Tantamount to Freedom

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Tantamount to Freedom

© Michelle Sexton ND 2013

Thus far in my lifetime, I have become involved in two different movements that I realized have several common threads.  The first movement for me was the becoming a midwife and participating in homebirth. This “becoming” was partially as a result of my own hospital surgical birth and the desire to be more self-empowered, and partially to help other women realize the same.  (Later it had nothing to do with this for me, but was solely about nonviolence for the new arrivals!)The second movement was natural health and herbal medicine (which has gone hand-in-hand with homebirth) and subsequently led me to become a naturopathic doctor and researcher of Cannabis as medicine.  One thing common to both of these interests is that they used to be considered “hippy”, counterculture phenomenon and today they have both become more mainstream.  And in the end, both of these choices are tantamount to freedom!  

Here are what I see to be a few elemental similarities between homebirth and Cannabis as medicine:

1) Affordability- there is a relative lowcost for both homebirth and Cannabis as medicine compared to hopsital/pharmaceuticals and this applies whether or not one has access to healthcare insurance. 

2) Risk/benefit ratio- there is a relative measure of safety at a homebirth that is due to the lace of hospital intervention.  Likewise, there can be a risk reduction when discountinuing a number of pharmaceutical drugs in favor of using Cannabis.  The effects of a treatment that produce a negative outcome are called “iatrogenic”, so in alignment with the idea of “not messing with Mother Nature” both homebirth and Cannabis and medicine are more aligned with this value;  

3) Effectiveness- if measured by empowerment, quality of life and outcome, both homebirth and Cannabis as medicine have these in common.

To describe a couple of other abstruse analogies between these two movements, consider both of these practices from a more anthropological perspective.  The first method common to both homebirth and medical Cannabis is the attempt to dismantle hegemonic authority. What does this mean??  This means that people are questioning what the perceived “authorities” attempt at domination over others by forcing certain prescribed rituals or medicine.

The medicalization of childbirth and the medicalization of health have parallels in the emergence of “Western” medicine.  Both homebirth and alternative health and healing could be considered as ethical challenges to the status quo.  However, contemporary homebirthers and medical Cannabis users (or adult users) are no longer necessarily “radicals” or “extremists” rather just educated and empowered people living their lives as they see fit.  

Second, both groups could be considered to be engaged in a more ritualistic form of living, of bringing meaning to and carefully considering how to engage: the body, the spirit, the soul.

Third, the acts of ‘giving’ birth and choosing/preparing/titrating/ one’s own medicine bring meaning and empowerment to the individual.  In this  sense, they could both be considered to be “manipulated rituals of technocratic subversion”.

levi baby

The real common thread between these two involvements of mine is the people!  Both movements are filled with folks that may have at one time been considered ‘counterculture’.  But wait, just because wanting to participate fully in the birth of your child, you’re not counterculture anymore!   And wait, if you think you are going to be all culturally deviant by using Cannabis for pain relief, or to treat irritable bowel syndrome, or depression or just to alter your consciousness, you’re not!  The dominant values and behavior of society are changing!  If you think you could have either homebirth or medical Cannabis (or other natural medicine) in a system of collaboration and mutual respect, you can!

You are now just a member of the emerging culture, deliberately peeling away at the fiction of the medicalization of LIFE.   Our health and our life, how we live and how we die, do not need legitimacy in political and medical theaters.  To territorialize how we are born, how we die, and how we live the ‘dash’ in between our date of birth and date of death inscribed on a tombstone (or urn!) is tantamount to freedom!

CASP public comments to the Working Group

Dear Washington State Liquor Control Board (WSLCB):          November 12, 2013

Please accept the following as my contribution to public comments concerning the DRAFT recommendations to the legislature of the Medical Marijuana Working Group, constituted by representatives from the WSLCB, the Department of Revenue (DOR), and the Department of Health (DOH), and presented by the WSLCB on October 21, 2013.  Our Washington State nonprofit organization, the Center for the Study of Cannabis and Social Policy, is dedicated to the promotion of reality-based cannabis policies, significantly made possible by the legalization of cannabis under Initiative 502.  We are concerned that these draft recommendations are based more in the production of political theater than in the realities of currently existing patient access, on the one hand, and a lack of understanding about Washington State cannabis markets on the other.  We do, however, understand that the legislature is responding to an absence of regulatory frameworks around medical cannabis, and that there is a compelling need to do so.  We propose a simple, pragmatic two-step solution that would minimize cost to taxpayers and preserve patient access, while hardly affecting potential state revenues.  We propose that the legislature re-visit a bill they already approved, but was then substantively section-vetoed by the governor’s office in 2011.  And we propose that the state establish a scientific commission to study the realities of patient access to medical cannabis.

