Doctors testifying about the opioid epidemic on Capitol Hill on Tuesday made clear that marijuana has medical potential as an alternative pain treatment option and that federal prohibition is inhibiting cannabis research.
The Senate Health, Education, Labor and Pensions Committee held a hearing to discuss how to manage the nation’s opioid crisis, and medical marijuana was a point of particular interest raised by several lawmakers.
Sen. Lamar Alexander (R-TN), who chairs the panel, asked Dr. Andrew Coop of the Maryland School of Pharmacy what he considered “the most promising, non-addictive painkiller treatments or medicines that are coming down the road.”
“The drugs that are coming—I mentioned cannabinoids,” Coop said. “I know that’s a controversial topic, but this is great—”
The senator cut in to ask why it was controversial and Coop said it was because cannabis remains federally illegal. He clarified for Alexander that he was referring to “medical marijuana” when he brought up cannabinoids.
“Medical marijuana, yes,” Coop said. “I think that has great potential.”
Sen. Mitt Romney (R-UT) later said that while he didn’t have time during his allotted five minutes to ask about marijuana, he wanted Coop to “instruct us as to the path forward on cannabis research.”
The next senator to bring up cannabis was Sen. Jacky Rosen (D-NV). She said her state’s medical marijuana program “has reduced the prescriptions for high-potency painkillers” and asked Coop whether cannabis could serve as “a non-addictive approach or alternative to chronic pain—just another tool in the toolbox.”
“I, first of all, think it has great potential to be another tool in the toolbox,” he said. However, “I don’t think there’s ever going to be a one-size-fits-all magic bullet because pain is different in different people.”
“In terms of how to move the research forward in medical marijuana, one of the issues has been because of the usual legal status in the United States, research has been limited,” he said. “There’s no consistency between the different types of marijuana, the studies done. We need good, consistent, well-designed clinical studies with good, consistent material so that we can fully assess the impact, and don’t get me wrong, also the potential drawbacks.”
David Mangone, director of government affairs for the advocacy group Americans for Safe Access, said in a press release that it was “great to see witnesses and senators alike discuss the potential of medical cannabis as a tool in combating the opioid crisis,” but that “we need real action from from our lawmakers to change federal laws.”
Sen. Doug Jones (D-AL) was the last to raise marijuana at the hearing. He emphasized that while lawmakers sometimes approach their questioning in hearings with an agenda in mind, “this is not one of those” situations. He wanted to hear from the three other witnesses who hadn’t testified on the topic.
Cindy Steinberg, national director of policy and advocate at the U.S. Pain Foundation, said “cannabis has helped a number of people living with pain” and that it’s “another option” in the toolbox for pain patients. She stressed that marijuana’s legal status make it hard to standardize cannabis treatment.
“Doctors need to be the one prescribing it, but they don’t know what they’re doing with it,” she said. “They’re not trained with it either. Without having a really good research base, we’re just flying blind.”
So what’s preventing that research, Jones asked?
“The fact that it’s not legal,” Steinberg said.
While Mayo Clinic physician Halena Gazelka said she wasn’t convinced that cannabis isn’t addictive, she agreed that “the impediment has been that it’s a Schedule I substance and it’s not permissibly prescribed by providers.”
“But I do think that there may be some significant areas where this may be very useful,” she said. “I have some palliative medicine patients using it for nausea, appetite, pain, and I think it can be helpful.”
Finally, Anuradha Rao-Patel, a physician representing the health insurance company Blue Cross Blue Shield of North Carolina, said “the limitations such as the fact that it is illegal in some states as well as on a federal level makes research [on marijuana] difficult.”
“From a physician’s standpoint, I think there is some potential to the utility of medical marijuana for the treatment of chronic pain,” she said. “I’ll say, putting on my other hat as an insurer, that we obviously only cover procedures and drugs that are [Food and Drug Administration]-approved, so we would obviously need some clinical evidence and support to be able to cover these kinds of medications.”
Don Murphy, director of federal policies at the Marijuana Policy Project, told Marijuana Moment that the “questions from senators proved there is a need for a hearing devoted exclusively to cannabis as an alternative to opioids.”
“Of course, such a hearing may expose a truth some of them don’t want to hear,” he said.
Photo courtesy of Philip Steffan.
