"Thank You, and Some Corrections"

On December 17th, our post dealt with the State of Maine setting up their medical marijuana program. A few days later we received a comment on our post via Live Journal from Becky DeKeuster of Berkeley Patients Group. We would like to share her thoughts with you as we close out 2009. Next week we will be back to respond to Becky's comments.

Thank you, and some corrections
Greetings, and thank you for addressing the important work that Maine's medical cannabis task force is undertaking to ensure that qualified patients have safe access to medical cannabis there. In the interest of an open exchange of ideas and facts, I write to address some of the concerns you express in this posting, and to clarify certain inaccuracies therein.

First I must correct your statement that "The same people who are helping Maine set up a medical marijuana program are also trying to have full on legalization voted on in the next year in California." Berkeley Patients Group takes no official stand on legal or recreational use of cannabis, and has not contributed to the ballot initiative that California voters may vote on in 2010. To do so would in no way advance our mission, which is as follows:

"The mission of the Berkeley Patients Group is to provide the purest, most effective, and affordable medical cannabis along with integrated holistic health services. We create and maintain the standards of excellence for medical cannabis in all that we do. We foster a compassionate community that advances understanding and inspires action."

As we enter our second decade of operations, BPG is still guided by the vision of our founder Jim McClelland, who died of AIDS-related complications in 2000. To blur the bright line between legalized medical use and legalized adult use would be to do a disservice to Jim, and to the patients who rely on us for medicine, services, and support. We are expert at successful, legal dispensary operations. Legalization is not on our agenda.

My second point refers to the perception that "the west is a mess." If I had a do-over button I would not have used the "Wild West" metaphor in that media interview. It's an easy shorthand, but it paints an inaccurate picture of what is actually happening in western states with medical cannabis laws. (These include Alaska, Washington, Oregon, California, Hawaii, Montana, Arizona, Nevada, and New Mexico.) Each of these states is dealing with implementation in its own way and each is facing various complexities.

It is important to keep in mind that these states are working separately because our federal government has so far refused to accept the findings of its own DEA Chief Administrative Law Judge Francis Young, who ruled in 1988 that "marijuana, in its natural form, is one of the safest therapeutically active substances known." He further stated that "the provisions of the Controlled Substances Act permit and require the transfer of marijuana from Schedule I to Schedule II," and that "it would be unreasonable, arbitrary and capricious for the DEA to continue to stand between those sufferers and the benefits of this substance."

That being said, for the purposes of this comment I will limit my focus to California, which I suspect is the true target of the "wild west" concerns. Of course, the issues that L.A. is facing make for great media and so, unfortunately, those are the reports that the nation hears.

What is less often reported is that there are cities and counties in California where medical cannabis cultivation, dispensing, and use happen with reasonable oversight and without negative impact on local communities or patients. Oakland, San Francisco, Sebastopol, and Berkeley all come to mind as examples. These local governments early on implemented sensible regulations that allowed for, and put reasonable checks on, how patients, dispensaries, and communities can co-exist. And in the case of Berkeley, voters last year authorized a city commission to oversee dispensary operations and safety standards. In short, locales that allow for dispensary operations within clear, fair guidelines simply do not have the proliferation issues that we are seeing in the southern part of CA today. Because their programs are successful, because they work for their communities and don't make waves, they are not sensationalized in the media. The last media BPG received before this past Tuesday was an article in the Oakland Tribune about the City Council of Berkeley unanimously proclaiming our 10th birthday as "Berkeley Patients Group Day" in our city this year. [here is a link to the city's proclaimation "Berkeley Patients Group Day CA 2009" ]

I understand your call for cannabis to be treated as other pharmaceuticals. We have heard it again and again here in California--why can't they just have it in pharmacies? You can get synthesized THC in your local pharmacy, with a prescription. It's called Marinol, or Sativex. Patient responses, though, indicate a strong preference for the natural herbal form of the medicine, which can be self-titrated, and which offers a plethora of strains for the patient to choose from--and yes, scientists here, in Holland, and elsewhere are working hard to match specific strains to relief from specific ailments, and why. We know from our patients' anecdotal experience that various strains work best for different illnesses, but are currently working to link chemical components of each strain to the types of health issues that respond best to each strain. (Again, such research is taking place on a self-regulated basis and under considerable legal restraints, due to the federal government's refusal to address this important concept.) There are even four patients in the U.S. who receive 300 pre-rolled joints a month from the federal government itself, which operates a grow facility at a university in Mississippi.

