February 2018

Overall teen drug use stable, but marijuana edging up, survey finds

(CNN)Teen drinking, smoking and drug use overall are stable, but the percentage of teens using marijuana is increasing, according to a new report from the University of Michigan’s Institute for Social Research.

This year’s edition of the Monitoring the Future report, an annual survey of drug and alcohol use and attitudes among Americaneighth-, 10th- and 12th-graders, found that the percentage of students who had used pot in the previous year increased to 24%, up 1.3% from 2016.
Nearly 40% of all 12th-graders surveyed had used some sort of illicit drug in the past year, while 55.7% of them had used alcohol. Nearly 28% of 10th-graders had used an illicit drug, and 37.7% of them had alcohol in the past year. For eighth-graders, the percentage who had used illicit drugs in the previous year was just 12.9%, while 18.2% had had a drink.
    The study, which is in its 43rd year, assesses about 45,000 students from 380 public and private secondary schools across the country.

    Fewer teens see pot as dangerous

    The increase in marijuana use was enough to boost the percentage of teens who used illicit drugs overall. This is the first time in seven years that there has been a statistically significant increase in marijuana use, said Richard Miech, lead author of the studyand a research professor who studies drug use trends at the University of Michigan.
    However, rates for both marijuana and illicit drug use overall are still lower than their peak in 1997, when 42.7% of 12th-graders had used any illicit drug and 38.5% had used marijuana in the previous year. In fact, overall drug use has generally been trending downward for all three grades since 2013.
    Miech said the increases in marijuana use aren’t surprising.
    “Typically, as adolescents see less risk of marijuana use, the prevalence (of use) increases,” he said. “And today, levels of perceived risk from marijuana use are at the lowest levels we’ve ever seen in decades. “
    Last year’s survey found that 68.5% of 12th-graders disapproved of regular marijuana use. This year, that percentage dropped to 64.7%. Miech and his colleagues also found that high school seniors from states with medical marijuana laws were more likely to have vaped marijuana and consumed marijuana edibles than those in states that had more restrictive laws.
    Eight states and the District of Columbia have loosened laws on recreational marijuana use, according to NORML, a nonprofit geared toward marijuana law reform.
    The perception that marijuana is not dangerous has been driven in part by society, said Dr. Nora Volkow, director of the National Institute on Drug Abuse, a part of the National Institutes of Health. Volkow’s group funded the study.”Certainly, that leads to the idea that the marijuana can not be so harmful.”
    In fact, more high school seniors now use marijuana on a daily basis than smoke cigarettes. When asked how frequently they had used in the past month, just 4.2% of 12th-graders said they smoked cigarettes every day, but 5.9% said they used marijuana.
    Both Miech and Volkow said increased marijuana use was somethingto be on the lookout for. “My fear is that we may be seeing the start of a long-term increase in marijuana use among youth,” Miech said.

    Vaping trends

    The survey also noted that while cigarette use continued to decline, nearly one in three 12th-graders had vaped over the past year. Vaping involves using an electronic cigarette, hookah or similar device and inhaling the vapors or aerosols. When asked what they had inhaled, over half of the seniors surveyed (51.8%) said they had used only flavored vaping liquids.
    What was even more striking was that 11.1% of high school seniors said they had vaped with marijuana or hash oil, and nearly a third had vaped with nicotine.
    “We are especially concerned, because the survey shows that some of the teens using these devices are first-time nicotine users,” Volkow said.
    Miech agreed: “There is considerable concern that vaping can led to use of cigarettes.” He pointed to a recent analysis published in the journal JAMA Pediatrics of nine studies that found that even when controlling for factors like impulse and perceived risk of smoking, teens who vaped were more likely to experiment with cigarettes in the future.

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    The rate of students vaping overall remained relatively the same as in 2016. However, 2017 was the first year the survey asked detailed questions about what substances students vaped.
    Though much of the larger national conversation about drugs has focused on opioid overdoses, teen use of heroin and prescription narcotics like oxycodone remains low, the survey found.

    Read more: http://edition.cnn.com/

    Marissa SafontOverall teen drug use stable, but marijuana edging up, survey finds
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    Berkeley declares itself a sanctuary city for cannabis

    (CNN)Berkeley City Council members have passed a resolution declaring the city a sanctuary for recreational marijuana.

