Medical marijuana from a dispensary in California. Credit: David Trawin/cc by 2.0

By Roger Hamilton-Martin
NEW YORK, Feb 4 2015 (IPS)

A bill which will bring medical marijuana to New York State in 2016 will leave the treatment inaccessible to low-income patients, community groups warn.

New Yorkers spoke out about limitations to the draft regulations of the Compassionate Care Act, which should introduce medical marijuana to the state early next year.“I have stage four prostate cancer, so I have access, but I’m trying to broaden this for those who aren’t included. I’m concerned about veterans with post traumatic stress, victims of agent orange, traumatic brain injury from IEDs, and the effects of depleted uranium poisoning." -- Bill Gilson

At a public forum held Tuesday in the Bronx, concerns were raised about the proposed regulations, including access for low income patients, and the small number of illnesses which qualify for the treatment.

“The Department of Health can create incentives for industry,” said Julie Netherland of the Drug Policy Alliance, a drug-reform advocacy organisation that worked with legislators during negotiations.

“One of the things they could weigh as criteria for selecting companies who will produce the strains would be their plan to support low-income patients,” said Netherland.

The bill was signed into law last July, but the programme will likely be implemented in New York State in January 2016. This will be nearly two decades after medical marijuana was first introduced to the United States, with an initiative in California to allow medical cannabis in 1996.

Some 23 U.S. states and the District of Columbia have legalised cannabis for medical use, and four allow its recreational use.

In their current form, the regulations allow treatment for only 10 illnesses: cancer, HIV/AIDS, amyotrophic lateral sclerosis (ALS), Parkinson’s disease, multiple sclerosis, spinal cord injury with spasticity, epilepsy, inflammatory bowel disease, neuropathy, and Huntington’s disease.

The commissioner of health for New York State, Howard Zucker, has the power to include any number of conditions as he sees fit.

To pass the bill, legislators were forced to drastically narrow the eligibility criteria, according to the Alliance.

In the bill’s original form, marijuana was to be prescribed at a physician’s discretion. Partway through negotiations, it was reduced to 25 conditions, then in the final days before being passed, it was cut to just 10.

Those with anxiety, post-traumatic stress disorder and rheumatoid arthritis would be ineligible for the treatment.

Bill Gilson, president of the New York City chapter of Veterans for Peace, told IPS, “I have stage four prostate cancer, so I have access, but I’m trying to broaden this for those who aren’t included. I’m concerned about veterans with post-traumatic stress, victims of Agent Orange, traumatic brain injury from IEDs (improvised explosive devices), and the effects of depleted uranium poisoning.

“The Department of Health has to broaden the eligibility conditions,” he said.

There is no requirement that insurance cover medical marijuana, raising concerns that the treatment will be inaccessible to low-income groups.

Also under the regulations, as patients are not allowed to smoke the drug, they will be using vaporisers, which range in cost, and a registration fee is needed in order to receive a patient identification card.

The Drug Policy Alliance is calling on the department of health to make companies who want to produce the marijuana come up with a plan to support those with lower incomes who need the treatment.

Another option could be for the state government to divert some of the significant tax money to support those in need. Medicaid will not provide for the treatment.

The small scale of the proposed programme was also criticised. There will be only five producers of the drug and 20 dispensaries across the whole state.

Netherland from the Alliance told IPS, “It’s insufficient to meet patient demand. Also geographically, having just 20 dispensaries across a state 54,000 square miles large isn’t enough.”

Many see the regulations as a step toward full legalisation of marijuana in the state, including New York City Council member Mark Levine, who told IPS, “I’m really excited, but there are many limitations we need to address. I see this legislation as a step towards taxation and regulation.”

Limitations have also been placed on the delivery method the treatment will take – only oils and extracts are allowed, no smoking.

As the 45-day public comment period comes to a close on February 13th, those with concerns are encouraged to submit testimony on the New York State Department of Health website.

Marijuana is still illegal under federal law, although four states have now legalised it for recreational use, and 23 states and the District of Columbia have enacted medical marijuana laws.

Helen Redmond, a clinical social worker for the NGO Community Access, told IPS, “The exciting thing is, for the people who I work with, medical marijuana will help. Some people with mental illness have symptoms that are very distressing, for example, hearing voices, anxiety.