So. Why can't we dispense it in pharmacies? Well, the folks who make Marinol would like that very much, but the patients say that THC compounded synthetically in a lab doesn't approach the efficacy of using whole plant medicine. Furthermore, cannabis is proven to be less lethal than aspirin. Yes, over the counter aspirin. In terms of patient needs, and taking into account societal impacts, this is not a medicine that requires Schedule I handling (also on Schedule I: heroin and fentanyl. Cocaine and meth are both Schedule II).

Finally, I want to say that I personally appreciate the work you do to help those with addictions to various substances. Your concerns about Maine's implementation of this law are understandable. However, it is especially vital for those in your profession to fully understand the facts about medical cannabis, and to consider Maine's law, and our advisory role, not as a threat but as an opportunity to learn more and to help debunk damaging myths about this substance. I would invite you to research more on the issues I have stated above, and to also consider the emerging role of medical cannabis as a valuable harm reduction tool.

Again, thank you for taking up this issue. I look forward to continued conversation with you as Maine crafts regulations that encourage safe access and sensible medical use standards.

Be well,

Becky DeKeuster
Berkeley Patients Group

"You Cannot Separate The Mind And The Body"

"You cannot separate the mind and the body", said Rep. Patrick Kennedy, D-R.I. People in need of mental health care may finally get the help they need. Insurance companies have always provided the least amount of coverage for mental health and substance abuse patients. Countless people have been denied coverage for mental health related problems, to the point where people have come to accept that that is the way it is. With the help of the late Sen. Edward Kennedy and his son, Rep. Patrick Kennedy, D-R.I., politicians were able to get the parity bill on to the Wall Street bailout package in September 2008. While the entire nation was preoccupied with the presidential election and the economy, the bill was passed without anyone even noticing. Starting Jan. 1, 2010 large group health insurance plans that provide mental health coverage must provide the same level of coverage at the same price as physical and surgical coverage; the new law only applies to group health plans which cover 50 or more. This is the beginning of a very significant change in the way health care is provided. "This is a major piece of civil right's health care legislation," the younger Kennedy told an audience honoring him and Ramstad at Mar-a-Lago last year according to the Palm Beach Post.

Just as with any new bill, there is still a lot that hasn't been worked out, such as the guideline for how the new law will be implemented. Companies that offer mental heath care with their package may choose to drop mental health coverage all together rather then be burdened with the new law. Nobody knows if student health care plans and employee assistance plans fall under the umbrella of this bill or not. Naturally, if insurance companies have to provide equal coverage, the cost of coverage will increase; heightened costs may be unaffordable for a significant amount of employers, forcing them to drop coverage all together.

Despite the kinks that still need to be worked out this is a big step and providing patients what they need and deserve. Routinely, those in need of drug and alcohol treatment have been denied coverage by the health care provider. For too long mental health patients have slipped through the cracks - not any more!

Buju Banton Arrested Trying to Distribute Five Kilograms of Cocaine

Another famous musician has got themselves caught up in the drug business. The world renowned reggae artist, Buju Banton, was arrested with two other people allegedly trying to distribute five kilograms of cocaine. Buju Banton (real name is Mark Anthony Myrie), has been in U.S. federal custody in Miami since Thursday. The Associated Press reports, "Drug Enforcement Administration spokesman David Melenkevitz said Sunday that Banton was arrested on a charge of conspiracy to possess with intent to distribute more than five kilograms of cocaine. The charge stems from a DEA case in Tampa". One has to wonder why a reggae star, like Buju Banton, would get caught up in the distribution of cocaine of any amount.

On April 5, 2004, Banton was fined $9000 for drug possession and cultivation of cannabis; two mature marijuana plants were found in his studio. Banton's defense was that he had just got back from a tour and the plants were there. It is clear that Banton had a history with drugs, but, two marijuana plants is a far cry from 5 kilos of cocaine. "Gargamel Music Incorporated (Banton's label) has announced loyal support for Banton, real name Mark Anthony Myrie, who was arrested December 10 on federal drug conspiracy charges", according to BET. Buju Banton will have help from one of the top law firms in the country, the legal aid will come in the form of David Oscar Markus. Markus defended the former Panama military dictator Manuel Noriega, so it is fair to say that Marcus is known for high-profile drug cases.

It is not clear yet which direction this case will head, there still are many facts that will need to be considered. It appears that Banton has a long trial ahead of him and there are many people who are against Banton and what he stands for. We will keep you updated as to the progress of this trial.

