CMMNJ is a 501(c)(3) educational organization and public charity. Donations to CMMNJ are income tax deductible. All volunteer organization.

Transcription

1 CMMNJ is a 501(c)(3) educational organization and public charity. Donations to CMMNJ are income tax deductible. All volunteer organization. T-shirts $15; hemp wristbands $1. CMMNJ meetings are the second Tuesday of each month at the Lawrence Twp. Library (Mercer County) from 7:00 PM until 9:00 PM. Join our list for monthly updates. Sign up or visit: Facebook: Friends of the Coalition for Medical Marijuana-NJ CMMNJ TV from the Princeton Community Television studio on Comcast and Verizon FIOS.

2

3

4 James Burton ex-felon in America; respected government employee in Europe for doing the same thing

5 New Jersey State Nurses Association Resolution Concerning Therapeutic Marijuana Recognizes the therapeutic value and safety of medically recommended marijuana; and, Supports legal access to medically recommended marijuana for patients in New Jersey who are under the care of a licensed health care provider; and, Urges the Governor of New Jersey and the New Jersey State Legislature to move expeditiously to make medical marijuana legally available to New Jersey residents who can benefit from it. Date Approved: March 20, 2002

6

7

8 Coalition members hold diverse opinions, but we all agree: Arresting patients is wrong, and it must stop now. Modern clinical research, centuries of experience and the impassioned personal accounts of thousands of real patients concur: Marijuana can alleviate symptoms of certain serious medical conditions, and it can do so when other drugs fail to help. Doctors should be free to recommend this medicine to promote health, and sick or injured New Jerseyans should be free to use it responsibly. The safety margin for therapeutic marijuana is as wide as it can be there is no known lethal dose.

9 The mission of our non-profit organization is to educate the public about legal access to marijuana for New Jersey patients who are under the care of licensed physicians and nurse practitioners. Marijuana is a safe, effective and inexpensive therapeutic agent for a wide variety of diseases, symptoms and conditions. It should be available to any patient who can benefit from it. No patient should suffer needlessly, and no patient should ever go to jail for following the advice of a doctor.

10 AMA 2009 calls for further adequate and wellcontrolled studies of marijuana and related cannabinoids urges that marijuana as a federal Schedule I controlled substance be reviewed; DEA affirmed Schedule I status 7/2011 & 8/2016. (This should not be viewed as an endorsement of state-based medical cannabis programs)

11 Congressional Research Service Report for Congress Controlled Substances Act (1970) Schedule I substances have a high potential for abuse, no currently accepted medical use in treatment in the United States, and a lack of accepted safety for use of the drug... under medical supervision. Possession of marijuana for personal use, a misdemeanor, can bring up to one year in federal prison and up to a $100,000 fine for a first offense. Growing marijuana is a felony. A single plant can bring an individual up to five years in federal prison and up to a $250,000 fine for a first offense.

12 Endorsements of Medical Marijuana American College of Physicians; American Academy of Family Physicians; American Public Health Assn.; New England Journal of Medicine, 1997.

13 Supporting Organizations MPP GREAT workshops 2003 & 2004; MPP $40,000 grant to CMMNJ 7/04 6/05; DPA Compassionate Use Campaign 4/05; SSDP Princeton U. works with CMMNJ; 11/05 CMMNJ at Lawrence Library

14 Supporting Organizations LEAPs Jack Cole (26 yrs NJSP) at P.U. 12/05; NORML NJ Board meetings 2003 and national s pre-written s (capwiz); ASA Patients in the Crossfire ; 1 st State House rally June 2005 after Raich;

15 New Jersey Compassionate Use Medical Marijuana Act S-2200 Introduced January 2005 A-4501 introduced 12/05 Committee Hearings 2006/2007/2008/2009 Passed entire Senate 2/2009 Amended bill passed Assembly Health Committee 6/2009 CUMMA passed entire Assembly and Senate 1/11/10 Signed into law by Gov. Jon Corzine 1/18/10 Gov. Chris Christie inaugurated 1/20/10 Law took effect 10/1/10 Medical marijuana finally available in NJ on 12/6/12 (NJ OAG still considers Marijuana a Schedule I Drug)

16 New Jersey Compassionate Use Medical Marijuana Act Regulations/Rules from the DHSS Draft rules published in Oct., 2010; Assembly & Senate voted that these rules were not consistent with the legislative intent, but did not pass SCR 151, a resolution to invalidate all or part of the regulations. DHSS published RFA for ATCs; got 20 applicants; Permits awarded to six (6) ATCs on 3/21/11; Marijuana promised to pts. by summer, BUT: Marijuana finally available to patients December 6, 2012 from Greenleaf ATC in Montclair, NJ.

