The recalls of six batches of medical marijuana available on the state’s regulated market since January have prompted industry and health expert concerns about continuing to let caregivers grow and create pot products to meet a shortage in the licensed market.
More than 50 pounds of medical marijuana product were recalled in January from provisioning centers in Detroit, Lansing, Jackson, Kalamazoo and Ypsilanti for issues such as chemical residue, E. coli, arsenic, cadmium and Salmonella. The majority of the 43 products failing the testing were caregiver grown, the state has said.
Despite the recalls, the state Medical Marihuana Licensing Board approved a resolution in mid-January allowing licensed facilities to purchase medical marijuana from caregivers through March 31 in an effort to meet an industry shortage while newly licensed growers prepare their first harvests. The state’s testing of caregiver products sold at provisioning centers lasted two weeks, from early to mid-January.
The potential for contaminated product to slip through the licensed system for lack of testing could pose a risk to patients, in particular those with compromised immune systems, said Jamie Alan, an assistant professor in Michigan State University’s Department of Pharmacology and Toxicology.
“If it’s not tested, you don’t know what’s in it,” Alan said. “But the alternative is that they’re in pain. It’s probably a somewhat small risk, but you can’t guarantee that.”
While licensed facilities want the state’s 350,000 patients to have access to medical marijuana, “we also want people to be able to know what they’re ingesting.” said Joe Neller of Green Peak Innovation in Dimondale, which grows marijuana. “There’s no way to know how contaminated that product that patients have been consuming has been.”
Over the next two months, patients searching for medical marijuana from a licensed provisioning center can buy from a small supply of tested product or sign a release and purchase untested, caregiver-supplied marijuana, said David Harns, a spokesman for the state Department of Licensing and Regulatory Affairs.
Patients also have the option of bringing their untested marijuana to a licensed safety compliance facility for testing, Harns said.
“The products will not be required to have met state testing standards, so patients need to understand that fact and assume the potential risk that the products may present,” he said in a statement.
The batches recalled in the past month largely consisted of marijuana flower, as well as other products such as marijuana concentrate, patches and tinctures. Marijuana flower can be used in a variety of ways; marijuana tinctures are consumed on their own or added to a food or beverage, while concentrate is usually inhaled as a vapor.
‘Selective enforcement’
As the grace period for untested product continues through March, licensed growers and processors will be required to continue testing their own product, giving caregivers and unlicensed sellers a market edge over licensed facilities.
The resolution penalizes “certain licensed facilities by selective enforcement” and fails to provide patients access to safe medical marijuana, the Michigan Coalition of Independent Cannabis Testing Laboratories said in a statement.
“Under this new ruling, Michigan’s most vulnerable patients are buying purported medical cannabis products that could legitimately harm them,” the group said in a statement.
The coalition, made up of more than a dozen licensed testers, growers and processors, proposed the state instead test caregiver marijuana prior to sale and put restrictions on caregiver product based on failure rates for chemical residue, heavy metals and residual solvents.
Because most users will be buying from regulated provisioning centers in the future, the Michigan Cannabis Industry Association is not overly concerned by the short-term use of untested product, said association spokesman Josh Hovey.
Many caregivers had tested their product voluntarily prior to the state’s regulatory framework requiring as much for licensed facilities, Hovey noted. “This is especially true for those that were serving pediatric patients and patients with autoimmune deficiencies,” he said.
While not ideal, the state’s decision to allow caregiver product to be used on the regulated market through March was the appropriate response to the shortage, said Jamie Lowell, a board member of MILegalize and representative for the medical marijuana group, Americans for Safe Access.
“I agree that people should not be consuming things with contaminants in them, but just because a couple things showed up in this testing, you cannot label all caregiver product as being bad for consumers,” Lowell said.
Caution urged amid recalls
Medical marijuana batches in Lansing Jan. 11 tested above state limits for chemicals, such as the mite-killing insecticide Spiromesifin, Salmonella and E. coli. Some items tested at more than double the state limit for Spiromesifin, while others tested positive for Salmonella and E. coli, which the state has ruled should not be detected at all.
