in the less-restrictive Schedule II category.

While APA isn’t calling for changes to marijuana’s criminal penalties, its criticism of the roadblocks to marijuana research created by the drug’s current federal classification adds to a growing consensus that something needs to change.

The U.S. Senate Appropriations Committee called on federal agencies last month to prepare a report on the ways Schedule I limits cannabis research.

Also last month, California lawmakers passed a joint resolution calling for federal marijuana rescheduling.

APA, in its advocacy briefing, pointed out that DEA’s role in the marijuana research process creates unnecessary confusion.

“Investigators often report that the guidance they receive is unclear and that DEA inspections, security requirements and variable experiences with state DEA field offices add to the obstacles they face,” the organization said.

The organization, working in a coalition with other groups — including leading prohibitionist outfit Smart Approaches to Marijuana (SAM) — is supporting a new bipartisan Senate bill to remove some of the barriers to cannabis research.

That legislation was filed last month by Sen. Orrin Hatch (R-UT) and an initial list of four cosponsors. Sen. Kirsten Gillibrand (D-NY) added her name to the bill on Monday.

“By creating an exception for marijuana from the current obstacles of Schedule I registration and review procedures, the bill provides a sensible streamlined approach for the review of applications and granting of registrations to conduct research with marijuana,” APA, SAM and other groups including the American Pain Society, the American Psychiatric Association and the American Society of Addiction Medicine wrote in their sign-on letter.

Photo courtesy of Interiorrain.

Politics

Congress Debates Medical Marijuana For Cops

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A powerful Congressional committee just held a nearly 30-minute debate on a measure calling on federal agencies to study the use of medical marijuana by police officers.

“The federal government has lied to the American people for a generation about cannabis,” Congressman Matt Gaetz (R-FL), the amendment’s sponsor, said during the lengthy discussion in a U.S. House Judiciary Committee meeting on Thursday. “There is substantial evidence that indicates that there is a case to be made for the medical efficacy of cannabis in the treatment of mental health and particularly PTSD.”

The stated goal of the overarching legislation, the Law Enforcement Mental Health and Wellness Act of 2017, is to “protect the mental health and well-being of law enforcement officers” and requires the U.S. attorney general to consult with the secretary of defense and the secretary of veterans affairs to author a report on mental health practices and services that could be adopted by police agencies across the country.

Gaetz’s amendment would have required that the report examine “Department of Defense and Department of Veterans Affairs mental health practices and services, including medical cannabis treatment on mental health, that could be adopted by Federal, State, local, or tribal law enforcement agencies.”

During the debate, Gaetz decried what he called an “idiotic, indefensible policy in this country where we list cannabis as a Schedule I drug.”

The Controlled Substance Act’s Schedule I — the most restrictive category — is supposed to be reserved for drugs with no medical value and a high potential for abuse. Researchers have long complained that marijuana’s classification there creates additional hurdles that don’t exist for studies on other substances.

Heroin and LSD are also in Schedule I alongside cannabis, yet cocaine and methamphetamine are classified in the less restrictive Schedule II category.

A number of other members from both parties spoke during the hearing about a shared desire to increase studies on marijuana’s medical benefits, but several voiced concerns that the law enforcement legislation was not the most appropriate vehicle to address the issue.

Chairman Bob Goodlatte (R-VA), for example, referred to a separate bill that Gaetz has been drafting in consultation with Judiciary Committee staff which would change regulations that currently block expanded medical cannabis research, saying that he supports that effort.

Gaetz said his amendment requiring federal officials to include medical marijuana in the law enforcement report is necessary because the Department of Justice has been “totally nonresponsive” to requests from members of Congress to modernize its approach to the drug. He also said the Department of Veterans Affairs has a “gag rule” on letting its doctors discuss medical cannabis with their patients.

And, he expressed some frustration that Judiciary Committee staff hasn’t moved as quickly on helping him draft the broader research legislation as he would like.

Nonetheless, Gaetz withdrew the amendment without forcing a vote in the hopes that Congressional leadership is serious about working with him to remove research roadblocks through standalone legislation.

“Our policies should follow the science and not this ridiculous, antiquated dogma perpetuated by lies through the federal government,” he said.

Last week, Gaetz gave a speech on the House floor about how medical cannabis can help people with breast cancer.

See the full text of Gaetz’s marijuana amendment below:

Matt Gaetz Marijuana Amendment by tomangell on Scribd

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Politics

Former Surgeon General: Legalize Marijuana; Decrim Not Good Enough

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A physician who once served at the U.S.’s top medical official is speaking out for the legalization of marijuana, saying that mere decriminalization is not good enough.

“The war on marijuana exacerbates poverty, which is strongly correlated with— among other problems—reduced access to health care. The unjust prohibition of marijuana has done more damage to public health than has marijuana itself,” Dr. Joycelyn Elders, who served as U.S. surgeon general during the Clinton administration, wrote in a new article in the November issue of the American Journal of Public Health.

