All posts tagged: Health

NFL player makes medical marijuana history: ‘I have a life to live’

July 5, 2018 Mary Jane Blog

(CNN)NFL running back Mike James calls it his medicine for pain management, but league officials call it a banned substance. Now, James’ athletic career is hanging in limbo because he chose pot over pills.

In 2013, James was prescribed opioid painkillers after injuring his left ankle in a Monday night football game. Within weeks, he developed a dangerous dependency on the drugs.

To get off of the opioids, he turned to medical marijuana for his pain.

Suddenly, “my pain subsided,” James told CNN Chief Medical Correspondent Dr. Sanjay Gupta in an exclusive interview in the documentary “Weed 4: Pot vs. Pills,” which aired Sunday night.

“I never had something where I could be coherent and still have pain relief,” he said.

He turned to the sport that both he and his mother loved to help overcome his grief. “For him to be all right and mentally deal with this, he was going to lean on football,” said his wife, Aubrey James.

Three years later, James was drafted by the Tampa Bay Buccaneers. As a Bleacher Report headline put it, James proved that he had the talent to enjoy a “promising future” with the Buccaneers, but then he injured his ankle, and his life changed.

Doctors prescribed a cocktail of opiates to deal with the pain, a common prescription among professional athletes for sports-related injuries.

A study published in the journal Drug and Alcohol Dependence in 2011 found that more than half — 52% — of former NFL players reported using opioids during their career, and 71% of those players reported misusing opioids.

The prevalence of current opioid use among those players was 7%, according to that study: about three times the rate of use among the general population. The study included 644 retired players who answered questions in a telephone survey about their opioid use.

James never worried about developing an opioid addiction, “because I was getting them from a doctor,” he said, but Aubrey worried.

Within weeks of his injury, James joined the about 2.5 million Americans who struggle with opioid use disorder.

In an effort to help him stop using pills, his wife suggested that James use pot to treat his pain.

James, a 27-year-old father of two, knew that he needed to stop using opioids whenever he thought about “the notion that I would do what my father did to me, to my boys,” he said. His sons are 4 and 1.

He remained skeptical, however, about using marijuana to make that change.

“I thought, ‘Weed? No, that’s a street drug.’ I didn’t even want to hear what it had to offer,” he said, but after more convincing, he finally tried marijuana in February 2014, and it helped him get off the opioids.

“I felt like I was beginning a new life,” he said.

Yet since cannabis is banned in the NFL and James was unsure how he could get more, he said, he didn’t use it again until last year.

Goodell addresses NFL ban on marijuana use

Then, in August, James took a drug test as part of the NFL’s routine testing program. In October, he learned that the test was positive for marijuana, leading to his filing of the therapeutic use exemption for cannabis.

“This is the first active player who’s been willing to put their professional career on the line, to openly admit that they not only have been using this cannabis but need it to function at the highest level,” said Dr. Sue Sisley, an Arizona-based physician who is a board member of the nonprofit Doctors for Cannabis Regulation and has been helping James with his exemption application.

“Mike’s case is such a perfect example of why cannabis needs to be made available, because he’s really not a candidate for opioids,” she said. “So this is a safe alternative for him.”

‘I’m not ashamed of it. … I have a life to live’

Twenty-nine states, the District of Columbia, Guam and Puerto Rico have approved some form of legalized cannabis. The first state in the US to legalize marijuana for medicinal use was California, in 1996.

As it turns out, 69% of Americans say they approve of a professional athlete using marijuana for pain, and 67% saythat using a doctor’s prescription for an opioid is a greater health risk than using a doctor’s prescription for marijuana, according to a Yahoo News/Marist Poll released last year.

The stance of the NFL remains somewhat unclear, and the league did not respond to a request for comment.

In 2016, the NFL Players Association formed a committee to investigate all pain management options for players, including cannabis.

“Our job is to find the best medical science to support your therapeutic use exemption,” DeMaurice Smith, executive director of the NFL Players Association, told Gupta.

As for James’ case, “what I would say to him and every NFL player: Our job is to figure out, how do we build the best medical support for the best treatment for you?” Smith said.

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James never would have guessed that he would make history due to a therapeutic use exemption, but if, 30 years from now, his biography states “medicinal marijuana advocate,” he would be fine with that.

“I’m not ashamed of it,” James said. “I’m not embarrassed about it. It is something that I will continue to use, because I have a life to live.”

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Getting off opioids with medical marijuana: Patients turn to pot over pills

July 4, 2018 Mary Jane Blog

(CNN)In 2016, opioids killed more Americans than breast cancer. The drug overdose epidemic has become one of the most concerning public health issues of recent time, and in an effort to stem the tide, moreg and more patients and doctors are turning to pot over pills.

Watch Chief Medical Correspondent Dr. Sanjay Gupta’s CNN Special Report “Weed 4: Pot vs. Pills” on Sunday, April 29, at 8 p.m. ET.

For much of the past two decades, 51-year-old Angie Slinkertook a cocktail of narcotics, antidepressants and anti-anxiety medications to manage the pain stemming from a car accident in 1998. She had between 50 and 60 surgeries, but her pain persisted, and doctors kept giving her more pills.

“It was just a vicious cycle,” she told CNN Chief Medical Correspondent Dr. Sanjay Gupta. “You started taking something for pain, and before you knew it, you were into another surgery. Which brought on anxiety.” To treat the anxiety, doctors prescribed more pills. And when she felt depressed, they added even more medications.

All the drugs left in her a fog. She spent most of her days in bed. When Slinker woke up, she was in pain and looking for immediate relief.

By 2012, she was taking up to 25 pills a day. She weighed close to 350 pounds, and she didn’t want to move, because the medications sapped whatever will or desire she had. “I can’t do this anymore. It is killing me from the inside out,” she told her doctors.

And so she stopped cold turkey.

The withdrawal symptoms were severe. Slinker said she was moody and irritable from the pounding headaches and constant nausea. Without any medications, her hands began to spasm and freeze.

Her then 22 year-old sonsuggested cannabis. The relief was quick. “I realized immediately that there are medicinal properties within cannabis,” she said.

It didn’t completely eliminate her pain, but pot allowed her to live again, she says. She was able to play with her granddaughter and participate in life. “I’m never going to be pain-free, ever. But cannabis has given me a reason to live,” Slinker said.

But it is also illegal in her home state of Indiana. “I could have bought cannabis off the street. But that was not me. I wanted to do it the right way. I wanted to do it legally,” she said. So in July 2012, Slinker moved to Maine.

