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Patient Advocate since 1977


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“I don’t feel high or stoned, All I know is I feel better when I take this.” – Ruth Brunn, 98

Ruth Brunn finally said yes to marijuana. She is 98.

She pops a green pill filled with cannabis oil into her mouth with a sip of vitamin water. Then Ms. Brunn, who has neuropathy, settles back in her wheelchair and waits for the jabbing pain in her shoulders, arms and hands to ebb.

“I don’t feel high or stoned,” she said. “All I know is I feel better when I take this.”

Ms. Brunn will soon have company. The nursing home in New York City where she lives, the Hebrew Home at Riverdale, is taking the unusual step of helping its residents use medical marijuana under a new program to treat various illnesses with an alternative to prescription drugs. While the staff will not store or administer pot, residents are allowed to buy it from a dispensary, keep it in locked boxes in their rooms and take it on their own.

From retirement communities to nursing homes, older Americans are increasingly turning to marijuana for relief from aches and pains. Many have embraced it as an alternative to powerful drugs like morphine, saying that marijuana is less addictive, with fewer side effects.

For some people, it is a last resort when nothing else helps.

Marijuana, which is banned by federal law, has been approved for medical use in 29 states, including New York, and the District of Columbia. Accumulating scientific evidence has shown its effectiveness in treating certain medical conditions. Among them: neuropathic pain, severe muscle spasms associated with multiple sclerosis, unintentional weight loss, and vomiting and nausea from chemotherapy. There have also been reports that pot has helped people with Alzheimer’s disease and other types of dementia as well as Parkinson’s disease.Across the nation, the number of marijuana users who are in their later years is still relatively limited, but the increase has been significant, especially among those 65 and older, according to recent studies.

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Marcia Dunetz, 80, said that she worried at first about what people would think. “It’s got a stigma,” she said. “People don’t really believe you’re not really getting high if you take it.”CreditPhotographs by Yana Paskova for The New York Times

“It’s a bigger issue than we thought,” said Brian Kaskie, a professor of health policy at the University of Iowa who co-wrote a study published in January, “The Increasing Use of Cannabis Among Older Americans: A Public Health Crisis or Viable Policy Alternative?” “This is an elephant we’re just starting to get our hands on.”

A medical marijuana education and support club started by residents of Rossmoor Walnut Creek, a retirement community east of San Francisco, has grown to 530 members — so many that it has changed meeting rooms three times.

“I would be in a lot worse shape if I wasn’t using cannabis, both physically and mentally,” said Anita Mataraso, 72, a grandmother of six who is the program director and takes marijuana daily for arthritis and nerve pain, among other ailments.

In the state of Washington, at least a dozen assisted living facilities have formal medical marijuana policies in response to demands from their residents, said Robin Dale, the executive director of the Washington Health Care Association. The association, an industry group, has posted a sample medical marijuana policy on its website.

In March, an influential group of medical providers, AMDA — The Society for Post-Acute and Long-Term Care Medicine, will tackle the issue at its annual conference. Cari Levy, the group’s vice president, will offer a “Marijuana 101” lesson on the benefits, the risks and the potential pitfalls for providers.

“People are using it, and we need know how to respond,” she said.

But as older people come to represent an emerging frontier in the use of marijuana for medical purposes, questions are being raised about safety and accessibility. Even in states where medical marijuana is legal, older people who stand to benefit often cannot get it. Most nursing homes do not openly sanction its use, and many doctors are reluctant to endorse pot use, saying not enough is known about the risks in the oldest age groups.

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The president and chief executive of RiverSpring Health, Daniel Reingold. He said he administered marijuana to his father as a painkiller shortly before his death.

CreditYana Paskova for The New York Times

“This is a target demographic that may have their access limited, if not cut off altogether, simply because they reside in a facility,” said Paul Armentano, deputy director of NORML, a group that advocates the legalization of marijuana. “It is a problem that may infringe on their quality of life.”

While there is no shortage of research on marijuana, relatively little of it has focused explicitly on older users even as their numbers grow — and not just in the United States. In Israel, for instance, older people have been treated with medical marijuana for years. And Americans for Safe Access, an advocacy group, helped open a research center in the Czech Republic that is evaluating its impact on older people.

“It’s an area that’s very important to look at,” said Dr. Igor Grant, the director of the Center for Medicinal Cannabis Research at the University of California, San Diego, adding that older people are now one of the center’s research priorities.

“Older people can be more sensitive to medicine,” he said. “It’s possible a dose safe for a 40-year-old may not be in an 80-year-old.”

Dr. Thomas Strouse, a psychiatrist and palliative care doctor at the University of California, Los Angeles, said that just as sleeping and pain medications could harm older people, marijuana could possibly make them confused, dizzy or more likely to fall.

“There is no evidence that it is particularly helpful to older people, and some reason that it could be harmful,” he said.

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Medical marijuana is kept in a safe in Marcia Dunetz’s room at the Hebrew Home at Riverdale. CreditYana Paskova for The New York Times

Most nursing homes have also taken a cautious position, often resorting to a “don’t ask, don’t tell” approach.

“If residents are taking it, they are taking it undercover without the staff knowing so it’s not part of their care plan,” said Dr. Cheryl Phillips, senior vice president for public policy and health services for LeadingAge, an industry group representing more than 2,000 nursing homes. “I think that creates a safety problem.”

Fred Miles, a Colorado lawyer who represents nursing home operators, said nursing homes — unlike assisted living facilities — were regulated by the federal government, and were fearful of jeopardizing their Medicare and Medicaid funding. Staff members who administer marijuana could also theoretically face criminal prosecution under federal law, he said, though he has never heard of that happening.

