Lawmaker says top issue for constituents is marijuana; oncologist advocates for safe access

02/12/2017 12:39 PM

Far and away the largest number of phone calls from constituents of Rep. Jason Nemes, R-Louisville, are in support of marijuana legalization, and he says he’s heard plenty of other lawmakers also getting the calls.

Nemes recently published online what voters are calling him about, and in a phone interview with Pure Politics he said the calls on marijuana come in three forms: advocating for medical marijuana in pill form, medical marijuana that can be smoked and full-scale state legalization of the federally illegal drug.

“I’m getting contacted on all three of those areas, I don’t know where I am on it, but the Kentucky Medical Association tells me there’s no studies that show that it’s effective,” Nemes said in a phone interview on Wednesday.

Dr. Don Stacy, a board certified radiation oncologist who works in the Kentucky and Indiana areas, said there’s a reason there’s no studies proving effectiveness — studies have not been allowed to take place.

“It’s one of those things where we can’t provide randomized phase three studies in cannabis without making it legal — that is the gold standard for any sort of medicine,” Stacy said. “We have a variety of studies of that nature from other countries of course, but American physicians are very particular about American data. The database we have now is plenty enough to say we shouldn’t be arresting patients for trying to help themselves.”

Stacy said he became interested in marijuana after he noticed some of his patients were doing better with treatment than similar patients. In reviewing their records and through private discussions with the patients, he learned “a significant portion” of those doing better were the patients using marijuana.

“I was surprised by that,” he said. “I’ve always been a skeptic of alternative medicines, but then I began to research the data. I was impressed with the data.”

Dr. Stacy said he’s had some particular patients who showed minor or moderate improvements or side effects, but patients who had to stop treatment because the toxicity of the treatment was so severe. The patients who had to stop treatment tried marijuana, and then they were able to complete their treatments showing “dramatic differences,” Stacy said.

Because of the improvements in patients, Stacy is advocating for safe and legal access to the drug.

Twenty-eight states and the District of Columbia allow access to medical marijuana in different forms. Through those states allowing access, Stacy said several show improvements outside of overall medical care.

In states that have legalized medical marijuana the suicide rate has dropped by 10 percent among males 18 to 40, he said.

“It says when people have serious medical or behavioral issues — if you cannot find the treatment that helps you then some people decide to end their lives, and cannabis apparently prevents a certain portion of people from doing that.”

Stacy said that there is also a 10 percent decrease in physicians prescribing narcotics in medical marijuana states. The effect of that, Stacy said is a 25 percent decrease in overdose deaths linked to narcotics in states with medical cannabis laws. With the level of heroin and opiate abuse in Kentucky, he said there would be positive effects seen here too.

“I think that one-quarter of the people who will overdose and die of narcotics in this state in this year would be alive if we had a medical cannabis law.”

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Kentucky Marijuana Legalization Not In Pre-Filed Bills For 2017

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Across America, Election Day showed strong support for marijuana legalization, but can Kentucky expect the same in 2017?

While Kentucky had some promise in 2016 that legalizing marijuana was in the works, they did not join the eight states that voted for either recreational or medical marijuana on November 8.

According to Marijuana Policy Project, marijuana was legalized for recreational use in California, Maine, Massachusetts, and Nevada. In addition, Arkansas, Florida, North Dakota, and Montana all voted for medical marijuana.

Currently, 28 states in America have legalized medical marijuana, but will Kentucky catch up anytime soon?

The excitement with Kentucky marijuana laws started in December, 2015, when state senator Perry Clark introduced the idea after many previous attempts.

Dated March 6, the bill Perry Clark introduced was called the Cannabis Freedom Act in Kentucky.

 

Following this, updates about Kentucky marijuana laws hit a milestone on July 5. As previously reported by the Inquisitr, meetings were being held “behind closed doors” about a proposed medical marijuana law.

