According to history books, during the late years of 1970’s, cannabis patient named Mr. Robert Randall sued the federal government for arresting him for using medicinal cannabis to treat his glaucoma. He won the case and with this, the presiding judge ruled that Randall should use cannabis for health purposes and required the Food and Drug Administration (FDA) to set up a program to allow cultivating, growing, purchasing and even selling cannabis.
The judge asked the FDA to allow growing this cannabis on a farm at the University of Mississippi and to distribute 300 cannabis cigarettes a month to Randall. Meanwhile, after several years, in 1992 to be exact, US President George H. W. Bush put an end to the program after the patient, Mr. Randall tried to make AIDS patients qualified for the said program as well.
Initially, there are thirteen people were already enrolled and were allowed to continue sniffing medical cannabis cigarettes to cure their medical conditions, then few years later, the US government just shipped medical cannabis cigarettes to merely seven medicinal cannabis patients. One cannabis patient named, Mr. Irvin Rosenfeld, who during those years has received medical cannabis attention from the program since 1982 to treat his rare bone tumors, urged the George W. Bush administration to reopen the program; however, in the end he was not successful though.
During those times, the state of Alaska is the only state in the United States where possession of up to one ounce is legal. Sacramento back then was not allowed to use this medical cannabis even as an alternative medicine to cure diseases.
Medical experts in Sacramento cited the dangers of cannabis even for medical purposes. They added that the lack of clinical research supporting its medicinal value to heal various medical conditions. Meanwhile, the American Society of Addiction Medicine (SAM) in March 2011 issued a white paper recommending a halt to using marijuana as a medicine in US states where it has been declared legal. But medical patients in the Sacramento region, who has been cured by this medical cannabis, beg to disagree about the proposal done by the (SAM). Medical cannabis patients defend the benefits they get through this medical cannabis, and they would rally behind the full legalization of this alternative medicine to cure their health problems.
During Governor Arnold Schwarzenegger’s reign as the Governor of California, medical cannabis has given so much attention. He prioritized the legalization of this alternative medicine to help medical patients who are looking for alternative treatment to cure their medical conditions.
Introduction:
Cannabis is not only the most abused illicit drug in the United States (Gold, Frost-Pineda, & Jacobs, 2004; NIDA, 2010) it is in fact the most abused illegal drug worldwide (UNODC, 2010). In the United States it is a schedule-I substance which means that it is legally considered as having no medical use and it is highly addictive (US DEA, 2010). Doweiko (2009) explains that not all cannabis has abuse potential. He therefore suggests using the common terminology marijuana when referring to cannabis with abuse potential. For the sake of clarity this terminology is used in this paper as well.
Today, marijuana is at the forefront of international controversy debating the appropriateness of its widespread illegal status. In many Union states it has become legalized for medical purposes. This trend is known as “medical marijuana” and is strongly applauded by advocates while simultaneously loathed harshly by opponents (Dubner, 2007; Nakay, 2007; Van Tuyl, 2007). It is in this context that it was decided to choose the topic of the physical and pharmacological effects of marijuana for the basis of this research article.
What is marijuana?
Marijuana is a plant more correctly called cannabis sativa. As mentioned, some cannabis sativa plants do not have abuse potential and are called hemp. Hemp is used widely for various fiber products including newspaper and artist’s canvas. Cannabis sativa with abuse potential is what we call marijuana (Doweiko, 2009). It is interesting to note that although widely studies for many years, there is a lot that researchers still do not know about marijuana. Neuroscientists and biologists know what the effects of marijuana are but they still do not fully understand why (Hazelden, 2005).
Deweiko (2009), Gold, Frost-Pineda, & Jacobs (2004) point out that of approximately four hundred known chemicals found in the cannabis plants, researchers know of over sixty that are thought to have psychoactive effects on the human brain. The most well known and potent of these is âÂÂ-9-tetrahydrocannabinol, or THC. Like Hazelden (2005), Deweiko states that while we know many of the neurophysical effects of THC, the reasons THC produces these effects are unclear.
Neurobiology:
As a psychoactive substance, THC directly affects the central nervous system (CNS). It affects a massive range of neurotransmitters and catalyzes other biochemical and enzymatic activity as well. The CNS is stimulated when the THC activates specific neuroreceptors in the brain causing the various physical and emotional reactions that will be expounded on more specifically further on. The only substances that can activate neurotransmitters are substances that mimic chemicals that the brain produces naturally. The fact that THC stimulates brain function teaches scientists that the brain has natural cannabinoid receptors. It is still unclear why humans have natural cannabinoid receptors and how they work (Hazelden, 2005; Martin, 2004). What we do know is that marijuana will stimulate cannabinoid receptors up to twenty times more actively than any of the body’s natural neurotransmitters ever could (Doweiko, 2009).