17 New Jersey Compassionate Use Medical Marijuana Act Medical Marijuana 1. Limited to two ounces/month with ID card; 2. Only obtained through licensed ATCs; 3. Must have bona fide MD/Pt. relationship: The physician has seen the patient for at least one year OR; The physician has seen the patient four times for the patient s debilitating condition OR; The physician assumes responsibility for providing management and care of the patient s debilitating condition after conducting a comprehensive medical history and physical examination. NO MARIJUANA SPECIALISTS!

18 NJ Medicinal Marijuana Program Currently, 5 ATCs serve about 11,000 NJ patients. New Jersey s Alternative Treatment Centers: Greenleaf ATC, Montclair, NJ; Compassionate Care Foundation, Egg Harbor Twp., NJ; Garden State Dispensary, Woodbridge, NJ; Breakwater ATC, Cranbury, NJ. Compassionate Sciences ATC, Bellmawr, NJ ; (Lozenges and topical solutions available 8/2016)

19 NJ DOH Physician Registration Current NJ medical license, CDS certificate and practice in NJ. Must have completed medical education in Addiction Medicine and Pain Management within the past 2 years. Your name, office location, and phone number will be publicly displayed on the participating physicians list.

20 Process for obtaining NJ ID card See an MD on the DOH list & obtain a reference number, Upload to the DOH the reference number, a Passport style photo, proof on NJ residence (low-income info, if applicable), DOH verifies the documents, then send a bill: $200/$20 for 2-year ID card.

21 New Jersey Compassionate Use Medical Marijuana Act Recognizes marijuana as medicine in New Jersey for: Amyotrophic lateral sclerosis, multiple sclerosis, muscular dystrophy, inflammatory bowel disease, terminal illness-- prognosis of less than 12 months of life; HIV/AIDS or cancer, IF severe or chronic pain, severe nausea or vomiting, or wasting syndrome results from the condition or its treatment; Seizure disorder, skeletal muscular spasticity, glaucoma, or PTSD, IF resistant to conventional medical therapy; Other conditions approved by the DOH 8/1/16--8/31/16.

22 Post-traumatic Stress Disorder PTSD added by an act of the legislature signed by the governor in September 2016; CMMNJ s Request for Rulemaking to add PTSD denied by the DOH in 2014; Bill was introduced in September veterans testified to legislative committees; PTSD--the first mental/emotional condition to qualify for marijuana therapy in NJ.

23 Vets Testify in Trenton

24 Adding Conditions to the NJ MMP DOH accepted 45 petitions to add qualifying conditions to the Medicinal Marijuana Program (MMP) in August 2016; A panel of 8 healthcare professionals are evaluating the petitions; initial OK to 43; Public hearings 2/22/17 & 5/11/17; DOH Commissioner makes final decision.

25 Adding Conditions to the NJ MMP CMMNJ: Opiate Use Disorder, Autism, Anxiety, Migraine Headaches (6), Osteoarthritis (6), & Neuropathic Pain (3). 40 of 45 Petitions were for pain; Chronic Pain (7); Tourette Syndrome, Alzheimer s Disease, Asthma & Chromic Fatigue. 60 day Public Comment Period; final recs., then DOH has 180 days to add conditions.

26 MMP Changes Needed 1. Eliminate physician registry & allow APN s to recommend marijuana in addition to MDs; 2. Expand qualifying conditions; 3. Restore home cultivation; 4. Include explicit employee workplace protection; 5. Any edible form is OK d for any age. 6. Ongoing training for all LEOs; 7. Honor out-of-state ID cards; 8. Test each batch of marijuana & on request; 9. Stop overly restrictive/unduly burdensome regulations.