Treating patients with weed

Medical marijuana has been legal in Maine since 1999. The state has one of the top ten highest rates of opioid overdose in the country. In 2016, the rate of overdoses from opioid drugs in Maine was nearly double the national rate. The number of heroin related deaths has jumped more than fourfold since 2012.

This is your brain on pain

For a state deeply embedded in the opioid crisis, Dustin Sulak believes that medical marijuana could be part of a solution. “There’s no pill, there’s no spray, no drop, no puff [that] can completely solve this problem,” Sulak told Gupta. “But cannabis, when it’s used in the right way, can take a big bite out of it.”

Sulak is a doctor of osteopathic medicine. He says he has treated hundreds of people with marijuana to wean them off opioid painkillers. He runs two outpatient clinics in Maine and started looking to marijuana as a potential solution when he noticed that a number of his patients were able to sustain their opioid dosages for years, never asking for more.

Production of natural opioids is triggered when the body experiences pain. But opioid medications can act as a signal to the body to stop producing endorphins; it instead becomes more and more reliant on the drugs. When the person takes more opioids, that increases the risk for overdose.

Sulak was curious as to why some of his patients didn’t need to increase their opioid doses, so he asked them what was different. “The answer was that they were using opioids in combination with cannabis. And they felt that it made the opioids stronger.”

Sulak’s review of the medical literature resulted in the same conclusion. He points out that when opioids are used in combination with cannabis in animals, marijuana can boost an opioid’s effectiveness without requiring higher dosages.

Slinker is now a patient of Sulak’s integrative health practice. Instead of taking 25 pills a day, she supplements smoking a gram of marijuana every three or four weeks with marijuana tinctures, oils and vapor. She also uses a drug called naltrexone to help with her autoimmune-related issues.

She credits her life now to cannabis and wants others to know about it. “I want people to know that they have options. Do not be afraid to tell your doctor that you do not want these chemicals in your body,” she said.

‘I don’t think I would be alive today if I didn’t have it’

Doug Campbell, another patient of Sulak’s, agrees that cannabis is a real alternative. “I don’t think I would be alive today if I didn’t have it,” he said.

Like Slinker, Campbell said he started off using narcotics to manage pain. He was 18 years-old when he fell off a roof and fractured three vertebrae in his lower back. But it wasn’t until he started getting involved in a more party lifestyle that opioids became more than just therapy.

After 32 times in and out of rehabilitation, he finally found a way to stop using opioids. “I have no cravings. I have no desire. I do not have any thought about it at all,” he told Gupta.

Dr. Mark Wallace, a pain management specialist and head of the University of California, San Diego Health’s Center for Pain Medicine, is seeing similar results in his patients. Wallace began investigating cannabis in 1999, when he received a grant from the state of California. He looked at the literature and realized that pot had a long history of therapeutic use for many disorders including leprosy, epilepsy and pain.

Within a decade, there were enough studies to convince him that marijuana was a real alternative to use in his practice. He estimates that hundreds of his patients, like Marc Schechter, have been weaned off pills through pot.

40,000 pills over 10 years

In the past 10 years, Schechter estimates, he took almost 40,000 opioid pills, all prescribed to him by his doctors. Percocet, fentanyl and OxyContin — they all worked, but when the dosage wore off, he needed more.

Schechter had a rare condition that flared up while he was playing golf in 2007. At the 17th hole, pain began radiating from his back. By the time he got back to his room, he couldn’t move his left leg at all.

Schechter was diagnosed with idiopathic transverse myelitis, an inflammation of the spine. He was eventually able to walk again, but the pain persisted.

Without the drugs, it felt like his leg was burning with pins and needles, as if it had fallen asleep. “It’s like that 24/7. Not a second of relief,” he said. He needed the drugs just to live.

“Were you addicted to them?” Gupta asked.

“Physically, yeah,” Schechter said.

The drugs never interfered with his work as an attorney, but Schechter kept needing more and more of them. He started to question their effectiveness. Schechter told his neurologist, “I really am starting to doubt whether this is even having any effect because I’m in so much neuropathic pain.”

His neurologist had heard of Wallace’s work and referred Schechter to the clinic. The first night Schechter used marijuana, he took a puff or two from a vaporizer. “Within a minute, I had immediate pain relief. … [The pain level] was so tolerable that I was, like, in heaven.”

‘We need objective data’

Patients and doctors across the country have told similar stories. But Dr. Nora Volkow, director of the National Institute on Drug Abuse, said anecdotes are not enough.

“We cannot be guided by wishful thinking. We need objective data,” she told Gupta.

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And a growing number of doctors and researchers like Wallace and Sulak are ready to provide those data. They say federal regulations are standing in the way of getting people the help they need.

According to the Drug Enforcement Administration, marijuana is a Schedule I drug, meaning it has no medical use and a high potential for abuse.

“We have enough evidence now that it should be rescheduled,” Wallace said.

Sulak wonders, “When will the medical community catch up with what their patient populations are doing?”

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Gupta to Jeff Sessions: Medical marijuana could save many addicted to opioids

July 4, 2018 Mary Jane Blog

(CNN)Dear Honorable Jeff Sessions,

Watch Chief Medical Correspondent Dr. Sanjay Gupta’s CNN Special Report “Weed 4: Pot vs. Pills” on Sunday, April 29, at 8 p.m. ET.

I feel obligated to share the results of my five-year-long investigation into the medical benefits of the cannabis plant. Before I started this worldwide, in-depth investigation, I was not particularly impressed by the results of medical marijuana research, but a few years later, as I started to dedicate time with patients and scientists in various countries, I came to a different conclusion.

Not only can cannabis work for a variety of conditions such as epilepsy, multiple sclerosis and pain, sometimes, it is the only thing that works. I changed my mind, and I am certain you can, as well. It is time for safe and regulated medical marijuana to be made available nationally. I realize this is an unconventional way to reach you, but your office declined numerous requests for an interview, and as a journalist, a doctor and a citizen, I felt it imperative to make sure you had access to our findings.

Mr. Sessions, there is an added urgency, as we are in the middle of a deadly opioid epidemic that has been described as the worst self-inflicted epidemic in the history of our country.

The drug overdose scourge claimed about 68,000 US lives in 2017, just over 45,000 of them from opioids alone. Every day, 115 Americans die from opioid overdoses. It has fueled a decline in an entire country’s life expectancy and will be remembered as a sad and tragic chapter in our collective history.