Perhaps the biggest mystery of all is the relationship between THC and the neurotransmitter serotonin. Serotonin receptors are among the most stimulated by all psychoactive drugs, but most specifically alcohol and nicotine. Independent of marijuana’s relationship with the chemical, serotonin is already a little understood neurochemical and its supposed neuroscientific roles of functioning and purpose are still mostly hypothetical (Schuckit & Tapert, 2004). What neuroscientists have found definitively is that marijuana smokers have very high levels of serotonin activity (Hazelden, 2005). I would hypothesize that it may be this relationship between THC and serotonin that explains the “marijuana maintenance program” of achieving abstinence from alcohol and allows marijuana smokers to avoid painful withdrawal symptoms and avoid cravings from alcohol. The efficacy of “marijuana maintenance” for aiding alcohol abstinence is not scientific but is a phenomenon I have personally witnessed with numerous clients.
Interestingly, marijuana mimics so many neurological reactions of other drugs that it is extremely difficult to classify in a specific class. Researchers will place it in any of these categories: psychedelic; hallucinogen; or serotonin inhibitor. It has properties that mimic similar chemical responses as opioids. Other chemical responses mimic stimulants (Ashton, 2001; Gold, Frost-Pineda, & Jacobs, 2004). Hazelden (2005) classifies marijuana in its own special class – cannabinoids. The reason for this confusion is the complexity of the numerous psychoactive properties found within marijuana, both known and unknown. One recent client I saw could not recover from the visual distortions he suffered as a result of pervasive psychedelic use as long as he was still smoking marijuana. This seemed to be as a result of the psychedelic properties found within active cannabis (Ashton, 2001). Although not strong enough to produce these visual distortions on its own, marijuana was strong enough to prevent the brain from healing and recovering.
Emotions:
Cannibinoid receptors are located throughout the brain thus affecting a wide variety of functioning. The most important on the emotional level is the stimulation of the brain’s nucleus accumbens perverting the brain’s natural reward centers. Another is that of the amygdala which controls one’s emotions and fears (Adolphs, Trane, Damasio, & Damaslio, 1995; Van Tuyl, 2007).
I have observed that the heavy marijuana smokers who I work with personally seem to share a commonality of using the drug to manage their anger. This observation has evidenced based consequences and is the basis of much scientific research. Research has in fact found that the relationship between marijuana and managing anger is clinically significant (Eftekhari, Turner, & Larimer, 2004). Anger is a defense mechanism used to guard against emotional consequences of adversity fueled by fear (Cramer, 1998). As stated, fear is a primary function controlled by the amygdala which is heavily stimulated by marijuana use (Adolphs, Trane, Damasio, & Damaslio, 1995; Van Tuyl, 2007).
Neurophysical Effects of THC:
Neurological messages between transmitters and receptors not only control emotions and psychological functioning. It is also how the body controls both volitional and nonvolitional functioning. The cerebellum and the basal ganglia control all bodily movement and coordination. These are two of the most abundantly stimulated areas of the brain that are triggered by marijuana. This explains marijuana’s physiological effect causing altered blood pressure (Van Tuyl, 2007), and a weakening of the muscles (Doweiko, 2009). THC ultimately affects all neuromotor activity to some degree (Gold, Frost-Pineda, & Jacobs, 2004).
An interesting phenomena I have witnessed in almost all clients who identify marijuana as their drug of choice is the use of marijuana smoking before eating. This is explained by effects of marijuana on the “CB-1” receptor. The CB-1 receptors in the brain are found heavily in the limbic system, or the nucleolus accumbens, which controls the reward pathways (Martin, 2004). These reward pathways are what affect the appetite and eating habits as part of the body’s natural survival instinct, causing us to crave eating food and rewarding us with dopamine when we finally do (Hazeldon, 2005). Martin (2004) makes this connection, pointing out that unique to marijuana users is the stimulation of the CB-1 receptor directly triggering the appetite.
What is high grade and low grade?
A current client of mine explains how he originally smoked up to fifteen joints of “low grade” marijuana daily but eventually switched to “high grade” when the low grade was starting to prove ineffective. In the end, fifteen joints of high grade marijuana were becoming ineffective for him as well. He often failed to get his “high” from that either. This entire process occurred within five years of the client’s first ever experience with marijuana. What is high and low grade marijuana, and why would marijuana begin to lose its effects after a while?