White House Drug Officials Say Legal Marijuana Is Up To States
Two top federal drug officials, including the White House drug czar, recently said that marijuana legalization should be left up to states.
The comments stand out coming from the Office of National Drug Control Policy (ONDCP), which has historically played a central role in defending blanket federal prohibition.
Jim Carroll, the Trump-appointed drug czar who directs the administration’s drug policies, told Fox 59 reporter Kayla Sullivan that he considers legalization a states’ right issue. He added that he’d like to see targeted education campaigns concerning cannabis use during pregnancy and underage usage as well as research into impaired driving.
Got the answer: He believes it should be left up to the state. However, he does want to educate people on the effect marijuana has on young brain development, pregnant women and wants to come up with better guidance & testing for marijuana while driving. https://t.co/eifryNJB1j
— Kayla Sullivan (@KaylaReporting) August 14, 2019
It’s a particularly notable position given that federal law stipulates that the drug czar is required to “take such actions as necessary to oppose any attempt to legalize the use of a substance” listed as Schedule I under the Controlled Substances Act, including marijuana.
Even if Carroll’s remarks arguably don’t directly violate that statute, they are significant in that he doesn’t seem to have taken the opportunity to proactively oppose state legalization efforts when asked by a reporter.
Anne Hazlett, senior advisor at ONDCP, also weighed in on cannabis legalization on Wednesday, telling CentralIllinoisProud.com that marijuana legalization is “a state decision.”
“Marijuana is an ongoing challenge that is being addressed in many of our states,” she said. “This is a state decision, and we would like to see additional research done so that these decisions being made at a state level are being made in a manor that is fully informed.”
Though the comments from Carroll and Hazlett seem to reflect an evolving understanding of the federal government’s role in imposing prohibition on the states, the ONDCP director has previously made clear he’s not enthusiastic about the burgeoning legal market.
During a House Committee on Oversight and Reform hearing in May, Carroll raised concerns about THC potency in marijuana products, saying “the marijuana we have today is nothing like what it was when I was a kid, when I was in high school.”
“Back then the THC, the ingredient in marijuana that makes you high, was in the teens in terms of the percentage,” he said. “Now what we’re seeing is twice that, three times that, in the plant.”
He also said that more research is needed and that the Drug Enforcement Administration as well as the Department of Health and Human Services are “working hard to make sure that we understand the impact of legalization of marijuana on the body.”
Photo courtesy of Philip Steffan.
New Industry-Backed Marijuana Legalization Measure Filed In Florida
Another measure to legalize marijuana has been filed in Florida—and this one is being spearheaded by a major industry stakeholder, the multi-state dispensary chain MedMen.
Make It Legal Florida—a political committee that was registered earlier this month and is chaired by Nick Hansen, MedMen’s director of government affairs in the Southeastern U.S —filed the 2020 ballot initiative on August 6.
The campaign shared language of the measure, which isn’t yet available on the Florida Department of State elections division site, with Marijuana Moment.
“Make it Legal Florida is proud to present a ballot initiative that will legalize the safe, adult use of marijuana,” Hansen said via email. “Public opinion is on our side, and the time to act is now. Florida voters on every side of the aisle overwhelmingly support this initiative and at Make it Legal Florida, we are committed to ensuring Floridians have a chance to have their voices heard.”
The proposed constitutional amendment would legalize the possession, use, transportation and retail sale of up to 2.5 ounces of cannabis for adults 21 and older. Medical marijuana dispensaries in the state would be permitted to sell marijuana to adults. The initiative doesn’t mention a licensing system to establish separate recreational shops, though the legislature will likely enact more detailed regulations consistent with the constitutional amendment’s text should it pass.
It also requires cannabis products to be “clearly labeled and in childproof packaging” and prohibits advertisements that are targeted at those under 21.
There’s also no mention of a home cultivation option, which is something that many advocates regard as a necessary civil liberties component but that some industry players have resisted or actively opposed.
A medical cannabis industry association based in New York faced backlash from advocates earlier this year after it was reported that it sent a document to Gov. Andrew Cuomo (D) recommending that the state prevent consumers from growing their own marijuana at home. MedMen was among the companies listed as members of the association at the time, though a representative later told Marijuana Moment that the business supports giving adults the right to grow their own cannabis.
The new Florida language is “currently being reviewed by the Florida Division of Elections to ensure the petition is in the proper form and we are awaiting their approval, per the usual process,” a spokesperson told Marijuana Moment.