These are desperate times, and while some may consider making medical marijuana widely available to be a desperate measure, the evidence has become increasingly clear of the important role cannabis can have.

We have seen real-world clues of medical marijuana’s benefits. Researchers from the Rand Corp., supported by the National Institute on Drug Abuse, conducted “the most detailed examination of medical marijuana and opioid deaths to date” and found something few initially expected. The analysis showed an approximately 20% decline in opioid overdose deaths between 1999 and 2010 in states with legalized medical marijuana and functioning dispensaries.

It’s not the first time this association between medical marijuana and opioid overdose has been found. Though it is too early to draw a cause-effect relationship, these data suggest that medicinal marijuana could save up to 10,000 lives every year.

The science of weed

Cannabis and its compounds show potential to save lives in three important ways.

Cannabis can help treat pain, reducing the initial need for opioids. Cannabis is also effective at easing opioid withdrawal symptoms, much like it does for cancer patients, ill from chemotherapy side effects. Finally, and perhaps most important, the compounds found in cannabis can heal the diseased addict’s brain, helping them break the cycle of addiction.

Mr. Sessions, there is no other known substance that can accomplish all this. If we had to start from scratch and design a medicine to help lead us out of the opioid epidemic, it would likely look very much like cannabis.

A better, and safer, way to treat pain

The consensus is clear: Cannabis can effectively treat pain. The National Academies of Sciences, Engineering, and Medicine arrived at this conclusion last year after what it described as the “most comprehensive studies of recent research” on the health effects of cannabis.

Furthermore, opioids target the breathing centers in the brain, putting their users at real risk of dying from overdose. In stark contrast, with cannabis, there is virtually no risk of overdose or sudden death. Even more remarkable, cannabis treats pain in a way opioids cannot. Though both drugs target receptors that interfere with pain signals to the brain, cannabis does something more: It targets another receptor that decreases inflammation — and does it fast.

I have seen this firsthand. All over the country, I have met patients who have weaned themselves off opioids using cannabis. Ten years ago, attorney Marc Schechter developed a sudden painful condition known as transverse myelitis, an inflammation of the spinal cord. After visiting doctors in several states, he was prescribed opioids and, according to our calculations, consumed approximately 40,000 pills over the next decade. Despite that, his pain scores remained an eight out of 10. He also suffered significant side effects from the pain medication, including nausea, lethargy and depression.

Desperate and out of options, Schechter saw Dr. Mark Wallace, head of University of California, San Diego Health’s Center for Pain Medicine, where he was recommended cannabis. Minutes after he took it for the first time, Schechter’s pain was reduced to a score of two out of 10, with hardly any side effects. One dose of cannabis had provided relief that 40,000 pills over 10 years could not.

Using marijuana to get off opioids

For Schechter, as with so many others, the seemingly insurmountable barrier to ending his opioid use was the terrible withdrawal symptoms he suffered each time he tried. When a patient stops opioids, their pain is often magnified, accompanied by rapid heart rate, persistent nausea and vomiting, excessive sweating, anorexia and terrible anxiety.

Here again, cannabis is proven to offer relief. As many know, there is longstanding evidence that cannabis helps chemotherapy-induced symptoms in cancer patients, and those symptoms are very similar to opioid withdrawal. In fact, for some patients, cannabis is the only agent that subdues nausea while increasing appetite.

Why we can’t ‘just say no’ to opioids

Finally, when someone is addicted to opioids, they are often described as having a brain disease. Yasmin Hurd, director of the Addiction Institute at Mount Sinai in New York City, showed me what this looks like in autopsy specimens of those who had overdosed on opioids. Within the prefrontal cortex of the brain, she found damage to the glutamatergic system, which makes it difficult for neural signals to be transmitted. This is an area of the brain responsible for judgment, decision-making, learning and memory.

Hurd told me that when an individual’s brain is “fundamentally changed” and diseased in this manner, they lose the ability to regulate opioid consumption, unable to quit despite their best efforts — unable to “just say no.”

It is no surprise, then, that abstinence-only programs have pitiful results when it comes to opioid addiction. Even the current gold standard of medication-assisted treatment, which is far more effective, still relies on less-addictive opioids such as methadone and buprenorphine. That continued opioid use, Hurd worries, can cause ongoing disruption to the glutamatergic system, never allowing the brain to fully heal. It may help explain the tragic tales of those who succeed in stopping opioids for a short time, only to relapse again and again.

Your brain on marijuana

This is precisely why Hurd started to look to other substances to help and settled on nonpsychoactive cannabidiol or CBD, one of the primary components in cannabis. Hurd and her team discovered that CBD actually helped “restructure and normalize” the brain at the “cellular level, at the molecular level.” It was CBD that healed the glutamatergic system and improved the workings of the brain’s frontal lobes.

This new science sheds lights on stories like the one I heard from Doug Campbell of Yarmouth, Maine. He told me he had been in and out of drug rehab 32 times over 25 years, with no success. But soon after starting cannabis, he no longer has “craving, desire and has not thought about (opioids) at all, period.”

For the past 40 years, we have been told that cannabis turns the brain into a fried egg, and now there is scientific evidence that it can do just the opposite, as it did for Campbell. It can heal the brain when nothing else does.

I know it sounds too good to be true. I initially thought so, as well. Make no mistake, though: Marc Schechter and Doug Campbell are emblematic of thousands of patients who have successfully traded their pills for a plant.

These patients often live in the shadows, afraid to come forward to share their stories. They fear stigma. They fear prosecution. They fear that someone will take away what they believe is a lifesaving medication.

Where do we go from here?

Mr. Sessions, Dr. Mark Wallace has invited you to spend a day seeing these patients in his San Diego clinic and witness their outcomes for yourself. Dr. Dustin Sulak could do the same for you in Portland, Maine, as could Dr. Sue Sisley in Phoenix. Staci Gruber in Boston could show you the brain scans of those who tried cannabis for the first time and were then able to quit opioids. Dr. Julie Holland in New York City could walk you through the latest research. All over the country, you will find the scientists who write the books and papers, advance the science and grow our collective knowledge. These are the women and men to whom you should listen. They are the ones, free of rhetoric and conjecture, full of facts and truth, who are our best chance at halting the deadly opioid epidemic.

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Making medicinal marijuana available should come with certain obligations and mandates, just as with any other medicine. It should be regulated to ensure its safety, free of contamination and consistent in dosing. It should be kept out of the hands of children, pregnant women and those who are at risk for worse side effects. Any responsible person wants to make sure this is a medicine that helps people, not harms.

