This document discusses a study examining the effects of cannabidiol (CBD) on smoked marijuana use. The study involved administering oral doses of CBD (0, 200, 400, 800 mg) prior to having participants smoke marijuana (0 or half a cigarette containing 5.6% THC). The study was conducted across three sites and involved collecting subjective, physiological, and cognitive measures over 7.5 hours to evaluate if CBD decreases the abuse liability and reinforcing effects of smoked marijuana. The study aims to determine CBD's potential as a treatment for marijuana abuse and dependence.
This document presents information on medical marijuana and its potential benefits. It discusses the history of marijuana use, current legality in different parts of the world, components of marijuana like THC and CBD, how marijuana works in the body, potential medical uses to treat conditions like epilepsy, inflammation and chronic pain, limitations and side effects, and arguments for legalizing medical marijuana.
CBD, Medical Marijuana & Traumatic Brain Injurycedwvugraphics
This document discusses the potential benefits of cannabidiol (CBD) and medical marijuana for treating traumatic brain injury (TBI). It notes that CBD and THC have antioxidant and neuroprotective properties, and the endocannabinoid system plays a role in neural signaling and cellular homeostasis. Preclinical studies suggest that CBD and THC may help limit neurological damage following TBI by reducing inflammation, protecting neurons, and regulating cell death and survival. While more research is still needed, CBD and whole-plant cannabis extracts show promise as a first-line treatment for TBI due to CBD's multifunctional properties and potential synergistic effects with THC and other cannabis compounds.
Beyond Certification: Navigating Legal Situations as a Medical Marijuana Pati...Benjamin Gelassen, MBA
This document provides a summary of a presentation about navigating legal situations as a medical marijuana patient in Maine. It begins with disclaimers that the information does not constitute legal advice. The presentation then covers definitions of rights, privileges, and duties as they relate to medical cannabis patients. It discusses driving, housing, parenting, gun ownership, and employment considerations for patients. Throughout, it emphasizes that patients have responsibilities to act safely and legally even when uses are permitted. The document stresses that state-level permissions do not override federal restrictions.
The document summarizes the current state of research on medical marijuana for treating epilepsy. It notes that preclinical evidence and preliminary human studies suggest cannabidiol and THC may help some epilepsy patients. However, large double-blind studies are still needed to determine safety and efficacy. The document outlines some positive effects seen in early trials as well as potential side effects and risks especially for children. It emphasizes the need for more rigorous clinical research before conclusions can be drawn about medical marijuana as an antiepileptic treatment.
Please share this video with anyone who may be interested!
Watch all our webinars: https://www.youtube.com/playlist?list=PL4dDQscmFYu_ezxuxnAE61hx4JlqAKXpR
In this webinar:
● An overview of the court case including the main details, the plaintiffs, and what they were seeking,
● Analysis of the evidence presented during the proceedings,
● What the decision means for patients and producers, and
● Things to come for medical marijuana in Canada
View the video: https://youtu.be/n80-7qGiEnU
Follow our social media accounts:
Twitter - https://twitter.com/survivornetca
Facebook - https://www.facebook.com/CanadianSurvivorNet
Pinterest - https://www.pinterest.com/survivornetwork
YouTube - https://www.youtube.com/user/Survivornetca
2017 ANNUAL REPORT: MEDICAL MARIJUANA ACCESS IN THE UNITED STATESTRISTAN TAYLOR
"Americans For Safe Access is proud to announce the 2017 edition of our Medical Marijuana Access in the United States report. Beginning in 2014 ASA recognized the need to evaluate and compare the myriad of medical cannabis laws across the country. To this end we worked with our members and patients nationwide to develop a grading matrix that would indicate how well a states laws met the needs of patients.
With medical cannabis programs now encompassing 44 states, the District of Columbia and the territories of Puerto Rico and Guam, 300 million Americans (85% of the population) now live in states with medical cannabis laws.
This report is intended to help law makers and regulators learn from the successes and challenges faced by their peers in other states and get an objective evaluation of their own program.
The report uses a point system to grade each medical marijuana law on:
Patients' rights and protection from discrimination
Access to medicine
Ease of navigation
Functionality
Product safety protocols
We're happy to report that despite the grades of a few states declining in 2016, overall our nation's grades are improving and we were excited to see some new states enter the report starting off on a very good foot. "
This document provides a summary of a presentation on translating the science on marijuana into effective public health messages. The presentation aimed to understand the latest science on marijuana use and how to frame prevention messages. It identifies concerns related to marijuana use and legalization such as addiction, impaired driving, and negative impacts on adolescent brain development and academic achievement. The presentation argues for using strong evidence from research to change the discussion on marijuana from complicated to simple and from negative to positive. It provides sample messages focused on how marijuana use could negatively impact things people care about like education, employment, and highway safety.
This document presents information on medical marijuana and its potential benefits. It discusses the history of marijuana use, current legality in different parts of the world, components of marijuana like THC and CBD, how marijuana works in the body, potential medical uses to treat conditions like epilepsy, inflammation and chronic pain, limitations and side effects, and arguments for legalizing medical marijuana.
CBD, Medical Marijuana & Traumatic Brain Injurycedwvugraphics
This document discusses the potential benefits of cannabidiol (CBD) and medical marijuana for treating traumatic brain injury (TBI). It notes that CBD and THC have antioxidant and neuroprotective properties, and the endocannabinoid system plays a role in neural signaling and cellular homeostasis. Preclinical studies suggest that CBD and THC may help limit neurological damage following TBI by reducing inflammation, protecting neurons, and regulating cell death and survival. While more research is still needed, CBD and whole-plant cannabis extracts show promise as a first-line treatment for TBI due to CBD's multifunctional properties and potential synergistic effects with THC and other cannabis compounds.
Beyond Certification: Navigating Legal Situations as a Medical Marijuana Pati...Benjamin Gelassen, MBA
This document provides a summary of a presentation about navigating legal situations as a medical marijuana patient in Maine. It begins with disclaimers that the information does not constitute legal advice. The presentation then covers definitions of rights, privileges, and duties as they relate to medical cannabis patients. It discusses driving, housing, parenting, gun ownership, and employment considerations for patients. Throughout, it emphasizes that patients have responsibilities to act safely and legally even when uses are permitted. The document stresses that state-level permissions do not override federal restrictions.
The document summarizes the current state of research on medical marijuana for treating epilepsy. It notes that preclinical evidence and preliminary human studies suggest cannabidiol and THC may help some epilepsy patients. However, large double-blind studies are still needed to determine safety and efficacy. The document outlines some positive effects seen in early trials as well as potential side effects and risks especially for children. It emphasizes the need for more rigorous clinical research before conclusions can be drawn about medical marijuana as an antiepileptic treatment.
Please share this video with anyone who may be interested!