The potency of marijuana is measured by the THC content within. As the market on the street becomes more competitive, the potency on the street becomes more pure. This has caused a trend in ever rising potency that responds to demand. One average joint of marijuana smoked today has the equivalent THC potency as ten average joints of marijuana smoked during the 1960’s (Hazelden, 2005).
THC levels will depend mainly on what part of the cannabis leaf is being used for production. For instance cannabis buds can be between two to nine times more potent than fully developed leaves. Hash oil, a form of marijuana developed by distilling cannabis resin, can yield higher levels of THC than even high grade buds (Gold, Frost-Pineda, & Jacobs, 2004).
Tolerance:
The need to raise the amount of marijuana one smokes, or the need to intensify from low grade to high grade is known clinically as tolerance. The brain is efficient. As it recognizes that neuroreceptors are being stimulated without the neurotransmitters emitting those chemical signals, the brain resourcefully lowers its chemical output so the total levels are back to normal. The smoker will not feel the high anymore as his brain is now “tolerating” the higher levels of chemicals and he or she is back to feeling normal. The smoker now raises the dose to get the old high back and the cycle continues. The smoker may find switching up in grades effective for a while. Eventually the brain can cease to produce the chemical altogether, entirely relying on the synthetic version being ingested (Gold, Frost-Pineda, & Jacobs, 2004; Hazelden, 2005).
Why isn’t there any withdrawal?
The flip side of the tolerance process is known as “dependence.” As the body stops producing its own natural chemicals, it now needs the marijuana user to continue smoking in order to continue the functioning of chemicals without interruption. The body is now ordering the ingestion of the THC making it extremely difficult to quit. In fact, studies show that marijuana dependency is even more powerful than seemingly harder drugs like cocaine (Gold, Frost-Pineda, & Jacobs, 2004).
With quitting other drugs like stimulants, opioids, or alcohol the body reacts in negative and sometimes severely dangerous ways. This is due to the sudden lack of chemical input tied together with the fact that the brain has stopped its own natural neurotransmission of those chemicals long ago. This is the phenomenon of withdrawal (Haney, 2004; Hazelden, 2005; Jaffe & Jaffe, 2004; Tabakoff & Hoffman, 2004).
While research has shown comparable withdrawal reactions is marijuana users as in alcohol or other drugs (Ashton, 2001), what I have witnessed many times in my personal interaction with clients is the apparent lack of withdrawal experienced by most marijuana users. Of course they experience cravings, but they don’t report having the same neurophysical withdrawal reaction that the other drug users have. Some marijuana smokers use this as their final proof that marijuana “is not a drug” and they should therefore not be subjugated to the same treatment and pursuit of recovery efforts as other drug or alcohol abusers.
The reality is that the seemingly lack of acute withdrawal is a product of the uniqueness of how the body stores THC. While alcohol and other drugs are out of a persons system within a one to five days (Schuckit & Tapert, 2004), THC can take up to thirty days until it is fully expelled from the body (Doweiko, 2009). When THC is ingested by the smoker, it is initially distributed very rapidly through the heart, lungs, and brain (Ashton, 2001). THC however, is eventually converted into protein and becomes stored is body fat and muscle. This second process of storage in body fat reserve is a far slower process. When the user begins abstinence, fat stored THC begins its slow release back into the blood stream. While the rate of reentry into the body’s system is too slow to produce any psychoactive effects, it will aid in easing the former smoker through the withdrawal process in a more manageable and pain free manner. The more one smokes the more one stores. The more body mass the smoker has, the more THC can be stored up as well (Doweiko, 2009). Thus, in very large clients I have seen it take up to thirty days before urine screens show a cleared THC level.
Similar to THC’s slow taper like cleansing is the slow rate of initial onset of psychoactive response. Clients report that they do not get high smoking marijuana right away – it takes them time for their bodied to get used to it before they feel the high. This is explained by the slow absorption of THC into fatty tissue reaching peak concentrations in 4-5 days. As the THC begins to release slowly into the blood stream, the physiological response will become heightened rapidly with every new smoking of marijuana resulting in another high. As the user repeats this process and high levels of THC accumulate in the body and continue to reach the brain, the THC is finally distributed to the neocortical, limbic, sensory, and motor areas that were detailed earlier (Ashton, 2001).
Physiology:
The neurology and neurophysiology of marijuana has been described thus far. There are many physical components of marijuana smoking as well. National Institute on Drug Abuse (2010) reports that marijuana smokers can have many of the same respiratory problems as tobacco smokers including daily cough, phlegm production, more frequent acute chest illness, and a heightened risk of lung infections. They quote research showing evidence that chronic marijuana smokers, who do not smoke tobacco, have more health problems than non smokers because of respiratory illnesses.