Recently, your fellow conservative John Boehner changed his mind after being “unalterably opposed” to marijuana in the past. If you do the same, Mr. Attorney General, thousands of lives could be improved and saved. There is no time to lose.

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Oklahoma voters approve medical marijuana measure

July 1, 2018 Mary Jane Blog

(CNN)Oklahomans voted in favor of legalizing medicinal marijuana Tuesday, with 56.8% approving the measure, according to unofficial results with 99.6% of precincts reporting.

The results in Oklahoma are unofficial, but Gov. Mary Fallin issued a statement Tuesday night.

“I respect the will of the voters in any question placed before them to determine the direction of our state,” she said. “It is our responsibility as state leaders to look out for the health and safety of Oklahoma citizens.”

Fallin had previously said that she planned on calling a special session if voters pass the measure, reported CNN affiliate KOCO.

“As I mentioned in previous public comments, I believe, as well as many Oklahomans, this new law is written so loosely that it opens the door for basically recreational marijuana. I will be discussing with legislative leaders and state agencies our options going forward on how best to proceed with adding a medical and proper regulatory framework to make sure marijuana use is truly for valid medical illnesses,” she said in a statement Tuesday after the vote.

Medical marijuana is legal in some form in 30 states, according to the National Conference of State Legislatures. Nine states and Washington, DC allow for recreational sales.

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Federal law says marijuana is illegal, but a majority of states and the District of Columbia have passed laws legalizing or decriminalizing its use for medical reasons.

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FDA approves first cannabis-based drug

July 1, 2018 Mary Jane Blog

(CNN)The US Food and Drug Administration approved a cannabis-based drug for the first time, the agency said Monday.

Epidiolex was recommended for approval by an advisory committee in April, and the agency had until this week to make a decision.

The twice-daily oral solution is approved for use in patients 2 and older to treat two types of epileptic syndromes: Dravet syndrome, a rare genetic dysfunction of the brain that begins in the first year of life, and Lennox-Gastaut syndrome, a form of epilepsy with multiple types of seizures that begin in early childhood, usually between 3 and 5.

“This is an important medical advance,” FDA Commissioner Dr. Scott Gottlieb said in a statement Monday. “Because of the adequate and well-controlled clinical studies that supported this approval, prescribers can have confidence in the drug’s uniform strength and consistent delivery.”

The drug is the “first pharmaceutical formulation of highly-purified, plant-based cannabidiol (CBD), a cannabinoid lacking the high associated with marijuana, and the first in a new category of anti-epileptic drugs,” according to a statement Monday from GW Pharmaceuticals, the UK-based biopharmaceutical company that makes Epidiolex.

Cannabidiol is one of more than 80 active cannabinoid chemicals, yet unlike tetrahydrocannabinol, or THC, it does not produce a high.

The FDA has approved synthetic versions of some cannabinoid chemicals found in the marijuana plant for other purposes, including cancer pain relief.

Justin Gover, chief executive officer of GW Pharmaceuticals, described the approval in the statement as “a historic milestone.” He added that the drug offers families “the first and only FDA-approved cannabidiol medicine to treat two severe, childhood-onset epilepsies.”

“These patients deserve and will soon have access to a cannabinoid medicine that has been thoroughly studied in clinical trials, manufactured to assure quality and consistency, and available by prescription under a physician’s care,” Gover said.

Epidiolex will become available in the fall, Gover told CNN. He would not give any information on cost, saying only that it will be discussed with insurance companies and announced later.

With Epidiolex meeting FDA standards, the drug will “finally be made available to the thousands that may benefit from it,” he said.

It’s an option for those patients who have not responded to other treatments to control seizures.According to the Epilepsy Foundation, up to one-third of Americans who have epilepsy have found no therapies that will control their seizures.

Shauna Garris, a pharmacist, pharmacy clinical specialist and adjunct assistant professor at the University of North Carolina’s Eshelman School of Pharmacy, said the drug is effective and works somewhere between “fairly” and “very well.” She has not used Epidiolex in her own clinical practice and was not involved in the development of the drug but said she’s not sure it will live up to “all of the hype” that has surrounded it.

There are side effects, the most common being sleepiness, Gover said. But Garris highlighted that many of the side effects occur when it is taken with other medications, which she said is a concern because most patients are on other medications.

There are likely to be drug interactions, she said, but “that’s not uncommon for antiepileptic medications,” and she noted that this could affect the effectiveness of the medication.

The European Medical Society is also considering approval of Epidiolex and is expected to announce a decision in the first quarter of next year, according to Gover.

A phase three clinical trial is underway for a third seizure-related condition called tuberous sclerosis complex, which begins in infancy and causes a sudden stiffening of the body, arms and legs, with the head bent forward. Glover said that if the results are positive, his company will apply for supplemental approval for this condition.

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In the meantime, it is possible that once on the market, Epidiolex could be prescribed for conditions other than the ones it’s approved for. This is called off-label use and is a common practice with many medications.

As part of the FDA’s review of the medication, the potential for abuse was assessed and found to be low to negative, according to Gover.

Still, this approval comes as the White House is said to be reconsidering federal prohibition of marijuana and as more and more states approve it for recreational and medicinal use.

Gover said the approval signals “validation of the science of cannabinoid medication.”

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Marijuana’s effects on young brains diminish 72 hours after use, research says

June 28, 2018 Mary Jane Blog

(CNN)Marijuana is notorious for slowing certain cognitive functions such as learning, memory and attention span (maybe that’s why they call it “dope”?). But new research in young people suggests that these cognitive effects, while significant, may not persist for very long, even among chronic users.

The meta-analysis, published Wednesday in the journal JAMA Psychiatry, combines data from 69 previous studies that look at the effects of heavy cannabis use on cognitive functioning in adolescents and young adults. It found that those young people who identified as heavy marijuana users scored significantly lower than non-users in a variety of cognitive domains such as learning, abstraction, speed of processing, delayed memory, inhibition and attention.

“There have been a couple of meta-analyses done in adult samples, but this is the first one to be done specifically in adolescent and young adult samples,” said Cobb Scott, assistant professor of psychiatry at the Perelman School of Medicine at the University of Pennsylvania and a lead author of the study.

“We looked at everything from learning and memory to different aspects of executive functioning such as abstraction ability,” Scott said. “And we basically showed that the largest effects — which was around a third of a standard deviation — was in the learning of new information and some aspects of executive functioning, memory and speed of processing.”