But simply ending arrests and incarceration for cannabis possession doesn’t fully address the harms of prohibition, Elders says.

“Times are changing. In 2017, even physicians who oppose legalization generally believe that marijuana should be decriminalized, reducing penalties for users while keeping the drug illegal,” she wrote. “Although decriminalization is certainly a step in the right direction, [it is] an inadequate substitute for legalization and regulation for a number of reasons.”

Elders co-authored the new piece with Dr. David L. Nathan and H. Westley Clark, a former director of the Center for Substance Abuse Treatment at the Substance Abuse and Mental Health Services Administration. Together, they are members of the advocacy group Doctors for Cannabis Regulation.

“Decriminalization does not empower the government to regulate product labeling and purity, which leaves marijuana vulnerable to contamination and adulteration,” the doctors wrote. “This also renders consumers unable to judge the potency of marijuana, which is like drinking alcohol without knowing its strength. More- over, where marijuana is merely decriminalized, the point of sale remains in the hands of drug dealers, who will sell marijuana— as well as more dangerous drugs—to children.”

This isn’t the first time Elders has spoken up about marijuana and drug law reform.

In 1993, while serving as surgeon general, she advocated that the country should seriously consider legalizing drugs. “I do feel we’d markedly reduce our crime rate if drugs were legalized,” she said. “I don’t know all the ramifications, but I do feel we need to do some studies.”

While acknowledging that state legalization “has not been perfect,” Elders and her coauthors ague that “it is far better than the prohibition it replaced, and the worst fears of opponents have not materialized.”

They also point out that decriminalization polices don’t actually fully protect consumers from criminal sanctions and other consequences.

“Contrary to popular belief, decriminalization does not actually end the arrests of marijuana users,” they wrote. “Despite New York State decriminalizing marijuana in the 1970s, New York City makes tens of thousands of marijuana possession arrests every year, with continuing racial disparities in enforcement. Finally, under a decriminalized system, the government prosecutes marijuana growers and sellers, thus constricting the supply chain. This drives up the price of marijuana, making the untaxed illegal product more lucrative, the market for it more competitive and violent, and purchasing it more dangerous.”

Atlanta’s mayor signed a marijuana decriminalization ordinance into law this week.

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Politics

Veterans Affairs Department Doubles Down On Medical Marijuana Opposition

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The U.S. Department of Veterans Affairs really wants the military veterans it is charged with serving to know that it isn’t going to do anything to help them access medical marijuana.

While longstanding VA policy has been to disallow government physicians from helping veterans qualify for state medical cannabis programs, a new update to the department’s website sends the message even more clearly — even though it misstates what the law actually is.

“Veterans should know that federal law classifies marijuana – including all derivative products – as a Schedule One controlled substance. This makes it illegal in the eyes of the federal government,” the department’s VA and Medical Marijuana webpage was updated to read this week. “The U.S. Department of Veterans Affairs is required to follow all federal laws including those regarding marijuana. As long as the Food and Drug Administration classifies marijuana as Schedule One VA health care providers may not recommend it or assist Veterans to obtain it.”

That’s not true, at least inasmuch as there is no overarching federal law that prevents V.A. from allowing its doctors to recommend medical cannabis, even though the drug is still considered illegal under federal law.

A leading Congressional champion of veterans’ medical cannabis access told Marijuana Moment that he’s concerned about the new VA website edit.

“This new language is very disturbing, but sadly, comes to no surprise. For years, the VA has been throwing up serious barriers to veterans’ safe access to cannabis,” Congressman Earl Blumenauer (D-OR) said in an emailed statement. “Yet, it’s had no problem prescribing them highly addictive opioids that have killed thousands. It makes no sense. Our veterans deserve better. They deserve equal treatment from the VA doctors who know them best.”

“VA clinicians may not recommend medical marijuana,” the newly update page says. The older version more correctly, though somewhat misleadingly, said, “VA clinicians may not prescribe medical marijuana.” [Italicized emphasis added.]

The distinction between recommendation and prescription is an important one. No physician in the U.S. — government or private — can prescribe marijuana, because prescription is a federally-regulated process and cannabis currently falls under the Controlled Substances Act’s restrictive Schedule I. That category is supposed to be reserved for drugs with a high potential for abuse and no medical value.

That’s why the 29 states with medical cannabis access allow doctors to simply recommend the drug, circumventing the prescription process.

Even with marijuana’s Schedule I status, there is nothing in federal law that prevents V.A. from allowing its doctors to fill out medical cannabis recommendation forms in states where it is legal.

The only thing standing in the way is V.A.’s own internal policy, something that Veterans Affairs Secretary David Shulkin can change at any time.