The perceived lack of medical cannabis regulation in Washington State is the direct result of former Governor Christine Gregoire’s 2011 section veto of key regulatory provisions in 69.51A.045.    This is illustrated by the following quote from a Seattle Times article dated April 29, 2011:

The governor took a combative posture in vetoing most of the bill, which would have licensed and regulated medical-marijuana dispensaries and grow operations, and given patients broader arrest protection … Recent letters from U.S. Attorneys around the country, including Washington’s two federal prosecutors, threatening more aggressive action against medical-marijuana programs and state workers enforcing them show a “changed landscape,” she said.

That logic, that explicit regulation might expose state employees to Federal sanction, was rendered irrelevant by U.S. Attorney General Cole’s Department of Justice memo dated August 29, 2013 (“Cole 2”).  As you well know, the Cole 2 memo explicitly states that as long as state regulatory frameworks meet eight conditions, the Federal government will allow state experiments with legalization.  There is nothing in the memo that bans state medical marijuana regulation, as long as those regulations are clear, substantive, and do not violate any of the eight conditions.  Washington State’s absence of clear regulatory frameworks for medical marijuana is clearly the result of Gregoire’s 2011 section vetoes.  If they had not happened, Washington State would be in Colorado’s position and there would be no need for your Working Group’s recommendations.

Therefore, the WSLCB should recommend a clear course of action to the legislature: establish a commission to study what was vetoed; modify to reflect the current landscape; and re-submit for executive signature, given the opening created by Cole 2.

I-502 said nothing about medical cannabis when the voters passed it, and it is a perversion of public initiative process for the state legislature, or any public stakeholder including the governor’s office and the Department of Revenue, to use it to dismantle the existing system of patient access.  The WSLCB was tasked with creating a workable legal system, not with destroying what is currently working for patient access.  Despite the Working Groups’ affirmation that patients now have a safe, legal alternative, the fact is that not one license has been given and the legal market will have a lot of kinks to work out.  No honest stakeholder disputes this.  It should be given space to work out these kinks without dragging patient access into the messiness.  Any recommendation that is based on asserting the viability of something that does not exist, has never been attempted, and/or is an optimistic projection, cannot be put forward to the legislature as a foundation for sound policy making.

As a result: each recommendation for which I-502 does not explicitly have a correlating mandate (designated “N/A” in the recommendations) should be withdrawn or amended to explicitly mandate credible, substantive studies of their potential effects on patients and patient access before being revisited at a later date.  That includes Section 2, establishing a mandatory patient registry; 3, regulations regarding health care professionals; and 4, eliminate collective gardens.  Sections 1, 5, and 6 are also problematic, but given the severity of our organization’s recommendation to completely eliminate sections 2, 3, and 4, our comments will focus on these.

We assert that the central problem with the Working Group’s competence and credibility is that it is comprised of state agencies with zero expertise in medical cannabis.  The secondary problems are corollaries: the DOR has no expertise in how licit cannabis markets are affected by quasi-licit medical markets and illicit markets that constitute the main competitors to legal cannabis markets; the DOH has no expertise in medical cannabis; and the LCB’s recently acquired field of knowledge is bounded by licit market regulation, not medical market regulation.  The problem is a profound lack of formal knowledge, in the absence of which politics rule the day over common sense.

The DOR bases its precise calculations on BOTEC’s work.  The acronym “BOTEC” stands for “back of the envelope calculations.”  Another acronym would have worked: SWAG, for scientific wild-ass guess.  The state’s contractor’s numbers are precise but accuracy is not the same as precision, and those numbers are suspect for a number of reasons but most of all, because BOTEC was mostly an outsider organization with no prior knowledge of Washington cannabis markets, much less knowledge about medical cannabis markets in the big picture, which includes a much more significant illicit cannabis markets.  BOTEC did come to the realization that medical markets are a tiny fraction of the overall cannabis markets in Washington State, relative to illicit markets.  This should mean, to you and to the legislature, that the State does not have a substantive economic interest in protecting licit state cannabis markets from quasi-licit medical cannabis markets, and that expensive and detailed regulation can only cost more than it would save.  It makes no economic sense, and the only way to explain this obsession is that it makes political capital for certain stakeholders.

This applies especially to the recommendation to ban “collective gardens,” which are quite different from commercial store fronts.  The true collective garden can be identified by its social relations of production: I recommend that the Working Group read a book titled “Dying to Get High, Dr. Wendy Chapkiss’ outstanding ethnography of the Wo/man’s Alliance for Medical Marijuana.  Patient participation in collective gardens can be important as cannabis consumption when it comes to palliative care.  Banning collective gardens hurts existing and potential patient access, and is therefore a human rights violation.  There is no reason, at all, to believe that collective gardens pose any sort of threat to the as-yet nonexistent legal cannabis market, because they are completely different from commercial relations of production.  If the recommendation to ban collective gardens comes from an urge to ban storefront dispensaries, an alternative might be to ban commercial storefronts.  But if these are illegal anyway, as US attorney Jenny Durkan has asserted, then the recommendation should be to enforce existing law.  There is no need to create additional regulatory work for which taxpayers would foot the bill without receiving any social benefits.  This can only be about political theater, and I urge you to refrain from participating.