At the time, Kentucky senator John Schickel, said they needed to hold the meetings about marijuana legalization to “vet” the issue, according to WFPL.

On July 11, WKMS reported that Kentucky’s medical marijuana laws got a boost of support by the prestigious health organization in the state, the Kentucky Nurses Association. About legalizing marijuana in Kentucky, a representative for the nurse’s association stated, “providing legal access to medical cannabis is imperative.”

Although it was talked about in meetings at the Kentucky Senate, according to their notes posted in July, August, and October, the marijuana legalization issue appeared to be stalled.

In late September, WFPL concluded their article about the marijuana legalization attempts in Kentucky with “the bill was assigned to a committee but never received a hearing.”

They also quoted Kentucky state senator Jimmy Higdon, stating that the lawmakers were confused about how the bill would be implemented. Senator Higdon said he would mainly be interested in allowing medical marijuana “to be prescribed in end-of-life situations.”

Does the lack of new updates mean that the bill has completely dried up, and Kentucky will not be seeing more medical marijuana laws to vote on in the next election?

Sadly, the pre-filed 2017 Kentucky House Bills that are available online do not reflect any updates about marijuana as of November 25.

Despite this, there could be updates in the near future because the Cannabis Freedom Act that was discussed in 2016 was actually filed in early December, 2015. This means Kentucky still has some time to see if marijuana legalization might be a big part of elections in the state in 2017.

 

On the other hand, Kentucky could get a lot of new laws about controlled substances in 2017, but they are not marijuana-related. For example, pre-filed bill BR 201 states it will “create the offense of aggravated fentanyl trafficking” in the state of Kentucky law books.

Adding to this, pre-filed bill BR 210 that sits before the Kentucky state senate in 2017 states its purpose is “to make trafficking in any amount of fentanyl or carfentanil subject to elevated penalties.”

New proposed bills in the state of Kentucky are also targeting the medical community. For example, pre-filed bill BR 202 states the following.

“[A] practitioner shall not issue a prescription for a narcotic drug for more than seven days unless specific circumstances exist.”

Of course, Kentucky might not have time to vote on marijuana legalization because Donald Trump may not be building his cabinet with marijuana supporters.

For example, CNN reported on November 25 that Donald Trump is appointing a marijuana legalization opponent, Senator Jeff Sessions, as his Attorney General.

About marijuana, Jeff Sessions was quoted as stating the following at a senate hearing in April, 2016.

“Good people don’t smoke marijuana. We need grown ups in Washington to say marijuana is not the kind of thing that ought to be legalized, it ought not to be minimized, that it is in fact a very real danger.”

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The Law of Unintended Consequences: Illicit for Licit Narcotic Substitution

Image result for heroin plant

Originally written July 15, 2014 at LINK below

Martin R. Huecker, MD and Hugh W. Shoff, MD, MS

 

The dealers will not use it. Heroin dealers have explicit knowledge of the addictive properties of their product. The heroin addict is no longer the desperate character living under a bridge. She is a 17-year-old high school senior who runs out of her grandmother’s oxycodone. He is the stockbroker who weighs the economics of purchasing one oxymorphone on the street for $100 or ten doses of heroin for $200. Because these people are ingesting and injecting products of unknown composition and unfamiliar potency, they can potentially overdose. If lucky, they end up in the emergency department rather than the morgue.

Kentucky ranks third in the nation in drug overdose mortality rate per 100,000 persons, with opioid pills making up the majority.1 In response to these statistics, the State of Kentucky passed House Bill One (HB1) in April 2012, effective October 2012. Also known as “the pill mill bill,” HB1 contains provisions intended to limit opioid prescriptions by pain management physicians and by other acute care providers such as emergency physicians. To prescribe narcotic pain medications, physicians must perform a full history and physical, prescribe only a short course, educate the patient on risks of controlled substances, and obtain a report from a statewide prescription monitoring program (PMP) (Kentucky All Schedule Prescription Electronic Reporting [KASPER]).2

