A new study adds to the evidence that letting patients use cannabis saves lives by reducing consumption of pharmaceuticals.
Insys Therapeutics, the Arizona-based pharmaceutical company that recently became the biggest financial supporter of the campaign against marijuana legalization in that state, makes an oral spray that delivers the opioid painkiller fentanyl and plans to market another one that contains dronabinol, a synthetic version of THC. Insys says it gave $500,000 to the main group opposing Arizona’s legalization initiative because the measure “fails to protect the safety of Arizona’s citizens, and particularly its children.” But one needn’t be terribly cynical to surmise that Insys also worries about the impact that legalization might have on its bottom line, since marijuana could compete with its products.
A new study suggests Insys has good reason to worry. In an article published last week by the American Journal of Public Health, Columbia University epidemiologist June Kim and her colleagues report that fatally injured drivers are less likely to test positive for opioids in states that allow medical use of marijuana. That finding, together with the results of earlier studies, indicates that making marijuana legally available to patients saves lives by reducing their consumption of more dangerous medications.
Kim et al. collected data from the Fatality Analysis Reporting System (FARS) for 1999 through 2013, focusing on 18 states that drug-tested at least 80% of drivers who died in crashes. They found that drivers between the ages of 21 and 40 were half as likely to test positive for opioids in states that had implemented medical marijuana laws (MMLs) as in states that had not.
“Among 21-to-40-year-old deceased drivers, crashing in states with an operational MML was associated with lower odds of testing positive for opioids than crashing in MML states before these laws were operational,” the researchers write. “Although we found a significant association only among drivers aged 21 to 40 years, the age specificity of this finding coheres with what we know about MMLs: a minimum age requirement restricts access to medical marijuana for most patients younger than 21 years, and most surveyed medical marijuana patients are younger than 45 years.”
The fact that a driver tested positive for opioids does not necessarily mean the painkillers he took contributed to the crash, so it is not safe to draw any conclusions about medical marijuana’s impact on traffic safety from this study. But the FARS data are an indirect way of measuring the extent of opioid consumption in a given state. Kim et al. note that “severe or chronic pain is among the most common indications cited by medical marijuana patients.” It therefore makes sense that opioid use would decline (or rise less) in states that recognize cannabis as a medicine.
The FARS numbers reinforce the results of another recent study, published last July in the journal Health Affairs, that looked at prescriptions covered by Medicare from 2010 through 2013. Ashley Bradford, a graduate student in public policy at the University of Georgia, and her father, W. David Bradford, an economist at the same school, found that “the use of prescription drugs for which marijuana could serve as a clinical alternative fell significantly once a medical marijuana law was implemented.”
The most dramatic decline was in painkiller prescriptions, which fell by 3,645 daily doses per physician after medical marijuana laws were implemented. There were also statistically significant drops in prescriptions for drugs used to treat seizures (down 1,370 daily doses per doctor), depression (1,280), psychosis (1,123), anxiety (1,106), nausea (1,028), and sleep disorders (615). Meanwhile, Bradford and Bradford “found no changes after implementation of a medical marijuana law in the number of daily doses filled in condition categories with no medical marijuana indication,” which “provides strong evidence that the observed shifts in prescribing patterns were in fact due to the passage of the medical marijuana laws.”
Medicare prescription drug coverage is mainly available to people who are 65 or older, although people receiving federal disability payments also can qualify. Bradford and Bradford note that “previous studies have suggested that Medicare patients may make up a relatively small percentage of people who use medical marijuana and that only 13–27 percent of people who used medical marijuana were ages fifty and older.” But Kim et al.’s analysis of FARS data suggests a similar shift to cannabis from other medications is occurring among 21-to-40-year-olds, who account for the bulk of medical marijuana users.
Other studies indicate that replacing prescription drugs with marijuana reduces opioid-related deaths. A 2014 study reported in JAMA Internal Medicine, based on death certificate data from 1999 through 2010, found that “states with medical cannabis laws had a 24.8% lower mean annual opioid overdose mortality rate…compared with states without medical cannabis laws.” Furthermore, internist Marcus Bachhuber and his co-authors reported, “such laws were associated with a lower rate of overdose mortality that generally strengthened over time,” which makes sense if more patients are switching to marijuana from opioids (or choosing marijuana rather than opioids) each year.