    The move may be the first of its kind in the country, tweeted Berkeley Mayor Jesse Arreguin, who proposed the measure.
    Under the new resolution, which passed Tuesday night, no Berkeley department, agency, commission, officer or employee “shall use any city funds or resources to assist in the enforcement of federal drug laws related to cannabis.”
      The city will also oppose attempts by the US Drug Enforcement Administration to close cannabis businesses. “The city of Berkeley does not support cooperation with the Drug Enforcement Administration in its efforts to undermine state and local marijuana laws,” the resolution states.
      California voters approved a proposition in 2016 to allowing the use of recreational marijuana for adults 21 and older, which went into effect this year.
      “In light of threats by Attorney General Sessions regarding a misguided crackdown on our democratic decision to legalize recreational cannabis, we have become what may be the first city in the country to declare ourselves a sanctuary city for cannabis,” Arreguin tweeted Tuesday.
      His tweet referred to a move last month by Attorney General Jeff Sessions, who rescinded a federal stance of non-interference with marijuana-friendly state laws. Sessions made the announcement January 4, just days after laws went into effect allowing recreational marijuana use and commercial sales of pot in California.
      While California and many states have decriminalized or legalized marijuana use, the drug is still illegal under federal law.
      This isn’t the first time Berkeley city officials have used a sanctuary approach when it comes to marijuana.
      Ten years ago, the Berkeley City Council adopted a similar resolution that applied to medical marijuana, declaring the city a sanctuary for medical marijuana patients and providers.

      Read more: http://edition.cnn.com/

      Marissa SafontBerkeley declares itself a sanctuary city for cannabis
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      Los Angeles Is Set To Become The Largest U.S. City With Legal Marijuana

      The Los Angeles City Council approved regulations for the recreational marijuana industry on Wednesday, setting the stage for LA to become the largest city in the U.S. with legal cannabis when California’s adult-use marijuana laws go into effect on Jan. 1, 2018.

      The new rules, passed on a 12-0 vote, now go to Mayor Eric Garcetti for his signature, which is expected. City Council President Herb Wesson said the regulations for LA’s nearly 4 million residents could become a model for other cities. 

      “We are LA. We are a big city. We do big stuff, that’s who we are, that’s how we roll,” Wesson said. “And there are cities throughout this country that are looking at us today.”

      The complex regulations are considered a work in progress that will likely need refinement later, but for now, they provide the marijuana industry with some clarity before retailers open their doors next year.

      Retail marijuana shops will be allowed only in specifically zoned commercial and industrial areas in the city and will not be permitted within 750 feet of sites like schools, public parks and libraries. Growers and manufacturers of cannabis products will also be limited to specific industrial zones and required to locate at least 600 feet away from schools and similar sites.

      The rules will cap the number of shops, growers and manufacturers that can be licensed across Los Angeles. Stores will have to establish strict security measures, including video surveillance and electronic verification that customers are 21 or older. 

      In an effort to address the negative consequences of the war on drugs, the city will give license processing priority and other assistance to individuals applying for marijuana business licenses who have been previously convicted of low-level marijuana offenses or come from low-income communities hit hard by failed drug war policies.

      “Marijuana is about to become legally available and taxed in the largest city in the largest state in the country,” said Tom Angell, chairman of the drug policy reform group Marijuana Majority. “That’s a major benchmark, and it shows how far this movement for cannabis policy change has come from just a few short years ago when almost no one thought legalization was a realistic possibility.”

      Angell predicted that more states will lift prohibitions in 2018, increasing the pressure on the federal government “to finally modernize its outdated approach to marijuana.”

      California became the first state to permit marijuana for medical purposes in 1996, and 20 years later state voters approved the legalization of recreational marijuana. The state’s legal marijuana industry already has a projected value of $7 billion, and once California’s new regulatory framework is fully implemented, state and local governments could collect $1 billion annually in tax revenue.

      Seven other states, as well as the District of Columbia, have now approved recreational marijuana (although the District continues to ban sales of the plant). A total of 29 states, the District and the U.S. territories of Guam and Puerto Rico have legalized marijuana for medical purposes.

      Marijuana remains illegal under federal law, but states have pressed forward with their own cannabis laws under Obama administration guidance that urges federal prosecutors to refrain from targeting state-legal marijuana operations. However, that policy could be reversed or altered by Attorney General Jeff Sessions, a vocal marijuana opponent who suggested last month that the Justice Department is looking to make changes in that area. 

