MEDICINAL CANNABIS: POLITICS, MEDICINE, OR COMMERCE: & WV SENATE BILL 386 C. Clark Milton, DO, FACOI WVOMA: 115 th Annual Fall Conference 02 November 2017
2017: >50% States 29 Medical Marijuana Programs 8 States and Wash. DC: Adult-use Recreational
Signed by Gov. Kasich 08 June 2016 Effective 08 Sept. 2016 19 Qualifying Conditions PROHIBITS: Home growing and Smoking Cannabis
I AM GOING TO SIGN THIS INTO LAW AND I THINK ALL OF US IN WV FEEL LIKE WE ARE WV Medical Cannabis Act Qualified Medical Conditions Certifying Physician Regulatory Authority: WV Medical Cannabis Commission Limitations: pills, oils, gels, creams, ointments, tinctures, liquids and non-whole plant forms vaporization Access: Home cultivation is prohibited DUID Medical Cannabis Businesses Local Bans/Research Licensees/Taxes and Fees 01 July 2019 DOING SOMETHING GOOD FOR FAMILIES OUT THERE
MARIJUANA AS MEDICINE IS NOT NEW
EVIDENCE BASED VS. BELIEF BASED MEDICINE
MEDICAL MARIJUANA: POLITICS, MEDICINE, OR COMMERCE
2015: Legal marijuana market: $700 Million 2016: ~ $1 Billion
World s 6 th largest economy Economic Output $2.46 Trillion Retail sales to begin 2018 Tax Revenue: High hundreds of millions of dollars to over $1BILLION annually
Analyze the Impact of state-based medical cannabis programs on Clinicians Review the history of Cannabis Review the available scientific data on medicinal use Medicine by Popular Vote vs. Evidence Based Review endocannabinoid system and promising pharmacologic applications GOALS
Medical Legalization: AR, FL, and MO Recreational Use: CA, AZ, NV, ME, and MA
2017: >50% States 29 Medical Marijuana Programs 8 States and Wash. DC: Adult-use Recreational
MEDICINE BY POPULAR VOTE AND NOT SCIENTIFIC!
WHICH OF THE FOLLOWING PLANTS IS MOST CLOSELY RELATED TO CANNABIS? A. Tobacco B. Coca C. Sage D. Hops
MEDICAL CANNABIS IS HERE TO STAY 29 States and DC Paradoxical Federal Illegality vs. States Initiatives Is it Legal?? Use in best interests of Patients and/or Physicians
MEDICAL MARIJUANA ADVOCATES BELIEVE Therapy for Intractable Medical Problems Safety Effective Treatments
OPPONENTS BELIEVE Benefits are overblown Ignoring the Harms of medical marijuana
MEDICAL MARIJUANA HISTORY Late 18 th Century: American Medical journal Rec Irish physician W. O Shaughnessy 1906: Pure Food and Drug Act FDA 1914: Harrison Tax Act
REEFER MADNESS
MARIJUANA HX 1931: 29 states prohibit non-medical use 1937: Marijuana Tax Act 1942: Removed from the US Pharmacopoeia WWII: Federal Government encourages Hemp crop 1951: Boggs Act. 1956: Narcotics Control Act 1970: Controlled Substance Act
1957: Essentially banned Hemp prooduction (Marihuana Tax Act) 2014: President Obama signed Farm Bill to Legalize Hemp for Research Purposes 32 States have pro-hemp legislation KY very pro-active WV: 2016 State Dept. of Agriculture accepting application for permits WV Hemp Farmers Cooperative: WV jobs for a economic downturn Mike Manypenny D US House candidate: Grafton J. Morgan Leach candidate for House of Delgates: Parkersburg WVU
FBN: Henry Anslinger Secretary of Treasury A. Mellon William Randolph Hearst DuPont, GM, Oil
HOW WAS CANNABIS USED BY THE OFFICE OF STRATEGIC SERVICE, A WWII ERA US INTELLIGENCE AGENCY? A. As a gateway drug B. To Assassinate Targets C. As a Truth Serum D. To frame Political Enemies
MEDICAL MARIJUANA LINKED TO MARIJUANA DECRIMINALIZATION 1972: NORML petitioned BNDD to move marijuana from Schedule I to Schedule II
BLURRING THE LINE
2015: CO legal cannabis sales up 40% Close to $1 Billion in sales $135 Million in State Tax Revenue Increase in Cannabis Related ED visits Black Market persists 2016: Total US market $6.8B
BARRIERS TO CANNABIS RESEARCH: CI
SCHEDULE I AND RESEARCH John W. Huffman, PhD NIDA research 1984 450 synthetic compounds JWH-007 to JWH-424 In 2000 2 compounds were being sold in Germany.I figured it would spread.i m concerned it would hurt someone
FATHER OF MODERN CANNABIS Rapheal Mechoulam, Ph.D: Professor of Medicinal Chemistry: Hebrew University Jerusaleml 1964: Isolates then synthesize delta- 9-THC 1992: With others-id s Human endogenous cannabinoid (or endocannabinoid) natural THC : Named anandamide --Sanskrit: eternal bliss or supreme joy (1990: Miles Herkebham: NIMH cannabinoid receptors CB1, CB2) Increasing concentration of THC
2017
I WILL NOT COMMIT TO NEVER ENFORCE FEDERAL LAW IF AMERICANS DON T WANT ME TO ENFORCE MARIJUANA LAWS, THEY SHOULD CHANGE THEM
CANNABINOID BIOLOGY Cannabinoid receptors characterized in 1980-90 s (CB1 and CB2) Likely have a natural role in pain modulation, movement control, and memory Role in immune systems is likely multi-faceted and remains unclear Brain develops tolerance Animal research demonstrates potential for dependence Withdrawal symptoms can be observed in animals but appear to be mild compared to opiates and benzos
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