“Everything is being re-imagined. We are shaking the world with a new dream.” _Grace Lee Boggs : Medical Cannabis and pediatric patients.

The title quote from Grace Lee Boggs, a 98-year old philosopher, feminist and political activist who has been labeled “An American Revolutionary”, is passed on from the mother of a child who suffers from seizure and other diagnoses.  What, might you wonder is the cause of her pronoia? (defined as the opposite state of mind as paranoia)  Because of access to medical Cannabis in Washington State, she has some hope for her child.   She has begun to administer a non-psychoactive Cannabis extract to her daughter under an act passed by voter initiative in 1998. Her attitude, like that of many other families in this same circumstance, is one of expectation that there may be the chance to have improved in the quality of life for her family.

In a contemporary manifestation of the Underground Railroad, parents are turning out to be the heroes/heroines in a struggle against the abolitionist policy regarding Cannabis as medicine. Their children, who suffer from debilitating disorders, are the figurative fugitives in this story, and the parents are accessing local “safe houses” that provide the relief from Cannabis that they have sought for years from pharmaceutical drugs.

Current Washington State law states: “Humanitarian compassion necessitates that the decision to use cannabis by patients with terminal or debilitating medical conditions is a personal, individual decision, based upon their health care professional’s professional medical judgment and discretion”.

With the support of a compassionate doctor in Washington State, this mother is able to access Cannabis for her child under the voter initiative, and has now become an expert in many aspects of Cannabis as medicine.  She has learned how to dilute a cannabidiol-rich (CBD) concentrate so she can give a precise milligram dose of CBD, she is aware of potential drug interactions, how to monitor the weaning from the harmful anti-epileptic drugs her daughter has been on, and what to monitor her daughter for regarding any potential side-effects.  So far, the side effects have been mostly beneficial, such as improved sleep and improved behavior. The seizure reduction will likely follow as she slowly titrates the dose upward, as many other families like hers are teaching her to do.  She is learning that whole plant medicine works where single-agent compounds have largely failed her child.

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This is Samuel, age 9. He has a diagnoses of Mowat-Wilson syndrome and Lennox-Gastaut syndrome and is a medical Cannabis patient in Washington

For now this mother has a level of legal protection under the Washington State law: “Persons who act as designated providers to such patients shall also not be arrested, prosecuted, or subject to other criminal sanctions or civil consequences under state law, notwithstanding any other provision of law, based solely on their assisting with the medical use of cannabis”. Like the original Underground Railroad, these families don’t know what their next move will be, or whether it might be to another State where they can continue to provide medicine for their children, to either grow themselves, or access from a qualified facility.  Not unlike the original cargo, their journey has been fraught with confusion, a perceived danger of reprisal from their doctors, child protective services or family members, as they have “come out” on this new “Upperground Railroad” as Frederick Douglass coined a term.  Now not even Canada is  a safe haven, as it was for slaves, for parents such as these who might want to grow their own medicine. (Patients can no longer grow Cannabis in Canada)

However, as in the gospel lore “the wheels keep on turning”, and this gospel train of liberation from human suffering keeps chugging along, parent-to-parent, family-to-family!   How long will it take before Federal Governments won’t be the only legitimate drug dealers for several plants that have the capacity to alleviate human suffering?  How much longer until this plant and others are set free to interact with the human biome as they were likely designed to do, and not be captured and altered by pharmaceutics?

Until that time, it is likely that these parents, empowered by taking healthcare into their own hands with botanical medicine, will continue to “Follow the Drinking Gourd” to their own true north:  the healing of their children, their families and the trickle-down effects to their communities and the planet at large!

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This is two-year-old Jackson, who suffers from intractable epilepsy with multiple seizure types as well as infantile spasms second to an undiagnosed yet suspected complex 1 mitochondrial disease. He is a medical Cannabis patient

Here is a quote from another of these brave parents: “Parents have the right to save their children’s lives when conventional medicine isn’t effective and causing more harm than good.   With an open mind, researchers and doctors can discover what is true about this medicine that has been used for hundreds of years.  Anecdotal evidence is everywhere!”

AHP Monograph set for publication!

The American Herbal Pharmacopoeia has finalized the first installment of a Cannabis monograph.  Dr. Michelle Sexton has been an editor and technical advisor on this project.  Pre-order yours now for Christmas!

monograph

An herbal monograph is a document produced on the topic of a single plant that describes nomenclature, parts used, constituents, range of application, contraindications, side effects, incompatibilities with other medications, dosage, use, and action of the herb.  The first installment of the monograph, set to go to press this week, is “Standards of Identity, Analysis and Quality Control”.  This document has been adopted by rule to guide, specifically, the quality assurance testing of Cannabis and related products under I502.  The second installment will focus on therapeutic applications and is expected sometime next spring.  This monograph represents the most up-to-date review of topics from nomenclature, Identification, Constituents, Analytical Standards and International Status.  AHP monographs fill the mission to  “promote the responsible use of herbal medicines and ensure they are used with the highest possible degree of efficacy and safety. Our primary way to accomplish this is through the development of standards of identity, purity, and analysis for botanicals, as well as to critically review traditional and scientific data regarding their efficacy and safety”.