JAMA Internal Medicine
The reduced rate of opioid-related fatalities translated into about 1,700 fewer deaths in 2010 alone. The researchers suggest several possible explanations for this effect. “Patients with chronic noncancer pain who would have otherwise initiated opioid analgesics may choose medical cannabis instead,” Bachhuber et al. write. “In addition, patients already receiving opioid analgesics who start medical cannabis treatment may experience improved analgesia and decrease their opioid dose, thus potentially decreasing their dose-dependent risk of overdose. Finally, if medical cannabis laws lead to decreases in polypharmacy—particularly with benzodiazepines—in people taking opioid analgesics, overdose risk would be decreased.”
That last possibility could be more significant than you might think, since opioid-related deaths typically involve mixtures with other drugs, with benzodiazepines playing a substantial and increasing role. Bradford and Bradford found that medical marijuana laws were associated with decreases in prescriptions for drugs used to treat anxiety and sleep disorders. Benzodiazepines are commonly used for both purposes.
A working paper published last year by the National Bureau of Economic Research confirmed that the legal availability of medical marijuana is associated with a relative decline in opioid-related deaths. RAND Corporation researcher David Powell and two colleagues extended Bachhuber et al.’s analysis by including three more years of data. They also looked at drug treatment admissions related to opioids and found that they became less common in states that implemented medical marijuana laws.
“We find fairly strong evidence…that states providing legal access to marijuana through dispensaries experience lower treatment admissions for addiction to pain medications,” Powell et al. write. “We provide complementary evidence that dispensary provisions also reduced deaths due to opioid overdoses….Our findings suggest that providing broader access to medical marijuana may have the potential benefit of reducing abuse of highly addictive painkillers.” Like Bachhuber et al., they found that the longer medical marijuana was legally available, the bigger the apparent benefit.
Even while sounding the alarm about an “opioid epidemic” that included a record number of painkiller-related deaths in 2014, the federal government insists marijuana has “no currently accepted medical use.” Judging from these studies, its dogmatism may be deadly.
The Department of Licensing and Regulatory Affairs (LARA) is responsible for the state’s regulatory environment and makes the delivery of services more efficient for consumers and business customers. LARA oversees the licensing and regulation of more than 1.2 million individuals and entities on an annual basis.
DETROIT, Mich. — A judge on Wednesday heard arguments in a federal class action lawsuit filed by medical marijuana patients and caregivers against several Michigan law enforcement and crime lab officials.
The suit, filed in June, claims that because of false lab reports, prosecutors are charging people with felonies without proof, illegally arresting them and seizing assets. Four patients and caregivers are suing the directors of the Michigan State Police, their crime labs and the publicly-operated Oakland County lab and that county’s sheriff.
Chief Judge Denise Page Hood of the U.S. District Court for the Eastern District of Michigan in Detroit said she will issue an opinion and decide whether the labs’ marijuana reporting policies violate the Fourth Amendment and due process rights of the medical marijuana patients and caregivers.
“The problem is, the way that the Oakland County lab and the Michigan State Forensic Science Division is reporting still would allow for arrests, still would allow for these patients and caregivers to not have immunity because they’re reporting it as something other than marijuana,” said Michael Komorn, the plaintiffs’ attorney. “And the law enforcement community, as far as we know, is still arresting people for possessing these substances.”
In court Wednesday, Defense Attorney Rock Wood with the Michigan Attorney General’s office representing the state police and crime labs’ directors, along with Defense Attorney Nicole Tabin representing the Oakland County lab’s director and sheriff, declined requests for comment. Wood argued this is not a case involving altered, hidden or destroyed evidence. Instead, the defense writes in their motion to dismiss the case:
“The MSP policy is consistent with the current national standard for testing of seized drugs and avoids speculation as to the source of chemical components unless there is zero qualitative uncertainty.”