Some kinds of E. coli can cause diarrhea, urinary tract infections, pneumonia and other illnesses, according to the Centers for Disease Control and Prevention. A Salmonella infection can result in diarrhea, fever, abdominal cramps and, in severe cases, hospitalization and death, according to federal health officials.
The state contaminant limits for the marijuana products seem reasonable, especially given the historical context of a marijuana-linked Salmonella outbreak in the Midwest in the 1980s, MSU’s Alan said.
“With the chemical it’s hard to say,” Alan said, noting there’s little research of the impact of Spiromesifen on humans.
“With the bacteria, certainly if you’re immuno-compromised or have any serious illnesses, they pose a significant concern.”
The infection risk to the immuno-compromised — a population likely to consume medical marijuana product — is a real concern when it comes to the continued use of untested product, said Dr. Preeti Malani, the University of Michigan’s chief health officer and a professor of medicine in the division of infectious diseases.
A 2017 nationwide poll of people between the ages of 50 and 80 found 6 percent of those polled used medical marijuana and 31 percent said marijuana definitely provided pain relief. The survey, called the National Poll on Healthy Aging and conducted by a UM team Malani directed, should be a wake-up call to physicians, especially those dealing with immuno-compromised populations like the elderly, she said.
As Michigan enters the new world of legal recreational cannabis, some long-time holdouts in law enforcement are expected to stand down.
Although 63 percent of Michigan voters approved medical marijuana in 2008, Bouchard has been a leader, along with former Michigan Attorney General Bill Schutte, in quashing efforts in the decade since then to allow sales outlets for medical marijuana.
That’s a one of the reasons why dozens of the outlets called dispensaries sprung up along the south side of Eight Mile Road in Detroit in Wayne County.
Now, it looks like even Bouchard must yield to the tide of legal cannabis after Michigan voters in November legalized the recreational use of marijuana.
On Friday, a shop billed as Oakland County’s “first licensed dispensary” opened in Walled Lake.
Angie Roullier has muscular dystrophy and she said that “cannabis really changed my life” after she weaned herself from three decades of prescription drugs.
The opening comes a decade after Bouchard ordered undercover officers from OAKNET — the Oakland County Narcotics Enforcement Team — to gather evidence prior to a police raid of what then-Ferndale Mayor Craig Covey said was the county’s first dispensary, called Clinical Relief.
That shop had opened with the Ferndale City Council’s enthusiastic approval. But the ill-fated venture never reopened after OAKNET officers arrested more than two dozen people at the site.
In Walled Lake, the City Council has been equally enthused about the opening of the Greenhouse on Pontiac Trail. And the new outlet’s CEO, Jerry Millen, said he doesn’t expect trouble from Sheriff Bouchard or the county’s narcotics investigators, after he paid $66,000 for a state license and gained full approval to open under the state’s new law.
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In handing out a harsh sentence to a driver who smoked marijuana before she collided with a motorcyclist and killed him, Judge Rosemarie Aquilina is making an example of her.
The lesson: Don’t smoke weed and drive.
Problem is, in Michigan, it’s unclear what that lesson means. Marijuana is now legal, but any amount in a driver’s system could be considered intoxication under the current law.
The sentence given to Logan Brooke Turner, 21, of Dimondale, underscores what’s at stake. Aquilina handed her a minimum of nearly six years in prison for operating while intoxicated, causing the death of motorcyclist Blair Beck, 21.
Turner admits smoking marijuana the day of the crash, but her attorney, Lucas Dillon, argued she had no signs of intoxication beyond a blood test. A jury wasn’t convinced and convicted her after a four-day trial.
Dillon said Turner was prepared for a one- or two-year minimum sentence. Seventy months was stunning.
“We were basically outraged and shocked by the sentence,” he said. “I think it’s completely out of line.”
The judge’s sentence went beyond the five years sought by prosecutors — the same amount of time they argued that it would have taken Blair Beck to meet a girl and start a family, travel cross county with his dad on motorcycles or finish his education.