Brittany Murphy May Have Followed The Same Path As DJ AM And Michael Jackson

Actor Brittany Murphy, who got her start in the movie Clueless, died of cardiac arrest at her L.A. home Dec. 20 at the age of 32. The original autopsy was finished on December 21st and concluded that Murphy had died of natural causes; however, an investigator's notes in the coroner's office stated that there was a staggering amount of prescription drugs inside Murphy's LA home. "The investigator's notes reveal that Murphy "had been complaining of shortness of breath and severe abdominal pain" for 7 to 10 days before her death", reports the Examiner. A prescription drug overdose is what investigators are now trying to determine as the cause of the cardiac arrest. It will take 4-6 weeks before a toxicology report is completed. What's strange about Murphy's life and death is that she claimed that she never had tried hard drugs and prescription drugs were too powerful, "I am way too high-strung to do drugs. I can't even take a Sudafed. Can you imagine? My God. I think my heart would explode", according to the Examiner. It appears that Brittany Murphy may have followed the same path as DJ AM and Michael Jackson; three, possible prescription drug overdoses amongst stars in 2009.

The investigators' notes stated that the nightstands at the Murphy residence contained large amounts of prescription medications with Murphy's name on the bottles. There were a lot of empty prescription bottles in Brittany's husband, mother, and unidentified third parties' names. Yet, she never used or had a drug problem, she was perhaps able to hide her addiction problems from everyone. The drugs that Brittany had prescriptions for were:

• Topamax (anti-seizure med)
• Methylprednisolone (anti-inflammatory)
• Fluoxetine (depression med)
• Klonopin (anxiety med)
• Carbamazepine (treats diabetic symptoms and is also a bipolar med)
• Ativan (anxiety med)
• Vicoprofen (pain reliever)
• Propranolol (hypertension)
• Biaxin (antibiotic)
• Hydrocodone (pain medication)

It is clear just from that list of drugs that there was a tragedy unfolding in Brittany's life and it inevitably killed her. A beautiful, 32 year old star lost perhaps to the grips of addiction. Prescription medications are just as dangerous and life threatening than drugs that can be found on the street; 2009 has been a year that reminded us that prescription drugs are a clear and present danger. In the next few weeks there will be more developments that come to the surface, we will have a better understanding as people come forward - someone had to be aware of Murphy's addiction problems.

Maine has Turned to California for Help Setting up a Medical Marijuana Program

Maine has turned to California for help setting up a medical marijuana program; the hope is that they will be able to implement what has worked well in the past. With over 10 years of experience in California they have had plenty of time to make mistakes and to have hopefully learned from them; considering that we are on the edge of what appears to be full on legalization in the next five years. Maine proceeds cautiously into this new territory, hopes to figure out a system that addresses both public safety and the needs of those recommended patients for marijuana. Maine is trying to avoid the craziness that exists out west, dispensaries opening and closing daily and it doesn't seem like any one really understands what is happening - in short the west has become a mess. A task force has been set up, "figuring out how many medical marijuana patients there are in Maine and how many distribution clinics or dispensaries are needed to serve them. At least one member of the panel said he's not sure if the state needs one, 10 or 50", according to ABC News. The task force is composed of 14 members, they will determine rules effective within 120 days; the task force hopes to be able to take every factor into account in order to give the voters exactly what they voted for. Becky DeKeuster, of the Berkeley Patients Group said, "This should not have a negative connotation. This is a medicine. This is essentially a pharmacy with a community center component in our model".

If marijuana is going to be considered a medicine then it needs to be held to the same standards as every other pharmaceutical, the same laws and restrictions should apply to weed as they do to Vicodin. There is no other way to make this a legitimate program, therein lies a huge problem with the legality of marijuana; some are trying to have a medicine and others are trying to have a recreational drug, like alcohol. The same people who are helping Maine set up a medical marijuana program are also trying to have full on legalization voted on in the next year in California. It is noteworthy that Maine is taking the time to create a successful program, but it seems like all of this is a slippery slope and no matter what, all the factors present cannot be addressed. "This task force is not going to be able to accomplish the dotting of every 'I' and the crossing of every 'T', but addressing the issues ahead of time is crucial so that you don't end up with a wild-west situation", DeKeuster said.