“Marijuana lowers the anxiety that they feel, and can boost a sense of wellbeing. It’s a beautiful thing. There are few side effects.

“Having a registration fee is problematic,” she added. “Also oils and extracts cost more to produce compared to having plant material – people can’t afford that. There are so many people in New York who are at poverty level or below. People who need medicine, their lives matter.”

Edited by Kitty Stapp

Caden Clark has Lennox-Gastaut syndrome, a catastrophic form of epilepsy that causes him to have seizures from 10 to 20 times a day. Courtesy of the Clark Family.

By Matthew Charles Cardinale
SPOKANE, Washington, Mar 14 2014 (IPS)

Beth Collins recently picked up and moved from Virginia to Colorado, but it wasn’t for the typical reasons: new job, better schools, nicer weather. Collins’ 14-year-old daughter, Jennifer, has intractable epilepsy. Medical cannibis eases her frequent seizures. But it’s illegal in their home state.

“We got here the first week in December [2013]. She has been on THCA [a strain of cannabis],” Collins told IPS. “She takes it three times a day. We are seeing a 70 to 90 percent decrease in seizures. She’s been on the medication now for close to two months.”"It's just a huge gift and a trauma. Coming here and sort of ripping away, it was horrible and it was so hard." -- Kim Clark

Prior to the THCA, Jennifer tried a variety of drugs and diets, but they all had bad side effects, her mother says.

“She’s feeling better but she misses her dad, she misses her sister, she misses her friends. When you have a sick kid, we have a network of people it takes a long time to [build]. You have to start over again finding that support system when you move,” she said.

“Just she and I came. We want to make sure it works before we sell the house,” Collins said, adding that her family will probably be forced to permanently relocate to Colorado.

“I can’t leave with the medicine – we’ll be criminals if we do. They have pretty harsh fines [in Virginia]. I’d rather not be a criminal – it’s not how I want my daughter to see things, that if things don’t go your way, you’d commit a crime. I’d rather have her see us fighting,” Collins said, crying. “It’s emotional, it’s a hard thing. My family’s split.”

The Collins family is just one of hundreds that have migrated to the states of Colorado and Washington to access medical cannabis, or marijuana, to treat their children or other relatives, since voters in those states legalised the drug in the November 2012 elections.

An estimated 36,284 people moved to Colorado in 2013, almost 8,000 more than the year before, according to the Daily Beast. A good part of this increase is believed to be due to families migrating for medical cannabis, legal recreational cannabis, and cannabis-related business opportunities.

Caden and his mother, Kim Clark. The 10-year-old has been through numerous surgeries, including a partial lobotomy, which failed to stop his seizures. Courtesy of the Clark Family.

At least 200 families moved after cannibis oil was featured in a documentary called “Weed” by Dr. Sanjay Gupta of the cable television news station CNN.

One is the Clarks, whose 10-year-old son Caden has Lennox-Gastaut syndrome, a catastrophic form of epilepsy that causes him to have seizures from 10 to 20 times a day.

“He’s never had a seizure-free day in his life, ever,” said Caden’s mother, Kim Clark.

Kim moved with Caden from Georgia to Colorado after trying everything the legal medical community had to offer: prescription medications with severe side effects; a starvation diet; severing the brain hemispheres; even a partial lobotomy.

“We are not anti-science people. We are very pro-science people. Our child has had a lobotomy per science. It just didn’t work for him,” she told IPS.

The Clarks are on a waiting list for cannabis oil and said they had just received a phone call that their medicine might be ready as early as next week.

“We saw the special that Sanjay Gupta did on CNN about Charlotte Figi [a child whose epilepsy was cured by cannabis oil]. I took it to my husband, who is a narcotics officer in Atlanta, Georgia,” Clark said. “He’s the guardian of the drug vault, so there’s a bit of a conflict of interest there.

“When I approached him, my husband is highly anti-drug. He was like ‘not happening, anywhere’. I had to bring the science hard and heavy, with of course our son dying in front of us. It had to be really convincing,” she recalled. “We packed up everything. It’s very hard.”

Clark’s husband and other son stayed in Georgia. “We’re living in separate states. It’s what we have to do. Our older son actually said it. He looked at us, and he said, how can we not do it if we love him [Caden]? That became our mantra, our resounding call to Colorado,” Clark said.