Recreational marijuana was illegal at the time Turner caused Beck’s death but legal by the time a jury found her guilty.
Dillon, who is not a marijuana advocate, said the case points to the need for Michigan to better define impairment, especially now that it’s legal.
“People are going to be driving around all the time with weed in their system. That doesn’t mean that they’re high,” he said.
As my colleague Kara Berg has reported, how laws against driving while high are enforced depends on who is doing the enforcement. She spoke with nine prosecutors for a December report and found almost as many answers.
”Michigan has a zero tolerance law for drivers with certain narcotics in their system, such as cocaine, marijuana and heroin. That hasn’t changed with the legalization of recreational marijuana.
“Or maybe it has, depending on who you ask,” she wrote.
Some prosecutors said evidence of intoxication, such as swerving while driving or failing a sobriety test, is needed in addition to evidence of tetrahydrocannabinol, or THC, the active ingredient in marijuana. Others said THC alone was enough.
Some clarity on marijuana intoxication may be in the offing. An Impaired Driving Safety Commission, appointed in 2016 by then-Gov. Rick Snyder, has been working to make recommendations to the governor and Legislature on legal marijuana intoxication levels. A report is due out in March.
Michigan State University Professor Norbert Kaminski, director of the Institute for Integrative Toxicology, is a member of the task force. He said recommendations are being finalized.
“Certainly, the commission is wanting an appropriate and fair way to judge whether people are impaired,” he said.
In Turner’s case, she had 5 nanograms of THC, the same amount of marijuana that constitutes impairment in states that have a set limit, including Colorado, a state with a high threshold for impairment.
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So she may have been found guilty even under well-thought-out, reasonable standards, though Dillon said evidence was submitted that Turner smoked after the accident and before she was taken into police custody for testing.
The sentence is tougher than some convictions for drunk driving that led to deaths.
Dillon cited the sentence of Cleveland Browns wide receiver Donte’ Stallworth to 30 days in jail for killing a pedestrian while driving drunk in Florida in 2009 as a contrast to Turner’s 70-month sentence.
That’s in another state, under another set of laws. More locally, a Mason man driving while intoxicated who hit and killed a pedestrian, was given a one-year sentence in 2016.
Years ago, I heard a prison reform advocate describe how we should save our prison space for those people we are afraid of, not people we’re mad at. The reason? Prison is expensive, and we should use our resources wisely.
That makes Aquilina’s lesson a pricey one. And nearly six years of prison seems much more like anger than fear.
(WXYZ) — They are called Child Abuse Pediatricians, and they say their mission is to protect children. However, local parents, attorneys and even some doctors say some of these specialists are tearing families apart.
The Parker family says they were emotionally and financially devastated after a false accusation of child abuse. Their lawyer says she’s had to fight against the same Child Abuse Pediatrician who accused the Parkers about 20 times, and they want to warn other families.
Allie and Jimmy Parker are grateful for every second with their children, Isabella and Dylan.
Last April, Child Protective Services workers took both babies from the Westland couple because one pediatrician accused them of abusing 6-week-old Dylan.
“I said why can’t we get a second opinion, why is this one physician’s opinion the end all be all to your decision to terminate our parental rights,” Allie said, adding that it was just how things go because the doctor was the expert.
The Parkers are talking about Child Abuse Pediatrician Bethany Mohr from the University of Michigan’s C. S. Mott Children’s Hospital. They’re not the only family who says Dr. Mohr’s accusation of child abuse tore their family apart.
“It’s been the hardest thing I’ve ever been through in my life,” said Josh Burns in 2015, after he was accused of abusing his daughter.
“I went to what I was told was the best children’s hospital in the state of Michigan,” said a mother who talked to us on the condition of anonymity out of fear that allegations would be reinstated. “They turned it all around on me. Blamed me for every part of it.”
ANYHOW...Here is some information from the Council of Pediatricians Subspecialties…Ironically using the acronym CoPS.
SUB-SPECIALTY PEDIATRICS INVESTIGATOR NETWORK… Ironically using the acronym (SPIN).