Watch all our webinars: https://www.youtube.com/playlist?list=PL4dDQscmFYu_ezxuxnAE61hx4JlqAKXpR
In this webinar:
● An overview of the court case including the main details, the plaintiffs, and what they were seeking,
● Analysis of the evidence presented during the proceedings,
● What the decision means for patients and producers, and
● Things to come for medical marijuana in Canada
View the video: https://youtu.be/n80-7qGiEnU
Follow our social media accounts:
Twitter - https://twitter.com/survivornetca
Facebook - https://www.facebook.com/CanadianSurvivorNet
Pinterest - https://www.pinterest.com/survivornetwork
YouTube - https://www.youtube.com/user/Survivornetca
2017 ANNUAL REPORT: MEDICAL MARIJUANA ACCESS IN THE UNITED STATESTRISTAN TAYLOR
"Americans For Safe Access is proud to announce the 2017 edition of our Medical Marijuana Access in the United States report. Beginning in 2014 ASA recognized the need to evaluate and compare the myriad of medical cannabis laws across the country. To this end we worked with our members and patients nationwide to develop a grading matrix that would indicate how well a states laws met the needs of patients.
With medical cannabis programs now encompassing 44 states, the District of Columbia and the territories of Puerto Rico and Guam, 300 million Americans (85% of the population) now live in states with medical cannabis laws.
This report is intended to help law makers and regulators learn from the successes and challenges faced by their peers in other states and get an objective evaluation of their own program.
The report uses a point system to grade each medical marijuana law on:
Patients' rights and protection from discrimination
Access to medicine
Ease of navigation
Functionality
Product safety protocols
We're happy to report that despite the grades of a few states declining in 2016, overall our nation's grades are improving and we were excited to see some new states enter the report starting off on a very good foot. "
This document provides a summary of a presentation on translating the science on marijuana into effective public health messages. The presentation aimed to understand the latest science on marijuana use and how to frame prevention messages. It identifies concerns related to marijuana use and legalization such as addiction, impaired driving, and negative impacts on adolescent brain development and academic achievement. The presentation argues for using strong evidence from research to change the discussion on marijuana from complicated to simple and from negative to positive. It provides sample messages focused on how marijuana use could negatively impact things people care about like education, employment, and highway safety.
This document summarizes a presentation on synthetic cannabinoids and other emerging drugs of abuse. It discusses how synthetic cannabinoids like Spice, K2, and bath salts are sold as herbal incense products but actually contain potent synthetic cannabinoid chemicals. It describes the effects of these drugs and challenges around detecting and regulating them. The presentation also covers natural drugs like cannabis and kratom, and discusses drug development related to cannabinoid receptors.
This article reviews 37 controlled clinical studies from 2005-2009 evaluating the therapeutic effects of cannabinoids. The studies assessed cannabinoids for neuropathic or chronic pain (11 studies, 631 patients), multiple sclerosis and spasticity (9 studies, 1300 patients), and nausea/vomiting/appetite (2 studies, 228 patients). The studies evaluated cannabis, THC, CBD, nabilone, dronabinol, and Cannador for efficacy and safety. The results showed cannabinoids have potential as analgesics for chronic neuropathic pain, as appetite stimulants for cancer/AIDS, and for treating multiple sclerosis.
PUNTOG - HEAD SHOP - VAPE SHOP - HEMP SHOP - GROW SHOP
VENDITA E ASSISTENZA ON LINE SU PRODOTTI NATURALI E AL CBD - (CANAPA)
www.puntog-shop.com
Mobile +39 345 889 3933
Email : info@puntog-shop.com
ORDINI TELEFONICI PER PRODOTTI NATURALI AL CBD
Spediamo la merce in tutta Italia con Consegna in pacco assolutamente robusto. Riceverai la merce entro tre giorni lavorativi dall’ordine. Chiama Ora!
Cannabidiol (CBD) shows potential as an anti-seizure treatment based on animal studies and anecdotal human reports. CBD appears to reduce seizures independently of CB1 receptors and has a more favorable safety profile than THC in studies. Open-label trials of CBD-enriched cannabis in pediatric epilepsy patients showed reductions in seizure frequency for most participants. However, placebo-controlled studies are still needed to determine CBD's efficacy and safety compared to existing anti-seizure medications.
The document discusses a presentation given to pharmacists about marijuana. It aims to provide information on the clinical pharmacology, evidence for medical use, adverse effects and drug interactions of marijuana so that pharmacists can educate patients and colleagues. The presentation covers the background of marijuana regulation, cannabinoid pharmacology, types of marijuana drugs available, indications for use, evidence of effectiveness for conditions like pain and nausea, side effects, risks of long-term use and interactions with other drugs.
Formulation and product development of CBD formulations at AHL _wo_ingredien...Dr Syed Arshad raza
Cannabinoids are chemical compounds present in cannabis plants as well as present naturally in the body , have diversified effect on whole body. Some key cannabinoids present in hemp / cannabis plants are THC (< than 0.3 % in hemp), Cannabidiol (CBD), CBDA, CBDV, CBG, CBN, CBC and terpenes are other minor constituents.
CBD is devoid of psychoactive effects and have broad clinical potential for a wide spectrum of ailments such as Neuroprotective, anxiolytic, anti-inflammatory, Antioxidant. Arthritis cancer, Epilepsy, Alzheimer’s disease, Schizophrenia, cognitive dysfunction & Psychosis.
Oral bio-availability of CBD is poor, which can be addressed by formulating water soluble powders through nano-emulsions, micro-emulsions or liposomes, thereby improving Bio-availability. Further augmentation of hemp CBD can be attained by adapting novel synergistic blends considering molecular mechanism along with interactions of resultant synergistic cumulative effects. Furthermore more stability is attained by using functional excipients to improve stability and bio-availability.
Oral as well as topical dosage delivery forms are developed by Arshad herbal Laboratories to utilize the benefits of CBD synergistic blends.
Vitality Biopharma is a cure development company, dedicated to unlocking the power of cannabinoids to treat serious neurological and inflammatory disorders.
Endocannabinoid System - Literature ReviewLouis Cady, MD
In this brief review of the literature, Dr. Louis Cady of the Cady Wellness Institute reviews the endocannabinoid system and the role it plays in bridging the connection between mind and body, modulating anxiety, inflammation, memory and other physiological processes. Nothing in this presentation suggests that any of the products mentioned are appropriate for the treatment, remediation, cure, or prevention of any disease or illness. It does appear, however, that this natural, indwelling, genetically passed down endocannabinoid system may have major implications for holistic physicians and health care practitioners, and for the patients that they serve.
Cannabis (also known as marijuana) is the most frequently used illicit psychoactive substance in the world, with more than 500 components. Cannabinoids are psychoactive compounds extracted from the cannabis plants (cannabis stavia), and classified mainly into 5 classes: classical cannabinoids, non-classical cannabinoids, hybrid cannabinoids, aminoalkylindoles, and eicosanoids cannabinoids. Cannabinoids are endogenous in humans, animals and plants, or synthetically produced. In recent years, the use of synthetic cannabinoids as a substitute for cannabis has been on the increase. However, there is also some concern about their potential effects on users. Cannabidiol and tetrahydrocannabinol (THC) are the most studied cannabinoids and both interact with endocannabinoid receptors in various human tissues, so there are a trend to use cannabinoids in Medicine and Pharmacology. Cannabis plants produce many compounds of possible medical importance. In this article, we discuss the natural cannabis and synthetic cannabinoids and their extraction, their principle components, their abuses, and their effects on the human body, and their roles in medicine and pharmacology, also we discus the biosynthesis of cannabinoids, and the synthetic cannabinoid classification system.
