New study seeks to understand whether people are using cannabis for evidence-based reasons
Date: February 4, 2019 Source: Michigan Medicine – University of Michigan Summary: A new study seeks to understand whether people are using medical cannabis for evidence-based reasons.
Slowly but surely, the stigma surrounding marijuana use is losing its grip in the U.S. Since the 1990s, advocates have pushed for a re-evaluation of cannabis (the plant species name often used interchangeably with marijuana) as a viable treatment for a host of ailments. As of 2018, 33 states and the District of Columbia have approved the medical use of cannabis, while 10 states have legalized marijuana for recreational use. Despite this fact, at the federal level, marijuana remains a Schedule 1 drug under the Controlled Substances Act, defined as a drug with no currently accepted medical use and a high potential for abuse.
New research from the University of Michigan, published in the February issue of Health Affairs, takes a deeper dive into state medical marijuana registry data to provide more insight into its use.
Hmm…what data?
“We did this study because we wanted to understand the reasons why people are using cannabis medically, and whether those reasons for use are evidence based,” says lead author Kevin Boehnke, Ph.D., research investigator in the department of anesthesiology and the Chronic Pain and Fatigue Research Center.
He and his U-M colleagues Daniel J. Clauw, M.D., a professor of anesthesiology, medicine, and psychiatry and Rebecca L. Haffajee, Ph.D., assistant professor of health management and policy, as well as U-M alum Saurav Gangopadhyay, M.P.H., a consultant at Deloitte, sought out data from states with legalized medical use of marijuana.
To examine patterns of use, the researchers grouped patient-reported qualifying conditions (i.e. the illnesses/medical conditions that allowed a patient to obtain a license) into evidence categories pulled from a recent National Academies of Sciences, Engineering and Medicine report on cannabis and cannabinoids. The report, published in 2017, is a comprehensive review of 10,000 scientific abstracts on the health effects of medical and recreational cannabis use. According to the report, there was conclusive or substantial evidence that chronic pain, nausea and vomiting due to chemotherapy, and multiple sclerosis (MS) spasticity symptoms were improved as a result of cannabis treatment.
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Evidence-based relief
One major finding of the Health Affairs paper was the variability of available data. Less than half of the states had data on patient-reported qualifying conditions and only 20 reported data on the number of registered patients. The authors also noted that the number of licensed medical users, with 641,176 registered medical cannabis patients in 2016 and 813,917 in 2017, was likely far lower than the actual number of users.
However, with the available data, they found that the number of medical cannabis patients rose dramatically over time and that the vast majority — 85.5 percent — of medical cannabis license holders indicated that they were seeking treatment for an evidence-based condition, with chronic pain accounting for 62.2 percent of all patient-reported qualifying conditions.
“This finding is consistent with the prevalence of chronic pain, which affects an estimated 100 million Americans,” the authors state.
This research provides support for legitimate evidence-based use of cannabis that is at direct odds with its current drug schedule status, notes Boehnke. This is especially important as more people look for safer pain management alternatives in light of the current opioid epidemic.
Notes Boehnke, “Since the majority of states in the U.S. have legalized medical cannabis, we should consider how best to adequately regulate cannabis and safely incorporate cannabis into medical practice.”
BUT WAIT…WHAT’S THIS ??? A CONTRADICTION
Major study finds ‘no evidence’ that cannabis relieves chronic pain
Do cities and townships have the ability to restrict where caregivers grow medical marijuana?
Over the course of the legalization of Medical and Recreational marijuana many have debated about whether control over dispensaries should be at the local or state level.
A 2016 event in Byron Township, which is located south of Grand Rapids. A medical marijuana caregiver as well as patient registered with the state as a medical marijuana commercial grower back in 2016.
The township has zoning laws that restrict medical marijuana caregivers to use their homes for their grow operations and prohibits the use of commercial property. The township also requires caregivers to obtain a local permit.
The Township then ordered the patient to stop all operations the same year.
The medical marijuana grower then sued the Township.
In July of 2018 when the Michigan Court of Appeals upheld a lower trial court’s decision that stated there is no provision in the Michigan Medical Marihuana Act that would allow a municipality to restrict where caregivers can grow medical marijuana.
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The Court of Appeals concluded:
We conclude that the Michigan Medical Marihuana Act permits medical use of marijuana, particularly the cultivation of marijuana by registered caregivers, at locations regardless of land use zoning designations as long as the activity occurs within the statutorily specified enclosed, locked facility
After that Court of Appeals ruling Byron Township, the Michigan Townships Association and the Michigan Municipal League appealed the ruling to our state Supreme Court. That is the status today.
Lawyers for the Michigan Municipal League wrote in their amicus brief:
The voters who approved the MMMA did not clearly intend to immunize medical marijuana patients and caregivers from all local land use laws, and the Court of Appeals’ finding of such immunity ignores both that lack of intent and the very concept of local home rule
It makes a lot more sense to have people who are truly accountable to the public making the decisions
This situation will certainly have an eye kept on it
(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.”
Cannabis advocates are suing the State of Michigan to remove marijuana from the state’s list of controlled substances in its Public Health Code.
Although the passing of the adult-use marijuana law in Michigan in 2018, medical marijuana laws and the addition of bureaucracy and state taxes on marijuana sales, the state’s Public Health Code still treats marijuana like heroin.
“For 80 years they’ve been locking people up and taking their possessions and harassing and terrorizing us as citizens because we like to smoke weed,” said poet and activist John Sinclair
“I want to be part of every effort to completely remove the police from our lives regarding to marijuana. They’ve got nothing at all to do with marijuana.”
Sinclair is one of several plaintiffs on the lawsuit against the Michigan Board of Pharmacy and its chairwoman Nichole Cover, filed last week in the Michigan Court of Claims.
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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.”