The definitive research documenting the significant negative biophysical health effects of marijuana is not conclusive. We do know that marijuana smoke contains fifty to seventy percent more carcinogenic hydrocarbons than tobacco smoke does (Ashton, 2001; Gold, Frost-Pineda, & Jacobs, 2004; NIDA, 2010). While some research shows that marijuana smokers show dysregulated growth of epithelial cells in their lung tissue which can lead to cancer, other studies have shown no positive associations at all between marijuana use and lung, upper respiratory, or upper digestive tract cancers (NIDA, 2010). Perhaps the most eye opening fact of all is that all experts agree that historically there has yet to be a single documented death reported purely as a result of marijuana smoking (Doweiko, 2009; Gold, Frost-Pineda, & Jacobs, 2004; Nakaya, 2007; Van Tuyl, 2007).
Pharmacology – “Medical Marijuana”:
This last fact regarding the seemingly less harmful effects of marijuana smoking even in comparison with legal drugs like alcohol and nicotine is most often the very first quoted by proponents of legalizing marijuana for its positive medical advantages (Dubner, 2007; Nakaya, 2007; Van Tuyl, 2007). Nakaya (2007) points to the seemingly positive effects of marijuana on alzheimers, cancer, multiple sclerosis, glaucoma, and AIDS. While not scientific, personal experiences of the positive relief of sufferers from chronic illness is quoted as benefits that are claimed to outweigh the negative effects.
Van Tuyl (2007) states “almost all drugs – including those that are legal – pose greater threats to individual health and/or society than does marijuana.” She agrees that legalizing the smoking of marijuana would not justify the positive effects but posits still that the risks associated with smoking can be “mitigated by alternate routes of administration, such as vaporization” (pg. 22-23). The arguments point to clinically riskier drugs like opioids, benzodiazepines, and amphetamines that are administered by prescription on a daily basis. These drugs, like Vicodine, Xanex, or Ritalin, are internationally acceptable when deemed “medically necessary.”
Conclusion / Reflection:
While I am not comfortable weighing in on the controversy of the legalization of marijuana, in conclusion of this research paper there are clear implications for me as a practitioner. Alcohol too is quite legal, as is nicotine, but for the addiction counselor it is important to continue keeping a directive on the biopsychosocial considerations regarding the misuse of any substance. Because of the large lack of empirical knowledge regarding the neurobiological properties associated with exact brain functioning, a crucial focus moving forward will prove to be keeping tabs on breakthrough discoveries in the neuroscience of THC and other cannabanoids. The discoveries of particular importance for current practice are the pathology of marijuana’s relationship with emotional self-medication, tolerance, and most of all the withdrawal process. I have already begun to utilize the knowledge of the physical and pharmacological effects of marijuana expressed heretofore with personal success and look forward to continue utilizing farther research to do the same.
Bibliography:
Adolphs, R., Tranel, D., Damasio, H., Damaslio, A. (1995). Fear and the Human Amygdala. The Journal of Neuroscience 75(9): 5879-589. Retrieved March 4, 2011
Ashton, C. H. (2001). Pharmacology and Effects of Cannabis: a Brief Review. The British Journal of Psychiatry 178(2) 101-106. Retrieved March 4, 2011
Cramer, P. (1998). Coping and Defense mechanisms: What’s the Difference? Journal of Personality, 66(6), 919-046. Retrieved March 4, 2011
Dubner, S. (2007). On the Legalization, or Not, of Marijuana. The New York Times. Retrieved March 2, 2011
Eftekhari, A., Turner, A., & Larimer, M. (2004). Anger Expression, Coping, and Substance Use in Adolescent Offenders. Addictive Behaviors 29(5). Retrieved March 3, 2011. doi:10.1016/j.addbeh.2004.02.050
Gold, M., Frost-Pineda, K., & Jacobs, W. (2004). Cannabis as found in The American Psychiatric Textbook of Substance Abuse Treatment (3rd Ed., Ch. 15). American Psychiatric Publishing, Inc.
Haney, M. (2004). Neurobiology of Stimulants as found in The American Psychiatric Textbook of Substance Abuse Treatment (3rd Ed., Ch. 3). American Psychiatric Publishing, Inc.
Hazelden (2005). Marijuana, Escape to Nowhere (video). The Matrix Model. Hazelden Publishing.
Hazelden (2005). The Matrix Model. Hazelden Publishing.
Hazelden (2005). The Neurobiology of Addiction (video). The Matrix Model. Hazelden Publishing.
