Opioid Commission To Trump: Declare Emergency, Ignore Science

Per The New York Times:

WASHINGTON — President Trump’s commission on the opioid crisis asked him Monday to declare a national emergency to deal with the epidemic.

The members of the bipartisan panel called the request their “first and most urgent recommendation.”

Mr. Trump created the commission in March, appointing Gov. Chris Christie of New Jersey to lead it. The panel held its first public meeting last month and was supposed to issue an interim report shortly afterward but delayed doing so until now. A final report is due in October.

The initial recommendations are completely silent to the fact that medical marijuana access is associated with reduced rates of opioid use and abuse, opioid-related hospitalizations, opioid-related traffic fatalities, and opioid-related overdose deaths.

Chris Christie, sitting Governor of New Jersey until Jan. 17, 2018

Chris Christie, sitting Governor of New Jersey until Jan. 17, 2018

Over the last two months, over 8,000 voters contacted the Office of National Drug Control Policy commission, chaired by marijuana prohibitionist Chris Christie, with their personal stories and the relevant science to encourage the group to support medical marijuana as part of the approach to reduce the tragic effects of the opioid crisis. This effort was undertaken both by NORML and Marijuana Majority.

Governor Christie has zero percent credibility on drug policy, or any other policy, for that matter,” Erik Altieri, Executive Director of NORML said to Forbes of Christie at the time of his appointment to head the commission.

Nonetheless, this administration and Attorney General Jeff Sessions has continued to express skepticism with regard to the safety and efficacy of medical marijuana. Now, we now know that the President’s opioid commission is not interested in real solutions, but rather more empty rhetoric.

We have until October until the final report is to be issued.

Click here to send a message to the ONDCP commission to yet again tell them the facts and if you have one, please share your personal on how marijuana is a safer alternative to opioids. 

 

Study: Patients Report Substituting Cannabis For Opioids, Other Pain Medications

medical_mj_shelfPain patients report successfully substituting cannabis for opioids and other analgesics, according to data published online in the journal Cannabis and Cannabinoid Research.

Researchers from the University of California, Berkeley and Kent State University in Ohio assessed survey data from a cohort of 2,897 self-identified medical cannabis patients.

Among those who acknowledged having used opioid-based pain medication within the past six months, 97 percent agreed that they were able to decrease their opiate intake with cannabis. Moreover, 92 percent of respondents said that cannabis possessed fewer adverse side-effects than opioids. Eighty percent of respondents said that the use of medical cannabis alone provided greater symptom management than did their use of opioids.

Among those respondents who acknowledged having recently taken nonopioid-based pain medications, 96 percent said that having access to cannabis reduced their conventional drug intake. Ninety-two percent of these respondents opined that medical cannabis was more effective at treating their condition than traditional analgesics.

Authors concluded: “[M]ore people are looking at cannabis as a viable treatment for everyday ailments such as muscle soreness and inflammation. … [T]his study can conclude that medical cannabis patients report successfully using cannabis along with or as a substitute for opioid-based pain medication.”

The study’s conclusions are similar to those of several others, such as these herehereherehere, and here, finding reduced prescription drug use and spending by those with access to cannabis. Separate studies report an association between cannabis access and lower rates of opioid-related abuse, hospitalizations, traffic fatalities, and overdose deaths.

Full text of the study, “Cannabis as substitute for opioid-based pain medication: patient self-report,” appears online here.

First Meeting Of Trump’s Opioid Commission: Will It Be Effective?

Marijuana medicineToday, the Office of National Drug Control Policy convened its first meeting of President Trump’s “Commission on Combating Drug Addiction and the Opioid Crisis.”

The Commission is tasked with making recommendations for improving the Federal response to opioid misuse and abuse.

Best evidence informs us that medical marijuana access is associated with reduced levels of opioid-related abuse, hospitalization, and mortality. Nonetheless, this administration continues to express skepticism with regard to the safety and efficacy of medical marijuana.

Today in The Hill newspaper, NORML Deputy Director Paul Armentano writes:

With opioid overdose deaths having risen four-fold since 1999, it is imperative that lawmakers and public health experts approach this issue with an open mind and remain willing to entertain all potential alternatives.

For many patients, cannabis provides a safe and effective substitute for the use of opioids and other potentially harmful substances. Committee members should set their political ideologies aside and give strong consideration to this rapidly growing body of scientific evidence.

You can read the full piece in The Hill by clicking here.

It is crucial that our government hear from us. Click here to send a message to the Commission urging them to include medical marijuana as part of any national response to the opioid crisis.

Pharma Company Admits Opposing Marijuana Legalization to Protect Its Corporate Profits

C1_8734_r_xThose of us involved in the marijuana legalization movement have long assumed that those companies that produce and sell competing products — especially alcohol and tobacco — were working behind the scenes to try to maintain marijuana prohibition and to protect their duopoly for legal recreational drugs. These industries have lobbyists who regularly work with state and federal elected officials to keep legal marijuana off the market.