What does a Child Abuse Pediatrician do? Child Abuse Pediatricians are responsible for the diagnosis and treatment of children and adolescents who are suspected victims of any form of child maltreatment. This includes physical abuse, sexual abuse, factitious illness (medical child abuse), neglect, and psychological/emotional abuse. Child Abuse Pediatricians participate in multidisciplinary collaborative work within the medical, child welfare, law enforcement, and judicial arenas as well as with a variety of community efforts. Child Abuse Pediatricians are often called to provide expert testimony in the court systems. This field offers the opportunity for involvement and leadership roles in community, regional and national advocacy, and in prevention efforts and public policy.
What are the career opportunities? Most Child Abuse Pediatricians practice in academic settings and are responsible for patient care, teaching and research within an academic health center. However, there are other Child Abuse Pediatricians who practice in solely clinical settings such child advocacy centers, community hospitals and clinics.
What Board, if any, certifies Child Abuse Pediatrics? Child Abuse Pediatric Boards are administered by the American Board of Pediatrics. Certification in General Pediatrics and completion of Child Abuse Pediatrics fellowship training are required for eligibility to take the subspecialty board examination.
What is the lifestyle of a Child Abuse Pediatrician? Personal time and family life are essential to all physicians. Most Child Abuse Pediatricians balance the workload and stress of complex medical care with fulfilling personal life. Patient care, court testimony, teaching, research and administrative responsibilities vary depending on the specific position. In most centers, that ability to teach and conduct research provides academic enrichment that leads to a rewarding and balanced career and lifestyle.
How do I become a Child Abuse Pediatrician? Child Abuse Pediatrics training includes three years of fellowship training in an accredited Child Abuse Pediatrics fellowship program. Fellowship training includes medical evaluations of children with manifestations of acute and chronic child maltreatment, as well as children with a broad range of other diagnoses. The trainee develops expertise in determining non-accidental trauma and other forms of maltreatment by developing excellent diagnostic expertise and knowledge of various disorders which may mimic child maltreatment. Training will include mandatory reporting laws, legal proceedings, child abuse and family violence prevention, teaching opportunities, and clinical research.
Where do I find out about available programs? Information about Child Abuse Pediatrics training programs is available on The Ray Helfer Society and ACGME websites, as well as FREIDA and ERAS websites. Child Abuse Pediatrics participates in the National Residency Matching Program (NMPR) Pediatric Subspecialties Fall Match. Applications through ERAS occur in July and August, with interviews in September and October. The Match occurs in November, the fall before the Fellowship starts.
Why should I choose to become a Child Abuse Pediatrician? Child Abuse Pediatrics is an exciting field with opportunities for a broad clinical experience that includes multidisciplinary team work with medical and non-medical providers, contributions to investigative and legal proceedings, teaching a wide variety of audiences, clinical research, as well as, child abuse prevention and advocacy work. As a new subspecialty of the American Board of Pediatrics, there is tremendous opportunity to shape the future of this field and contribute to the health, well-being and safety of children.
Certifications
Eligibility Criteria for Certification in Child Abuse Pediatrics
The American Board of Pediatrics (ABP) has established a procedure for certification in child abuse pediatrics. In addition to the specific admission requirements listed below, General Eligibility Criteria for all ABP Subspecialties must be fulfilled to be eligible for certification.
ADMISSION REQUIREMENTS
Physicians who enter training in child abuse pediatrics on or after January 1, 2013, are required to complete their training in a program accredited for training in child abuse pediatrics by the Accreditation Council for Graduate Medical Education (ACGME) in the United States or the Royal College of Physicians and Surgeons of Canada (RCPSC).
A subspecialty fellow entering child abuse pediatrics training before January 1, 2010, may apply for admission on the basis of completion of 2 years of subspecialty fellowship training in child abuse pediatrics in a program under the supervision of a director who is certified in child abuse pediatrics or, lacking such certification, possesses appropriate educational qualifications. Only those child abuse pediatrics training programs that are operated in association with general comprehensive pediatric residency programs accredited by the ACGME or by the RCPSC will be considered. The Subboard requires that the period of training be at least 22 months, excluding leave. A Verification of Competence Form(s) will be required from the director(s) of the fellow’s child abuse pediatrics program(s).