The DOH, in these recommendations, would be tasked with overseeing doctor-patient relationships in a manner that deviates substantially from current regulations regarding the sanctity of the doctor-patient relationship.  We note that if the legislature is concerned about fraudulent authorizations, then that is an indication that the DOH is not doing its job or that what is being recommended is a system of physician oversight for which there is no licit precedent.  If the DOH is not currently applying the regulatory power it does have, how can it be expected to fulfill the oversight function for which it has been recommended?  Also of great concern is the absence of any expertise regarding medical cannabis in the DOH itself – how is a licit bureaucracy going to know more about a field of medicine that is only now opening up, where research is advancing at a rapid rate, and due to its illicit nature the people who know the most about cannabis as an herbal medicine are the patients themselves; and brave health care workers who have treated patients despite legal risks, because public health should not be sacrificed to political policy.

Finally, the LCB itself.  With the exception of the secrecy around this working group, the LCB has done a terrific job seeking and listening to public input.  You have learned much in the last 11 months or so, but your learning has been focused – rightly – on how to write rules for implementing a legal cannabis market.  This is what the voters asked you to do, and it is not your fault that the legislature made this extra request.  It seems to me that most of you in the LCB have wanted nothing to do with this, and this is reflected by the dominance of one stakeholder in these recommendations: the Department of Revenue.  But I ask you to take what you have learned in the last eleven months and tell the legislature the truth:  all recommendations that might impact a single patient’s access to cannabis as medicine have to be studied at length before being made, much less implemented.  The problematic assumption that many medical cannabis patients game the system has to be compared with the totally unproblematic assumption that many real patients exist and they should not be sacrificed on the twin altars of politics and revenue.  The WSLCB knows this because it has met those patients, heard from them, at public hearings across the state.  That is only half the picture, however: the WSLCB has not, to my knowledge, made a systematic effort to listen to clinical researchers, physicians, and naturopaths regarding the study of cannabis as medicine.  And why would you?  You were not tasked or funded to do so.

In sum, the Center for the Study of Cannabis and Social Policy asserts that Washington State public health policy would be adversely affected by the Working Group’s recommendations as they now stand.  Further, there is no social benefit that would be created that could offset the fact that these recommendations constitute bad public health policy.  Legal cannabis policy must be constructed to work with with other kinds of social policy, grounded in reality rather than fearful political maneuvering.  It should not create new problems that are totally unnecessary and counterproductive in the long term.  We are committed to making legal cannabis work, and convinced that Washington State has a historic opportunity to serve as a positive model for making things work instead of making a mess that other states and even nations would look at as a cautionary tale.

Thank you                                                                                                              Dr. Dominic Corva                                                                                          Executive Director                                                                                                Center for the Study of Cannabis and Social Policy

 

Partner Project Vashon Island/VIMEA

CASP is overjoyed to announce our first sustainable livelihood partner project, a collaboration with Shango Los’ nonprofit Vashon Island Marijuana Entrepreneurs Alliance!  While the Grange has yet to find a dedicated partner, VIMEA is a perfect example of our organization’s Action-Research mission to find, support and collaborate with people who are already organizing their communities to inform the public and assist with adjusting to the post-502 landscape.

The following press release describes well how VIMEA and CASP missions and activities will complement each other going forward.

#Press Release#
VIMEA and CASP form Partnership for implementation of legal marijuana in rural Washington State
October 18th, 2014
Vashon Island, WA

The Vashon Island Marijuana Entrepreneurs Alliance (VIMEA) announces their partnership with The Center for the Study of Cannabis and Social Policy (CASP).  Through this partnership, VIMEA will gain access to valuable research, marijuana industry contacts and increased funding opportunities.  The Center will gain first person reports, photos and legal marijuana implementation best practices from VIMEA.  Both groups see this partnership as an opportunity to widen the understanding of marijuana as business and medicine.

Director of VIMEA, Shango Los stated, “We are very pleased to to form this partnership with CASP.  Securing access to the center’s vast resources and marijuana policy experience will assist greatly to VIMEA’s success in rural Washington.  CASP Director Dominic Corva’s in-depth understanding of global approaches to marijuana production and policy supports our goal to implement I-502 in a way that sustains our local food security while also integrating legal marijuana farming in ways consistent with our local community standards.”
CASP Director, Dominic Corva stated, “VIMEA is providing the local community organizing necessary to implement legal marijuana in a way that respects the Vashon Island community.  We are grateful to secure first hand accounts to inform our policy research.  We look forward to studying the VIMEA approach and help disseminate their best practices throughout the country.”