But when the researchers separated the studies based on length of abstinence from marijuana use, the difference in cognitive functioning between marijuana users and non-users was no longer apparent after 72 hours of marijuana abstinence. That could be an indication “that some of the effects found in previous studies may be due to the residual effects of cannabis or potentially from withdrawal effects in heavy cannabis users,” Scott said.

The study comes as America continues to debate the merits of marijuana legalization. Recreational marijuana use is legal in nine states. Twenty-nine states and the District of Columbia have legalized some form of medical marijuana use, with at least three additional states potentially deciding on the issue in the upcoming November election, according to Melissa Moore, New York deputy state director for the nonprofit Drug Policy Alliance.

Studies on the long-term cognitive effects of marijuana use among adolescents and young adults have shown inconsistent results. A 2008 study reported that frequent or early-onset cannabis use among adolescents was associated with poorer cognitive performance in tasks requiring executive functioning, attention and episodic memory.

A 2014 study also warned against the use of marijuana during adolescence, when certain parts of the brain responsible for executive functioning — such as the prefrontal cortex — are still developing.

“There have been very important studies showing evidence for irreversible damage (from marijuana use), and so there needs to be more research in this area,” said Kevin Sabet, assistant adjunct professor at the Yale School of Medicine and president of the nonprofit Smart Approaches to Marijuana, who was not involved in the new study.

“I hope they’re right. We want there to be little effect after 72 hours. But given the other studies that have had very large sample sizes that have been published over the past five years in prominent journals, I think we need to look into that more,” added Sabet, whose group is focused on the harms of marijuana legalization.

But a number of recent studies have also shown that the association between marijuana use and reduced cognitive functioning disappears after controlling for factors such as psychiatric illness and substance use disorders, according to Scott.

In an attempt to make sense of these discordant results, the new research combined data from 69 previous studies, resulting in a comparison of 2,152 frequent marijuana users with 6,575 non-users. Participants ranged in age from 10 to 50, with an average age of 21.

The researchers found that, overall, the cognitive functioning of frequent marijuana users was reduced by one-third of a standard deviation compared with non-frequent marijuana users — a relatively small effect size, according to Scott.

“It surprised, I think, all of us doing this analysis that the effects were not bigger than we found,” Scott said. “But I would say that the clinical significance of a quarter of a standard deviation is somewhat questionable.”

But according to Sabet, even a relatively small effect size could be important, especially in a large meta-analysis such as this one.

“The small effect size may be meaningful in a large population, and again, all (cognitive) measures are worse for those using marijuana,” Sabet said.

“The study is pretty bad news for marijuana users,” he added. “Overall, I think this is consistent with the literature that marijuana use shows worse cognitive outcomes among users versus non-users.”

In an effort to identify other potential factors that could have affected the relationship between marijuana use and cognition,the researchers also separated the studies based on the length of marijuana abstinence, age of first cannabis use, sociodemographic characteristics and clinical characteristics such as depression.

Of these, only the length of marijuana abstinence was found to significantly affect the association between chronic marijuana use and reduced cognitive functioning. Specifically, cognitive functioning appeared to return to normal after about 72 hours of marijuana abstinence — a threshold identified in previous studies, according to Scott.

“The reason we chose the 72-hour mark is that in looking at the data on cannabis withdrawal effects in heavy cannabis users, 72 hours seems to be past the peak of most withdrawal effects that occur,” he said.

However, the 69 studies included in the review did not have a uniform definition for “chronic” or “frequent” marijuana use, one of the study’s main limitations, according to Sabet.

“When you put all of these studies together that have different definitions of marijuana users and are from different times, it’s not surprising that you’d get a smaller effect size,” Sabet said.

The studies also relied on a variety of tests to determine cognitive functioning, including the Trail Making Test, the Digital Span Memory Test and the California Verbal Learning test, according to Scott.

“The other thing that’s important to highlight is that we’re only looking at cognitive functioning. We’re not looking at risks for other adverse outcomes with cannabis use, like risk for psychosis, risks for cannabis use problems or other medical issues like lung functioning outcomes,” Scott said.

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But the results still suggest that the negative cognitive effects of marijuana use, while significant in the short-term, probably diminish with time. They also shed light on the need for more research in this area, particularly as cannabis policy in the United States continues to change at a rapid pace.

“As attitudes change about cannabis use and cannabis use becomes a little bit more accepted in terms of policy and government regulation and medical cannabis use increases, I think we need to have a real understanding of the potential risks and benefits of cannabis use,” Scott said.

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Marijuana legalization could help offset opioid epidemic, studies find

June 18, 2018 Mary Jane Blog

(CNN)Experts have proposed using medical marijuana to help Americans struggling with opioid addiction. Now, two studies suggest that there is merit to that strategy.

Watch Chief Medical Correspondent Dr. Sanjay Gupta’s CNN Special Report “Weed 4: Pot vs. Pills” on Sunday, April 29, at 8 p.m. ET.

The studies, published Monday in the journal JAMA Internal Medicine, compared opioid prescription patterns in states that have enacted medical cannabis laws with those that have not. One of the studies looked at opioid prescriptions covered by Medicare Part D between 2010 and 2015, while the other looked at opioid prescriptions covered by Medicaid between 2011 and 2016.

The researchers found that states that allow the use of cannabis for medical purposes had 2.21 million fewer daily doses of opioids prescribed per year under Medicare Part D, compared with those states without medical cannabis laws. Opioid prescriptions under Medicaid also dropped by 5.88% in states with medical cannabis laws compared with states without such laws, according to the studies.

“This study adds one more brick in the wall in the argument that cannabis clearly has medical applications,” said David Bradford, professor of public administration and policy at the University of Georgia and a lead author of the Medicare study.

“And for pain patients in particular, our work adds to the argument that cannabis can be effective.”

Medicare Part D, the optional prescription drug benefit plan for those enrolled in Medicare, covers more than 42 million Americans, including those 65 or older. Medicaid provides health coverage to more than 73 million low-income individuals in the US, according to the program’s website.

“Medicare and Medicaid publishes this data, and we’re free to use it, and anyone who’s interested can download the data,” Bradford said. “But that means that we don’t know what’s going on with the privately insured and the uninsured population, and for that, I’m afraid the data sets are proprietary and expensive.”

‘This crisis is very real’

The new research comes as the United States remains entangled in the worst opioid epidemic the world has ever seen. Opioid overdose has risen dramatically over the past 15 years and has been implicated in over 500,000 deaths since 2000 — more than the number of Americans killed in World War II.