      Earlier this year, Sessions named a task force to review the hands-off approach to state marijuana laws. But the task force’s report largely reiterated the current policy and did not push for a crackdown, according to The Associated Press.

      In May, Sessions urged Congress not to renew the federal law that blocks the Justice Department from spending money to interfere with states’ legalization of medical marijuana. Lawmakers rejected that advice.

      Although then-presidential candidate Donald Trump said he would respect states’ rights on the issue, Sessions’ long track record of opposing marijuana reform remains deeply troubling to people who favor progressive drug laws.

      Meanwhile, support for marijuana legalization in the United States is at a historic high. A recent Gallup poll found that 64 percent of Americans favor making marijuana legal ― the greatest level of public support for legalization since the pollster first posed the question almost five decades ago. Another first in the survey was that majorities of Republicans, Democrats and independents all voiced support for legal marijuana.

      Read more: http://www.huffingtonpost.com/

      Marissa SafontLos Angeles Is Set To Become The Largest U.S. City With Legal Marijuana
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      Dream catchers, succulents and joints: a visit to an LA cannabis shop

      Catering to wealthy people, todays dispensaries aim to present the drug as part of a healthy lifestyle

      Dream catchers, succulents and joints: a visit to an LA cannabis shop

      Dream catchers, succulents and joints: a visit to an LA cannabis shop

      Catering to wealthy people, todays dispensaries aim to present the drug as part of a healthy lifestyle

      Read more: http://www.theguardian.com/us

      Marissa SafontDream catchers, succulents and joints: a visit to an LA cannabis shop
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      Heavy marijuana use linked to rare vomiting illness

      For 17 years, Chalfonte LeNee Queen suffered periodic episodes of violent retching and abdominal pain that would knock her off her feet for days, sometimes leaving her writhing on the floor in pain.

      “I’ve screamed out for death,” said Queen, 48, who lives in San Diego. “I’ve cried out for my mom who’s been dead for 20 years, mentally not realizing she can’t come to me.”
      Queen lost a modeling job after being mistaken for an alcoholic. She racked up tens of thousands of dollars in medical bills, and her nausea interrupted her sex life. Toward the end of her illness, Queen, who stands 5-foot-9, weighed in at a frail 109 pounds.
        Throughout the nearly two decades of pain, vomiting and mental fog, she visited the hospital about three times a year, but doctors never got to the bottom of what was ailing her. By 2016, she thought she was dying, that she “must have some sort of cancer or something they can’t detect,” Queen said.
        But she didn’t have cancer. She had an obscure syndrome called cannabinoid hyperemesis syndrome, a condition only recently acknowledged by the medical community. It affects a small population — namely, a subset of marijuana users who smoke multiple times a day for months, years or even decades.
        There’s no hard data on the prevalence of the illness. But in California and Colorado, which have loosened marijuana laws in recent years, emergency physicians say they’re seeing it more often. One study in Colorado suggests there may be a link.
        Dr. Aimee Moulin, an emergency room physician at UC-Davis Medical Center in Sacramento, said she has seen a rise in the number of cases since California voters legalized recreational marijuana last November. She expects to see another increase after commercial sales are permitted starting in January.
        Doctors say it’s difficult to treat the condition. There is no cure other than to quit using marijuana, and many patients are skeptical that cannabis is making them sick, so they keep using it and their vomiting episodes continue.
        Doctors can do little to relieve the symptoms, since traditional anti-nausea medications often don’t work and there are no pills to prevent the onset of an episode. Patients may need intravenous hydration and hospital stays until the symptoms subside.
        “That’s really frustrating as an emergency physician,” said Moulin. “I really like to make people feel better.”
        Diagnosing the syndrome can also be frustrating — and expensive. There is no blood test to link the stomach ailment with marijuana use, so physicians often order pricey CT scans and lab tests to rule out other medical problems.
        Cannabinoid hyperemesis syndrome was first documented in Australia in 2004. Physicians have historically misdiagnosed it as the more generic cyclic vomiting syndrome, which has no identifiable cause or, as in Queen’s case, acute intermittent porphyria (AIP).
        “Five years ago, this wasn’t something that [doctors] had on their radar,” said Dr. Kennon Heard, an emergency physician at the University of Colorado in Aurora, who co-authored the Colorado study showing a possible tie between the liberalization of marijuana and a surge of the vomiting illness. “We’re at least making the diagnosis more now.”
        One surefire sign of the illness is when patients find relief in hot showers and baths. Queen said she would vomit repeatedly unless she was in a hot shower — so she’d stay in there for hours. Toxicologists say the heat may distract the brain from pain receptors in the abdomen but, like the syndrome itself, that phenomenon is not well understood.
        The exact cause of the condition is still a mystery. Toxicologists say the chemical compounds in marijuana may throw off the normal function of the body’s cannabinoid receptors, which help regulate the nervous system.
        Some people may be genetically predisposed to the syndrome, or marijuana’s potency or chemical makeup may have changed over time, said Dr. Craig Smollin, medical director of the San Francisco division of the California Poison Control System, who also works as an emergency physician at Zuckerberg San Francisco General Hospital.
        The vomiting link to cannabis is counterintuitive to many, because of its widely known reputation as an anti-nausea remedy for cancer patients.
        “A lot of times, people just don’t believe you,” said Dr. John Coburn, an emergency physician at Kaiser Permanente in south Sacramento. Even after being told that quitting may help, some patients will visit the hospital multiple times before they stop smoking marijuana, Coburn said. “I can’t really tell you why. I mean, why do people ride motorcycles without helmets on?”
        Cameron Nicole Beard, 19, of East Moline, Ill., said she struggled to believe her doctors about the link between pot and severe vomiting.
        “Who wants to be told you can’t smoke marijuana, when you think marijuana can help?” said Beard, while recovering from a marijuana-related vomiting episode at a University of Iowa hospital in Iowa City, Iowa, last month. She said she had lost 20 pounds in 10 days.
        Although there’s still no magic cure for a patient’s marijuana-related hyperemesis, Moulin and other doctors say they’re getting better at treating the symptoms, using old anti-psychotic medications and cream for muscle aches.
        Dr. Heard said the cases in Colorado seem to have leveled off. But without hard data, and because the overall numbers are small, it’s hard to say for sure. Heard said he doesn’t believe cases of the pot syndrome increased after recreational use was legalized in 2012, because chronic users probably already had medical marijuana cards.