Three years of full-time, broad-based fellowship training in child abuse pediatrics are required for fellows entering training on or after January 1, 2010.
Absences from Training
No continuous absence of more than 1 year will be permitted. Due to the potential for significant changes in medicine over time, the Credentials Committee must review requests for previous credit when a fellow has interrupted fellowship for more than 12 months.
Absences/leaves in excess of 3 months during the 3 years of training, whether for vacation, parental leave, illness, and so forth, must be made up. If the program director believes that the candidate is well qualified and has met all requirements, the program director may submit a petition to the ABP requesting an exemption to the policy. Training time cannot be waived for convenience, such as for fellows who begin training off cycle.
Part-time training may be completed over no more than 6 years.
For a fellow who began child abuse pediatrics training on or after January 1, 2010, the following must be accomplished in order to become certified in the subspecialty:
A Verification of Competence Form must be completed by the program director(s) verifying satisfactory completion of the required training, evaluating clinical competence including professionalism, and providing evidence of scholarly activity/research.
The fellow must meet the criteria stated in the “Principles Regarding the Assessment of Scholarly Activity”. Scholarly activity will not be required for individuals who began training before January 1, 2010.
The fellow must pass the subspecialty certifying examination.
ABP ID #: 1001911 Mohr, Bethany Anne Ann Arbor, MI United States of America
Certification AreaCertifiedCurrently Practicing in this Area of CertificationMeeting the Requirements of Maintenance of Certification in this area (Learn more)Child Abuse PediatricsCertificate# 122
Cannabis Advocates Want To Remove Marijuana From Controlled Substances List
A group of Michigan citizens and organizations is suing the Michigan Board of Pharmacy to eliminate marijuana from the Schedule I list of controlled substances.
The state’s Public Health Code, which was enacted in 1978, treats marijuana like opioids and heroin, and that is “unconstitutional under Michigan law,” wrote Michael KOMORN, attorney for the residents and organizations in the complaint recently filed in the Court of Claims.
“Even opium, a ‘hard narcotic’ and the root of the opioid epidemic, is a Schedule 5 drug when sold in small concentrations,” he said. “As there is no rational basis to classify marijuana with hard narcotics, it now must be classified below Schedule 5. As no such schedule exists, marijuana must be de-scheduled.”
Komorn, president of the Michigan Medical Marijuana Association, also argued that by passing the Medical Marihuana Facilities Licensing Act (MMFLA), the “Legislature has by implication repealed . . . marijuana’s controlled substance status.”
The MMFLA and Michigan Controlled Substances Act (MCSA), he noted, are “fundamentally inconsistent and incapable of being harmonized.”
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Other plaintiffs include the Michigan Medical Marijuana Association, Dr. Christian Bogner, who researches the effects of cannabis to treat autism; Josey Scoggin, whose daughter is a medical marijuana patient; Paul Littler, a pharmacist; NORML of Michigan.
The “absurdity” of the legal conflict between the Medical Marihuana Facilities Licensing Act and the Public Health Code has to be addressed, said Michael Komorn, one of the attorneys behind the case.
“It’s intellectually dishonest,” Komorn said.
For the past year, state officials have allowed caregivers to grow marijuana at home and bring it to provisioning centers to sell to patients — a practice that continues as there’s a shortage of licensed marijuana in the market.
“This is not a controlled substance,” Komorn said. “The idea that someone would be growing an opioid … and bringing it to a pharmacy because they were running low on their meds is the scenario that would have to exist in order for marijuana to remain as a scheduled drug.”
“Michigan’s Public Health Code was adopted in 1978, and mirrored much of the national rhetoric towards drugs”, Komorn said.
“not only that there is no rational basis for classifying marijuana with the ‘hard narcotics’, but, also, that there is not even a rational basis for treating marijuana as a more dangerous drug than alcohol.”