But we now see the pharmaceutical companies are also getting directly involved in political efforts to maintain marijuana prohibition, worried that legal marijuana will undermine their bottom line.

Pharmaceutical company joins the war on marijuana smokers.

Recently, we saw the first direct evidence that pharmaceutical companies are now working to defeat marijuana legalization efforts, acknowledging that their intent is to protect their market in synthetic opioid drugs.

Earlier this month, Insys Therapeutics Inc., an Arizona-based company, donated $500,000 to a group calling itself Arizonans for Responsible Drug Policy, a newly formed organization established to try to defeat Proposition 205, the marijuana legalization voter initiative that will appear on the ballot this November in that state.

Insys currently markets just one product, Subsys, a sublingual fentanyl spray, a synthetic opioid far more potent than heroin (fentanyl is the drug found in Prince’s system following his death in April). “Insys Therapeutics made $62 million in net revenue on Subsys fentanyl sales in the first quarter of this year, representing 100 percent of the company’s earnings,” according to The Washington Post. “The CDC has implicated the drug in a ‘surge’ of overdose deaths in several states in recent years.”

Survey data compiled from medical marijuana patients show that subjects often reduce their use of prescription drug therapies — particularly opioids — when they have legal access to cannabis. According to a 2015 RAND Corp. study, opiate-related abuse and mortality is lower in jurisdictions that permit medical cannabis access, compared to those that outlaw the plant.

Insys has come under scrutiny of law enforcement. According to The Washington Post, a number of states are currently investigating Insys for illegally paying physicians to prescribe their drug in situations in which it was inappropriate. Illinois Attorney General Lisa Madigan filed a lawsuit against the company, claiming the company’s “desire for increased profits led it to disregard patients’ health and pushed addictive opioids for non-FDA approved purposes.”

The smoking gun.

When the company first made its half-million dollar contribution to the group opposing the Arizona legalization initiative — the largest single contribution to the group by a factor of four — the company claimed that its reason for opposing the voter initiative was “because it fails to protect the safety of Arizona’s citizens and particularly its children.”

But when the company filed a legally required disclosure statement with the Securities and Exchange Commission, it acknowledged to shareholders that it was making the donation because it feared a decline in the sales of its powerful opioid product and that of a second drug it is developing: Dranabinol, a synthetic cannabinoid. Synthetic cannibinoid is a blanket term for an artificial version of tetrahydrocannabinol, or THC — the active compound in the marijuana plant — intended to alleviate chemotherapy-caused nausea and vomiting. The company concedes that the scientific literature has confirmed the benefits of natural marijuana over synthetic THC:

“Legalization of marijuana or non-synthetic cannabinoids in the United States could significantly limit the commercial success of any dronabinol product candidate. … If marijuana or non-synthetic cannabinoids were legalized in the United States, the market for dronabinol product sales would likely be significantly reduced, and our ability to generate revenue and our business prospects would be materially adversely affected.”

The Arizona Republic reported that the company, while publicly claiming to have kids’ best interests in mind, is clearly more concerned with ways to “protect its own bottom line.”

And the company has good reason for that fear. Recently published studies have found that states that provide for the legal use of medical marijuana had a 25 percent decline in opioid prescriptions. Another recent study from Columbia University found the implementation of medical marijuana programs is associated with a decrease in the prevalence of opioids detected among fatally injured drivers, based on a review of 69,000 fatalities in 18 states, according to data published in the American Journal of Public Health. Where legal marijuana is available, people use far fewer opioid drugs.

So we now have direct evidence that this pharmaceutical company in Arizona is spending large amounts of money to avoid having to compete with legal marijuana, in order to protect its market share for an addictive and dangerous synthetic opioid and a synthetic form of THC, at the expense of public health.

This is not the first instance of pharmaceutical companies pouring money into the “war on drugs.” In 2014, The Nation published an article revealing that the makers of Oxycontin and Vicodin were two of the largest contributors to The Partnership for Drug Free Kids and the Community Anti-Drug Coalition of America, two groups that oppose marijuana legalization and support continued prohibition.

Insys will certainly not be the last pharmaceutical company caught putting company profits ahead of concern for public health, but it is the first instance we have seen where a company was caught with its hands in the cookie jar, opposing a marijuana legalization initiative purely for reasons of corporate greed.

Tobacco and alcohol companies have long opposed legal marijuana.

It is understandable that recreational and pharmaceutical industries would not wish to compete with legal marijuana. By any measure, their products are far more dangerous and far more addictive.

Overdose Deaths.

For comparison purposes, according to the National Institute on Alcohol Abuse and Alcoholism, excessive alcohol use results in approximately 88,000 deaths per year in this country. And, according to the Centers for Disease Control and Prevention, tobacco smoking results in more than 480,000 deaths each year in this country, about 1,300 people each day.

A 2014 study by Johns Hopkins University found that states that legalized medical marijuana saw a 25 percent decline in overdose deaths from prescription drugs.

