This presentation was created for a health policy class as part of a nursing practice doctoral program. It reviews the pro-and cons of creating a health policy to allow medical marijuana.

1. Kentucky and Medical
Marijuana:
1.9% Must Get Stoned
Jaclyn Engelsher

2. Should Kentucky Enact
Legislation to Legalize the
Use of Medical Marijuana?

3. Why Consider Considering?
 Need for research, not anecdotes
 KY leads the nation in non-medical use of
controlled pain relievers and tranquilizers
 We are loosing millions of dollars in potential
revenue
 We are spending millions of dollars in
prohibition

4. If all the other states jumped
off a bridge . . .
 Effective: CA, AK, OR, WA, ME, CO, NV, HI,
VT, MT, RI, NM, MI
 Workable: MD
 Research: AL, GA, IL, MA, MN, NJ, NY, SC,
TX
 Symbolic: AZ, CT, DC, IA, LA, NH, TN, VA,
WI
 Expired/Repealed: AR, FL, NC, OH, WV
(MPP, 2008)

5. Current KY Law
 218A.1421 - trafficking marijuana.
 < 8 oz: Class A misdemeanor 1st, Class D
felony 2ed & subsequent offence
 >8oz <5lbs: Class D felony 1st, Class C felony
2nd & subsequent
 5+lbs: Class C felony 1st, Class B 2nd &
subsequent
 Possession >8z + intent to sell/transfer
 902 KAR 55:020 - MJ and THC schedule I;
Marinol schedule III

6. Getting Around
Federal Law
 Illegal to possess, grow, or distribute since
1937
 Can be enforced anywhere in the US
 Cannot force state authorities to enforce
federal law
 Cannot force state to have identical federal
law
 99% of MJ arrests are by state & local, not
federal, authorities
 States determine drug scheduling class

7. Marijuana Basics
 Pharmacokinetics
 Pharmacodynamics
 Short term effects
 Delivery methods
 Smoke
 Vapor
 Ingestion

8. Current “Recommended”
Medical Uses
 Chemotherapy related N/V
 AIDS/HIV Wasting Disorder
 Terminal Illness/ChronicPain
 Glaucoma

9. Other “Recommendations”
(“but it really works, doc”)
 Alzheimer's Agitation/Prevention
 Asthma & Breathing Disorders
 GI Disorders
 Epilepsy and Seizure Disorders
 Hepatitis C
 Migraines
 Multiple Sclerosis
 Psychological Disorders (including PMS)
 Tourette's syndrome

10. But . . . We Already Have
Medical Marijuana!

11. Marinol
 Synthetic delta-9-Tetrahydrocannabinol (THC)
approved by FDA for n/v & appetite stimulant
 Low diversion & abuse led DEA to move from
schedule II to schedule III in 1998
 Patch & inhaler under development
 Safe, regulated dose without chemicals or tar
 Longer onset & effect, increased psychoactive
effects, only one active ingredient
 Metabolized by CP450 3A4/2C9
(USDEA, 2010 )

12. Coming Soon . . . Sativex
 Approved in Europe & Canada
 In Phase III in US clinical trial
 Indicated for neuropathic pain relief in MS
and cancer
 Natural extract THC & CBD
 Spray delivery
 Less intoxication
 Statistically significant improvement
compared to placebo/existing medications

13. GO vs NO
 Provides alleviating  Efficacy of existing
therapy for multiple & emerging
disorders
pharmaceuticals
 Lower addiction potential
than opioid analgesics  No reliable field
 Regulations ensure sobriety test
potency & purity  “Recommended”
 Generates state revenue use is a farce
& decreases spending  Risk>Benefit
 Benefit>Risk
Lack of reliable clinical research

14. Recommended Model
Legislation for KY
 MD in certain specialties may certify MJ for use in
specific, pre-determined conditions for maximum 1
year
 Register with health department for ID tracking card
 Possess up to 6oz and 12 plants
 State-regulated, non-profit dispensaries
 Prohibit public use and driving
 Medical necessity defense not permissible
 Employers and insurers may restrict

15. How Would You Vote?

16. Sources Consulted
 AMA Policy: Medical Marijuana (2009). Retrieved from
http://medicalmarijuana.procon.org/sourcefiles/AMA09policy.pdf
 Gettman, John (2009). Marijuana arrests in the United States (2007):
Arrests, usage, and related data [Electronic version]. The bulletin of
cannabis reform, 1-24. Retrieved from
http://www.drugscience.org/Archive/bcr7/Gettman_Marijuana_Arrests_in
_the_United_States.pdf
 Marijuana Policy Project (2008). State-by-state medical marijuana
laws:How to remove the threat of arrest [PDF document]. Retrieved from
http://www.mpp.org/assets/pdfs/download-
materials/SBSR_NOV2008_1.pdf
 Net Resources International (n.d.). Sativex: Investigational cannabis-
based treatment for pain and multiple sclerosis. Retrieved from
http://www.drugdevelopment-technology.com/projects/sativex/

17. Sources Consulted
 Net Resources International (n.d.). Sativex: Investigational cannabis-
based treatment for pain and multiple sclerosis. Retrieved from
http://www.drugdevelopment-technology.com/projects/sativex/
 Office of National Drug Control Policy Drug Policy Information
Clearinghouse (2008). State of Kentucky: Profile of drug indicators
[PDF document]. Retreived from
http://www.ondcp.gov/statelocal/ky/ky.pdf
 U.S. Department of Health and Human Services, (2005). Prescription
drugs abuse and addiction. National Institute on Drug Abuse
Research Report Series [Electronic version]. Retrieved from
http://www.drugabuse.gov/PDF/RRPrescription.pdf
 U.S. Drug Enforcement Administration (n.d.). “Medical” marijuana -
The facts. Retrieved from
http://www.justice.gov/dea/ongoing/marinol.html