Jaffe, J., & Jaffe, A. (2004). Neurobiology of Opioids as found in The American Psychiatric Textbook of Substance Abuse Treatment (3rd Ed., Ch. 2). American Psychiatric Publishing, Inc.
Martin, B. (2004). Neurobiology of Marijuana as found in The American Psychiatric Textbook of Substance Abuse Treatment (3rd Ed., Ch. 5). American Psychiatric Publishing, Inc.
Nakaya, A. (2007). Marijuana. Reference Point Press.
National Institute on Drug Abuse (2010). NIDA Info Facts: Marijuana. Retrieved March 6, 2011
Schuckit, M. & Tapert, S. (2004). Alcohol as found in The American Psychiatric Textbook of Substance Abuse Treatment (3rd Ed., Ch. 14). American Psychiatric Publishing, Inc.
Tabakoff, B., & Hoffman, P. (2004). Neurobiology of Alcohol as found in The American Psychiatric Textbook of Substance Abuse Treatment (3rd Ed., Ch. 1). American Psychiatric Publishing, Inc.
UNODC (2010) World Drug Report 2010. United Nations Publication.
US DEA (2010) Marijuana. United States Department of Justice, Retrieved March 2, 2011, from http://www.justice.gov/
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On Jan 1st Illinois became the 20th US state to legalize medical marijuana, launching medical marijuana dispensaries under regulations that are the strictest in the nation. From limited licenses to zoning ordinances, Illinois strict model may end up being the standard that states follow when considering medical marijuana legislation in the future. The regulations attempt to balance the values of Illinois diverse communities with the well being of medical marijuana patients, some of whom suffer from conditions such as cancer, Lupus, and HIV.
According to the Chicago Tribune, Illinois’s strict limitations on medical marijuana limits the number of dispensaries to 60 statewide and the number of grow operations to 22. Some towns and cities have in turn passed down stricter ordinances to limit dispensaries and grow operations in their jurisdictions. Chicago Mayor Rahm Emanuel opted to pass an ordinance limiting dispensaries to manufacturing districts as well as requiring a minimum amount of parking.
The nationwide implications of Illinois becoming a medical marijuana state cannot be understated. Chicago is one of the largest cities in America and a cultural center for the Midwest. Long thought to be a west coast phenomenon, the growing acceptance of legalized medical marijuana has even moved New York’s governor to announce a limited trial involving 20 hospitals as reported by the Los Angeles Times. With two of the most highly populated cities in the US moving toward legalization, it is only a matter of time until more follow.
Along with the strictness of zoning and licensure requirements comes one of the strongest regulations for packaging of medical marijuana for sales. A representative of vialsondemand.com, a California-based company specializing in medical marijuana packaging supplies, explains: “There have been incidents of accidental ingestion of medical marijuana in Colorado due to sales in unsafe plastic bags, and Illinois wants to avoid that by requiring sales in opaque medical cannabis containers with child-resistant caps.”
A&A Packaging is seizing the largest market share for distribution of dispensary supplies and is positioned as a leader in the industry. They have provided high quality regulation compliant medical marijuana packaging to California, Colorado, and Washington as they rolled out their medical marijuana laws. “As more states enact medical marijuana legislation, demand for our products will be on the rise, but we have the experience to help new dispensaries meet the standards for safe and compliant packaging. We have increased our inventory to anticipate the needs of our new customers in Illinois and elsewhere.”
A&A Packaging is a California-based company that specializes in providing storage medical marijuana containers and products for customers and dispensaries of medical cannabis. For more information on state complaint labeling and packaging, please contact A&A at (888) 315-2453or visit their website at http://www.vialsondemand.com.
I wouldn’t be a good attorney unless I prefaced this article with a few disclaimers: 1) Marijuana is still a controlled schedule I substance and is illegal in the eyes of the Federal Government of the United States; 2) This article is not to be construed as legal advice, nor is intended to take the place of the advice of an attorney, and you should consult with an attorney before taking any actions in furtherance of the subject matter of this article. Ok, let’s begin.
In the month of November, the State of Arizona passed Proposition 203, which would exempt certain people from controlled substances laws in the State of Arizona. However, it will still take some time before medical marijuana is implemented as policy in Arizona. The Arizona Department of Health Services has released a proposed timeline for the drafting of the rules surrounding the implementation of Proposition 203. So far, these are the important time periods that should be paid close attention to:
December 17, 2010: The first draft of the medical marijuana rules should be released and made available for comment on this date.
January 7, 2011: This will be the deadline for public comment on the first draft of rules mentioned above.