The Vashon Island Marijuana Entrepreneurs Alliance is an advocacy and trade organization for legal marijuana produced on Vashon Island in Washington State.  VIMEA’s goals are to create an environment welcoming to local marijuana farmers, assist marijuana entrepreneurs in setting up their businesses, re-establish the Vashon Island marijuana brand and encourage successful farmers to reinvest a portion of their profits into the community.  VIMEA is based on Vashon Island, WA.www.vimea.org and www.Facebook.com/vimea
The Center for the Study of Cannabis and Social Policy (CASP) produces, reviews, and disseminates objective research and opinions about the relationship between Cannabis Policy and other forms of Social Policy including but not limited to environmental policy, agricultural policy, public health policy, policing, foreign policy, and economic policy.  CASP is based in Seattle, WA.www.cannabisandsocialpolicy.org
For more information, contact Shango Los at 206-595-9006 or Shango@vimea.org

 

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Shango Los
Vashon Island Marijuana Entrepreneurs Alliance
www.vimea.org coming soon
PO Box 2327
Vashon Island, WA 98070

 

 

Whither medical cannabis in Washington state?

As the Liquor Control Board works to finalize its rules for implementing Initiative 502, it turns to a key piece of unfinished business: making recommendations to the state legislature regarding the much less regulated medical cannabis industry.  To do this, they have enlisted the help of the Departments of Health and Revenue, forming a joint committee that has been meeting since July.

From the WSLCB listser announcement:”Section 141 of the state operating budget directs the Liquor Control Board to work with the departments of Revenue and Health to develop recommendations to the Legislature regarding the interaction of medical marijuana and the emerging recreational marijuana system. The workgroup, which includes senior staff from each agency, has been meeting since July.”

The timetable:

October 21
Provide draft recommendations to stakeholders for comment
November 8
Deadline for written comments
November 21-22
Present draft recommendations to appropriate House and Senate committees at Legislative Assembly Days
January 1, 2014
Deadline for delivering final recommendations to the Legislature

Note that the process is a speeded-up version of what they did for 502 draft rulemaking; and that while the Department of Health makes sense, the Department of Revenue is trickier business and undoubtedly related to the differential taxation structure from 502, which adds an excise tax of 25% at each stage of the process: producer to processor, processor to retailer, and retailer to consumer.

The announcement of this process and its timeline has caught many of us by surprise — it arrived to my inbox while I was at a group meeting to hammer out a legislative proposal for regulating medical cannabis producers, processors, and retailers after 502 kicks in, presumably in January.

It should be interesting to see what the joint committee comes up with.  I can’t report on what our grassroots committee is deliberating, but I would like to offer my thoughts on what can work, politically and economically.

First, it’s my understanding that the joint committee will settle on a timeline for phasing out the medical cannabis supply chain as it exists.  I’ve been quoted anywhere from 6 months to 2 years, during which medical producers, processors, and distributors may continue to operate under existing medical cannabis (largely self-) regulation.  Now, whether such operators will be subject to US Attorney prosecution is another question: I suggest that at the very least some low-hanging fruit will be plucked, but most likely it will be gray market participants that shade towards black.  In any case, the legal field will get very messy, but remember that a messy legal field favors defendants.

Second, it is very hard for me to imagine that new medical cannabis frameworks will include producers and processors.  Simply put: 502 licenses for producers and processors will be much more easily obtained than retail licenses, and their product(s) are exactly the same as medical products — in fact much more regulated.  I don’t see any scenario in which the legislature carves out exceptions to 502 producing and processing rules.

The extent to which the legislature may be amenable to continue medical cannabis in some form hinges on the question of patient access, which is an end-use question rather than a producing and processing question.  This is more complicated than it seems, since retail stores (a) won’t be very convenient to access for most and (b) aren’t allowed to have any mention of “medical” use associated with packaging and labeling, per I-502 language.

That leaves the possibility that the state may carve out a retail exception to 502, with a much more tightly regulated system for authorizing and patient database registration — probably a different list of conditions, as well, on which I presume the Department of Health will be weighing in.  One exception that will have to be made is the age-limit for purchasing medical cannabis.  Post-Sanjay Gupta, I can’t imagine that medical cannabis for children won’t be permitted.

To be clear, this is my analysis of what will be possible to secure for medical cannabis patients and industry in the coming year.  A broader range of existing allowances, in my opinion, should be allowed but are unlikely to attract political support in the legislature (whose primary interest is producing revenue, not protecting patients).  These include: collective gardens, home grow provisions, and more than an ounce to purchase at a time.