Caden (right) and his brother, Jackson, who stayed in Georgia with their father. HB 885 is a bill currently pending in the state that would allow for medical cannabis to be administered to patients like Caden suffering from seizure disorders. Courtesy of the Clark Family.

An eighth-generation Georgian, she is bitter that her home state has not yet legalised medical cannabis and considers her and Caden to be “refugees”.

“My grandma taught me to grow vegetables and love God. I knew what county I’d raise my children in when I was 10 years old,” she said. “Do I feel disenfranchised and unwelcome [in Georgia]? Yes, you bet your ass I do,” she said.

“This is such a huge emotional screw. It’s a trauma. It’s just a huge gift and a trauma. Coming here and sort of ripping away, it was horrible and it was so hard,” Clark said.

Clark said eventually her family will run out of savings and will have to sell their house in Georgia in order to support a split household that is half living in Colorado.

Helping with the huge expenses involved in uprooting a family from one state to another are grassroots organisations like the Undergreen Railroad (a twist on the historic “Underground Railroad,” which during the 1800s helped slaves escape the U.S. South).

Another charity, Ride to Give, has raised 12,000 dollars for one family, the Coxes, who relocated from Georgia to Colorado to access medical cannabis for an ailing child, Haleigh, who also suffers from Lennox-Gastaut.

Nicole Mattison tells a similar story. “We moved in January from Tennessee to Colorado for our two-year-old daughter,” she told IPS.

“It’s been a bit of an undertaking, but so far it’s been well worth it,” she said. “Our daughter is diagnosed with intractable infantile spasms.”

Like other parents, Mattison had tried everything, including the starvation diet, which had the side effect of causing kidney failure in her daughter, Millie.

Mattison has been giving Millie THCA, with amazing results. “She’s been on it for six weeks now. We’ve seen a 75 to 90 percent decrease. She hasn’t had any infantile spasms.”

Mattison’s whole family made the move. “My husband owned a landscape company in Tennessee. We sold that to help fund the move. Currently, neither one of us have a job. It’s been really tough. We have two other children,” she said. “We left our church, our established support group.”

But Mattison does not regret her decision. “I would take the hardships any day for the possibility that Millie could one day have an improved quality of life.”

The controversial topic of medical cannabis has been put under a microscope after the internationally known neurosurgeon Dr. Sanjay Gupta came out in support of its use this week.

An ounce of “Green Crack” bought from a dispensary in California. Credit: Coaster420/public domain

In a lengthy opinion piece on CNN, Gupta outlines the benefits of medical cannabis, claims that U.S. citizens have been misled by the government for years, and apologises for his role in that. This reversal of opinions occurred during the yearlong production of his documentary “Weed”, which premiers this Sunday on CNN.

“Gupta literally made a 12 or 13 year turn on this,” the executive director of the advocacy group NORML, Allen St. Pierre, told IPS. “But as a really genuine doctor who is a scientific minded person, he really did want to see the science and let it led him to a different standing.”

The benefits

Illinois is the most recent state to legalise medicinal marijuana, making a total of 20 U.S. states and the District of Columbia that allow its medical use. Approval conditions, regulations and quantity limits can vary from state to state.

The federal law enforcement agency, the Drug Enforcement Administration (DEA), has classified marijuana as a Schedule I drug, meaning it has no medical benefit and has a high potential for abuse, with nine to 10 percent of its adult users becoming addicted.

Cocaine, according to the DEA, is less dangerous than marijuana and is a Schedule II drug even though 20 percent of its users become addicted.

“They didn’t have the science to support that claim [of marijuana as a Schedule I drug], and I now know that when it comes to marijuana neither of those things are true,” wrote Gupta in his CNN piece. “It doesn’t have a high potential for abuse, and there are very legitimate medical applications.”

Gupta uses Charlotte Figi, a patient in Colorado, as an example of the benefits. She began having seizures soon after birth, and by age three she was having up to 300 a week despite being on seven different prescription medicines. Medicinal cannabis calmed her brain and limited her seizures to two to three times per month.

According to NORML, cannabis is specifically used to alleviate pain from nerve damage, nausea, spasticity, glaucoma and movement disorders. It is also a powerful appetite stimulant, which is beneficial for patients suffering from dementia, HIV and AIDS.