“As somebody who treats patients with opioid use disorders, this crisis is very real. These patients die every day, and it’s quite shocking in many ways,” said Dr. Kevin Hill, an addiction psychiatrist at Beth Israel Deaconess Medical Center and an assistant professor of psychiatry at Harvard Medical School, who was not involved in the new studies.

“We have had overuse of certain prescription opioids over the years, and it’s certainly contributed to the opioid crisis that we’re feeling,” he added. “I don’t think that’s the only reason, but certainly, it was too easy at many points to get prescriptions for opioids.”

Today, more than 90 Americans a day die from opioid overdose, resulting in more than 42,000 deaths per year, according to the US Centers for Disease Control and Prevention. Opioid overdose recently overtook vehicular accidents and shooting deaths as the most common cause of accidental death in the United States, the CDC says.

Like opioids, marijuana has been shown to be effective in treating chronic pain as well as other conditions such as seizures, multiple sclerosis and certain mental disorders, according to the National Institute on Drug Abuse. Research suggests that the cannabinoid and opioid receptor systems rely on common signaling pathways in the brain, including the dopamine reward system that is central to drug tolerance, dependence and addiction.

“All drugs of abuse operate using some shared pathways. For example, cannabinoid receptors and opioid receptors coincidentally happen to be located very close by in many places in the brain,” Hill said. “So it stands to reason that a medication that affects one system might affect the other.”

But unlike opioids, marijuana has little addiction potential, and virtually no deaths from marijuana overdose have been reported in the United States, according to Bradford.

“No one has ever died of cannabis, so it has many safety advantages over opiates,” Bradford said. “And to the extent that we’re trying to manage the opiate crisis, cannabis is a potential tool.”

Comparing states with and without medical marijuana laws

In order to evaluate whether medical marijuana could function as an effective and safe alternative to opioids, the two teams of researchers looked at whether opioid prescriptions were lower in states that had active medical cannabis laws and whether those states that enacted these laws during the study period saw reductions in opioid prescriptions.

Both teams, in fact, did find that opioid prescriptions were significantly lower in states that had enacted medical cannabis laws. The team that looked at Medicaid patients also found that the four states that switched from medical use only to recreational use — Alaska, Colorado, Oregon and Washington — saw further reductions in opioid prescriptions, according to Hefei Wen, assistant professor of health management and policy at the University of Kentucky and a lead author on the Medicaid study.

“We saw a 9% or 10% reduction (in opioid prescriptions) in Colorado and Oregon,” Wen said. “And in Alaska and Washington, the magnitude was a little bit smaller but still significant.”

The first state in the United States to legalize marijuana for medicinal use was California, in 1996. Since then, 29 states and the District of Columbia have approved some form of legalized cannabis. All of these states include chronic pain — either directly or indirectly — in the list of approved medical conditions for marijuana use, according to Bradford.

The details of the medical cannabis laws were found to have a significant impact on opioid prescription patterns, the researchers found. States that permitted recreational use, for example, saw an additional 6.38% reduction in opioid prescriptions under Medicaid compared with those states that permitted marijuana only for medical use, according to Wen.

The method of procurement also had a significant impact on opioid prescription patterns. States that permitted medical dispensaries — regulated shops that people can visit to purchase cannabis products — had 3.742 million fewer opioid prescriptions filled per year under Medicare Part D, while those that allowed only home cultivation had 1.792 million fewer opioid prescriptions per year.

“We found that there was about a 14.5% reduction in any opiate use when dispensaries were turned on — and that was statistically significant — and about a 7% reduction in any opiate use when home cultivation only was turned on,” Bradford said. “So dispensaries are much more powerful in terms of shifting people away from the use of opiates.”

The impact of these laws also differed based on the class of opioid prescribed. Specifically, states with medical cannabis laws saw 20.7% fewer morphine prescriptions and 17.4% fewer hydrocodone prescriptions compared with states that did not have these laws, according to Bradford.

Fentanyl prescriptions under Medicare Part D also dropped by 8.5% in states that had enacted medical cannabis laws, though the difference was not statistically significant, Bradford said. Fentanyl is a synthetic opioid, like heroin, that can be prescribed legally by physicians. It is 50 to 100 times more potent than morphine, and even a small amount can be fatal, according to the National Institute on Drug Abuse.

“I know that many people, including the attorney general, Jeff Sessions, are skeptical of cannabis,” Bradford said. “But, you know, the attorney general needs to be terrified of fentanyl.”

‘A call to action’

This is not the first time researchers have found a link between marijuana legalization and decreased opioid use. A 2014 study showed that states with medical cannabis laws had 24.8% fewer opioid overdose deaths between 1999 and 2010. A study in 2017 also found that the legalization of recreational marijuana in Colorado in 2012 reversed the state’s upward trend in opioid-related deaths.

“There is a growing body of scientific literature suggesting that legal access to marijuana can reduce the use of opioids as well as opioid-related overdose deaths,” said Melissa Moore, New York deputy state director for the Drug Policy Alliance. “In states with medical marijuana laws, we have already seen decreased admissions for opioid-related treatment and dramatically reduced rates of opioid overdoses.”

Some skeptics, though, argue that marijuana legalization could actually worsen the opioid epidemic. Another 2017 study, for example, showed a positive association between illicit cannabis use and opioid use disorders in the United States. But there may be an important difference between illicit cannabis use and legalized cannabis use, according to Hill.

“As we have all of these states implementing these policies, it’s imperative that we do more research,” Hill said. “We need to study the effects of these policies, and we really haven’t done it to the degree that we should.”

The two recent studies looked only at patients enrolled in Medicaid and Medicare Part D, meaning the results may not be generalizable to the entire US population.

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But both Hill and Moore agree that as more states debate the merits of legalizing marijuana in the coming months and years, more research will be needed to create consistency between cannabis science and cannabis policy.

“There is a great deal of movement in the Northeast, with New Hampshire and New Jersey being well-positioned to legalize adult use,” Moore said. “I believe there are also ballot measures to legalize marijuana in Arizona, Florida, Missouri, Nebraska and South Dakota as well that voters will decide on in Fall 2018.”

Hill called the new research “a call to action” and added, “we should be studying these policies. But unfortunately, the policies have far outpaced the science at this point.”

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Cannabis oil stopped his seizures but may keep him from his football dream

June 1, 2018 Mary Jane Blog

(CNN)A high school football player who takes cannabis oil to prevent his seizures has been ruled ineligible to play in college, a decision that has sparked outrage from advocates, lawmakers and sports fans.