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        Chalfonte LeNee Queen is still struggling to completely quit marijuana, but her symptoms are down to a dull stomachache. She now smokes a couple of times a day, compared with her near-constant use in the past. She said it’s the only thing that works for her depression and anxiety.
        Queen is back to a healthy weight and hasn’t been to the hospital in a year. She said she wouldn’t want to discourage anybody from smoking weed; she just wants people to know heavy use can bring them some serious misery.
        “Now, if I get sick, as sad as I’ll be and as upset and disappointed with myself as I would be, at least it’s a freaking choice,” she said.

        Read more: http://edition.cnn.com/

        Marissa SafontHeavy marijuana use linked to rare vomiting illness
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        How Uruguay made legal highs work

        The South American countrys move to full legalisation of cannabis has so far proved a success, especially for its 17,391 users

        Every afternoon a long queue of people gathers outside a tiny neighbourhood pharmacy in Montevideo. The shop is so small that they can only be let in one at a time. Its a slow process but the mostly young clients dont seem to mind. They stand outside or sit on doorsteps chatting in groups of twos and threes as they wait their turn in the warm southern spring.

        A chemist inside in a green medical coat asks them each to press their thumb on a fingerprint scanner. The electronic device is connected to a central government computer that will either authorise or deny the purchase of their allotted 10 weekly grams of legal marijuana. It is a state-controlled, high quality product guaranteed to provide excellent highs.

        On the street 25 grams of marijuana would cost you 3,000 pesos, thats about $100 for something with probably a large amount of pesticide, seeds and stems, says Luciano, a young buyer who is next in line. But here the same amount would cost you only $30, and it comes in guaranteed, premium quality, thermosealed 5g packs.

        In July this year, tiny Uruguay became the first country in the world to legalise the sale of marijuana across its entire territory.

        The most important thing has been the change of paradigm, says Gastn Rodrguez Lepera, shareholder in Symbiosis, one of the two private firms producing cannabis for the governments Institute for the Regulation and Control of Cannabis. Uruguay dived in at the deep end without too much international support. They said it wouldnt work. Well, its working now.

        With a population of only 3.4 million, squeezed in between its two giant South American neighbours Brazil and Argentina (population 208 million and 43 million respectively), Uruguay has long been at the forefront of liberal policies not only in South America but worldwide.