Ultimately, the labs’ policy states that unless there is marijuana plant matter seen along with THC, scientists label it “Schedule 1 THC, origin unknown,” instead of marijuana. This is the difference between a felony, or a marijuana possession misdemeanor which patients and caregivers can be immune for under the Michigan Medical Marijuana Act.
The plaintiffs’ attorneys and their experts say that 100 percent certainty for any evidence, even DNA is not possible.
“You know that nobody’s going to go through the trouble of synthesizing THC, along with other cannabinoids,” said Timothy Daniels, another attorney representing the plaintiffs. “And therefore you know to almost a 100 percent, and I won’t say 100 percent, let’s say 99 percent certainty, that is marijuana, not synthetic.”
Overall, the Michigan Medical Marijuana Act protects licensed patients and caregivers from charges and prosecution for having limited amounts of usable marijuana, not THC with an unknown origin. It’s this lab policy the suit is working to stop.
“It’s a little troubling that the defense is still suggesting their reporting practices are honorable,” said Komorn.
Statewide, as crime labs continue to report THC and marijuana in ways that many call controversial, the decision now rests in the judge’s hands. It’s a decision that could potentially reopen hundreds of cases across Michigan.
Meanwhile, recently passed legislation now legalizes medical marijuana patients and caregivers use of marijuana extracts like oils and edibles. The defense argued the lawsuit is moot in part due to this, however the plaintiffs’ attorneys stand firm that people continue to be unlawfully arrested, charged, and prosecuted for possession of extracts due to the labs’ reporting policy.
A Michigan State Police lieutenant’s decision to destroy more than 500 marijuana plants without a judge’s order has led to dismissal of felony charges against two defendants.
Inspector James Wolf, the former lieutenant/commander of the Western Wayne narcotics unit, testified at a hearing Thursday that he destroyed the plants because they were rotting and had become a health hazard.
Livingston County District Judge Carol Sue Reader expressed surprise that a law enforcement veteran was unaware he had to receive a judge’s order to destroy the 556 large, tree-size plants seized in a Western Wayne Narcotics and Criminal Investigations Unit’s investigation in 2015.
“I cannot believe an officer who has been in the (Michigan) State Police for 27 years would not have known about these steps,” she said. “It wasn’t takenin this case so the court order never got issued. It would be like going in and searching a house without a search warrant. …
“I don’t think (the officer) can complain the health, molding and everything is why he did it,” Reader said. “The judge should have been the one who issued the order.”
Reader dismissed multiple manufacture marijuana counts lodged against Darryl Scott Berry of Howell Township, and codefendant Jeffrey Allen Michael of Fowlerville.
However, Berry still faces a charge alleging he delivered marijuana to an undercover officer in October 2014. The attorney general’s office said the marijuana related to that count was not destroyed. The defense believes it was and expects that count also will be dismissed.
Michael remains charged with one count alleging he possessed marijuana found in his home as well as felony firearms.
Berry and Michael return to Reader’s Howell courtroom on Jan. 20 for a preliminary exam on the remaining counts.
Assistant Attorney General Paul Cusik told the court his office may file a motion asking Reader to reconsider her decision as well as to amend the felony complaint to delivery of marijuana allegations.
During a hearing Thursday, Wolf testified that the marijuana plants seized Sept. 28, 2015, were stored at two warehouses and, despite officers’ attempts to dry out the plants for preservation, they became a health hazard.
“We could not keep up with removing the water, the moisture from the plant, and they were decomposing,” he said. “The plants were rotting and molding. … We weren’t able to preserve them.”
Wolf said he contacted his supervisor as well as Cusik, who advised that “he could not tell me to destroy evidence.” Wolf said he then made the decision himself to destroy the seized marijuana plants because it was a health hazard.
The plants were destroyed about three days after the seizure.
On cross examination, defense attorney Michael Komorn, who represents Berry, asked Wolf if he was familiar with a Michigan law that states a court order is needed to destroy evidence.
“Not until reading your motion,” Wolf replied.
Cusik argued the evidence is not destroyed because scientists with the Michigan State Police crime lab took “a sample” from each plant seized at Wolf’s request during the execution of the 2015 search warrants executed at five properties in Livingston County. Court documents show police seized an estimated 545 plants.