Measure To Legalize Pot May Be On California's November Ballot

California residents may find that they are casting their vote in November regarding the legalization of marijuana. The original consensus was that marijuana advocates would wait until 2012 to put it on the ballot, but, 680,000 people signed a petition in favor of legalization causing the timeline to speed up. Marijuana buzz is sweeping the country, as more and more states tarry with the idea of medical marijuana programs; it seems like with every passing month the snowball increases it size and moves faster towards all out legalization. These are big times in the United States, nothing like this has happened since Roosevelt's New Deal; when a country hits hard financial times then it is time to legalize something in order to bring in revenue. Or at least that has been the American way in the past, to make money on the addiction and suffering of others. On the surface it seems like California and America are heading in the right direction: smaller prison populations, less crime, generates tax revenue, pharmaceuticals, hemp, oil, paper, etc... The pros listed are certainly worth agreeing with, it is clear that marijuana does have benefits and could be utilized in number of ways. However, California may be heading down a slippery slope and could possibly bring the whole country with it.

Richard Lee, the measure's main proponent, said to the LA Times, "It was so easy to get them, People were so eager to sign". Richard Lee has already invested over a million into the campaign, he owns a dispensary and a marijuana college called Oaksterdam in Oakland, California. "The initiative would allow cities and counties to adopt laws to allow marijuana to be grown and sold, and to impose taxes on marijuana production and sales. It would make it legal for anyone who is at least 21 to possess an ounce of marijuana and grow plants in an area of no more than 25 square feet for personal use", according to the LA Times. Medical marijuana has completely shifted how we look at marijuana in the United States, opening the door to all out legalization talks such as this; it appears at this point that the pro-marijuana campaign is having more success than those against it.

We are still a year out from the polls and naturally a lot will take place between now and then. It is still anyone's guess! What we can be certain of is that money will end having the final say in this debate. As with most political battles, those who spend the most have the best chance of passing something - even if it is the worst possible thing. In many people's eyes marijuana is already legal because it is so easy to get a recommendation to use cannabis. If this trend keeps up, marijuana and alcohol will be in the same class. My only hope is that addiction is considered in the debates and the public is made aware of the implications of legalizing an illicit drug.

California Medical Marijuana Is Doping Our Youth

Marijuana is being used to help treat Attention-Deficit Hyperactivity Disorder (ADHD) with children in California, has medical marijuana gone too far? This is one of those things that is a question of ethics and certainly needs to be addressed before there is a catastrophe. In 1999 California voters passed a law which allowed doctors to recommend cannabis for medical use, including minors. A seventeen year old with leukemia is a far cry from a twelve year old with ADHD. In California Marijuana can be recommended "for any ... illness for which marijuana provides relief". It has been known for a long time that marijuana inhibits focusing and motivation, how marijuana could be considered useful for ADHD is beyond me; the Washington Times reports, "ADHD is described as a neurological disorder that prevents children from focusing on a specific task. In essence, people with ADHD have difficulty with self-regulation and self-motivation, owing to problems with distractibility, organization and prioritization".

In the United States we are guilty of over-medicating our children and as a result our children suffer. With 14 million Adderall prescriptions last year it is obvious that we are too quick to medicate. Now we are drifting into the world of alternative medications like marijuana to fix our problems with out doing all the research. There needs to be a certain level of digression by doctors when recommending marijuana, otherwise we will be fueling addiction throughout our youth. "What they don't realize is that marijuana use during childhood and the early-teen years produces significantly different effects than marijuana use later in life. The behaviors exhibited by introducing tetrahydrocannabinol -- the active ingredient in marijuana -- to the brain are similar to those demonstrated by alcohol consumption", reports the Washington Times.

We need to start getting real with ourselves regarding the benefits of medical marijuana. Its uses are limited and do not apply to everyone, it has side-effects that have no place in a child's life. If marijuana is going to be legal it needs to be treated like every other prescription drug and be held up to the same scrutiny. We wouldn't give Oxycontin to a child for a hang nail!

Cannabis Could Help Combat Substance Abuse

A new study at the University of California, Berkeley showed interesting results regarding marijuana and what it could be used for. The study showed that many people are using marijuana to keep themselves from drinking alcohol or doing other illicit drugs. It seems counter intuitive to use a drug to stay off other drugs, but, in these studies researchers have found that cannabis could help combat substance abuse. The study consisted of a 350 cannabis users at a cannabis dispensary the Berkeley Patient's Group. Out of the 350 patients, 40 percent claimed that marijuana helped control their alcohol. 66 percent of the group used cannabis as an alternative to prescription drugs and 26 percent used it to replace hard drugs like heroin and cocaine. These findings are rather alarming but not surprising, addicts have been substituting one drug for another for a long time; marijuana may be less harmful than other drugs but the disease is still present and thriving.