There are countless questions when it comes to medical cannabis and colorectal cancer: How can it help? How do you get it? Are there drug interactions with chemo? What are the side effects? Is it legal where I live?
Cannabinoids have been found to have antioxidant properties, unrelated to NMDA receptor antagonism. Here in this document, you will everything about CBD and CBD oil benefits.
There are countless questions when it comes to medical cannabis and colorectal cancer: How can it help? How do you get it? Are there drug interactions with chemo? What are the side effects? Is it legal where I live?
ExploringYourMedicalCannabisOptions-FINALKaren Kelly
The document discusses the medical benefits of cannabinoids, particularly CBD and CBG. It notes that the US Department of Health and Human Services holds a patent on cannabinoids for their antioxidant and neuroprotective properties. It summarizes some of the medical conditions that cannabinoids have shown promise in treating, including inflammation, pain, anxiety, epilepsy, cancer, and others. The document also discusses different methods of consuming cannabis, including vaporizing, edibles, tinctures, and concentrates, noting that alternatives to smoking can provide health benefits and discretion.
- Cannabinoids, the active components of Cannabis sativa, act by mimicking endogenous substances called endocannabinoids that activate cannabinoid receptors.
- The best established palliative effect of cannabinoids in cancer patients is inhibiting chemotherapy-induced nausea and vomiting. Capsules of THC and nabilone are approved for this purpose.
- Cannabinoids also have potential palliative effects in stimulating appetite and inhibiting pain, and inhibit tumour growth in laboratory animals by modulating cell signaling pathways and inhibiting tumour angiogenesis and metastasis. However, further research is still needed before cannabinoids can be routinely used in cancer therapy.
Cannabis: The Insider's Guide to The World's Most Popular Drug.Shadow Foundry
This document provides an overview of cannabis and its main components. It discusses the two main cannabis subspecies, Cannabis indica and Cannabis sativa, and explains that the main psychoactive component is delta-9-THC. It also covers the non-psychoactive component cannabidiol (CBD) and describes the endocannabinoid system that THC interacts with in the body. The document discusses consumption methods and their differing bioavailability, and provides safety guidelines and warnings for CBD usage.
Dr. Tom Frieden, Director of the Centers for Disease Control and Prevention, keynote presentation at the National Rx Drug Abuse & Heroin Summit on March 30, 2016.
This document summarizes a presentation on synthetic cannabinoids and other emerging drugs of abuse. It discusses how synthetic cannabinoids like Spice, K2, and bath salts are sold as herbal incense products but actually contain potent synthetic cannabinoid chemicals. It describes the effects of these drugs and challenges around detecting and regulating them. The presentation also covers natural drugs like cannabis and kratom, and discusses drug development related to cannabinoid receptors.
This article reviews 37 controlled clinical studies from 2005-2009 evaluating the therapeutic effects of cannabinoids. The studies assessed cannabinoids for neuropathic or chronic pain (11 studies, 631 patients), multiple sclerosis and spasticity (9 studies, 1300 patients), and nausea/vomiting/appetite (2 studies, 228 patients). The studies evaluated cannabis, THC, CBD, nabilone, dronabinol, and Cannador for efficacy and safety. The results showed cannabinoids have potential as analgesics for chronic neuropathic pain, as appetite stimulants for cancer/AIDS, and for treating multiple sclerosis.
PUNTOG - HEAD SHOP - VAPE SHOP - HEMP SHOP - GROW SHOP
VENDITA E ASSISTENZA ON LINE SU PRODOTTI NATURALI E AL CBD - (CANAPA)
www.puntog-shop.com
Mobile +39 345 889 3933
Email : info@puntog-shop.com
ORDINI TELEFONICI PER PRODOTTI NATURALI AL CBD
Spediamo la merce in tutta Italia con Consegna in pacco assolutamente robusto. Riceverai la merce entro tre giorni lavorativi dall’ordine. Chiama Ora!
Cannabidiol (CBD) shows potential as an anti-seizure treatment based on animal studies and anecdotal human reports. CBD appears to reduce seizures independently of CB1 receptors and has a more favorable safety profile than THC in studies. Open-label trials of CBD-enriched cannabis in pediatric epilepsy patients showed reductions in seizure frequency for most participants. However, placebo-controlled studies are still needed to determine CBD's efficacy and safety compared to existing anti-seizure medications.
The document discusses a presentation given to pharmacists about marijuana. It aims to provide information on the clinical pharmacology, evidence for medical use, adverse effects and drug interactions of marijuana so that pharmacists can educate patients and colleagues. The presentation covers the background of marijuana regulation, cannabinoid pharmacology, types of marijuana drugs available, indications for use, evidence of effectiveness for conditions like pain and nausea, side effects, risks of long-term use and interactions with other drugs.
Formulation and product development of CBD formulations at AHL _wo_ingredien...Dr Syed Arshad raza
Cannabinoids are chemical compounds present in cannabis plants as well as present naturally in the body , have diversified effect on whole body. Some key cannabinoids present in hemp / cannabis plants are THC (< than 0.3 % in hemp), Cannabidiol (CBD), CBDA, CBDV, CBG, CBN, CBC and terpenes are other minor constituents.
CBD is devoid of psychoactive effects and have broad clinical potential for a wide spectrum of ailments such as Neuroprotective, anxiolytic, anti-inflammatory, Antioxidant. Arthritis cancer, Epilepsy, Alzheimer’s disease, Schizophrenia, cognitive dysfunction & Psychosis.
Oral bio-availability of CBD is poor, which can be addressed by formulating water soluble powders through nano-emulsions, micro-emulsions or liposomes, thereby improving Bio-availability. Further augmentation of hemp CBD can be attained by adapting novel synergistic blends considering molecular mechanism along with interactions of resultant synergistic cumulative effects. Furthermore more stability is attained by using functional excipients to improve stability and bio-availability.
Oral as well as topical dosage delivery forms are developed by Arshad herbal Laboratories to utilize the benefits of CBD synergistic blends.
Vitality Biopharma is a cure development company, dedicated to unlocking the power of cannabinoids to treat serious neurological and inflammatory disorders.
Endocannabinoid System - Literature ReviewLouis Cady, MD
In this brief review of the literature, Dr. Louis Cady of the Cady Wellness Institute reviews the endocannabinoid system and the role it plays in bridging the connection between mind and body, modulating anxiety, inflammation, memory and other physiological processes. Nothing in this presentation suggests that any of the products mentioned are appropriate for the treatment, remediation, cure, or prevention of any disease or illness. It does appear, however, that this natural, indwelling, genetically passed down endocannabinoid system may have major implications for holistic physicians and health care practitioners, and for the patients that they serve.