ASA_Patients_Focused

This publication is significant because for the first time since Cannabis was removed from the Us pharmacopoeia in 1942, this “red-headed step child” of a plant now has a home!  Additionally, the American Herbal Products Association  has developed documents to guide regulators and the industry in providing quality assurance and quality control.   Together, the monograph and AHPA standards have guided Americans for Safe Access in development of a Patients First Certification Program.   Despite the fact that I502 regulations will not at this time require medical Cannabis to have the same level of quality control as that marketed in retail stores for adult use, it is hoped that in time the quality of medical products will exceed that of adult use products.

Good Agricultural Practices are addressed in both AHP and AHPA documents and cultivation and processing guidelines are included.  If you want more information about either of these organizations, contact them and we encourage you to join the AHPA if you are involved in any area of production or distribution of Cannabis and related products.  The Chair of the Cannabis Committee at AHPA is Tim Smale.

Gardening, An Inalienable Human Right!

Greens

By Michelle Sexton ND

Recently I had the serendipitous occasion to have a long conversation with Dr. Jonathon Page, who published “The Draft Genome and Transcriptome of Cannabis sativa”.  We were on a bus traveling to the Bedrocan growing facility in The Netherlands.  (Bedrocan is the only licensed company by the Ministry of Health to grow medical grade Cannabis).  It turns out that plants have amazing “genomic resources” (not unlike humans) and Jonathan’s way of summing this up was in the statement “It’s ggod to be weedy, if your’re a crop!”  (Dr. Page published the discovery of olivetolic acid synthase (OAS), an major enzyme in the metabolic pathway of cannabinoids). 

In essence, what this means is that adaptability is important for change.  Plants must be able to survive year after year, in quite variable growing extremes (drought vs. flood; heat vs. freeze etc. . . )  I guess this could be likened somewhat to individuality in humans.  Individuality is an important factor in adapting, especially as we age or deal with disease, for refining our values and “wants”.   When faced with chronic pain or a debilitating disease, simple things may become more valued, just as in times of drought a plant will selectively conserve resources, and only produce the metabolites that are necessary for staying alive.

One factor important for humans’ quality of life, especially during illness is having a source of joy.  It turns out that such a common source reported by those who are ill is nature, specifically, gardening.  Avoidance of a sedentary lifestyle, even if this is by engaging in leisure activity has the potential to increase lifespan.  This has been termed “biopsychosocial benefits, meaning there are benefits to several aspects of well-being.  A reduction in mortality by all causes, enhancement of pain management in nursing home residents, improved happiness, less loneliness, greater life satisfaction, and enhanced psychologic well-being has been reported.  Gardening experiences by women in a homeless shelter, “interupted negative ruminations” and provided stress relief.  This type of “spiritual care” seems to be discounted and often entirely ignored in the current healthcare debate at large.  Healing gardens are used in France to enhance quality of life in Alzheimer patients.  

Obviously, the interactions between humans and the natural environment are complex and always one affects the other.  Tending our environment is a form of therapy, both for ourselves and plants!   The point of writing all of this is to address the recent Draft Recommendations of the Medical Marijuana Work Group from the Washington State Liquor Control Board.  From a perspective of a gardener (with a formal horticulture degree), herbalist and doctor, it is alarming me that the right to grow a medicinal plant may be forbidden.

At the recent International Association of Cannabinoid Medicines meeting in Cologne, Germany, growing one’s own Cannabis was a common theme,  was summed up by Raphael Mechoulam who stated something to the effect of “people smoking Cannabis that we don’t know what is in it, is not medicine”.  It is this sort of thinking that has long frustrated me, since I first became interested in natural medicine at the age of 17.  It has always made sense to me to “live naturally”, peacefully co-existing with the environment,  growing my own food, leaving no trace, etc. . . Our environment has undergone massive change, and we as humans have had to adapt, as has the environment.  

tinctureThe political environment surrounding Cannabis is now changing, and those of us intertwined with the plant must change, just as we have changed this plant.  It’s time for us “weedy” individuals to become more “weedy”!  This may be a time for opportunistic expansion and the development “refined niches” for the cultivation of medical Cannabis plant material.   It will take the collective creativity of us all to not follow a narrow path such as the one in The Netherlands (single-grower system) nor to merge paths with the “adult use” system (I502).  I see the patients who grow and use their own medicine as empowered individuals, and there is no simple scale by which to measure the benefits of empowerment on quality and quantity of life.  We simply can’t let the current climate  lead to the extinction of such a basic human right as the right to garden.


 

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

 

—-
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.

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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