        A divorce law that allowed women to separate from their husbands simply by asking a court for permission was passed as far back as 1913. Abortion was legalised in 2012, with Uruguay the only country in Latin America to do so apart from Cuba.

        Part of the reason for Uruguays liberal temperament is a longstanding separation of church and state in a region where the Catholic Church remains dominant. There is no official Christmas day on Uruguays state calendar. Most Uruguayans refer to the holiday by its government denomination of family day. Easter week is referred to as tourism week.

        Uruguay locator map

        Uruguays switch to a legal marijuana market has not been without its hitches, however, notably the resistance of most pharmacists to act as outlets for the recreational marijuana (medical marijuana remains illegal in Uruguay).

        Only 12 of the countrys 1,100 pharmacies have signed up so far to supply the 17,391 government-registered consumers served by the system, which explains the long queues outside. The low price and slim profit margin partly explain their reticence. But the main problem is that banks have threatened to close the accounts of pharmacies selling marijuana, said one chemist who sells marijuana in Montevideo, but who did not want to reveal his name for fear of such bank intervention.

        Although sales of the drug have been legalised in various US states, they remain illegal at federal level, leading to a situation where most banks refuse to handle marijuana-related accounts anywhere in the world. Even now that sales in Uruguay have been completely legalised, the fear of running into trouble with the US federal authorities has become concrete.

        The problem with the banks was an unforeseen hitch, says Eduardo Blasina, president of Montevideos cannabis museum, set in an old house in the artsy Palermo district of the capital city. But these bumps will get smoothed out eventually.

        The potency of the original government-licensed marijuana also failed to satisfy consumers at the start. The government made a mistake because the first batch they released to the market in July had a potency level of only 2% THC, says Blasina.

        THC, or tetrahydrocannabinol, is the main psychoactive constituent of cannabis content. This is much lower than the levels found in legal recreational weed in US states like Colorado.

        The government quickly got the message and has now upped the content to 9% THC, says the Montevideo pharmacist. A consumer himself, he adds: Ive tried it and I can assure you that it provides a most satisfactory experience.

        Registered
        Registered users queue outside a pharmacy to buy legal marijuana in Montevideo. Photograph: Andres Stapff/Reuters

        For those who would rather not buy their legal weed at a pharmacy, Uruguays marijuana law allows consumers to plant their own at home (up to six plants) or join special privately run cannabis clubs with a maximum of 45 members who are allowed to withdraw 40g per month from the clubs crop.

        The transformation of consumers has been astounding, says Blasina. Theyve gone from buying low-quality products from street dealers to becoming gourmet experts who compete with the crops at their clubs.

        Confident that pharmacists will eventually find a way to work round the refusal of banks to handle their accounts, Blasina is more worried about the ban on selling legal marijuana to visitors from abroad in a country where tourism keeps growing, partly due to Uruguays beautiful beaches, but also because of its growing reputation as a liberal haven in South America.

        Visitors arrive here hoping to enjoy freedom in one of the most liberal countries in the world, so they feel disappointed when they find out they cant buy legal marijuana, says Blasina. They end up buying it on the street, which contradicts the whole point of the law, which is to cut traffickers out of the business.

        Blasina and others have started pressing the government for the passports of tourists to be stamped with a permit to purchase a small amount of marijuana during their stay. A record number of visitors will arrive this summer and what will we say to them? Sorry, you cant smoke? he says.

        There are ways round the problem, however. The quality of the marijuana is so high that the 40 monthly grams permitted by the government far exceeds what I could smoke on my own, says one Uruguayan who works with foreigners travelling here. So I always have enough to share around with visitors.

        Read more: http://www.theguardian.com/us

        Marissa SafontHow Uruguay made legal highs work
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        California weed stored serves 23,606 people in first month

        Image: medmen

        The first month of California’s legal recreational marijuana sales showed that weed is big business, despite local government’s reluctance to issue permits.

        MedMen, a cannabis company that’s basically an Apple Store for pot products has dispensaries across Los Angeles, and found itself in an interesting position as one of the few places people could purchase marijuana in the most densely populated areas of Los Angeles when legalized sales began in California.

        At MedMen’s West Hollywood location, customer traffic clocked in a 23,606 people in January alone. Revenue was up 200 percent, compared to December, and up 500 percent compared to the year before. Its Santa Ana location brought in 5,051 people, doubling December’s revenue. 

        MedMen’s West Hollywood location.