A former Big Ten Coach of the Year sharply criticized the decision, saying “it’s not fair to the kid” and urging the NCAA to reconsider.

C.J. Harris, a standout strong safety, helped lead Warner Robins High School to the Georgia state championship game and committed to play for Auburn University next season. But he was recently notified by Auburn coaches that the NCAA will not allow him to play if he remains on cannabis oil, according to CNN affiliate WGXA.

Under NCAA guidelines, athletes are not permitted to have any tetrahydrocannabinol in their systems. Known as THC, it is one of the active ingredients in cannabis. It has some medical applications but is also psychoactive and can cause a “high.” The other active cannabis ingredient, cannabidiol or CBD, does not produce a high and is thought to offer wide-ranging health benefits, including against seizures.

The cannabis oil Harris takes for his seizures contains less than 0.3% THC, according to the label. He won’t be able to pass an NCAA drug test while on the medicine, WGXA reported.

“We urge the NCAA to review their existing guidelines on THC and explore possible exceptions to allow players under medical treatment, like C.J., the ability to fulfill their dreams of playing college football,” Phil Gattone, president and CEO of the Epilepsy Foundation, a nonprofit advocacy group, said in a statement. “We hope the NCAA would reconsider their decision and assess C.J. on his character and talent as a football player.”

Gattone said that although he couldn’t comment specifically about Harris’ use of CBD oil to treat his seizures, the “Epilepsy Foundation is committed to advocating for people with epilepsy live their fullest lives and realize their dreams.”

“We support safe, legal access to medical cannabis and CBD if a patient and their health care team feel that the potential benefits of medical cannabis or CBD for uncontrolled epilepsy outweigh the risks,” he said.

The NCAA has not responded to a request for comment.

Jerry Kill, who was named Big Ten Coach of the Year as the head football coach of the University of Minnesota, even as he battled his own seizure disorder, has sharply critical of the decision. In a phone interview with CNN, he urged Auburn and the NCAA to come together to reconsider the decision.

“That young man should not be punished for a disorder that is being controlled by cannabis oil,” said Kill, who had to retire due to seizures and has been a champion for those with epilepsy. “I encourage both parties to take a good look at what they’re doing to a young man’s dream.

“If it’s not safe for him to play, that is one thing. But if it’s because he’s using CBD oil and they won’t let him play, that’s another. A kid should not be punished for his seizures being brought under control. It’s not fair to the kid.”

Harris was an eighth-grader when he suffered his first seizure. By his sophomore year in high school, he was having two or three seizures a month. Typical anti-seizure medications didn’t work, so his doctors eventually put him on cannabis oil. He has not had a seizure since he began taking it in January 2017, WGXA reported.

CBD is legal for people with seizure disorders in Georgia as well as in neighboring Alabama, where Auburn is located.

Harris planned to attend Auburn, his “dream school,” as a walk-on next season. “I saw everything lining up perfectly for me,” he told WGXA.

But that dream was shattered when he was notified by Auburn staff that the NCAA ruled him ineligible if he stayed on cannabis oil.

“You’re taking something away from a kid who worked so hard his whole life to get there, and you’re just taking it away because he’s taking a medication that’s helping him with a disability,” father Curtis Harris told WGXA.

Allen Peake, a state representative who has championed medical marijuana for children in Georgia, expressed outrage at the news of Harris’ ineligibility. “We must fix this,” he tweeted.

Heath Clark, a state representative from Warner Robins, had rejoiced at the state Capitol in February when Harris committed to Auburn, saying that the young man being seizure-free was a wonderful example of good news resulting from the legalization of medical marijuana.

“His dreams are being fulfilled. He has a future. He’s going to get a quality education at that school across the Georgia border,” Clark said at the time.

As news of Harris’ ineligibility spread Friday, Clark took to Twitter to bash the NCAA. “The NCAA needs to fix their outdated policies,” he wrote.

Others expressed a similar sentiment. Brandon Marcello, a senior writer for the website Auburn Undercover, tweeted that the “NCAA needs to do the right thing here.”

Harris had committed to Auburn in February, announcing to his Twitter followers that “God has afforded me a once in a lifetime opportunity that I could not pass up.” He told WGXA he is now looking at junior college programs or other schools not under NCAA guidelines.

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He said he was speaking up for others with seizure disorders and standing in solidarity with them — to get the word out that there’s “no need for me to give up at anything I want to do in life.”

The issue is likely to come up more often as the US Food and Drug Administration considers approving an epilepsy drug that would be the first plant-derived cannabidiol medicine for prescription use in the United States.

The FDA will vote in late June on whether to approve the drug, Epidiolex, an oral solution, for the treatment of severe forms of epilepsy in a small group of patients. The FDA has approved synthetic versions of some cannabinoid chemicals found in the marijuana plant for other purposes, including cancer pain relief.

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What is CBD? The ‘miracle’ cannabis compound that doesn’t get you high

May 29, 2018 Mary Jane Blog

The cannabis-derived chemical is non-psychoactive, and while federally illegal has been hailed as a cure for disease

In early May, a federal court declined to protect cannabidiol (CBD), a chemical produced by the cannabis plant, from federal law enforcement, despite widespread belief in its medical value.

The ruling was contrary to existing evidence, which suggests the chemical is safe and could have multiple important uses as medicine. Many cannabis advocates consider it a miracle medicine, capable of relieving conditions as disparate as depression, arthritis and diabetes.

The perception of its widespread medical benefits have made the chemical a rallying cry for legalization advocates.

The first thing to know about CBD is that it is not psychoactive; it doesnt get people high. The primary psychoactive ingredient in marijuana is tetrahydrocannabinol (THC). But THC is only one of the scores of chemicals known as cannabinoids produced by the cannabis plant.

So far, CBD is the most promising compound from both a marketing and a medical perspective. Many users believe it helps them relax, despite it not being psychoactive, and some believe regular doses help stave off Alzheimers and heart disease.

While studies have shown CBD to have anti-inflammatory, anti-pain and anti-psychotic properties, it has seen only minimal testing in human clinical trials, where scientists determine what a drug does, how much patients should take, its side effects and so on.

Despite the government ruling, CBD is widely available over the counter in dispensaries in states where marijuana is legal.

CBD first came to public attention in a 2013 CNN documentary called Weed. The piece, reported by Dr Sanjay Gupta, featured a little girl in Colorado named Charlotte, who had a rare life-threatening form of epilepsy called Dravet syndrome.