As a result, the number of registered KASPER users in Kentucky has gone from 7500 to 23,000 from December, 2011 to November, 2012. Reports are up from 3300 to 17000 in the same time frame.3 According to the same press release, Kentucky witnessed a decrease of 10.4% total prescriptions in the first six months since HB1 was enacted.3

Mandating PMP reports, as sixteen states currently do, leads to an increase in reports, but so far no statistical difference in opioid overdose mortality.1,4,5,6 In fact, this legislation may not even lower the rate of opioid consumption, rather may shift which opioids are being prescribed.6

Researchers in Ohio looked at the impact of real time PMP information on opioid prescriptions. With PMP data, providers changed prescriptions in 41% of cases; 61% giving fewer opioids but 39% prescribing more opioids.7

House Bill One was intended to and has reduced opioid prescriptions in Kentucky. Forty-four pain clinics in Kentucky closed overnight.8 Preliminary analysis at a large, metropolitan emergency department has shown a decrease in prescriptions for hydrocodone and oxycodone, along with a decrease in ED administration of these medications. This type of “pill mill” legislation has been passed in Louisiana, Florida, Texas and California with varying results.9

Florida had a sharp decrease in opioid prescriptions after similar legislation. Having 90 of the top 100 physicians on the Drug Enforcement Agency (DEA) 2010 list of top opioid purchasers, Florida saw the number decrease to 13 in 2011, and zero as of April 2013.10 In 2011, Ohio passed a “pill mill bill” to crack down on pain management clinics.11 This legislation led to seizing of 91,000 prescription pills with 38 doctors and 13 pharmacists losing their medical licenses. In the end, 15 medical professionals were convicted on diversion charges.11 With all of this, pill overdose deaths began to decline, but heroin overdoses “skyrocketed.”11

The unintended but foreseeable consequence of such measures has been increase in distribution, abuse, and overdose of heroin. Heroin has gained market share in a similar way in the past. In 2010, Purdue Pharma began manufacturing a reformulated OxyContin after a $600 million fine for misrepresentation.12 Endo Pharmaceuticals Inc. followed in 2011 with an Opana ER reformulation. This resulted in making the pills harder to crush into powder for snorting or injecting.13,14 States such as Florida, Ohio, Minnesota, and Utah have seen patients turn to heroin after crackdown on prescription opioid availability.11,14

The New England Journal of Medicine warned us of what would be a two-fold increase in heroin use after the reformulation of Oxycontin.15 In the 2010 ODLL report, the United States DEA also attempted to warn health care organizations that Oxycontin users might switch to heroin.16,17 The first paper we know of to report this warning was published 3 years later in 2013.16 This paper, a qualitative study of the transition of opioid pill users to heroin users, provides insight into the economic and convenience factors associated with the switch. The researchers interviewed a small sample of heroin users, forty-one in all. All but one of the 19 heroin users aged 20–29 started with pills and progressed to heroin – “termed pill initiates.”16

Numerous popular news reports directly implicate decreased opioid pill availability in the rise of heroin abuse and overdose.16 However, very little discussion of this phenomenon has entered the emergency medicine literature.

The drug cartels have capitalized on the United States opioid appetite and now decreased supply of pills. The route from Mexico to Detroit, then south through Ohio, ends up in northern and central Kentucky. The Kentucky State Police recovered 433 samples of heroin in 2010. In 2012 the number was 1349.13 In Lexington, KY, the eight total heroin arrests in 2011 exploded into 160 in the first 6 months of 2013.18,19 Undercover narcotics officers in Lexington find it easier to buy heroin than marijuana.