January 31, 2011: The second draft of the rules will be released on this date. Once again, it will be available for informal comment as in the draft referred to above.
February 21 to March 18, 2011: More formal public hearings will be held about the proposed rules at this time, after which the final rules will be submitted to the Secretary of State and made public on the Office of Administrative Rules website.
April 2011: The medical marijuana rules will go into effect and be published in the Arizona Administrative Register.
It is important that at all times throughout the consultation process, interested parties submit briefs and/or make oral presentations when permitted. Groups with interests contrary to those of medical marijuana advocates may also be making presentations, and may convince the State to unnecessarily restrict the substance or those who may qualify to access it if there is no voice to advocate in favor of patients’ rights.
Some key points about Proposition 203’s effects
-Physicians may prescribe medical marijuana for their patients under certain conditions. “Physician” is not defined in a way limited to normal medical doctors. Osteopaths licensed under Title 32, Chapter 17; naturopaths licensed under Title 32, Chapter 14; and homeopaths licensed under Title 32, Chapter 29 may all be eligible to recommend marijuana for their patients.
-In order to be prescribed medical marijuana, a person must be a “qualifying patient.” A qualifying patient is defined as someone who has been diagnosed by a “physician” (as defined above) as having a “debilitating medical condition.”
-Debilitating medical conditions include:
• Cancer, glaucoma, HIV positive status, AIDS, hepatitis C, amyotrophic lateral sclerosis, Crohn’s disease, or agitation of Alzheimer’s disease or the treatment of these conditions.
• A chronic or debilitating disease or medical condition or its treatment that produces one or more of the following: Cachexia or wasting syndrome; severe and chronic pain; severe nausea; seizures, including those characteristic of epilepsy; or severe and persistent muscle spasms, including those characteristic of multiple sclerosis.
• Any other medical condition or its treatment added by the Department of Health Services pursuant to Section 36-2801.01.
This last qualifying condition is underlined because it is vitally important during the rulemaking process. Although Proposition 203 allows for the public to petition the Department of Health Services to exercise its discretion to add conditions under this section, bureaucracy is notoriously difficult to get to change any law. The initial discretionary rules for additional treatments could be exercised during the public consultations that occur between December and March, though this is not certain.
It is therefore important that, in the event that the addition of medical conditions is considered during the consultations, any stakeholder who wishes for a medical condition not listed in the first two bulleted items above to lobby during the public consultation periods for the Department to add the additional medical condition to the list of debilitating medical conditions. In order to increase the prestige of any presentations made to justify adding medical conditions under Section 36-2801.01, it may be helpful to solicit the testimony of sympathetic Arizona-licensed medical doctors who can testify on paper and at the public hearings about why the proposed condition should be added. Documents showing that other jurisdictions, both in the United States and elsewhere, currently use marijuana as a treatment for the proposed condition may be helpful, as would medical journals on the subject.
It should be remembered that despite his cheery YouTube videos about the medical marijuana rule drafting process, Director of Health Services Will Humble wrote a submission in opposition to the passing of Proposition 203. He did so on the grounds that the FDA does not test the drug, and even though the federal government’s anti-marijuana policy is well-known it should not be relied on as an authority for unbiased medical marijuana research. There is no reason to believe that Director Humble will be any less inclined to obstruct the use of medical marijuana during the rulemaking stage, and all proponents of medical marijuana should be sure to make their voices heard at the consultations to prevent the obstruction of the intent of Proposition 203.
Extent of Rulemaking during Consultations
There are other provisions in Proposition 203 which will be discussed during the initial rulemaking process, and they will probably be the main focus of the consultations. The consultations will create rules:
• Governing the manner in which the Department of Health Services will accept the petitions from the public previously mentioned, regarding the addition of medical conditions to the list of the already enshrined debilitating medical conditions.
• Establishing the form and content of registration and renewal applications submitted under the medical marijuana law.
• Governing the manner in which the Department will consider applications for and renewals of medical marijuana ID cards.
• Governing the various aspects around the newly legalized nonprofit medical marijuana dispensaries, including recordkeeping, security, oversight, and other requirements.
• Establishing the fees for patient applications and medical marijuana dispensary applications.
The most crucial part of the consultation period will be regarding the rules governing the establishment and oversight of medical marijuana dispensaries. If interest groups lobby the Department to make the recordkeeping, security, oversight, and other requirements around dispensaries too restrictive, it will have the effect of reducing the availability of medical marijuana to patients and driving up the price of medical marijuana due to the lack of supply. It could simply become too costly to comply with all of the regulations.