“The government and some of our opponents will say with a straight face that it [medical marijuana] has no utility,” St. Pierre told IPS. “It is cheaper than most pharmaceuticals and can be used for over a dozen aliments. The utility combined with the price makes it hard for them to make a convincing argument.”

A new survey done at the nonprofit organisation The Partnership at Drugfree.org found that 70 percent of respondents support the medical use of marijuana and 50 percent support decriminalisation. Forty percent of respondents supported the legalisation of marijuana altogether.

“Most frightening to me is that someone dies in the United States every 19 minutes from prescription drug overdose, mostly accidental,” Gupta wrote. “It’s a horrifying statistic. As much as I searched, I could not find a documented case of death from a marijuana overdose.”

The consequences

According to a study done in the United Kingdom, people who smoke marijuana regularly tend to produce less dopamine, a feel good chemical in the brain that plays a large role in reward-driven behaviour and motivation. Regular marijuana use can also lead to inflammation in the brain, according to the study, which can affect coordination and learning.

Gupta also admitted in his CNN piece that regular marijuana use in younger and developing brains can lead to a permanent decrease in IQ. There is also clear evidence that some users can experience withdrawal symptoms including insomnia, anxiety and nausea.

“Much in the same way that I wouldn’t let my own children drink alcohol, I wouldn’t permit marijuana until they are adults,” wrote Gupta. “If they are adamant about trying marijuana, I will urge them to wait until they’re in their mid-20s when their brains are fully developed.”

Project SAM, the nonprofit organisation advocating for the responsible use of medicinal cannabis, is urging Gupta to clarify what he is referring to when he says marijuana. According to the organisation, CBD is a non-intoxicating element found in medically used cannabis whereas street bought marijuana contains THC, which is specifically used to get a high.

“Dr. Gupta is a person Americans looks up to with high esteem. And for good reason – he is thoughtful, thorough and dispassionate about the science. That is why we are troubled by how people might interpret his comments,” Project SAM said in a press release.

Despite the highly documented consequences and concerns, marijuana is the third most popular recreational drug in the United States, behind alcohol and tobacco. About 100 million citizens use it, and about 14 million do so regularly.

Some 50,000 people each year die from alcohol poisoning and 400,000 people die from tobacco each year, but marijuana is a non-toxic drug that cannot cause death by overdose.

“The fact that this guy [Gupta] enjoys a really wonderful national reputation, and now he is saying ‘my bad’ in a culture where alpha males don’t usually admit that they are wrong, will…affirm that we are in an era of change,” St. Pierre told IPS.

While some 200 million people worldwide take cannabis illicitly, Israelis take it seriously - production and use of medical cannabis is legal here. Credit: mista stagga lee/CC-BY-2.0

By Pierre Klochendler
KIBBUTZ NA’AN, Israel , Dec 15 2012 (IPS)

With his shaky hands, eighty-year-old Moshe Roth can barely pour the green powder into his pipe. Seated in a wheelchair, he murmurs in a trembling voice, “Even the scent’s good.”

He survived the Holocaust as a child; he survived a stroke two years ago and almost lost the use of his hands; and he lost his wife last year.

But life’s a bit easier now – with a little help from a pipe packed with pot. “Grieving the loss of a loved one is more bearable with a good pipe between your lips,” he smiles. “It changed my life.

“I imagine you walking with me hand-in-hand, O my forever young, beloved beauty,” says the retired Israeli official and spare-time painter and writer, in a moving eulogy to an old black-and-white portrait of his wife.

Shortly after he takes a hit, Moshe can draw or write with an inspired, confident hand. He’s one of some 10,000 patients who freely, legally consume marijuana in Israel.

At the Hadarim nursing home, cannabis is on the menu of medical treatments. In fact, 19 patients out of 36 use medical cannabis.

“Though we know how to extend life, the pain is great. In geriatrics, the future doesn’t matter any longer. What matters is the now – how to add quality of life to longevity,” explains Head Nurse Inbal Sikorin while opening the safe containing bags of powder and flowers.

Sucked from a syringe, peppered in a yoghourt, administered three times a day in half-gramme doses, cannabis dramatically reduces the need for medication, say doctors, nurses and patients. “Why use painkillers? I feel great with cannabis,” says Rivka Haloup, 85, who suffers from acute arthritis.