There is no question that marijuana is a better alternative than a lot of different chemicals out there, but, the disease of addiction is being fed by smoking weed and a person's problems are far from being dealt with. Amanda Reiman heads up this study and feels that marijuana could be an effective treatment for other addictions; she may be right, as far as the detoxification process goes. However, this proposed treatment method will not show the addict a better way of life, just another way to blanket one's problems. Marijuana may be an effective medication for certain ailments, I'm not sure that the disease of addiction is one of them.

We can be sure that all the new studies that are taking place will generate the need for more research into the medical benefits of cannabis. The times are changing with regard to marijuana and its new found acceptance, according to Reiman, The Independent reports: "The economic hardship of the Great Depression helped bring about the end of alcohol prohibition. Now, as we are again faced with economic struggles, the US is looking to marijuana as a potential revenue generator. Public support is rising for the legalization of recreational use and remains high for the use of marijuana as a medicine".

Ecstasy Users are at Higher Risk of Sleep Apnea

On any given night in Los Angeles throughout the club scene people are using various illicit drugs. Drugs, known as "club drugs," include MDMA/Ecstasy (methylenedioxymethamphetamine), Rohypnol (flunitrazepam), GHB (gamma hydroxybutyrate), and ketamine (ketamine hydrochloride). There are several other designer drugs out there as well, 5-MeO-MiPT or Foxy Methoxy is one of them, what makes these drugs so dangerous is that they are very difficult to dose. Perhaps the most popular of these drugs, MDMA(3,4-Methylenedioxymethamphetamine or Ecstasy); characteristically found in the night club and rave scenes, is a psychoactive amphetamine that has been known to do severe damage to the brain. Scientists who have been researching the effects of Ecstasy have discovered that Ecstasy users are at higher risk of sleep apnea. US News reports, "People who use ecstasy need to know that this drug damages the brain and can cause immediate and dangerous problems such as sleep apnea", study author Dr. Una McCann, of the Johns Hopkins School of Medicine in Baltimore, said in a news release".

How long a person used Ecstasy directly affected how severe their sleep apnea is, according to the study. The study comprised of 71 ecstasy users (or had used) and 62 people, normal non-users. What was determined was the people who had used Ecstasy had an eight-fold increased risk of sleep apnea. Obviously, non-users do experience apnea, at least mildly; mild sleep apnea rates were similar in both groups, 27 % of non-users experienced mild sleep apnea. However, the study showed that 13% of ecstasy users experienced moderate apnea and 1% showed severe sleep apnea. "They also found that ecstasy use was a greater risk factor for sleep apnea than obesity", according to US News.

What is clear is that MDMA or Ecstasy does damage to the brain that may not be reversible. MDMA is not widely understood by scientists, let alone your typical addict; everyday we are seeing what these drugs do to the brain and it is not a pretty sight. "Our findings may be explained by how ecstasy damages neurons related to serotonin, a chemical in the brain that is involved in sleep regulation and breathing, among other important functions", McCann said. "Sleep apnea in itself is dangerous, but it can also contribute to thinking problems in people who use ecstasy because chronic sleep disruption is known to have a negative effect on how a person functions during the daytime". People going out at night for a good time are doing damage to their brain that cannot be repaired.

Fentanyl The Strongest Opiate Medication On The Market

Fentanyl, the strongest opiate medication on the market is being found on the streets today. Fentanyl is generally only prescribed to people with the severest of pain, patients with cancer, burn victims, and those who have had intensive surgery. Naturally, like all other opiate drugs, Fentanyl is being abused either by itself or it is being mixed with drugs like heroin to increase potency. The drug can be found in several different forms; from trans-dermal patches to lollipops there are multiple ways to consume Fentanyl. Every medical center in the country is at risk of having the medication stolen by patients or employees; drugs like Fentanyl need to be closely monitored to limit the amount that makes it to the streets. The drugs highly addictive properties has some people asking whether or not the drug should be restricted, which could make it very difficult for people who legitimately need the drug to acquire it.

Thaindian News reports, "some people have already started to distribute Fentanyl lollipops illegally. These illegal drugs uses the nickname, "perc-a-pop" and has become popular among a large number of people for its sweet taste. Though the price of the illegal drugs is double than the original drugs, number of people getting addicted to this drug is increasing. Not only people are using "perc-a-pop" but also some people who have been addicted to this drug have stolen them from medical centers, stated sources". Opiates have been known to be highly addictive and continued use will guarantee dependency. Drugs, like Fentanyl, have their place in society because the are highly effective for pain relief; however, if we continue to distribute these drugs we need to track them closely. Overdoses are common with strong opiates and many people do not understand how easy it is to take too much.

It will be interesting to see if drugs like Fentanyl will be heavily restricted in the near future.