I’ll update you on the progress of this process, but leave you with this thought:  every state that already has medical cannabis regulations is going to have to go through this process after passing legalization initiatives or legislation.  It’s a very messy process — states are already divergent with respect to qualifiying conditions and authorizers.  It’s also another reminder that legalization is only the beginning of a process, and that continuous organizing must happen to shape outcomes.  Beyond that, though, is the question of moving beyond highly regulated legalization to total Federal de-scheduling.  I believe that the current steps that are being taken are familiarizing the rest of the US with cannabis and to their surprise, cannabis is not the bogeyman they’ve been led to believe.  There is absolutely no non-political need, in my opinion, for cannabis regulation to be as strict as it is.

 

 

 

A Tale of Two Zoning Maps

 

by Dominic Corva, Executive Director

NOTE: Zoning maps are estimates and not final, at this point — except the second map, which was viable about a week.

Estimated Area for I502 Licensed MAP Marijuana under City and State Restrictions

Estimated Area for I502 Licensed MAP Marijuana under City and State Restrictionscommonpatch

Map of Common Path of Travel Analysis

Last week, the Washington State Liquor Control Board (LCB) had to take back a proposed zoning language revision for the 1000-foot rule.  This revision would have defined 1000 feet from “as the crow flies” to “common path of travel,” a change that gave the second map of possible cannabis industrial location above some breathing room compared with the first map.  Take a look.

The re-revision gives us some idea of just how restrictive the zoning regulations will be for Washington’s most cannabis-friendly polity.  This regulatory “barrier to entry” will drive differential land prices in the City, raising alarm bells for the Port of Seattle whose summer efforts to exclude cannabis-related businesses from industrial Port spaces has culminated, for now, in a compromise whereby IG1 (the part closest to downtown, including much of SoDo) is scheduled to zone 10,000 square feet instead of 50,000 originally planned.  IG2 is also revised down to 20,000 square feet.

Under the current rules, the rest of the state may permit up to 30,000 square feet.  Whether they do so or not, increasing urban land prices and restricted producer space (processor space is not necessarily a problem) make it more cost-effective, once political zoning regs are relaxed in the rest of the state, to locate in rural areas.  The future of cannabis agriculture, in terms of production cost, is rural hybrid greenhouses that use supplemental lighting.  That model, in Israel, is currently producing 4-5 cycles per year at 50 cents a gram.

Currently, however, uncertainty about local municipal authority politics limiting 502 production outside of Seattle/King County will drive a real estate bubble centered in the most contiguous yellow space shown in the first map, south of downtown.  This uncertainty, in my opinion, is easily managed by access to policymaker education and interest in getting a piece of the cannabusiness pie.

If you are a rural farmer/grower, right now is a good time to get ahead of the curve.  Your land costs are way cheaper and your cost of production, with the right guidance, are way lower.  The first thing to do, however, is to reach out to local authorities — policymakers and police — to discuss their attitudes towards 502.  Get to know your neighbors, be a good citizen, do everything by the books, give back to your communities, and you’ll find that this is the best no-cost way to mitigate risk.

 

How is Cannabis Traditional Medicine?

by Dr. Michelle Sexton                       IMG_2380

Traditional medicine (TM) is the generational and societal healing wisdom that has developed sequentially by cultures, prior to the genesis of modern medicine.  The World Health Organization defines TM as “the health practices, approaches, knowledge and beliefs incorporating plant, animal and mineral-based medicines, spiritual therapies, manual techniques and exercises, applied singularly or in combination to treat, diagnose and prevent illnesses or maintain well-being.”

The contemporary exploitation of plant compounds, via the chemical revolution and the genesis of synthetic compounds, has culminated in modern chemically-based medicine that is unsustainable, and in many cases with questionable risk:benefit ratios. The United States is in a minority compared to 80% of countries that still primarily use traditional medicine to treat the whole person.   Some examples of these ancient approaches include Ayurveda, Siddha medicine, Unani, ancient Iranian medicine, Islamic medicine, traditional Vietnamese medicine, traditional Chinese medicine, traditional Korean medicine, and traditional African medicine systems such as Multi and Ifá.

The earliest written records of plant-based medicine or herbal/botanical medicine (sometimes known as “herbals”) from Egyptian, Chinese, Indian and Arabic texts all included Cannabis in their repertory. An Egyptian manuscript known as “Fayyum Medical Book” compiled knowledge dating from 6 BCE and discussed using topical application of an herbal mixture that included Cannabis (sometimes heated) for “curing” of tumors. It appears that Cannabis was often used topically also as  “a treatment for the eyes” (Papyrus Ramesseum III, A 26, ca. 1700 BCE.). There are records indicating that it taken internally to treat diarrhea, urinary problems, pain, spasticity, as a vermicide, as a love potion, for impotence, pulmonary congestion, anxiety, as an anti-inflammatory, and possibly to “cure anger and sorrow” (C. H. Oldfather, Diodorus Siculus, Harvard University Press, Cambridge, MA, 1933, p. 470).  The ancient Greek physician, pharmacologist and botanist Pedanius Dioscordes referenced hemp in his medical/botanical book “De Materia Medica” (50-70 CE) which is the primary source of historical information on Greek, Roman and other medicines of antiquity. Of hemp, he wrote:  “being juiced when it is green is good for the pains of the ears”. Pliny the Elder, who was a Roman naturalist, included hemp in a volume he wrote, Naturalis Historia, (77 CE). Skipping ahead to more modern times, the French writer M. Marcandier reported in 1778 that hemp was reported to be useful in thetreatment of “tumors”.  The term “tumor” may have been used to describe any kind of “abscess, sores, ulcers or swelling” but it is unclear if these tumors included what we consider today to be cancerous tumors.  Based on these documentations, Cannabis has clearly been an element of TM from the earliest recorded history to more contemporary times.