It’s not clear to what extent MedMen will be funding or running the campaign, but the cannabis company appears to be taking a more active role in legalization efforts this election cycle.
In Arizona, an adult-use legalization measure filed at the beginning of the month is also reportedly being backed by MedMen, as well as other existing medical cannabis companies in the state.
Make it Legal Florida will be competing against at least one other campaign that’s working to legalize cannabis in Florida. Sensible Florida, another advocacy group, announced last month that it had collected enough signatures to prompt a state Supreme Court review of the ballot language. It’s collected about 80,000 signatures so far.
To qualify for the ballot, the campaigns will have to gather a total of 766,200 valid signatures. If an effort clears that hurdle, passing a constitutional amendment requires 60 percent support from voters.
“Floridians are ready to legalize marijuana,” Ben Pollara, a political consultant who worked on 2014 and 2016 medical cannabis measures in the state, the latter of which was enacted, told Marijuana Moment. “If this measure makes it on the ballot in 2020, it is almost certain to pass.”
Personal injury attorney John Morgan, who bankrolled the state’s previous medical cannabis initiatives but only recently expressed interest in contributing to this recreational push, told The Miami Herald that Sensible Florida’s challenge will be raising millions of dollars to push their measure forward, whereas Hansen’s operation is well supported by the industry.
“Last time I did, I was the lone trombone player marching down the street,” he said of his role in medical marijuana legalization. “This will be the University of Miami marching band with trumpets and tubas and snare drums. I’ll just be one trombone player, marching with them.”
Read the full text of Make It Legal Florida’s marijuana proposal below:
Photo courtesy of WeedPornDaily.
Defense Department Official Stresses CBD Ban For Military Members
A Department of Defense (DOD) official is reiterating that military service members are barred from using CBD products despite the legalization of hemp and its derivatives under the 2018 Farm Bill.
Patricia Deuster, director of the Human Performance Laboratory at the federal government-run Uniformed Services University of the Health Sciences, said in a call with reporters this week that the non-intoxicating compound is “completely forbidden for use by any service member in any of the services at this point of time.”
While CBD products are widely available—in grocery stores, gas stations and online—the lack of regulations for these items from the Food and Drug Administration (FDA) creates uncertainty about levels of THC in the preparations. And military members who test positive for THC can be punished with an other-than-honorable discharge and the potential loss of other benefits.
“It’s a real conundrum, and it’s going to be a major issue for the military because it is available [nearly everywhere],” Deuster said, according to Military.com, which first reported her remarks. “You go into any store, and you can find gummy bears with a supplement fact panel on it.”
Though the Tuesday press call simply provided clarity on existing military CBD policy, it represents the latest example of DOD interest in preventing the use of cannabis among service members.
The Navy released a notice earlier this month stipulating that “all hemp and CBD products are strictly prohibited for use by Sailors” no matter the legal status. And the Coast Guard said its members aren’t even allowed to visit marijuana shops or use online or delivery cannabis services, according to an order released last month.
That order didn’t specify policy around hemp-derived CBD, but a Coast Guard official told Mililtary.com that if members “have a desire to use a product that may or may not fall into the definition of what’s prohibited, they should seek guidance or use caution.”
Last year, the Air Force wrote in a post that “consumption [of marijuana] is not permitted in any fashion, period.” It emphasized the need to take caution as more states legalize, with one risk factor being your “friend’s grandma’s miracle sticky buns” that “might look mighty tasty and get rave reviews at the big shindig,” but could contain THC.
In a memo released in April, the Air Force said that “Airmen are advised against using CBD products” and could face disciplinary action if they use CBD that isn’t the FDA-approved drug Epidiolex.
The Army issued a similar notice in November 2016 that stated service members may not use marijuana, hemp or hemp oil.
Though not a military branch, NASA also sent a warning to its workforce this month that the unregulated nature of CBD products means employees could inadvertently consume THC that could get them fired.
“The problem is there is no regulatory framework to ensure that the CBD products being sold meet the Farm Act,” Deuster said on the call this week. “[CBD] is everywhere. We are waiting for the FDA to do something,”
She added that service members shouldn’t “believe what [the companies] are telling you” about the benefits of CBD.
Photo by Sam Doucette on Unsplash.