Cannabis (also known as marijuana) is the most frequently used illicit psychoactive substance in the world, with more than 500 components. Cannabinoids are psychoactive compounds extracted from the cannabis plants (cannabis stavia), and classified mainly into 5 classes: classical cannabinoids, non-classical cannabinoids, hybrid cannabinoids, aminoalkylindoles, and eicosanoids cannabinoids. Cannabinoids are endogenous in humans, animals and plants, or synthetically produced. In recent years, the use of synthetic cannabinoids as a substitute for cannabis has been on the increase. However, there is also some concern about their potential effects on users. Cannabidiol and tetrahydrocannabinol (THC) are the most studied cannabinoids and both interact with endocannabinoid receptors in various human tissues, so there are a trend to use cannabinoids in Medicine and Pharmacology. Cannabis plants produce many compounds of possible medical importance. In this article, we discuss the natural cannabis and synthetic cannabinoids and their extraction, their principle components, their abuses, and their effects on the human body, and their roles in medicine and pharmacology, also we discus the biosynthesis of cannabinoids, and the synthetic cannabinoid classification system.
There are countless questions when it comes to medical cannabis and colorectal cancer: How can it help? How do you get it? Are there drug interactions with chemo? What are the side effects? Is it legal where I live?
Cannabinoids have been found to have antioxidant properties, unrelated to NMDA receptor antagonism. Here in this document, you will everything about CBD and CBD oil benefits.
There are countless questions when it comes to medical cannabis and colorectal cancer: How can it help? How do you get it? Are there drug interactions with chemo? What are the side effects? Is it legal where I live?
ExploringYourMedicalCannabisOptions-FINALKaren Kelly
The document discusses the medical benefits of cannabinoids, particularly CBD and CBG. It notes that the US Department of Health and Human Services holds a patent on cannabinoids for their antioxidant and neuroprotective properties. It summarizes some of the medical conditions that cannabinoids have shown promise in treating, including inflammation, pain, anxiety, epilepsy, cancer, and others. The document also discusses different methods of consuming cannabis, including vaporizing, edibles, tinctures, and concentrates, noting that alternatives to smoking can provide health benefits and discretion.
- Cannabinoids, the active components of Cannabis sativa, act by mimicking endogenous substances called endocannabinoids that activate cannabinoid receptors.
- The best established palliative effect of cannabinoids in cancer patients is inhibiting chemotherapy-induced nausea and vomiting. Capsules of THC and nabilone are approved for this purpose.
- Cannabinoids also have potential palliative effects in stimulating appetite and inhibiting pain, and inhibit tumour growth in laboratory animals by modulating cell signaling pathways and inhibiting tumour angiogenesis and metastasis. However, further research is still needed before cannabinoids can be routinely used in cancer therapy.
Cannabis: The Insider's Guide to The World's Most Popular Drug.Shadow Foundry
This document provides an overview of cannabis and its main components. It discusses the two main cannabis subspecies, Cannabis indica and Cannabis sativa, and explains that the main psychoactive component is delta-9-THC. It also covers the non-psychoactive component cannabidiol (CBD) and describes the endocannabinoid system that THC interacts with in the body. The document discusses consumption methods and their differing bioavailability, and provides safety guidelines and warnings for CBD usage.
Similar to Rx15 tt tues_330_1_babalonis_2barnes (20)
Dr. Tom Frieden, Director of the Centers for Disease Control and Prevention, keynote presentation at the National Rx Drug Abuse & Heroin Summit on March 30, 2016.
Kana Enomoto, Acting Administrator, Substance Abuse and Mental Health Services Administration, keynote presentation at the National Rx Drug Abuse & Heroin Summit March 29, 2016
This document summarizes a presentation on managing morphine equivalent dose (MED) and identifying high-risk opioid use through "red flagging." It discusses how calculating MED at the point of sale can help identify unsafe dosages and decrease opioid prescriptions. It also evaluates different methods to screen for overdose risk, finding that simple opioid use thresholds to flag patients may not accurately target those most likely to experience preventable overdoses. The presentation aims to explain MED management, describe payer solutions that reduced opioid use, and identify more precise ways to intervene with highest-risk patients.
Web rx16 prev_tues_330_1_lawal_2warren_3huddleston_4pershingOPUNITE
This document discusses the role of health departments in preventing neonatal abstinence syndrome (NAS). It notes that NAS rates have increased significantly in recent years, disproportionately affecting women. Health departments engage in surveillance to monitor NAS trends, partner with other organizations, support treatment and recovery programs, and provide education to prevent NAS, which is entirely preventable. The document outlines specific strategies health departments use across these areas to address the opioid epidemic and protect maternal and infant health.
The document discusses the opioid crisis in the United States, including rising rates of prescription opioid misuse and abuse, as well as heroin use and overdose deaths. It outlines how research can help address this crisis through developing less abusable analgesics, expanding access to treatment medications like naloxone and buprenorphine, and exploring new treatment approaches such as immunotherapies and precision medicine targeting genetic factors. The National Institute on Drug Abuse is supporting these research efforts and working to disseminate findings to improve prevention and intervention programs.
This document summarizes the opioid crisis in the United States from 2000 to 2014. It shows that the number of opioid-related overdose deaths more than tripled during this period, increasing from about 8,000 to over 28,000. Additionally, 7.9 million Americans aged 12 or older met the criteria for an illicit drug use disorder in 2013-2014 but only 20% received treatment. The document outlines actions by the Obama administration to address the crisis and increase funding for treatment. It emphasizes that stories can help reduce stigma and that recovery is possible through working together.
Web rx16 prev_tues_200_1_bretthaude-mueller_2scott_3debenedittis_4cairnes copyOPUNITE
This presentation covered multi-media prevention strategies for issues like prescription drug overdoses. It discussed the CDC's digital Rx drug prevention campaign, best practices for digital messaging, and programs using expectancy challenge theory and media literacy education in schools. Presenters included representatives from the CDC, Media Literacy for Prevention, and the Hanley Center Foundation who discussed their work developing and implementing digital communications and single-session prevention programs.
This document discusses strategies for reducing buprenorphine diversion and pill mills while improving access to treatment. It notes that limiting access to buprenorphine treatment is associated with increased diversion, while expanded access to quality treatment decreases diversion and overdose deaths. The document recommends educating prescribers, using medically-derived prescribing standards, ensuring adequate insurance coverage of safe prescribing practices, and addressing diversion risks for other controlled medications. It argues against onerous new regulations that could limit treatment access. The goal is to identify and support high-quality treatment while prosecuting criminal operations.
This document summarizes a presentation on linking and mapping prescription drug monitoring program (PDMP) data. It discusses the benefits of linking PDMP data to clinical data, including improving patient safety, evaluating prescribing decisions, and assessing the impact of PDMP interventions. It describes challenges with linking data, such as obtaining consent and negotiating data use agreements. It also discusses Washington State's MAPPING OPIOID AND OTHER DRUG ISSUES (MOODI) tool, which integrates PDMP data with other databases to map and target treatment and overdose prevention efforts at the community level.
Rx16 prev wed_330_workplace issues and strategiesOPUNITE
This document discusses workplace issues related to prescription drug abuse and strategies for prevention. It begins with introductions of the presenters and moderators. The learning objectives are then outlined as understanding challenges of prescription drug abuse in the workplace, identifying prevention strategies, and describing programs available through SAMHSA. The document then covers topics such as the scope of prescription drug misuse among workers, risks to the workplace, prevention strategies employers can consider, and available resources from SAMHSA.