Dr. William Brooke O’Shaughnessy introduced Cannabis to contemporary western or “modern” medicine, around 1839 when he described successfully treated cases of rheumatism, hydrophobia, cholera, tetanus, and epilepsy he observed at the Medical College of Calcutta. Upon his return to England in 1843, he introduced “Indian Hemp” as “an anti-convulsive remedy of the greatest value.”  Western medicine reacted promptly as a wave of cholera was in motion and in France, Dr. Louis Aubert-Roche, successfully used it in treating “the plague”. Hemp had also found its way into Hahnemann’s  and otherhomoepathic “material medica” from 1811, where it remains today.

The American Eclectic physicians, an early branch of American medicine that peaked around 1890, relied heavily on botanical use that they drew from the Native Americans. The Eclectics included Cannabis in their materia medicas (the contemporary “herbal” texts) at the turn of the 20th century.  The American Materia Medica (1919) by Finley Ellingwood (a major Eclectic practitioner) classified Cannabis as a narcotic. Roberts Bartholow was a more “conventional” American doctor at this time who did the first experiments with electrical stimulation of the brain. He dared to investigate the Eclectic’s claims and  classed Cannabis as a “cerebral excitant” (From the Eclectic Medical Gleamer, March 1912 vol.8,2). These opposite effects of being sedative and excitant may demonstrate what modern science would consider biphasic actions of cannabinoids at their receptors. Ellingwood’s text continues: “its mode of

Indian Cannabisaction is sedative, narcotic, anodyne and anti-spasmodic.  It acts upon disturbed function of the nervous system”.  The monograph goes on to describe therapy for “pain, insomnia, melancholia, hypochondria of the menopause, epilepsy, heart disturbance, functional disorder of the stomach, neuralgic dysmenorrhea, menorrhagia and metorrhagia, gonorrhea, arresting priapism, for genito-urinary infection and impotence, coughs, and laryngeal spasm”.  These are some of the documentations of the traditional use of Cannabis as a therapeutic agent.                                                                                                                   This brief, and in no way comprehensive, historical background is intended to demonstrate the documented ancient history of Cannabis as a TM. These documentations illustrate the efficacy and relative safety of this plant medicine and serve as the historical analog to western medicine’s drug approval process.  It is improvident to assign plants to reductionistic scrutiny that single-agent synthetic drugs should be subjected to, as the historical records speak for themselves. Also, the complex and synergistic way that herbs or herbal formulas work alongside other natural and traditional approaches to restore health, are too elaborate to reduce to the current gold standard of randomized controlled trials (RCTs), the defining feature of

Cannatolechemically-based medicine.  However, cannabis in inhaled and oral forms has been subjected to rigorous large RCTs for specific indications such as pain and spasm and has prevailed. There are adequate records to show that humans have known which plants are toxic and deadly, and which are helpful and healing by trial and error over centuries. Plants and human beings are biologically too intertwined for solely viewing their relationship through the impoverished current models that were designed for single agents and a more reductionistic approach to medical treatment and healing.

The trial-and-error method, or what might be viewed as “uncontrolled” clinical trials, continue today with a host of plant medicines, while increasingly “We the People” are turning to them for their greater safety profile and history of efficacy. Combine this movement with a return to nurturing our bodies, relationships, communities, societies, cultures and our planet, and there is room for hope of a healthy future. Indeed, there are lessons to be learned from the current phenomenon of cultivating and using Cannabis as a botanical medicine, such as how organic gardens, growing our own medicine, locally, cooperatively, and responsibly is a means to sustainable health.  According to the UN Universal Declaration of Human Rights (1948)  “Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family including, food, clothing, housing and medical care . . .” (Art. 25 Sec.1).  May our right to pursue traditional medicine and natural health not be overcome by municipalities, higher governments, capital gain, healthcare plans or other forces that have high social costs and mitigate our larger freedoms to pursue the time-honored means of healing ourselves with plants.