Heroin-related overdoses in Kentucky increased from 22 cases in 2011 to 143 cases in 2012, and 170 in the first 9 months of 2013.8,20,21 Kentucky’s percentage of overdose deaths involving heroin went from 3.2 in 2011 to 19.5 in 2012 and up to 26 in 2013.8.21 This phenomenon has occurred in Florida, California, Massachusetts, New York, Oregon, Washington and Ohio.11,2224

The emergency medicine literature has minimal recent discussion of heroin overdose management in the ED; nor have we discussed secondary prevention. Supportive therapy suffices in the ED, with liberal naloxone use and airway protection. State and federal actions to curb heroin deaths can be effective. Good Samaritan laws, present in only one third of states, protect from prosecution those lay individuals attempting to help themselves or companions in overdose situations.

Also present in only one third of states are laws to expand community access to reversal agents such as naloxone. Twenty-two states have laws requiring or recommending education for opioid prescribers. Medicaid expansion to cover substance abuse treatment has occurred thus far in less than half (24) of states.1

As more states enact measures intended to reduce total opioid prescriptions, legislators and healthcare providers alike must be aware of the predictable and devastating rise in heroin sales, abuse, and overdose. Funding for this legislation should include monies allocated toward substance abuse treatment programs and availability of naloxone. Similarly, pill mill bills could universally be coupled with Good Samaritan laws in anticipation of the increase in parenteral opioid overdoses. Funds could be allocated to lay population education via public service announcements. Stricter punishments for drug traffickers could accompany such legislative changes. Many of these measures have been presented as interventions to combat prescription opioid abuse and can now be applied to the subsequent heroin abuse and overdose dilemma.9

At the first line of medical care, emergency physicians must be involved in efforts to minimize collateral damage in this long-term process of curing America’s addiction to opioid drugs and their horrible consequences.

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Maryland has recently been cited as a state with a high rate of opioid addiction, and now some are seeing legalizing marijuana as taking a lead against the epidemic and are also urging southern states like Kentucky to join in.

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Maryland has recently been cited as a state with a high rate of opioid addiction, and now some are seeing legalizing marijuana as taking a lead against the epidemic and are also urging southern states like Kentucky to join in.

Newsmax reports that nine states will be voting on marijuana legalization in 2016, but is there some specific reason Maryland is urging southern states to join in?

The Hill explained in an opinion piece on August 4 that Maryland will be fighting back at the opioid epidemic in their state by legalizing marijuana. They also state that some drug treatment specialists in Maryland are considering medical cannabis as treatment for opioid addiction due to a recent study from the University of Georgia.

Citizens in the state of Kentucky have also expressed an interest in this form of opioid treatment, but medical marijuana is still illegal in the state despite recent considerations, as previously reported by the Inquisitr.

Part of the reason that Maryland could be urging other states to join in with legalizing cannabis pertains to the lack of opioid treatment options in other states in the south.

For example, NPR reported on June 15 that those in the opioid treatment industry in Georgia were outraged when the state decided to place limits on opening new clinics.

The rehabilitation clinics they do have are needed because Georgia has almost 70 opioid treatment programs. By contrast, nearby Tennessee has 12, Alabama has 24, and Mississippi has one.

Although any clinic for opioid addiction is better than no clinic at all, many Kentuckians have learned from states like Massachusetts, that they need to have medical marijuana options, specifically for opioid addiction, according to CBS News.

States that use marijuana to treat addiction could also become leaders because the numbers of opioid deaths are rapidly increasing nationwide.

Whether it is heroin, painkillers, or fentanyl, Americans are now dying at higher rates from opioid drugs, and the rate exceeds other types of accidents. For example, Vox wrote on June 2 that more Americans were killed by painkillers (42,000) in 2014 than car crashes (34,000), or gun violence (34,000).

Naturally, any help Kentucky can get to fight opioid addiction with or without legalizing marijuana would be welcome, and a 2015 report from the Boston Globe about the epidemic in Eastern Kentucky quoted a drug treatment prevention worker stating the following.

“We’ve lost a whole generation of people who would have been paying taxes, and buying homes, and contributing to society.”