Web only rx16 pharma-wed_330_1_shelley_2atwood-harlessOPUNITE
This document discusses a presentation on pharmacy burglary, robbery, and diversion of prescription drugs. The presentation covers trends in prescription drug diversion, particularly those involving robbery and burglary of pharmacies. It identifies preventative measures to enhance pharmacy security and safety. Strategies to reduce pharmacy crimes are outlined. The offender perspective is examined based on interviews with convicted offenders. Routine activities theory is discussed as relating to suitable targets, capable guardians, and motivated offenders. Partnerships between regulatory agencies and law enforcement are emphasized as key to prevention efforts.
Linking and mapping PDMP data can provide several benefits but also faces challenges. Linking PDMP and clinical data allows for evaluating the impact of PDMP interventions on outcomes and prescribing decisions. However, obtaining permissions and data is difficult due to legal and resource barriers. Mapping PDMP data using GIS tools in Washington identified areas for targeting overdose prevention efforts by visualizing patterns in prescribing risks, treatment availability, and overdoses. Stakeholders used these maps to guide education and funding decisions. Sustaining these tools requires ongoing funding and expanding included data sources.
This document discusses drug court models and the role of law enforcement in drug courts. It begins with introductions from presenters and outlines learning objectives about explaining drug court operations and benefits, how law enforcement can utilize drug courts, and identifying best practices. The following sections provide details on drug court models, including how they integrate treatment into the justice system using a non-adversarial approach. Key components of drug courts are outlined, and presenters discuss issues like prescription drug and heroin abuse as well as outcomes from drug courts in reducing recidivism and saving money. Law enforcement can play roles in prevention, addressing domestic violence, and targeting the right populations for drug court involvement through assessment.
This document summarizes presentations from two communities - Huntington, WV and Camden County, NJ - on their responses to heroin crises. It outlines programs implemented in Huntington, including a harm reduction program, centralized information system, and drug court expansion. It also discusses the region's history with prescription drug abuse and rise in heroin and associated issues like hepatitis and neonatal abstinence syndrome. Long-term strategies proposed include expanding treatment services, promoting career opportunities for those in recovery, and preventing relapse through environmental design changes.
This document discusses neonatal abstinence syndrome (NAS) and universal maternal drug testing. It provides background information on NAS including trends showing large increases in incidence and costs associated with NAS. It outlines objectives related to describing NAS trends, identifying legislative activities impacting NAS, describing family planning for women in substance abuse treatment, and explaining a hospital program using universal drug testing. The document then covers topics including NAS symptoms, incidence and geographic trends, costs of NAS, opioid use in women of childbearing age, unintended pregnancy rates, contraceptive use among opioid users, and maternal drug exposure sources.
Web only rx16-adv_tues_330_1_elliott_2brunson_3willis_4deanOPUNITE
This document outlines an advocacy track presentation on activating communities to address prescription drug abuse. It provides biographies of the presenters and moderators and discloses any conflicts of interest. The learning objectives are to identify best practices for implementing CADCA's seven strategies for community change to impact prescription drug issues. It then provides examples of how various coalitions across the country are utilizing each of the seven strategies, such as providing education, enhancing skills, supporting communities, and changing policies.
This document discusses recovery ready ecosystems and recovery community organizations. It introduces presenters from Young People in Recovery and Hope House Treatment Track who will discuss interventions, prevention, and recovery programs. Examples of Young People in Recovery chapters, programs, and services are provided, including employment workshops, education workshops, housing workshops, and recovery support services. The document also discusses recovery community organizations and initiatives in Texas and Georgia, such as the Association of Persons Affected by Addiction in Dallas and the Georgia Council on Substance Abuse.
This document summarizes a presentation on health plan involvement in safe prescribing. It includes:
1) Presentations from medical experts on prescription drug abuse trends from medical examiner data and a tribal health system's safe prescribing program.
2) A discussion of health plan policies to reduce "red flag" medication combinations like opioids plus benzodiazepines through prior authorization, formulary changes, and provider restrictions.
3) Examples of one health plan's implementation of policies like restricting methadone prescriptions to pain specialists and removing carisoprodol from its formulary.
NURSING MANAGEMENT OF PATIENT WITH EMPHYSEMA .PPTblessyjannu21
Prepared by Prof. BLESSY THOMAS, VICE PRINCIPAL, FNCON, SPN.
Emphysema is a disease condition of respiratory system.
Emphysema is an abnormal permanent enlargement of the air spaces distal to terminal bronchioles, accompanied by destruction of their walls and without obvious fibrosis.
Emphysema of lung is defined as hyper inflation of the lung ais spaces due to obstruction of non respiratory bronchioles as due to loss of elasticity of alveoli.
It is a type of chronic obstructive
pulmonary disease.
It is a progressive disease of lungs.
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1. Trending Topics Track
Marijuana: Emerging Medical
and Legal Issues
Presenters:
• Shanna Babalonis, PhD, Assistant Professor, Department of
Behavioral Science and Center on Drug and Alcohol
Research, University of Kentucky
• Michael C. Barnes, JD, Executive Director, Center for
Lawful Access and Abuse Deterrence (CLAAD), and
Member, Rx Summit National Advisory Board
Moderator: Nancy Hale, President and CEO, Operation UNITE
2. Disclosures
• Shanna Babalonis, PhD, has disclosed no relevant, real or
apparent personal or professional financial relationships with
proprietary entities that produce health care goods and
services.
• Michael C. Barnes, JD, has disclosed no relevant, real or
apparent personal or professional financial relationships with
proprietary entities that produce health care goods and
services.
• Nancy Hale has disclosed no relevant, real or apparent
personal or professional financial relationships with
proprietary entities that produce health care goods and
services.
3. Disclosures
• All planners/managers hereby state that they or their
spouse/life partner do not have any financial
relationships or relationships to products or devices
with any commercial interest related to the content of
this activity of any amount during the past 12 months.
• The following planners/managers have the following to
disclose:
– Kelly Clark – Employment: Publicis Touchpoint Solutions;
Consultant: Grunenthal US
– Robert DuPont – Employment: Bensinger, DuPont &
Associates-Prescription Drug Research Center
– Carla Saunders – Speaker’s bureau: Abbott Nutrition
4. Learning Objectives
1. Outline key issues in the national debate
regarding marijuana.
2. Describe challenges posed by state laws in
conflict with federal policy.
3. Explain in detail isolated plant CBs.
4. Compare CBs to medical marijuana as
treatment medications.
5. Cannabinoids: Pharmacology, Treatment
Utility and Abuse Liability
Shanna Babalonis, Ph.D.
University of Kentucky
College of Medicine
Department of Behavioral Science
Center on Drug and Alcohol Research
6. Disclosures
Shanna Babalonis, PhD has disclosed no relevant, real or apparent
personal or professional financial relationships with proprietary entities that
produce health care goods and services.