Marijuana has never caused an overdose death in the history of mankind. According to a recent report from the World Health Organization, one would have to smoke “between 238 and 1,113 joints a day – or at least 10 joints an hour, for 24 hours straight – before overdose would become a realistic concern” for marijuana.

Addictive potential.

While one can develop a dependence on marijuana smoking, the threat of dependence with marijuana is far less than with either alcohol or tobacco. Here is what the National Academy of Sciences Institute of Medicine concluded in regard to cannabis’ potential dependence liability, in the context of other controlled substances:

“In summary, although few marijuana users develop dependence, some do. But they appear to be less likely to do so than users of other drugs (including alcohol and nicotine), and marijuana drug dependence appears to be less severe than dependence on other drugs.”

Here are their dependence ratings:

Tobacco: 32 percent (proportion of users who ever become dependent)
Heroin: 23 percent
Cocaine: 17 percent
Alcohol: 15 percent
Anxiolytics/sedatives: 9 percent
Marijuana/hashish: 9 percent

So if one is electing to use a recreational drug, marijuana is clearly the safest alternative. And if one is using an opioid drug for pain, they should experiment with marijuana as a substitute for the more dangerous and addictive opioids. For many, it is an effective and far less dangerous alternative.

_____________________________________________________________________

Keith Stroup is a Washington, D.C. public-interest attorney who founded NORML in 1970.

This column was first published in ATTN.com.

http://www.attn.com/stories/11586/pharmaceutical-company-admits-opposing-marijuana-legalization

 

Study: Vaporized, Low-Potency Cannabis Mitigates Neuropathic Pain

The administration of vaporized, low THC cannabis is associated with reduced pain in subjects with neuropathy, according to clinical trial data published online by The Journal of Pain.

Investigators at the University of California, Davis Medical Center conducted a double-blind, placebo-controlled, crossover study evaluating the analgesic efficacy of vaporized cannabis in 39 subjects, the majority of whom were experiencing neuropathic pain despite traditional treatment. Subjects inhaled cannabis of either moderate THC (3.53 percent), low dose THC (1.29 percent), or zero THC (placebo). Subjects continued to take all other concurrent medications as per their normal routine during the 3- to 4-week study period. Spontaneous pain relief, the primary outcome variable, was assessed by asking participants to indicate the intensity of their current pain on a 100-mm visual analog scale (VAS) between 0 (no pain) and 100 (worst possible pain).

Researchers reported: “Both the low and medium doses proved to be salutary analgesics for the heterogeneous collection of neuropathic pain conditions studied. Both active study medications provided statistically significant 30% reductions in pain intensity when compared to placebo.”

They concluded: “Both the 1.29% and 3.53% vaporized THC study medications produced equal antinociception at every time point. … [T]he use of low doses could potentially be prescribed by physicians interested in helping patients use cannabis effectively while minimizing cognitive and psychological side effects. Viewed with this in mind, the present study adds to a growing body of literature supporting the use of cannabis for the treatment of neuropathic pain. It provides additional evidence of the efficacy of vaporized cannabis as well as establishes low-dose cannabis (1.29%) as having a favorable risk-benefit ratio.”

Previous clinical trials have indicated that inhaled cannabis can safety and effectively relieve various types of pain, particularly neuropathy — a hard-to-treat nerve condition often associated with cancer, HIV, spinal cord injury, diabetes, multiple sclerosis, and other conditions. These include the following double-blind, placebo-controlled (FDA gold-standard) studies:

Ware et al. 2010. Smoked cannabis for chronic neuropathic pain: a randomized controlled trial. CMAJ 182: 694-701.

Wilsey et al. 2008. A randomized, placebo-controlled, crossover trial of cannabis cigarettes in neuropathic pain. Journal of Pain 9: 506-521.

Ellis et al. 2008. Smoked medicinal cannabis for neuropathic pain in HIV: a randomized, crossover clinical trial. Neuropsychopharmacology 34: 672-80.

Abrams et al. 2007. Cannabis in painful HIV-associated sensory neuropathy: a randomized placebo-controlled trial. Neurology 68: 515-521.

Wallace et al. 2007. Dose-dependent Effects of Smoked Cannabis on Capsaicin-induced Pain and Hyperalgesia in Healthy Volunteers Anesthesiology 107: 785-796.

Separate clinical trial data also reports that inhaled “cannabis augments the analgesic effect of opioids” and therefore “may allow for opioid treatment at lower doses with fewer side effects.”

Since 1999, US sales of opiate drugs have tripled in number and in 2010, a record-setting 254 million prescriptions for opioids were filled in the United States — enough to medicate every American adult around the clock for a month. (In particular, the manufacturing of the drug Oxycodone has increased from 8.3 tons in 1997 to 105 tons in 2011, an increase of 1,200 percent.) Overdose deaths from the use of prescription painkillers are also now at record levels, totaling some 15,000 annually — more than triple the total a decade ago.

Full text of the study, “Low-dose vaporized cannabis significantly improves neuropathic pain,” appears in The Journal of Pain.

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