During this stage, it is important that stakeholders-particularly medical marijuana dispensaries from out-of-state, and perhaps pharmacists with a bit of economic knowledge-submit briefs explaining why certain proposed rules may have a negative effect on the patients this Proposition is supposed to help. The proposed rules have not come out yet, but when they do, they should be closely scrutinized for the possible negative impact that unnecessarily tough security and recordkeeping on nonprofit dispensaries might have on patients.
The other major factor in the rulemaking will have to do with the fees. The Department will be setting fees for medical marijuana dispensaries during the consultation period. Proposition 203 provides that the fees may not exceed $ 5,000 per initial application, and $ 1,000 per renewal. However, with some lobbying during the public consultation, it is possible that the actual fees will be much less since these are simply the maximum that the Department may charge.
Discrimination against Medical Marijuana Users
Under Proposition 203, discrimination against medical marijuana users will be prohibited in certain circumstances. Based on our analysis, a person may not:
• As a school or landlord, refuse to enroll someone or otherwise penalize them solely for their status as a medical marijuana cardholder, unless not doing so would result in the loss of a monetary or licensing related benefit under federal law or regulations.
• As an employer, discriminate against hiring someone, or terminate them or impose any conditions on them because they are a medical marijuana cardholder, unless not doing so would result in the loss of a monetary or licensing related benefit under federal law or regulations. Employers may still terminate employees if the employee is in possession of or impaired by marijuana on the premises of the place of employment or during the hours of employment.
• As a medical care provider, discriminate against a cardholder, including in matters of organ transplants. Medical marijuana must be treated as any other medication prescribed by a physician.
• Be prevented, as a cardholder, from having visitation custody or visitation or parenting time with a minor, unless the cardholder’s behavior “creates an unreasonable danger to the safety of the minor as established by clear and convincing evidence.”
Although there are certain prohibitions on discrimination, there are also provisions which permit discrimination against medical marijuana cardholders:
• Government medical assistance programs and private health insurers are not required to reimburse a person for their medical marijuana use.
• Nobody who possesses property, including business owners, is required to allow medical marijuana on their premises (this seemingly includes landlords who, although they cannot refuse tenants based on their being a cardholder, are permitted to prevent cardholders from bringing marijuana onto the landlord’s property).
• Employers are not required to allow cardholders to be under the influence of or ingest marijuana while working, though the presence of marijuana in the body which is not of a sufficient concentration to cause impairment does not establish being under the influence of it.
Rules Related to the Establishment of Dispensaries
Although the final rules around security, recordkeeping, and other requirements for medical marijuana dispensaries will not be established until April 2011, there are certain requirements which are enshrined in Proposition 203 itself and can be known ahead of the time that the final rules come out. These minimal requirements may not be as restrictive as the final requirements which are published in April 2011.
• Medical marijuana dispensaries must be nonprofit. They must have bylaws which preserve their nonprofit nature, though they need not be considered tax-exempt by the IRS, nor must they be incorporated.
• The operating documents of the dispensaries must include provisions for the oversight of the dispensary and for accurate recordkeeping.
• The dispensary must have a single secure entrance and must implement appropriate security measures to deter and prevent the theft of marijuana and unauthorized access to areas containing marijuana.
• A dispensary must not acquire, possess, cultivate, manufacture, deliver, transfer, transport, supply, or dispense marijuana for any purpose other than providing it directly to a cardholder or to a registered caregiver for the cardholder.
• All cultivation of marijuana must take place only at a locked, enclosed facility at a physical address provided to the Department of Health Services during the application process, and accessible only by dispensary agents registered with the Department.
• A dispensary can acquire marijuana from a patient of their caregiver, but only if the patient or caregiver receives no compensation for it.
• No consumption of marijuana is permitted on the property of the dispensary.
• A dispensary is subject to reasonable inspection by the Department of Health Services. The Department must first give reasonable notice of the inspection to the dispensary.
Comparison to California’s Medical Marijuana Law
The Arizona law is by no means the same as the law in California. There are certainly some differences between the two, though in some respects they are comparable. This is a comparative analysis of the two laws.
Similarities:
• Both laws, as a practical matter, allow for broad discretion on the part of a physician to prescribe marijuana to patients who suffer from pain. In the Arizona law, “severe and chronic pain” is the legislated standard. In the California law, any “chronic or persistent medical symptom” that substantially limits the life of the patient to conduct one or more major life activities as defined by the Americans with Disabilities Act of 1990, or that if not alleviated, will cause serious harm to the patient’s physical or mental safety, qualifies.
• Both laws have a number of illnesses which are automatically considered qualifying illnesses for the prescription of medical marijuana. These include, but are not limited to, AIDS, cachexia, cancer, glaucoma, persistent muscle spasms, seizures, and severe nausea.