VA SECRETARY MISSTATES FEDERAL LAW

Shulkin has on a number of occasions indicated that he does see medical potential for marijuana but has consistently falsely claimed that Congressional action is needed before he can do anything to increase veterans’ access. And he has often used the term “prescribe” — intentionally or not — as something of a distraction from the real issue of recommendations. But the new VA website update addresses recommendations, albeit incorrectly.

During a White House briefing earlier this year, Shulkin said that state medical cannabis laws may be providing “some evidence that this is beginning to be helpful, and we’re interested in looking at that and learning from that.” But he added that “until time the federal law changes, we are not able to be able to prescribe medical marijuana for conditions that may be helpful.”

In a separate interview, he said, “From the federal government point of view, right now we are prohibited by law from doing research on it or prescribing it… We are not going to be out there doing that research or prescribing these different medicinal preparations unless the law is changed.”

In another interview, he said that it is “not within our legal scope to study that in formal research programs or to prescribe medical marijuana, even in states where it’s legal.” He added, “if a law change at the federal level is appropriate, that could happen.”

Shulkin, who previously served in the Obama administration as V.A.’s undersecretary of health, wrote in a letter last year that he “wholeheartedly agree[s] that VA should do all it can to foster open communication between Veterans and their VA providers, including discussion about participation in state marijuana programs.” He went so far as to say that he “recognize[s] that the disparity between Federal and state laws regarding the use of marijuana creates considerable uncertainty for patients, providers, and Federal, state, and local law enforcement personnel.”

Under a current internal V.A. administrative directive, the department’s policy is “to prohibit VA providers from completing forms seeking recommendations or opinions regarding a Veteran’s participation in a State marijuana program.” The directive technically expired on January 31, 2016, but remains in force in practice until a new one is instituted to replace it.

In July, Shulkin announced that a new directive is in the final stages of internal review. While he didn’t reveal what it will say, he wrote in a letter to a U.S. House member that it would “maintain the same policy” as the earlier directive.

CONGRESSIONAL EFFORTS

A bipartisan group of members of the House and Senate has tried over the years to pass legislation forcing the VA’s hand on medical cannabis, but has been consistently blocked by Congressional leadership.

Most recently, Republican-controlled House Rules Committee blocked an amendment on the issue from even being considered on the floor this summer. But a rider preventing VA from spending money to enforce its existing internal ban is in the Senate version of 2018 spending legislation, and so the issue will be decided by a conference committee that later merges both chambers’ bills into a single proposal.

Last year, however, both the House and Senate approved different version of the medical cannabis language but the conference committee removed both of them from the final bill.

VETERANS ADVOCATES PUSH FOR CHANGE

The American Legion, which represents more than 2.4 million military veterans, has been pressuring the federal government to evolve on medical cannabis. Most recently, in August, it adopted a resolution calling on VA to let its doctors write medical marijuana recommendations.

“More than half the states in the union have passed medical marijuana laws to date,” the group’s resolution reads. “The American Legion urge the United States government to permit VA medical providers to be able to discuss with veterans the use of marijuana for medical purposes and recommend it in those states where medical marijuana laws exist.”

The Legion and other medical cannabis advocates have also called for rescheduling and pressed VA to stop blocking federally-approved researchers from recruiting veterans for research on medical cannabis.

One such study on marijuana’s effects on PTSD has been prevented from reaching veterans at the Phoenix, Arizona VA hospital.

“This study needs 50 more participants and the Phoenix VA is in the best possible position to assist by simply allowing principle investigators to brief [VA] medical staff on the progress of the study, and by allowing clinicians to reveal the existence of the study to potential participants,” the Legion wrote to Shulkin last month. “Your immediate attention in this important matter is greatly appreciated. We ask for your direct involvement to ensure this critical research is fully enabled.”

MORE VA WEBSITE CHANGES

Other new changes to the V.A. webpage include the removal of bullet points that read, “VA doctors and clinical teams may advise Veterans who use marijuana of the drug’s impact on other aspects of the Veterans’ care such as pain management, PTSD or substance use disorder treatment” and “VA doctors and clinical staff will record marijuana use in the Veterans VA medical record along with its impact on the Veterans treatment plan.”

In their place, the page now says, “VA health care providers will record marijuana use in the Veterans VA medical record in order to have the information available in treatment planning. As with all clinical information, this is part of the confidential medical record and protected under patient privacy and confidentiality laws and regulations.”

An existing point reading, “The use or possession of marijuana is prohibited at all VA medical centers, locations and grounds,” was followed up with a new clarification that says, “When you are on VA grounds it is federal law that is in force, not the laws of the state.”

The department does make it clear that “veteran participation in State medical marijuana program does not affect eligibility for VA care and services.” That longstanding policy means that patients won’t lose access to their government-provided healthcare just because they use medical cannabis.

But, until Shulkin acts to change the internal prohibition or Congress steps in and forces his hand, the VA isn’t going to do anything to help veterans get medical cannabis.

Photo courtesy of U.S. Air Forces Special Operations Command.

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