This step to preserve evidence, Cusik argued, showed officers acted in good faith.
“There is not any destruction of evidence,” he said. “… There are lab reports on the samples, which have been preserved.”
Officers also seized about 15 pounds of marijuana, 7 pounds of processed marijuana and suspected marijuana edibles, and more than $195,000 in cash, according to court documents.
Komorn argued the state acted in bad faith and violated his client’s due process. He said there is no way for the defense to confirm how badly, if at all, the plants had decomposed because there is “no description, no report, no additional photos” to prove what police claimed.
“We’re asserting my client was under the amount allowed and protected under immunity” in the Michigan Medical Marihuana Act, Komorn said.
“The state says no. How do we argue that? We have to accept their word? We’re going to resolve it by trusting the prosecution and investigating officers … and forensic scientists who have no training in collection of evidence?” he asked. “Their job is to analyze, not collect the evidence. … There was clearly an intention to destroy (the marijuana plants) from the outset.”
Two of the codefendants earlier entered plea deals and are awaiting sentencing.
Contact Livingston Daily justice reporter Lisa Roose-Church at 517-552-2846 or lrchurch@gannett.com. Follow her on Twitter @LisaRooseChurch.
A person who smokes marihuana in his or her own car while parked in the parking lot of a private business that is open to the general public is not entitled to assert the immunity or defense provisions of the Michigan Medical Marihuana Act
In People v. Carlton, security personnel monitoring live feed cameras of a casino parking lot observed Carlton smoking what appeared to be marihuana inside his car. Police officers responded to the parking lot to investigate. Carlton, a qualifying patient under the Michigan Medical Marihuana Act (MMMA), MCL 333.26421 through MCL 333.26430, admitted to the officers that he had been smoking marihuana. The officers observed a marihuana roach on the dashboard and found four bags of marihuana during a subsequent search of Carlton’s car. Carlton was the only person in the car at the time.
In People v. Rea, officers were dispatched to Rea’s house to investigate a noise complaint. Upon arrival, an officer observed the door to Rea’s detached garage open and watched as Rea backed his vehicle “about 25 feet” before stopping at a point in his private driveway in line with his house. Rea then pulled the vehicle back into the garage. At all times Rea’s vehicle was either in his side yard or backyard. (See pictures in the Court’s opinion.) Rea was arrested and charged with operating while intoxicated pursuant to MCL 257.625(1).
MCL 257.625(1) provides in relevant part:
A person . . . shall not operate a vehicle upon a highway or other place open to the general public or generally accessible to motor vehicles, including an area designated for the parking of vehicles . . . if the person is operating while intoxicated.
Before trial, the circuit court granted the defendant’s motion to dismiss the case, ruling that “the upper portion of [Rea’s] private residential driveway” does not constitute an area “generally accessible to motor vehicles” as required by MCL 257.625(1) and the prosecution appealed.
Read much more on the Michigan State Police Legal Update link below
AN ACT to establish a statewide monitoring system to track marihuana and marihuana products in commercial trade; to monitor compliance with laws authorizing commercial traffic in medical marihuana; to identify threats to health from particular batches of marihuana or medical marihuana; to require persons engaged in commercial marihuana trade to submit certain information for entry into the system; to provide the powers and duties of certain state departments and agencies; to provide for remedies; and to provide for the promulgation of rules.
The People of the State of Michigan enact:
Sec. 1. This act shall be known and may be cited as the “marihuana tracking act”.
Sec. 2. As used in this act:
(a) “Department” means the department of licensing and regulatory affairs.
(b) “Licensee” means that term as defined in section 102 of the medical marihuana facilities licensing act.
(c) “Marihuana” means that term as defined in section 7106 of the public health code, 1978 PA 368, MCL 333.7106.
(d) “Registered primary caregiver” means that term as defined in section 102 of the medical marihuana facilities licensing act.
(e) “Registered qualifying patient” means that term as defined in section 102 of the medical marihuana facilities licensing act.
(f) “Registry identification card” means that term as defined in section 3 of the Michigan medical marihuana act, 2008 IL 1, MCL 333.26423.