Eastern Kentucky has been highly documented in regards to having one of the worst opioid epidemics in America, and an investigative report about the Appalachian crisis in the Guardian in 2014 stated that “stigma and inadequate access to treatment are the biggest barriers to overcoming the ongoing crisis in Appalachia and across the country.”

However, outside of being an effective treatment for battling the state’s opioid epidemic, many Kentuckians are excited to see the other improvements that legalizing marijuana, or hemp, could have for economies like the one in Eastern Kentucky.

According to some reports, the process begins with decriminalizing marijuana. The act of decriminalization of marijuana will also likely protect the prominent illegal operations already deeply entrenched in Eastern Kentucky, as described by Columbus Dispatch.

Kentuckians for Medical Marijuana published a 2013 study by Charles B. Fields, Ph.D., Professor of Justice Studies at Eastern Kentucky University, that stated “economic benefits… can be realized by the State of Kentucky by both receiving tax benefits and reducing expenditures enforcing current marijuana laws.”

In other words, there is a price to pay to keep marijuana illegal in Kentucky, and legalizing cannabis or decriminalizing the growing, selling, or distribution could reduce Kentucky’s overall drug enforcement costs.

Currently, the unregulated marijuana industry in Eastern Kentucky produces an estimated $4 billion per year, according to a commonly cited 2008 History Channel documentary on Appalachia called Hillbilly: The Real Story.

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Tobacco continues to green up Kentucky’s economy

 

 

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August 3, 2016

Tobacco continues to green up Kentucky’s economy

It used to be nearly impossible to drive through Kentucky in August and not see tobacco growing in a field.

In the summer of 1998, the leaf crop accounted for 25 percent of the state’s farm cash receipts and was grown by 46,000 farmers statewide. It was also grown by many of those farmers’ parents and their parents before them. For many, tobacco was Kentucky. 

Today the number of Kentucky tobacco growers has fallen to 4,500, but tobacco is still very much alive across the state. The crop accounts for a fair amount of all agricultural cash receipts– about six percent–at a time when overall agricultural cash receipts are at record levels. And that success is largely due to tobacco, too, says Governor’s Office of Agricultural Policy Executive Director Warren Beeler.

Beeler told the state legislative Tobacco Settlement Agreement Fund Oversight Committee today that Kentucky’s dedication of half of the funds received from a 1990s national master settlement with tobacco companies to agricultural diversification is the envy of many states. The appropriation was set out in 2000 House Bill 611 which helped propel the state to a record $6.5 billion in agricultural cash receipts in 2014.

“We are the envy of all states with our tobacco money,” said Beeler. “We’ve gone from $3.7 billion (in total agricultural cash receipts) when we got the (settlement) money to $6.5 billion now, and I don’t think that’s a coincidence….”

Lawmakers thanked Beeler, former GOAP Executive Director Roger Thomas and others for speaking at last month’s Southern Legislative Conference Annual Meeting in Lexington about HB 611’s successes. Committee Co-Chair Rep. Wilson Stone, D-Scottsville, said many delegates to the meeting were impressed with Kentucky’s use of its tobacco settlement dollars to diversify its agricultural economy.

Beeler said he heard from individuals in state after state across the South who said “they wish they’d done what we’d done.” Kentucky’s efforts have almost doubled its receipts at the farm gate, he said.

“It’s no coincidence… Don’t tell me it is, because plain-and-simple fact is we know this money has worked,” he told the committee.

The biggest project in the history of the GOAP and the Kentucky Agricultural Development Board which it administers is a $30 million grain crops and forages center planned for construction on the property of the UK Research and Education Center in Princeton. Half of the project amount, of $15 million, will be provided as a matching grant from the Agriculture Development Board, said Beeler. UK must match the award for the center.

Beeler said the project, which is also supported by the Kentucky Corn Growers Association, Kentucky Small Grain Growers Association, Kentucky Cattlemen’s Association and others, will pay dividends for the next 50 years. Proposed work with ryegrass alone could have a big payoff, he said.