• Both laws require the use of an identification card by those who have been prescribed medical marijuana, after the cardholders have gone through an initial application process in which the use of the drug has been recommended by a physician.
• Both states do not factor in the unusable portion of the marijuana plant in determining the maximum weight of marijuana that is permissible for possession by a cardholder.
Differences:
• Though the rules have not been finalized, the Arizona law appears as though it will be regulated on the state level and therefore uniform across Arizona. The California law, however, is regulated significantly on the municipal level, and therefore the rules around dispensaries can vary greatly from one municipality to the next.
• The Arizona law provides a broader spectrum of people who are considered a “physician” for the purpose of prescribing medical marijuana. In California, only medical doctors and osteopaths are considered to be physicians. In Arizona, in addition to medical doctors and osteopaths, naturopaths and homeopaths will also be permitted to prescribe medical marijuana.
• In California, patients or their caregivers may grow marijuana plants in lieu of using a medical marijuana dispensary. In Arizona, patients may only grow marijuana or designate someone else to do so in lieu of visiting a dispensary on the condition that there is no dispensary operating within 25 miles of the patient’s home.
• The maximum possession limit for marijuana in California is eight ounces per patient, whereas the limit is only 2.5 ounces per patient in Arizona.
-This is not meant to be legal advice and is provided purely as an analysis of the current legislation. You should consult with an attorney to discuss these matters. We are available for consultations for this matter by appointment only and via prepayment of the consultation fee.
There are many different ways to smoke weed. Some prefer joints, spliffs or blunts, while others like bongs or pipes, and others still prefer to vape or eat their marijuana. This article isn’t for all of them. This article is for people like me: people who smoke from glass pipes.
There are many great advantages to smoking with a glass pipe. They are more portable then a bong, and more convenient then rolling something. (and if you are in a place that the legality of your medicine is in question, glass pipes are easy to break so you can avoid that paraphernalia charge). The biggest disadvantage to a Glass Pipe is keeping them clean.
How to Clean a Glass Pipe
Sooner or late you are going to have to clean your glass pipe. Scraping it only does so much, and sooner or later the resin will build up thick enough that you will burn your thumb on the carb with every hit… (or is that just me?). Well thankfully, I have found an easy way to Clean a Glass pipe. here is what you will need:
Once you have assembled your cleaning tools the process is vey simple. All you need to do is put the pipe in the bag, fill the bag with rubbing alcohol (because after-all: Alcohol really IS a solution), and let it soak.
The alcohol very quickly begins to eat away at the resin build up in the glass pipe. Now you just let the alcohol due it’s magic. I usually will leave the pipe soak for a week. I have no idea if that is necessary, but it works for me.
The alcohol solution in the bag will begin to get very dark as it breaks away the resin that is clinging to the walls in the pipe. I like to agitate the bag every day or so to ensure the mixture is getting at all the gross stuff.
After a week you will notice the liquid in the bag has turned very dark. If your pipe was really dirty, you may not be able to see through the bag at all. This is when it is time to take the pipe out and begin step 2.
Remove your pipe from the cleaning solution, and bring it to the sink. Wash it normally. Turn the sink on full volume and blast the water through every opening on the pipe. The alcohol should have loosened the sediment enough that most of it will come out. However, you will likely need to use a pipe cleaner to get some stubborn areas. On occasion, I have had a pipe that was filthy enough that I had to do this process twice to fully clean the pipe, but if you clean them semi regularly, this will be the easiest way you can find to clean a glass pipe.
Let you pipe dry, and enjoy a nice clean hit from your sparkling clean pipe!
According to history books, during the late years of 1970’s, cannabis patient named Mr. Robert Randall sued the federal government for arresting him for using medicinal cannabis to treat his glaucoma. He won the case and with this, the presiding judge ruled that Randall should use cannabis for health purposes and required the Food and Drug Administration (FDA) to set up a program to allow cultivating, growing, purchasing and even selling cannabis.
Medical experts in Sacramento cited the dangers of cannabis even for medical purposes. They added that the lack of clinical research supporting its medicinal value to heal various medical conditions. Meanwhile, the American Society of Addiction Medicine (SAM) in March 2011 issued a white paper recommending a halt to using marijuana as a medicine in US states where it has been declared legal. But medical patients in the Sacramento region, who has been cured by this medical cannabis, beg to disagree about the proposal done by the (SAM). Medical cannabis patients defend the benefits they get through this medical cannabis, and they would rally behind the full legalization of this alternative medicine to cure their health problems.