        Image: medMen

        Since recreational pot sales began on Jan. 1, Californians have been flocking to the few dispensaries that are allowed to sell to residents without medical cards. Proposition 64, which legalized recreational cannabis, lets local governments regulate sales. 

        Some cities in Los Angeles county have been resistant to recreational weed. Santa Monica, for example, has banned non-medical marijuana storefronts entirely. Long Beach issued a 180 day ban on recreational sales at the end of 2017, giving the city time to figure out regulations. 

        The city of Los Angeles set up framework for regulation, but businesses couldn’t apply for licenses until January 3. Vendors also had to apply for a separate license from the state-run Bureau of Cannabis Control.

        The city of West Hollywood issued temporary permits for stores like MedMen. The California Bureau of Cannabis Cannabis Control issued only 47 temporary retail licenses, but they’ll expire by May 1. 

        The unique position helped set up MedMen to be a marijuana unicorn. Canadian investment firm Captor Capital invested $30 million in the company for just 3 percent, valuing the company at about $1 billion.

        Read more: http://mashable.com/

        Marissa SafontCalifornia weed stored serves 23,606 people in first month
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        This holiday wreath comes with some extra-special flowers. Hint: It’s weed

        Image: henry’s original

        Wreaths aren’t exactly the most exciting thing about the holidays — unless they come loaded with weed, dude.

        Cannabis company Henry’s Original has unveiled a limited-edition handcrafted holiday wreath, which you’ll probably want to hang on the inside of your door instead of the outside, because it comes loaded with a full ounce of marijuana flower.

        The actual wreath is made of eucalyptus, evergreen, dried wheat and grasses, moss, berries, and pine cones, and plastered throughout is an ounce of sun-grown “artisanal cannabis” grown in Mendocino County. Henry’s Originals assures customers that the cannabis can easily be removed for consumption without disrupting the structural integrity of the wreath. 

        Image: HENRY’S ORIGINAL

        The wreath will set you back $400, which isn’t an insane price considering the amount of pot it comes with. However, due to the legal status of cannabis in the United States, it is only available in the Los Angeles area, and you must have a valid medical marijuana card.

        Although cannabis is legal in the state of California, the state is still putting finishing touches on its retail regulations for recreational use, licensing for which will begin in 2018.  

        Read more: http://mashable.com/

        Marissa SafontThis holiday wreath comes with some extra-special flowers. Hint: It’s weed
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        These Doctors Want Your Doctor To Know More About Weed

        Dr. Janice Knox was several years into retirement in Oregon when she was asked to fill in at a “card mill” ― a facility where patients can be diagnosed with conditions that qualify them for a medical card to buy cannabis.

        This was a few years ago, and public sentiment about medical marijuana wasn’t quite what it is today. “I had the mindset that most people had at the time ― ‘marijuana is a terrible drug, it’s just a drug,’” Knox told HuffPost.

        When she arrived at the clinic, the makeup of the waiting room was “not who I was expecting,” she said.

        “There were businesspeople, doctors, lawyers, moms, dads, grandmothers, grandfathers. I just couldn’t believe who I saw,” Knox said. “They were coming because conventional medicine had failed them. They wanted a better quality of life.”

        “People were coming in with their last dime to get a card,” she added. “I was stunned.”

        Equally surprising to Knox was how she, a practicing anesthesiologist for 35 years, had been taught so little about the mechanisms and effects of cannabis ― a substance that people said eased their suffering, even from symptoms related to chronic diseases.

        “I knew nothing about this medicine. I felt so embarrassed as a physician that that’s where I was. So I really made it a point to learn everything that I could about it,” Knox said. Since then, she’s tried to “change the narrative” about who uses cannabis and why.

        The Canna MDs
        Dr. Janice Knox grew the American Cannabinoid Clinics from her existing wellness clinic.

        In 2014, Knox founded the American Cannabinoid Clinics from her existing wellness clinic in Portland, Oregon, where marijuana has been legal for medical purposes since 1998 and legal for recreational use since 2015. Other than Knox, there are very few U.S. medical professionals who specialize in cannabis therapeutics. Fortunately, three of them are members of her family. 

        Knox’s husband, David, is a former emergency room doctor. Their two daughters, Rachel and Jessica, are physicians who received both medical and business degrees from Tufts University.

        At his wife’s urging, David Knox also visited the “card clinics” where his wife had been providing care. Like Janice, he was struck by the diversity of patients and conditions for which the plant seemed to offer relief.