DSCN4040

The current awakening to herbs, and specifically Cannabis, for medicine is a portal “back to the garden” of botanical and sustainable medicine that is misconstrued as “alternative” when it is in fact universal and time-honored. Animals and plants are made for each other.  We have co-existed from the beginning of time, with plants the servants that provide us food, shelter, clothing and medicine, thus sustaining our survival.  Cannabis: the gateway herb.  DSCN4038

 

Needless Suffering of Medical Marijuana Patient Embodies Federal-State Conflict: A Prison Extraction

Sunil Kumar Aggarwal at Huffington Post – Associate Member of the New York Academy of Medicine, Senior Resident Physician at Large Academic Medical Center in New York City

When I was in the graduate school portion of the Medical Scientist Training Program at the University of Washington in the Department of Geography, I had an opportunity to work with an intrepid defense attorney by the name of Douglas Hiatt, who brought me face-to-face with major health and human rights cases of persecuted, ill and disabled patients who were caught up in the federal-state conflict on medical marijuana. While the story I share below is from 2005, and was covered by the AP wire, it seems it is only in this age of majority support for ending the federal war on marijuana, when there is still doubt being expressed about the severity of marijuana prohibition enforcement, that people may be able to read and appreciate the full medical details of the following case. I did try to submit the write-up below to medical journals several years ago, but it seems like they were not yet willing to listen. Please lend me your ears and consider the consequences of a federal health policy built on denial of scientific fact of the medical utility of herbal cannabis.

Read the story here

Cannabis and the Medical Community

by Will Duffield

The past few weeks I have been attending classes at my local ambulance station, working toward getting my EMT certification. I think it is important to look at how new EMTs are taught to deal with cannabis, as protocols surrounding the substance are often influenced more by dogmatic  legal speculation than science, even within the medical field.

Our textbook contains a brief paragraph about cannabis in the toxicology section, terming it marijuana. According to the book, smoking marijuana produces “euphoria, relaxation, and drowsiness”, and also impairs “short term memory and the capacity to complex thinking and work”. While the validity of some of these observations can be questioned, the data available to those researching behavioral trends among cannabis users has been limited. Government prohibition of cannabis use, as well as social discrimination, leads many users to lie about their use. The textbook goes on to estimate that 20 million americans smoke cannabis every day. Most cannabis related emergency calls come not from the desired effects of cannabis, but from unwanted “anxiety and panic” that sometimes occurs.

I would have liked to see a discussion of the THC to CBD ratios present in most smoked cannabis, and how they might affect the user’s experience, particularly with regard to the possibility for anxiety and panic. The textbook notes that “A person who has been using marijuana rarely needs transport to the hospital”. When a marijuana user is in such distress that they wish to go to the hospital (EMTs cannot refuse to transport a patient) the textbook advises the EMT to “reassure the patient and transport the patient with a minimum amount of excitement”. In essence, we understand that you’re freaking out, man, and we will try to keep you calm and comfortable in our alien vehicle. This is a remarkably progressive approach, particularly when juxtaposed with police procedures which treat cannabis users as potential threats. In fact, the book draws strong connections between alcohol and murder, traffic injuries, and suicide, while making no mention of a similar connection between cannabis and mayhem. It does warn that marijuana may be laced with other drugs, and a call for marijuana intoxication may turn out to be something far more dangerous. This is a symptom of the current black market and its lack of nonviolent methods of contract enforcement.

It is important to understand how various segments of the medical community currently view cannabis, and why these views are held. To the extent that they are shaped by legal prohibition, they may change as cannabis is legalized, however, the “how” of legalization may influence, and be influenced by, the medical community.

The advent of legal cannabis in Colorado has lead to an increase in the number of THC infused edible products available to consumers. While adults will rarely mistake commercially sold  marijuana edibles for normal baked goods, young children cannot often distinguish between the products, as both often have brightly colored, easily opened packaging. Michael Kosnett, a toxicologist and associate clinical professor at the University of Colorado School of Medicine has recommended that THC infused products be sold in childproof containers, as many modern medicines are. The problem could also be solved by more responsible parenting, and perhaps more respectful treatment of what is undoubtedly a mind altering substance.

While it is politically simple to treat cannabis like alcohol, in reality, the substances are incredibly different, both in effect and in how they are consumed. Children do not enjoy drinking vodka, and people do not die from smoking large amounts of cannabis. The medical community has accepted this to a far greater degree than our legislators and law enforcement officers, and has been quicker to address the unique specifics of cannabis.

*Textbook citation – Gulli, B., Ciatolla, J. A., Barnes, L., & American Academy of Orthopaedic Surgeons. (2011). Emergency Care and Transportation of the Sick and Injured. Sudbury, Mass.: Jones and Bartlett.

Operation Medical Access Transition

by Dominic Corva, Executive Director

The passage of I-502 meant that its Legal Landscape would operate in conjunction with current Washington State Medical Marijuana legislation, until or unless the legislature acted to clarify the situation.  This is quite significant, since current Medical Marijuana statutes are much more liberal than I-502, despite offering less formal protection as affirmative defense.  Many current Medical Marijuana patients are justifiably concerned that if the Medical regime is subsumed under the Legal, more restrictive regulations regarding production, distribution, and retail will translate into lack of access to the medical care.  For instance, under I-502 no home grows will be legally permitted and consumers may only buy one ounce at a time at retail stores, if they can get to retail locations given restrictive zoning rules.