7. Outline
- Background on cannabinoids
- Discuss cannabidiol and its treatment potential
- Current medications containing cannabinoids
- Marijuana in the United States – increasing potency and
changing make-up of cannabinoids
- Multi-site laboratory trial examining cannabidiol as a potential
treatment for marijuana abuse
- Conclusions
8. Phytocannabinoids
- There are approximately 500 phytochemicals that naturally occur in
the marijuana plant
- About 70 of these are unique to the marijuana plant and are called
cannabinoids or phytocannabinoids
- Present in the plant’s buds (leaves, stalks, seeds)
- There are several classes of plant-derived cannabinoids, including:
- Δ9 tetrahydrocannabinol (THC)
- cannabinol (CBN, CBDL)
- cannabidiol (CBD, CBDV)
- cannabichromenes (CBC)
- cannabigerols (CBG)
- Others: CBL, CBE, CBT
9. Phytocannabinoids
- There are approximately 500 phytochemicals that naturally occur in
the marijuana plant
- Approximately 66 of these are unique to the marijuana plant and are
called cannabinoids or phytocannabinoids
- Present in the plant’s buds (leaves, stalks, seeds)
- There are several classes of plant-derived cannabinoids, including:
- Δ9 tetrahydrocannabinol (THC, THCV)
- cannabinol (CBN, CBDL)
- cannabidiol (CBD, CBDV)
- cannabichromenes (CBC)
- cannabigerols (CBG)
- Others: CBL, CBE, CBT
Psychoactive effects
No known psychoactive effects
10. Endocannabinoids
- There are also endogenous cannabinoids produced in the body called
endocannabinoids
- Examples: Anandamide, 2-AG
- Endogenous ligands at the cannabinoid receptor
- Present in both the CNS and periphery
- Involved in regulation of sleep, memory, inflammation, immune function,
insulin sensitivity, fat and energy metabolism, reproduction (ovulation,
implantation), expressed in breast milk
- Degraded by naturally occurring enzymes: FAAH (fatty acid amide
hydrolase), MAGL (monoacylglycerol lipase)
- Isolated/synthesized endocannabinoids – have not administered
to humans (exogenously)
- THC and other cannabinoids exert their action through this system
11. Cannabinoid Receptors
Cannabinoids exert action at cannabinoid receptors: CB1 and CB2
CB1 receptor - the most abundant GPCR receptor in the CNS
- also located in the periphery (GI tract, cardiac tissue,
reproductive system, fat tissue, skeletal muscle)
CB2 receptor - primarily located in the periphery, regulation of immune
function; GI tract
- also present in the brain; less abundant than CB1
Evidence that additional cannabinoid receptors exist (e.g., GPR55)
13. Cannabinoid Receptor Agonists
Phytocannabinoids
THC - high affinity, partial agonist at CB1
also exerts some partial agonist effects at CB2
Endocannabinoids
Anandamide - moderate affinity, full or partial agonists at CB1
- partial agonist at CB2
2-AG - full agonist at CB1 and CB2
Synthetic Cannabinoid Chemicals (K2, Spice)
JWH compounds - not part of the marijuana plant – do not occur in nature
- synthetic, lab-made chemicals
- very high affinity, full agonist at CB1 and/or CB2
14. Cannabidiol (CBD)
- Cannabidiol is present in the marijuana plant in varying levels
(depending on the strain) and upon smoking, is absorbed into the
lungs, entering the blood and brain
- It is speculated to be a non-psychoactive component of marijuana
- Its mechanism of action is not completely clear
- There is little to no direct activity at CB1 and CB2 receptors; indirect
effects on cannabinoid receptors
- Increases availability of endocannabinoids through two mechanisms:
- inhibit uptake of endocannabinoids
- inhibit FAAH and MAGL (enzymes that degrade
endocannabinoids)
15. CBD: Additional Mechanisms
In cellular preparations and/or animal models CBD has displayed the following effects:
- Potent antioxidant, anti-inflammatory and neuroprotectant
- antioxidant effects ≥ vitamin C and E in cellular models
- Analgesic (antinociception, antihyperalgesia)
- thought to be mediated through action at glycine and transient receptor potential
channels (TRPs): TRPV1, TRPV2, TRPA1, TRPM8
- endocannabinoid effects may also contribute to analgesia
- Anticonvulsant (several animal models of seizure)
- does not appear to be mediated by activity of endocannabinoids
- Other activity:
- acts as serotonin (5HT1A) agonist (antidepressant, antiemetic, anxiolytic,
anti- cataleptic; may contribute to anticonvulsant effects)
- modulates adenosine A2A signaling (also anti-inflammatory)
16. Cannabidiol: Potential Treatment?
Trials (listed on ClinicalTrials.gov) that are being conducted to determine
CBD effects for the treatment of:
Schizophrenia (hypothesis: increases in anandamide decrease symptoms)
Solid Tumors
GVHD (Graft versus host disease) (anti-inflammatory, immunosuppressive)
Fatty Liver Disease
Crohn’s Disease, Inflammatory Bowel Disease, Ulcerative Colitis
Treatment for Marijuana Dependence
Opioid Craving/Relapse
Seizure Disorder
17. CBD/THC Trials
Trials are being conducted to determine CBD/THC combination for the
treatment of:
Cancer Pain, Intractable Cancer Pain
Head and Neck Squamous Cell Carcinoma
Postoperative Pain, Anxiety, Nausea/Vomiting
Neuroprotection in Huntington’s Disease
Cognitive Dysfunction in Schizophrenia
Bipolar Disorder
ADHD
Mucositis
Marijuana Dependence
Glioblastoma
Spasticity in children with Cerebral Palsy
Multiple Sclerosis – spasticity, neuropathic pain, detrusor overactivity
18. Cannabinoids: Also Schedule I Drugs
All marijuana plant material, oils and resins are currently Schedule
I under the US Controlled Substances Act.
Schedule I includes non-pharmaceutical cannabidiol oil and plants
with high CBD content.
Medications containing cannabinoids need to be reviewed by the
FDA (e.g., safety, abuse liability). There are two examples of
cannabinoid based drugs that have gone through this process in
the United States:
Marinol (dronabinol) = Schedule III
Cesamet (nabilone) = Schedule II
19. Pharmaceutical Products Containing Cannabinoids
Marinol® (dronabinol)
- oral medication
- synthetic THC
- marketed for the treatment nausea/vomiting (chemotherapy);
appetite stimulant (AIDS)
- available in 2.5, 5 or 10 mg capsules
Cesamet® (nabilone)
- oral medication
- analog of dronabinol
- marketed for the treatment of nausea/vomiting (chemotherapy)
- available in 1 mg capsules
20. Products Under Development, NOT FDA-Approved
Sativex® (1:1 ratio of CBD:THC)
- buccal spray
- approved in several European countries and Canada for MS
- clinical trials being conducted for US approval for cancer pain
- 2.7 mg THC, 2.5 mg CBD per spray
- patients titrate up to about 10-15 sprays/day
Epidiolex® (cannabidiol)
- oral solution (bottle of liquid with syringe dropper)
- CBD-only (98% CBD, trace cannabinoids, no THC)
- treatment INDs have been issued for pediatric seizure
disorder, sites are currently treating patients
- doses: 25 mg/mL and 100 mg/mL (doses up to ~1000 mg/day are
being tested)
-Both products are products manufactured by GW Pharmaceuticals
21. Arvisol - controlled release cannabidiol
- Phase I trials for schizophrenia
- Echo Pharmaceuticals, Netherlands
CBDV (cannabidivarin – analog of CBD)
- CBDV only
- Phase I trial for epilepsy scheduled to start in United Kingdom
THCV - thought to be psychoactive, although this has not been clearly
demonstrated
- in trials for obesity/metabolic syndrome (opposite effect of THC?)