        “It was an eye-opener. The potential is just incredible,” he said, adding that he’s seen patients successfully reduce or eliminate their use of opiates for chronic pain after beginning cannabis therapeutics. (Federally funded research has also found this result, which could have meaningful implications amid America’s ongoing opioid crisis.)

        People were coming in with their last dime to get a card. I was stunned. Dr. Janice Knox

        At their clinic, the Knoxes practice what they call “integrative cannabinoid medicine.” They counsel new and experienced cannabis patients alike on the best treatment options for their conditions, the best way to deliver the medicine (e.g. vaping, topical, ingesting), and how to mitigate undesired effects. These are all aspects of cannabis medicine that a general practitioner might not know as much, or indeed anything, about.

        “We’re looking at the whole patient, and how to use cannabis optimally, so the patient can get the best benefit from the minimal dosage without side effects or complications,” David said.

        Rachel Knox, 35, wasn’t particularly surprised by her parents’ new career path. She and her mother share an interest in natural medicine. For Rachel, this interest only grew stronger in a medical school and residency environment where emergency treatments for the most urgent symptoms of chronic illness were rarely followed up with meaningful conversations with patients about maintenance and prevention.

        “We weren’t being taught how to prevent or reverse chronic illness in our medical education,” she said. “We had this longing for more. My curiosity for natural medicine grew out of that frustration in conventional medicine.”

        “My sister and I really felt like if we were going to pursue medicine, we should do something different with it,” she went on. “When my mom and my dad said they had started writing cannabis authorization for patients, that fit right into the natural options I wanted to investigate for patient care.”

        The Canna MDs
        Dr. Rachel Knox’s involvement in cannabis therapeutics grew out of her interest in natural medicine.

        Cannabis provides therapeutic effects mainly through its impact on the endocannabinoid system, which regulates various processes throughout the body such as organ function and immune response. Last year, the National Academies of Sciences, Engineering, and Medicine produced a sweeping report on the health effects of cannabis and cannabinoids, concluding that restrictions on possession and consumption have made it difficult to develop research-based consensus on its medical utility.

        The barriers to conducting meaningful research on the effects of a federally prohibited substance are considerable. Trials involving cannabis have to be approved by three government agencies and an independent review board, the Knoxes said. After that, there’s the matter of procuring the cannabis itself.

        “Right now you can’t ship cannabis across state lines, so you have to rely on a secure source within that state to do that,” Rachel said.

        The American Medical Association has long referred to cannabis as a “public health concern” ― but it recently issued a policy update calling for a review of the plant’s Schedule I designation, which categorizes marijuana as a drug with no medical benefits and restricts its availability for research. Heroin and bath salts are also Schedule I substances

        SAEED KHAN via Getty Images
        The U.S. still officially considers cannabis a Schedule I substance with no medicinal value.

        Given the limits on research and accessibility, many doctors are reluctant to discuss cannabis-related treatment options with patients. Many of the Knoxes’ patients come to the clinic because they’re not sure whether their general practitioners condone medical cannabis, or even know very much about it.

        The Knoxes have seen more than 3,000 patients at the American Cannabinoid Clinics. Very few, they said, have any interest in getting high. In fact, many would prefer to avoid it.

        “Patients will tell me eight or nine times, ‘I don’t want to get high,’” David said. 

        Many patients, especially seniors, come in asking for CBD, or cannabidiol, a non-psychoactive component of cannabis, Rachel added.

        “What surprises the patients most who say that is when we come back and tell them, ‘This condition that you have actually will respond better with some THC on board, let us talk to you about how to use THC to avoid those adverse effects,’” she said. “I had a patient today who was surprised to hear that she could use THC without getting high.”

        Patients are also “shocked” to learn they don’t have to smoke the cannabis to feel better, Janice said.

        “People have this image of a smoker smoking the joint, and when you tell them, ‘No, you don’t have to do it that way, you can use it incrementally and won’t get a THC high’ ― I think that’s really shocking to them,” she said, adding that placing medicine under the tongue, rubbing it into the navel, and delivering THC through a rectal suppository are all effective and in some cases superior alternatives to smoking cannabis. 

        Patients will tell me eight or nine times, “I don’t want to get high.” Dr. David Knox

        Though based in Oregon, the Knoxes see patients from neighboring states such as California and Washington. Rachel Knox is vice chair of the Oregon Cannabis Commission, which oversees the state’s medical marijuana program, and serves as the medical chair for the Minority Cannabis Business Association. Janice Knox sits on the board of Doctors For Cannabis Regulation, which promotes safe practices and improved quality of medical cannabis products.