27 Common side/adverse effects Dizziness, dry mouth, euphoria, red eye, disorientation, confusion, sedation, lack of coordination, transient tachycardia, depth perception, reaction time, bronchitis, shortterm memory problems, nausea, emesis. Panic, anxiety, paranoia, addiction (9%). Psychotic episodes/spiritual awareness. Arrest and imprisonment.

28 Inhaled and oral dosing: After inhalation, within minutes, intoxication consists of a feeling of euphoria and relaxation (a high). These effects last 1 to 3 hours. After edibles, within 30 minutes to 2 hours, effects can last 4 to 8 hours. 10 mg THC average dose; start low and go slow.

29 The Merck Manual Chronic effects: Can cause dependence. However, heavy use and reports of inability to stop are unusual. Very little physical dependence is clinically apparent. Critics of marijuana cite much scientific data regarding adverse effects, but most claims of significant biologic effect are unsubstantiated.

30 Merck Manual Withdrawal: Cessation after 2 to 3 wk of frequent, heavy use can cause a mild withdrawal syndrome. Symptoms consist of insomnia, irritability, depression, nausea, and anorexia; symptoms peak at 2 to 3 days and last up to 7 days. Treatment Supportive measures

31 Merck Manual High-dose smokers develop episodes of acute bronchitis, wheezing, coughing, and increased phlegm, and pulmonary function may be altered. Even daily smokers do not develop obstructive airway disease. There is no evidence of increased risk of head and neck or airway cancers, as there is with tobacco.

32 Effects of marijuana Reduction in noxious symptoms like pain, anxiety, nausea, vomiting, diarrhea, muscle spasms and seizures; Mild euphoria, increased appetite; Anti-inflammatory, neuroprotective, antioxidative, anti-psychotic, and, immunosuppressive in autoimmune diseases (homeostasis).

33 Tetrahydrocannabinol (THC) Principal psychoactive phytocannabinoid Isolated in 1964 by Israeli scientist Prof. Raphael Mechoulam available by prescription in the U.S. as Schedule III synthetic cannabinoid, brand name Marinol, for N, V of chemo & wasting of HIV/AIDS

34 Endocannabinoid System (ECS) Consists of endocannabinoids, cannabinoid receptors (GPCRs CB1 and CB2), and enzymes for synthesis and catabolism Eat, sleep, relax, forget, and protect Clinical Endocannabinoid Deficiency (CECD; Russo 2004)

35

36 Emerging Applications

37 ECS researchers say: ECS activity may have therapeutic potential in almost all diseases affecting humans. P. Pacher, M.D., PhD the future of therapeutics depends heavily on understanding this system. Jahan Marcu, Ph.D.

38 CMMNJ Endorsed Legalization in 2014 Marijuana s enormous therapeutic potential Most efficient & effective way to meet the physical, mental & emotional needs; Can significantly reduce the need for expensive pharmaceuticals, surgeries, hospitalizations, emergency services, etc.; Reduce the need to fund charity health care, & care of institutionalized patients.

39 Harms of Prohibition NJSP: 24,765 arrests in 2013 for possessing small amounts of marijuana; Costs $127 million a year. Blacks 3 X more likely than Whites; Creates second class citizens less likely to have access to employment, education, and public housing, and are more likely to reoffend.

40 Unintended consequences of marijuana prohibition Sales to minors (what about the children?) Absent parents; decreased socio-economics. Political influence of prison-industrial complex (drug testing industry, substance abuse programs, private prisons and services, correction officers unions, etc.) Diminished trust of Health Care Practitioners

41 Medical Marijuana info: Patients Out of Time: Americans for Safe Access: Society of Cannabis Clinicians: American Cannabis Nurses Association: Project CBD The Answer Page: National Organization for the Reform of Marijuana Laws

42 Marijuana Reform New Jersey United for Marijuana Reform Drug Policy Alliance Marijuana Policy Project Law Enforcement Against Prohibition