(g) “Statewide monitoring system” or “system” means an internet-based, statewide database established, implemented, and maintained directly or indirectly by the department that is available to licensees, law enforcement agencies, and authorized state departments and agencies on a 24-hour basis for all of the following:
(i) Verifying registry identification cards.
(ii) Tracking marihuana transfer and transportation by licensees, including transferee, date, quantity, and price.
(iii) Verifying in a commercially reasonable time that a transfer will not exceed the limit that the registered qualifying patient or registered primary caregiver is authorized to receive under section 4 of the Michigan medical marihuana act, 2008 IL 1, MCL 333.26424.
Sec. 3. (1) The department shall establish a statewide monitoring system for use as an integrated marihuana tracking, inventory, and verification system. The system must allow for interface with third-party inventory and tracking systems as described in section 207 of the medical marihuana facilities licensing act to provide for access by this state, licensees, and law enforcement personnel, to the extent that they need and are authorized to receive or submit the information, to comply with, enforce, or administer this act; the Michigan medical marihuana act, 2008 IL 1, MCL 333.26421 to 333.26430; or the medical marihuana facilities licensing act.
(2) At a minimum, the system must be capable of storing and providing access to information that, in conjunction with 1 or more third-party inventory control and tracking systems under section 207 of the medical marihuana facilities licensing act, allows all of the following:
(a) Verification that a registry identification card is current and valid and has not been suspended, revoked, or denied.
(b) Retention of a record of the date, time, quantity, and price of each sale or transfer of marihuana to a registered qualifying patient or registered primary caregiver.
(c) Determination of whether a particular sale or transfer transaction will exceed the permissible limit established under the Michigan medical marihuana act, 2008 IL 1, MCL 333.26421 to 333.26430.
(d) Effective monitoring of marihuana seed-to-sale transfers.
(e) Receipt and integration of information from third-party inventory control and tracking systems under section 207 of the medical marihuana facilities licensing act.
(3) The department shall promulgate rules to govern the process for incorporating information concerning registry identification card renewal, revocation, suspension, and changes and other information applicable to licensees, registered primary caregivers, and registered qualifying patients that must be included and maintained in the statewide monitoring system.
(4) The department shall seek bids to establish, operate, and maintain the statewide monitoring system under this section. The department shall do all of the following:
(a) Evaluate bidders based on the cost of the service and the ability to meet all of the requirements of this act; the Michigan medical marihuana act, 2008 IL 1, MCL 333.26421 to 333.26430; and the medical marihuana facilities licensing act.
(b) Give strong consideration to the bidder’s ability to prevent fraud, abuse, and other unlawful or prohibited activities associated with the commercial trade in marihuana in this state, and the ability to provide additional tools for the administration and enforcement of this act; the Michigan medical marihuana act, 2008 IL 1, MCL 333.26421 to 333.26430; and the medical marihuana facilities licensing act.
(c) Institute procedures to ensure that the contract awardee does not disclose or use the information in the system for any use or purpose except for the enforcement, oversight, and implementation of the Michigan medical marihuana act, 2008 IL 1, MCL 333.26421 to 333.26430, or the medical marihuana facilities licensing act.
(d) Require the contract awardee to deliver the functioning system by 180 days after award of the contract.
(5) The department may terminate a contract with a contract awardee under this act for a violation of this act. A contract awardee may be debarred from award of other state contracts under this act for a violation of this act.
Sec. 4. The information in the system is confidential and is exempt from disclosure under the freedom of information act, 1976 PA 442, MCL 15.231 to 15.246. Information in the system may be disclosed for purposes of enforcing this act; the Michigan medical marihuana act, 2008 IL 1, MCL 333.26421 to 333.26430; and the medical marihuana facilities licensing act.
Enacting section 1. This act takes effect 90 days after the date it is enacted into law.
Enacting section 2. This act does not take effect unless House Bill No. 4209 of the 98th Legislature is enacted into law.
This act is ordered to take immediate effect.
STATE OF MICHIGAN – 98TH LEGISLATURE – REGULAR SESSION OF 2016
Introduced by Rep. Kesto
Michigan Medical Marihuana Laws are constantly changing. Please Research New Laws and Updates