Sen. Paul Hornback, R-Shelbyville, gave special thanks to the Corn Growers Association which Hornback said purchased property for the center that will be leased to UK for repayment. “I appreciate what you all did,” he said to members of the association and all involved in the project.

“Everybody is very appreciative” for this project, Beeler assured lawmakers.

The center will feature new meeting facilities, laboratories, offices and improved internet access “so professors at the center can teach classes for students in Lexington,” according to a press release on the center from the University of Kentucky. “…All commodity areas based at Princeton including beef cattle, forages and pastures and horticulture will benefit from the improvements and expansion.”

–END–

Marijuana Foes Losing Direction in Kentucky

 
With Thomas Tony Vance and Angela Gatewood.
 
Thomas Tony Vance

 

An Informational Town Hall meeting on Medical Cannabis was held on November 8. 2015 in Alexandria, KY sponsored by Veterans of Foreign Wars Campbell County Post 3205 Auxiliary and Veterans for Medical Cannabis Access. Having given the keynote speech at that event I was surprised and somewhat curious when immediately afterward the opponents of marijuana legalization organized and held one on December 1, 2015. The ‘Marijuana Summit’ was published as giving both sides of the issue.

 
I attended the event. They offered a ‘Legislative Breakfast’ and all our local legislators were there. They seemed to be very close with the organizers of the event. During breakfast Mr. Tony Coder, the Assistant Director of Drug Free Action Alliance, presided over a lively discussion of the issues. Senator Perry Clark, who attended, responded to the notion that since we already have a heroin problem we don’t need to legalize another drug. Ignoring the obvious attempt to link heroin with marijuana Senator Clark pointed out the report published in the Journal of the American Medical Association of a 25% drop in opioid drug overdose deaths in states that have medical cannabis programs and that that percentage is increasing.

The response was a change of subject.

I was struck by the snarky way Mr. Coder regaled us with the story of him breaking California law and lying to obtain a medical marijuana card to prove how easy it was to get one. At this point I was able to get a word in and posed him this query.

California has had medical marijuana since 1996. You say that’s a scam and Californians can access marijuana any time they want. Ok, I’ll give you that, (when I said that he looked surprised, then I continued), however that means the citizens of California have had easy access to marijuana for 20 years. You have to answer this. Where are the bodies? Where are all the bad things you all say will happen if marijuana is legalized?

Another change of subject.

Mr. Coder repeated his easy access claim during the next session on marijuana prohibition history. I quickly pointed out that he proves my point.
Change of subject.

The 3rd session was a speech by Mr. Ed Shemelya, the National Coordinator for the National Marijuana Initiative, a retired police officer who worked extensively with the High Intensity Drug Task Force and gives speeches for a living. He did point out, among a load of numbers that if 2 of the 6 states that will have legalization on the ballot pass it in 2016 it is, as he put it, “all over folks!”
Oh I wish it were true!

I had to leave at the halfway point. The first session after lunch was about hemp which is legal and really only a problem for the helicopter eradication program. The last was about the last 2 Monitoring the Future surveys concerning teen access and use which has not changed significantly with legalization. The interesting thing here is that with the exception of medical need supervised by a Doctor, no State has or will legalize marijuana for anyone under 21, so it’s really a moot point.

They always come back to protecting the children. I wonder? Marijuana has been used by women for menstrual cramps and morning sickness for 4000 years. In all that time there is no anecdotal evidence of birth defects or problems in birth resulting from marijuana use during pregnancy. Given the role we now know the cannabinoid system plays in maintaining good health and the fact of marijuana’s zero toxicity, one can envision a future in which ones Cheerios come, “fortified with THC for your protection”.

The ‘Marijuana Summit’, although misguided was certainly sincere, however we would be better served by them joining in as legalization comes and helping to craft effective policy rather than opposing it completely and having no say in the policy eventually enacted.

 

SOURCE