        Through their clinics and ancillary work in the industry, the Knoxes hope to help more medical practitioners integrate cannabis therapeutics into their practices and promote more specialization in cannabinoid medicine. They plan to launch their own training program for medical professionals later this year.

        “We need to be helping trained clinicians in the practical implementation of cannabis therapeutics in the same way we do it at the clinic,” Rachel said. “Patients should feel comfortable that the doctor they’re talking about cannabis with is knowledgeable about this medicine.”  

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        Marissa SafontThese Doctors Want Your Doctor To Know More About Weed
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        San Francisco To Dismiss Or Reduce Thousands Of Past Marijuana Convictions

        Prosecutors in San Francisco are reducing and dismissing thousands of past marijuana convictions, an extraordinary move that will retroactively apply California’s recreational marijuana legalization policy for cases stretching back decades.

        “While drug policy on the federal level is going backwards, San Francisco is once again taking the lead to undo the damage that this country’s disastrous, failed drug war has had on our nation and on communities of color in particular,” San Francisco District Attorney George Gascón said in a Wednesday statement about the effort.

        Gascón announced that his office will be applying the law to all misdemeanor and felony cases in San Francisco dating back to 1975. In total, his office will be reviewing, recalling and resentencing up to 4,940 felony marijuana convictions, as well as dismissing and sealing 3,038 misdemeanor cases that were sentenced prior to the ballot measure’s passage. 

        The process could end up helping thousands of people whose lives have been disrupted or derailed over activities that became legal as of Jan. 1. Criminal convictions can have devastating consequences long after the offense was committed, making it difficult to obtain employment, bank loans and housing.

        Voters approved Proposition 64 in 2016 to legalize marijuana for recreational purposes and reduce criminal penalties for various marijuana-related offenses for adults and juveniles. But the law did more than legalize marijuana, it also authorized a new process for individuals in the state to get previous marijuana-related convictions retroactively reduced, reclassified as lesser offenses or cleared altogether.

        And while the relief for past convictions is a component built into California’s new marijuana laws, the process is not automatic or well-known. Individuals with past marijuana convictions must know the relief exists, petition the courts themselves to file the appropriate paperwork and may need to retain an attorney to do so. The process can be time consuming and costly. Gascón’s approach, however, is novel because no action is required from eligible individuals with past marijuana convictions to take advantage of the law. His office is applying the relief process on its own.

        California produces vast amounts of marijuana and has done so for years. In 1996, it became the first state to legalize medical marijuana. And despite the passage of more permissive laws, there were still thousands of marijuana-related arrests annually. From 2006 to 2015, there were nearly 500,000 people arrested for marijuana offenses, a recent Drug Policy Alliance report found. And Rodney Holcombe, a legal fellow at DPA, said that there may be close to 1 million people in the state who have convictions that could now be eligible for relief.

        Across the state, only about 5,000 people have so far applied to have their marijuana sentences reviewed for possible relief, according to data compiled by the Judicial Council of California. In San Francisco specifically, only 23 petitions for reduction or sentencing clearing have been filed over the past year, according to Gascón’s office (the office has no active marijuana prosecutions).

        San Francisco city and county officials have found that the black community has been over-represented in marijuana-related arrests in the region. In a study from the city’s Human Rights Commission on the effects of marijuana policy in the region, between 1999-2000, arrests of African-Americans for marijuana-related offenses jumped from 34 to 41 percent, despite black San Franciscans comprising of less than 8 percent of the population in 2000. In 2011, after penalties for marijuana possession was downgraded from a misdemeanor in San Francisco, 50 percent marijuana-related arrests were of African-Americans, while they represented just 6 percent of the region’s population in 2010.

        “This example, one of many across our state, underscores the true promise of Proposition 64 ― providing new hope and opportunities to Californians, primarily people of color, whose lives were long ago derailed by a costly, broken and racially discriminatory system of marijuana criminalization,” Lieutenant Governor Gavin Newsom said in a statement. “This isn’t just an urgent issue of social justice here in California – it’s a model for the rest of the nation.”  

        Read more: http://www.huffingtonpost.com/

        Marissa SafontSan Francisco To Dismiss Or Reduce Thousands Of Past Marijuana Convictions
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