At age five, Charlotte suffered 300 grand mal seizures a week, and was constantly on the brink of a medical emergency. Through online research, Charlottes desperate parents heard of treating Dravet with CBD. It was controversial to pursue medical marijuana for such a young patient, but when they gave Charlotte oil extracted from high-CBD cannabis, her seizures stopped almost completely. In honor of her progress, high-CBD cannabis is sometimes known as Charlottes Web.

CBD has been sought for its healing properties. Illustration: George Wylesol

Lots of Doctors Recommend Weed Without Understanding It

May 14, 2018 Mary Jane Blog

If you go to a doctor and ask them to recommend you medical marijuana, don’t expect them to fully understand how the drug works, both for you as an individual patient and in general as a therapy. Because no one really does.

With more and more states legalizing marijuana for medical or recreational use, cannabis is shedding its stigma and entering the mainstream. That means folks who’ve shied away from the stuff are getting better access, and exploring cannabis as a non-addictive treatment for ailments like pain. But that new interest is running smack dab into a big problem plaguing medical cannabis: The research on what marijuana can actually treat, what components of the plant matter, and how different patients respond to them, is severely lacking.

Just how much doctors are struggling with it becomes clear today in the Journal of Clinical Oncology. A study reveals that half of surveyed oncologists say they recommended marijuana to patients in the last year. But half of those didn’t think they actually had sufficient knowledge to make those recommendations.

The biggest question for oncologists is what cancer symptoms cannabis can really treat. The survey found respondents split when it comes to the treatment of pain: A third of oncologists said cannabis is equally or more effective than standard pain treatments, a third said it was less effective, and a third didn’t know. “But there seemed to be clear consensus that medical marijuana is a good adjunct to standard pain treatment, so a good add-on medication,” says Ilana Braun, lead author and chief of Dana-Farber Cancer Institute's Division of Adult Psychosocial Oncology. In fact, two-thirds of respondents said it’d be a good supplemental treatment.

According to the National Academies of Sciences, Engineering, and Medicine—which last year published a massive, big-deal review of cannabis research—“there is substantial evidence that cannabis is an effective treatment for chronic pain in adults.” It’s also been shown to help control nausea and vomiting.

Now, doctors have long prescribed a synthetic THC called dronabinol, aka marinol, for the treatment of nausea and weight loss. Problem is, side effects include paranoia and “thinking abnormal.” Beyond that, you wouldn’t want to try to get high on it because it’s missing the galaxy of other active compounds in cannabis. “If it worked—it rarely does work—but if it really did work it would be abused on the streets,” says physician Allan Frankel, a pioneer in medical cannabis. “For 15 cents a pill? That's how bad marinol is.”

The reason, Frankel says, is the so-called entourage effect, the interaction of dozens of other cannabinoids in marijuana like CBD (which is an extremely effective treatment for seizures, by the way) that may produce different therapeutic effects. So by that logic, with marinol, patients aren’t getting the full effect of the cannabis plant.

And that full effect would be? Well, nobody really knows—in part because the US government makes the stuff very, very difficult to study. In the eyes of the feds, it’s still a very illegal schedule I drug, the most tightly controlled category, and the DEA decides who gets crop to research. Researchers don’t have access to a variety of strains that might produce a variety of benefits, given different levels of CBD and THC and other compounds.

Even if you could study lots of different strains, it’s not always possible to tell what a patient is going to get at the dispensary. Flowers can be mislabeled, and the THC content of oils doesn’t always match what’s on the label. “Composition standardization is a giant mess,” says Jeff Raber, CEO of the Werc Shop, a lab that tests cannabis. “So for an ultra traditional doctor, I can understand where they're like, Man, we don't really know what that is, is that OK? It's not standardized like a pharmaceutical product.”

A doctor can’t just say, Take two marijuana pills and call me in the morning. And on a physiological level, we all handle cannabis differently. “Even if I tell everybody, go inhale a tenth of a gram, their inhalation depths and absorption rates are going to be different,” says Raber.

“Unfortunately, we are going a little bit blind,” says physician Bonni Goldstein, medical director of the Canna-Centers, which provides cannabis consultations for patients. “But what I'm finding in clinical experience is I learn from every patient, and so we try to use the scientific research that we do have.”

So doctors like Goldstein try to tailor cannabis as best they can for a patient’s needs. Her patients have the luxury of attentive, personalized cannabis consultations. “Someone retired who has cancer who doesn't have to get up in the morning and get somewhere may be able to take bigger doses during the day,” says Goldstein, “versus a mom of four who has kids in and out of activities, who has breast cancer.”

But your typical oncologist isn’t going to sit down with a patient for an hour to walk through their lifestyle and needs. So patients are left to experiment with dosages on their own, or consult with their local dispensary.

Because it turns out that dispensaries have some experience dosing cannabis. “Some of the top dispensaries that have been doing this for a while know this better than anybody else,” says Rob Adelson, president and CEO of Resolve, which makes a smart inhaler for medical marijuana patients. “There's still so much about the pharmacokinetics of this plant that we just don't know yet. So asking a doctor to come in to try to solve the problem without any more data than the dispensary has is hard.”

What Adelson sees cannabis promoting is a new paradigm of medical care. “We've heard this from many doctors, that they might not know about medical cannabis, might not want to promote it, and that a patient comes in and says, ‘I'd like to try it,’” he says. “And patients bring studies with them." That inversion of responsibility has its downsides: An elderly patient might not be aware of side effects like dizziness, for example. But at the same time, it's impossible to overdose. For better or worse, if doctors don't feel they have the knowledge to appropriately prescribe a drug, patients will fill that void.

More cannabis science

Another big unknown with cannabis is the issue of safety. Namely, the stuff that's grown in the wilds of California can be very, very dirty.
Take a deeper dive into why it's so hard to properly dose marijuana.
Again, please never drive stoned, ever, even if it's currently impossible to determine just how intoxicated you are.

All posts tagged: Health

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Lots of Doctors Recommend Weed Without Understanding It

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Goodell addresses NFL ban on marijuana use

‘I’m not ashamed of it. … I have a life to live’

Treating patients with weed

This is your brain on pain

‘I don’t think I would be alive today if I didn’t have it’

40,000 pills over 10 years

‘We need objective data’

The science of weed

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Using marijuana to get off opioids

Why we can’t ‘just say no’ to opioids

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‘This crisis is very real’

Comparing states with and without medical marijuana laws

‘A call to action’

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