Other cannabinoids and different combinations of cannabinoids are also
under development for various indications
Products Under Development, NOT FDA-Approved
22. CBD: Phase II, Phase III
Cancer Pain - Phase III trials in progress with Sativex® (THC/CBD)
- most recent Phase III trial did not demonstrate
efficacy
Multiple Sclerosis - Sativex® (THC/CBD) approved in several
European countries, Australia and Canada
- Phase III U.S. Trials are planned
Neuropathic Pain - Phase II trials in progress
23. Cannabidiol – Seizure Disorder
- To date there have been no controlled clinical trials that demonstrate its
efficacy; however, trials are currently underway
- Being explored primarily for the treatment for intractable seizure disorders (i.e.,
Dravet Syndrome, Lennox Gastaut)
- Preliminary data from GW Pharmaceuticals from their open-label study of
(Epidiolex) indicate that only a small sub-set of pediatric seizure patients have
complete remission
- Physicians in Colorado (patients taking non-pharmaceutical CBD) report
similar findings; also report that CBD appears to worsen symptoms in a sub-
set of patients
- Non-pharmaceutical oils prepared from strains of marijuana with very high
CBD content and low THC content (e.g., Charlotte's Web):
- may contain contaminates
- may not contain CBD
- may be prepared under less-than-sterile conditions
- purity is unknown
24. Whole Plant Marijuana: Potential as Medicine?
– May be a less-than-ideal medicine due to:
– Schedule I status
– Most commonly combusted and inhaled (e.g., exposure to carcinogens)
– Abuse liability
– Not all cannabinoids in the plant are beneficial
– Examples: THC is not safe for all populations (e.g., seizure disorder, mental
illnesses)
– No assurances of potency, cannabinoid content
- Advocates frequently cite the “entourage effect” – cannabinoids can enhance the
effects of other cannabinoids (e.g., mutually synergistic)
- However, the proper ratios of cannabinoids have not been determined
- This effect could be potentially replicated with pharmaceutical cannabinoids
that have been thoroughly tested
25. THC Content Increasing
High THC content marijuana is now widely available in street marijuana,
medicinal marijuana and legalized recreational marijuana
Mean THC content of marijuana in the US:
1970s: 1 - 2 %
1990s: 3 - 4%
2010s: 10 - 15%
26. THC Content Over Last 20 Years
Mahmoud A. Elsohly (2014), Potency Monitoring Program, Supported by NIDA
1995 2000 2005 2010 2015
0
2
4
6
8
10
12
14
Year
MeanTHCconcentration(%)
Year
MeanTHCContent(%THC)
27. THC Content Over Last 20 Years
Mahmoud A. Elsohly (2014), Potency Monitoring Program, Supported by NIDA
1995 2000 2005 2010 2015
0
2
4
6
8
10
12
14
Year
MeanTHCconcentration(%)
Year
MeanTHCContent(%THC)
212% Increase
28. THC Content Increasing
High THC content marijuana is now widely available in street marijuana,
medicinal marijuana and legalized recreational marijuana
Mean THC content of marijuana in the US:
1970s: 1 - 2 %
1990s: 3 - 4%
2010s: 10 - 15%
Medical marijuana: 10 - 20%
Legal recreational marijuana: 15 - 20%+
THC oils : 50-80%+
29. THC Concentrates
- Very high THC content (50-80% and higher)
- Liquid, wax, semi-solid, solid forms available
- Extraction process can be dangerous due to butane and other chemicals
(although some use water and other non-toxic materials)
- Those chemical by-products may be inhaled or ingested during
preparation or during use
- Concentrates are often smoked, vaporized; blow-torches are sometimes
used to heat concentrates to high temperatures
- Legal in Colorado, Washington
- Terms: shatter, dabbing/dabs, oils, wax, butter
30. CBD Content Decreasing
As THC content is increasing, CBD content is decreasing (through
selective breeding, growing techniques); increases sales
Analysis of 206 marijuana samples confiscated from recreational users and
growing operations in Australia:
Recreational Users:
Mean THC content: 14.9%
Mean CBD content: 0.14%
Indoor Growing Operations:
Mean THC content: 19.6%
Mean CBD content: 0.14%
Marijuana purchased in Washington State
31. CBD Reduces Risk of THC?
There are a few reports that indicate CBD reduces the high and
psychoactive effects of marijuana; reduces anxiety/paranoia
However, this evidence is relatively weak:
- Animal studies have provided mixed results
- A few human studies that have suggested that CBD can decrease the
euphoric, anxiogenic and motor impairing effects of marijuana
- case studies or using non-standardized measurements
- Several small correlational studies have associated high THC, low
CBD marijuana with increased anxiety and a younger age of
onset of first psychotic episode
32. Multisite Trial: Cannabidiol Effects on
Smoked Marijuana
- The National Institute on Drug Abuse (NIDA) funded a 3-site trial that
examined oral CBD alone and in combination with smoked marijuana
- Conducted to determine if CBD decreases the abuse liability of smoked
marijuana and assess CBD as a potential treatment for marijuana abuse
and dependence
- Sites included: University of Kentucky, Columbia University, Medical
University of South Carolina
- Recently completed, 31 participants
33. Methods
Participants - healthy adults, ages 18 – 50
- frequent marijuana smokers (4x per week)
- not seeking treatment for marijuana use
Study Design - 8 week outpatient study
- 1 session per week (due to CBD half-life)
Drugs - oral cannabidiol: 0, 200, 400, 800 mg
- smoked marijuana: 0, 5.6% THC
(half of a marijuana cigarette)
- each dose combination tested once
- CBD administered 90 minutes prior to
marijuana
34. Methods
Measures
Subjective, physiological, psychomotor, and cognitive
assessments were collected at regular intervals (7.5 hrs)
Drug self-administration, measures reinforcing effect of a drug
- participants forego a portion of their study earnings
to smoke additional puffs (50 cents/puff)
- opportunity to smoke up to 3 additional puffs
- 2.5 hrs after sampling marijuana
35. Study Objectives
1) Assess the safety and abuse liability of oral CBD alone
2) Determine CBD effects on the reinforcing, subjective,
cognitive, and physiological effects of smoked marijuana
39. - Oral CBD was safely tolerated in a population of frequent marijuana
smokers (≤ 800 mg)
- CBD was placebo-like on all measures tested and there was no signal
for CBD to decrease marijuana subjective effects or physiological
effects (no change in marijuana-induced increases in heart rate)
- CBD did not display abuse liability in this population and did not alter the
abuse liability of smoked marijuana
- In this acute interaction study, there was no signal for CBD as a
treatment for marijuana abuse
Study Conclusions
40. Summary
- There is preclinical evidence indicating that cannabidiol acts as an
antioxidant, anti-inflammatory, analgesic, neuroprotectant and
anticonvulsive; however, there have been no controlled trials
demonstrating efficacy in humans
- Clinical trials are underway for numerous indications; treatment INDs have
been issued for pharmaceutical-grade cannabidiol oil for the treatment of
pediatric seizure disorders
- Whole plant marijuana does not appear to be an ideal medication (not all
cannabinoids are beneficial for every condition, high THC content); several
new cannabinoid-based medications are in development and under testing
41. Summary
- THC content in marijuana is increasing (12 fold+ increase since 1970s);
however, it does not appear that CBD, even at relatively high doses,
decreases the positive or aversive drug effects of marijuana
- The long term safety of cannabidiol has not been established; given that
cannabinoid receptors/endocannabinoids are ubiquitous in the brain and
periphery (particularly in cardiac tissue, reproductive system, GI tract),
requires careful examination
43. Conflict of Interest Disclosure
The Center for Lawful Access and Abuse Deterrence (CLAAD) receives funding
from businesses in the health care industry that share CLAAD’s mission to
reduce prescription drug fraud, diversion, misuse, and abuse while
advancing consumer access to high-quality health care. CLAAD’s funders
include pharmaceutical companies, treatment centers, and laboratories,
and are disclosed on its website, www.claad.org.