Parkinson patients inhale the smoke from a vapouriser six times a day (the nurse wears a mask). But the most potent effect comes from just smoking a joint. “Cannabis doesn’t change reality but makes it easier to accept,” says Sikorin. “At their age, it’s a blessing.”

The “blessing” comes from the pastoral village of Birya, sheltered amidst the Galilee hills.

While some 200 million people worldwide take cannabis illicitly, Israelis take it seriously. Production and use of medical cannabis is legal. A strong medical research sector under adequate government supervision makes Israel one of the world’s most cannabis-friendly countries.

The local industry flourishes. On three acres, the Tikkun Olam farm is the largest of eight greenhouses licenced by the Health Ministry to grow marijuana. Hundreds of kilos are produced year-round from hundreds of heads, all legal.

“Tikkun Olam” stands for “fixing the world” – with a fix of medical marijuana. “We distribute cannabis to patients and through our chain of shops,” explains Research and Development Manager Zach Klein.

The company has a pied-à-terre on Tel Aviv’s Ibn Gvirol Avenue. A guard and closed-circuit TV cameras secure the premises. There’s no sign on the shop, and the metal shutter is pulled down.

But inside, a green world reveals itself. The leafy company logo cites Psalm 118:23:  “This is the Lord’s doing; It is marvellous in our eyes.”

Patients with chronic neurological pain say cannabis is the only drug whose side-effects are welcome. “I’ve tried every pain killer, narcotic and non-narcotic,” says a customer. “This is the first thing that has really helped.”

With all the “holy smoke” paraphernalia on display (bongs, papers, etc), you’d think Tel Aviv was Amsterdam where weed is tolerated (though the sale of the “soft” drug remains technically illegal). People show their medical prescription, and buy the stuff.

The grass comes in all shapes and forms – from chocolate to cake, gum to toffee, honey to balm. At the counter, customers are instructed on how to make the best of it.

Menachem Barabi endured four strokes. He takes 60 grammes of cannabis a month for a mere 370 shekel (100 dollar). “I was in terrible pain, I couldn’t sleep,” he says. “Thank God I take cannabis.”

“I have lymphoma cancer,” says Guy Bar-Yosef. “I lost my appetite and went down 10 kilos. I started smoking joints, and started eating again. It’s healthy, a panacea, a magic potion.”

The twelve strains currently developed by the company’s agronomists often bear names of deceased patients, even eschatological names.

Tikkun Olam Spokesman Shay Amir shows samples neatly arrayed on shelves. ”This is our flagship product – the ‘Erez’, a great analgesic; plus it stimulates appetite, sleep. You ingest it and work without losing your senses. Here, the ‘end times’ – excellent for multiple sclerosis or osteoporosis. This one’s the ‘Raphael’.”

The “Raphael” is named after Raphael Mechoulam, professor of medicinal chemistry at the Hebrew University of Jerusalem – “the grandfather of cannabis”, as they call him. “It’s an excellent drug for certain things. Nothing’s excellent for everything,” Mechoulam says matter-of-factly.

Tetrahydrocannabinol (THC), the psychoactive chemical compound that is the main active ingredient in cannabis, was first isolated by Mechoulam in 1964.

This year, a new strain which contains Cannabidiol (CBD) as an active compound – and no THC – has just been developed for consumption by patients such as children with cancer.

Studies show that CBD relieves inflammation, convulsions, anxiety, depression, post-traumatic stress disorder, schizophrenia and nausea, while inhibiting the growth of cancer cells. It is now used by 500 of Tikkun Olam’s 2,000 customers.

Israel is at the cutting edge of cannabis science, says Mechoulam. “Government officials look at our research data, and they can’t just say no.”

Here, like in most countries, recreational marijuana use is prohibited. “When you want to enjoy yourself, you don’t go to a doctor,” says Mechoulam.

Yet sometimes, the border between recreational and medical use seems blurred. After all, isn’t it the same substance? “Sick people feel down,” says Klein, Tikkun Olam’s research and development manager. “When people get high on THC, they’re up like normal.”

Researchers and growers are now preparing to move the cannabis industry forward. The government is considering distribution through pharmacies starting next year, “like with any other therapeutic drug,” says Mechoulam.

“Israel can be an example, as it provides alternatives to conventional treatment. Cannabis is one of them,” says Tikkun Olam Managing Director Ma’ayan Weisberg. “And it’s organic.”