No matter what one thinks about the broad set of conditions for which one may become a medical marijuana patient in Washington State, a significant percentage of these are seriously ill and debilitated patients — patients that no reasonable person could accuse of “hiding” behind medical to get high.  Further, these patients often get free cannabis from their access points or from their caretakers, in the existing black- and grey-market industry.  For them, I-502 may take away their de facto (socially conferred) and de jure (legally conferred) right to affordable and accessible medicine.

This Project asks how Initiative 502’s relationship with current Medical Marijuana Policy in Washington State affects catastrophic patient access to medicine.  We will partner with existing medical dispensaries to select and track a sample population over time.

 

Cannabis is a particularly diverse economy

by Dominic Corva

Briceland, Sohum, Casa de Jakubal

I had the pleasure of visiting Kevin Jodrey at his propagation business, Garberville Grass, which is technically in Redway.  Propagation means breeding and cloning strains that are sold to 215-carded growers in Southern Humboldt, so all the plants there were strictly in vegetative state, from tiny clones barely removed from clipping to worn-out mothers brought into the sun as sort of botanical hospice care.

Kevin’s business is the only approved one of its kind in Sohum, a condition for which his regional credibility with municipal authorities and grower customer base played some part.  It was fascinating to learn about various ways in which Garberville Grass produces a social surplus above and beyond economic surplus — profits, and distributes that surplus among the population.  For instance, he recently learned how to produce organic inoculant tea (see photo), which multiplies like yeast from some samples.  These are given away from house barrels to customers that bring containers.  He also explains how to use it — something to do with local bamboo material and rice, apologies for the imperfect recollection.

How does this relate to our title’s “diverse economy”?  A diverse economy is characterized by lots of different capitalist and non-capitalist relations of production (think formal and informal markets, and hence black, gray and white markets for the purpose of our consideration).  It produces community resilience because lots of different values flow in lots of different ways, so a crisis in one kind of exchange can be absorbed by the heterogeneity of social resources.  It’s an ecological conceptualization of socioeconomic value, so if you understand the argument for genetic diversity, you understand the argument for economic diversity.  Diverse economies can flourish when they are not totally dependent on larger-scale mono-economic forces (think Finance, for example).  Diverse economies are therefore democratic economies, which means we aren’t just talking about distributing inoculant tea.  We are also talking about decentralized informal economies that play a part in cushioning forces of creative destruction unleashed by mono-economic forces.  How many distressed mortgages were saved by turning a McMansion into a grow-op?  How many parents in the recent financial crash paid their bills by growing or distributing Cannabis?  Is that number significant?  We know it could be because we remember the role the Bolivian coca economy played in absorbing surplus labor and generating foreign exchange in the 1980s.

Ray Raphael, a lifelong scholar and teacher of U.S.-American history, noted in his 1985 book Cash Crop that eradication efforts like CAMP made Jeffersonian small-scale rural agriculture possible by preventing the consolidation of the cannabis industry.  His argument about cannabis agriculture as a cash crop in a decentralized, democratic economy also holds for non-rural contexts. Domestic cannabis is produced by small-scale growers everywhere, and there are more of these than ever before all throughout the U.S, even as larger-scale cannabis agriculture also proliferates.  This is a situation shaped in no small part by policies of prohibition and practices of policing, and as these weaken against waves of state-level medical and legal Cannabis initiatives the obverse can be expected.  Right now, the consolidation of the cannabis industry into the hands of the Few, the Corporate, the Financed is far from fait accompli, but the un-diversification of diverse economies in which the Cannabis economy plays a part is a distinct possibility.

This is one of the lessons that will be learned from Washington and Colorado, though undoubtedly it will play out differently in both states.  Will the cannabis industry centralize?  If so, what are the effects of that?  Unemployment?  Decreased economic opportunity?  Will it affect women or ethnic communities?

There is some reason to be optimistic about what will be learned from Washington.  For totally different reasons, policymakers and consultants have consistently expressed an interest in preventing such consolidation.  One common reason given is so that industry profits won’t eventually soften attitudes towards allowing marketing, especially to children.  Corporate greed will work against the interests of public health — the risk of addiction — and the safety of children.  I share their latter concern, and note ironically that such a stance implicitly critiques the existing power of unregulated Capitalism and finds it wanting.  On the other hand, I think it’s possible that the more the population consumes cannabis, the less addiction problems it will have, especially to prescription drugs.

So the question may be, what kind of economy do we have? but the answer is, especially for newly Legal Cannabis, what kind of economy do we want?  Both of these are excellent research questions.