CLAAD is managed by DCBA Law & Policy. DCBA also provides legal and policy
counsel to professionals and businesses whose activities align with
CLAAD’s mission. To avoid conflicts of interest, DCBA adheres to
the District of Columbia Rules of Professional Conduct §§ 1.7-1.9.
44. Preview
• Legal Status of Marijuana
• Federal Supremacy
• Concerns Related to the Current System
• Federal Drug Authority
• Broader Implications
• Where To Go From Here
• Issues on the Horizon
45. Legal Status of Marijuana
• WA, CO, OR, AK, and DC have legalized
marijuana.
• Ballot initiatives in 2016: AZ, CA, MA, ME, NV.
• 23 States and DC have legalized marijuana for
medicinal purposes. (National Conference of
State Legislatures)
• Clear trend toward legalization.
46. Legal Status of Marijuana
• Under Federal law, marijuana is illegal.
– CSA: Schedule I; “no accepted medical use.”
• Current Congress is divided, but support is
increasing.
– Support: Harry Reid (D), Nancy Pelosi (D), Rand Paul
(R).
– Oppose: Mitch McConnell (R), John Boehner (R).
– A bill to bar the DoJ from preventing state
implementation of marijuana laws passed the House
in the 113th Congress.
47. Federal Supremacy
• Gonzales v. Raich (2004) – upheld the CSA classification.
– The Interstate Commerce Clause (Art. III, § 8, cl. 3) authorizes Congress
to regulate purely intrastate activities that have a substantial effect on
interstate commerce.
– Local marijuana cultivation and use affects national supply and
demand, so local use is part of the national market.
• 10th Amendment reserves for the States Plenary Police Powers.
– Includes legislating for the protection of citizens’ health, safety and
welfare. (The Best of Both Worlds: Applying Federal Commerce and
State Police Powers to Reduce Prescription Drug Abuse, 16 Md. J.
Health Care L. & Pol’y 271 (2013))
• When in conflict, fed. law prevails (Art. VI, cl. 2).
– Complex pre-emption tests. (State Legalization of Recreational
Marijuana: Selected Legal Issues, Congressional Research Service
(2014))
48. Concerns Regarding the Current
System
• Who has the final say?
– State and federal law conflict; citizens can use
marijuana in accordance with state law but be
arrested and prosecuted under federal law.
• DOJ: Marijuana is illegal, but federal enforcement
is limited.
– Federal enforcement will focus on particularly harmful
categories of sales, such as to minors, or those that
benefit criminal enterprise.
– Outside of those “enforcement priorities,” DoJ leaves
it to the states.
49. Federal Drug Authority
• Maine foreign drug importation law.
– 2013 Maine law permitted citizens to purchase
drugs from certain foreign countries (not FDA
regulated).
– Federal court decision (Feb. 2015).
• Federal government regulates foreign commerce.
• Maine law is pre-empted by federal law.
• Compromised the “tightly regulated structure” set up
by federal law.
50. State Actions & Implications
• ER Hydrocodone: FDA approved, states pushed back.
– Mass. enacted an emergency medication ban that was struck
down.
– Ruling: Supremacy Clause gives the FDA ruling more weight
than a contrary state determination. (Zogenix v. Deval Patrick,
Civ. Action No. 14-11689-RWZ (D. Mass. 2014))
• Broad undermining of Constitutional rights and federal law.
– Even if there are “bigger fish to fry,” selective enforcement is ill-
advised policy. Consider politicized women’s health issues.
– Ex: ID, KS, MO and AK passed the 2nd Amendment Preservation
Act, which prohibits state law enforcement officials from
enforcing federal gun control laws.
51. Where To Go From Here
• Political will has changed, and the economics are
simple.
– As of 2011, 77% of Americans support marijuana for
medicinal purposes (CBS News Poll).
– As of 2013, 52% of Americans favor legalizing marijuana
use (Pew Research Center).
– As supply increases, use will increase. (Office of
National Drug Control Policy, A Comprehensive
Approach: Reducing the Supply of Illegal Drugs, (1999)
(“When illegal drugs are readily available, the likelihood
increases that they will be abused.”))
• Treatment providers must be prepared.
52. Where To Go From Here
• Impossible to defy public will.
• Unilateral armament in public battles.
• How to regulate marijuana? Like alcohol? Like
tobacco?
• Consider the important issues that are on the horizon.
– A North American Opiate Medication Initiative (NAOMI)
study indicates that treating longtime addicts with heroin
is a safe and effective treatment for heroin addiction and is
more cost-effective than methadone. (Sheryl Ubelacker,
Medical Heroin: Study Says Giving Long-Term Addicts the
Real Deal More Efficient Than Methadone, Huffington Post,
(Mar. 12, 2012))
53. Issues on the Horizon
“Rather than having them [use
heroin] in the back alley, why
don’t we attract them into a
clinic where they will be in
contact with doctors and nurses
and counselors, we stabilize
them by getting them out of a
life of crime.”
– Martin Shechter, Epidemiologist at the
University of British Columbia & Study
Contributor
54. Conclusion
• Thanks to Cindy Lackey, Nancy Hale, Karen
Kelly, and co-presenters
• Questions and discussion at end of session
• Contact
– LinkedIn.com/in/michaelcbarnes
– @mcbtweets
– www.claad.org
– @claad_coalition
• Thank you
55. Trending Topics Track
Marijuana: Emerging Medical
and Legal Issues
Presenters:
• Shanna Babalonis, PhD, Assistant Professor, Department of
Behavioral Science and Center on Drug and Alcohol
Research, University of Kentucky
• Michael C. Barnes, JD, Executive Director, Center for
Lawful Access and Abuse Deterrence (CLAAD), and
Member, Rx Summit National Advisory Board
Moderator: Nancy Hale, President and CEO, Operation UNITE