At the Hebrew Home in the Bronx, the medical marijuana program was years in the making. Daniel Reingold, the president and chief executive of RiverSpring Health, which operates the home, said he saw its powers firsthand when his own father, Jacob, was dying from cancer in 1999. To ease his father’s pain, Mr. Reingold boiled marijuana into a murky brown tea. His father loved it, and was soon laughing and eating again.

“The only relief he got in those last two weeks was the tea,” Mr. Reingold said.

When Mr. Reingold requested approval from the nursing home’s board members, there were no objections or concerns, he said. Instead, they joked that they would have to increase the food budget.

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Hillary Peckham, of the medical marijuana dispensary Etain Health, showing an array of marijuana tincture, capsules and vaporizer cartridges. CreditYana Paskova for The New York Times

Then Dr. Zachary Palace, the medical director, developed a program that seeks to offer marijuana as an option but also comply with federal regulations: Though the nursing home recommends and monitors its use, residents are responsible for buying, storing and administering it themselves.

Last fall, the first three residents started taking marijuana pills. Their families obtain the pills at a dispensary in Yonkers run by Etain, a company licensed by the state to sell medical marijuana to qualifying patients or their designated caregivers, who must live in New York. Dr. Palace said that as the program expanded this month, as many as 50 residents could be using marijuana.

Marcia Dunetz, 80, a retired art teacher who has Parkinson’s, said she worried at first about what people would think. “It’s got a stigma,” she said. “People don’t really believe you’re not really getting high if you take it.”

But she decided to try it anyway. Now, she no longer wakes up with headaches and feels less dizzy and nauseated. Her legs also do not freeze up as often.

For Ms. Brunn, the marijuana pills have worked so well that she has cut back on her other pain medication, morphine.

Her daughter, Faith Holman, 61, said the pills cost $240 a month, which is not covered by health insurance. Ms. Holman, who lives in New Jersey, also has to ask a family friend to go to the Yonkers dispensary.

“Obstacles had to be overcome,” Ms. Holman said. “But I think she was meant to have it because everything has worked out.”


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Here’s Everything You Need to Know About Germany’s New Weed Laws

Germany just passed one of the world’s most progressive medical marijuana plans. The new law will put weed in more pharmacies and require public insurers to cover the costs of cannabis products, as they do other pharmaceutical prescriptions, when cannabis is prescribed for “severe conditions.”

Germany will also start growing its own weed. This will replace the old medical marijuana law, which granted permits for people to grow their own. So recreational growers will not have any excuses for ‘exotic houseplants.’

The drug dealers of Berlin’s infamous open-air marijuana market in Görlitzer Park that spoke to Highsnobiety were surprisingly supportive. “Obviously its not going to be so good for business, but it’s the right thing to do if it can help people,” said Jan*, 24. Like many of the dealers lining in the parks of Berlin, he is an African immigrant, this time from Lagos.

While Germany is standardizing its medical marijuana supply chain, authorities in the capital turn a blind eye to illicit dealers selling dime bags in public spaces. But although it will soon be easier to get free weed from the local pharmacy, most dealers we spoke to were not threatened by the competition.

“We also get people who buy weed from us to treat pain,” said Menis*, 27, a Gambian dealer.  “Some don’t come anymore, but a lot of them still do. You don’t get exactly the same experience from the pharmacy products as you do with the marijuana we sell. They spray it with something different. I didn’t like it as much.”

Currently pharmacy prices for medical marijuana fluctuate from 12 to 20 euro per gram, compared to the roughly 10-euro price in the park.

Who Stands to Lose from Medical Marijuana

If data from the United States’ research on the effects of medical marijuana is an indicator of how things could play out in Germany, there might be a reason drug dealers are so chill about the new law: pharmaceutical companies stand to loose more customers.

There is clear difference between annual drug doses prescribed by physicians in medical marijuana states, and in states where weed is completely illegal, according to a 2015 study. There were 1,826 fewer painkiller doses prescribed, followed by 562 fewer anxiety medications and 541 fewer pharmaceutical nausea treatments prescribed in states where patients could be treated with cannabis.

The U.S. National Bureau of Economic Research also found that legal access to medical marijuana is linked to a significant drop in the number of people abusing and dying from prescription painkillers.

This could catch on in Germany as Germans have already started turning away from traditional pharmaceuticals to more natural products. Over half the population has used some form of homeopathic treatment, with awareness and use of alternative drugs rising steadily since their introduction to pharmacies in 1976.

Germany Is Not California

It is no secret that California’s medical marijuana dispensary program has relatively lax requirements to determine who could benefit from a medical marijuana card, which are often used for recreational smoking rather than strictly for treatment of an illness. More than 91,000 medical marijuana cards have been issued since 2004, according to California’s Department of Public Health.

“Germany has much stricter guidelines than California for prescribing marijuana,” said Goerg Wurth, head of the German Hemp association. “Almost anyone who wants a prescription can get one there. In Germany things are more regulated and bureaucratic. Doctors are checking to make sure medical marijuana is not used for recreational purposes.”

There are roughly 30 illnesses for which the German government recommends cannabis, ranging from chronic pain to attention deficit disorder and epilepsy. But even after getting the green light from a doctor to use marijuana, the German system is more regimented than the dispensary model.

Instead of setting up new businesses that deal exclusively in weed, Germans must go through pharmacies. And while doctors can prescribe cannabis for a broad range of ailments, only those that prove to be “severe” will receive reimbursement from public insurers. Doctors also have more sway over what kind of cannabis you can get.

“Although you can get smoking and edible options, it is more likely doctors will suggest vaporizers or THC drops, which are less harmful and easier to dose,” Wurth said.

Where Does Germany Stand Compared to Its Neighbors?

Germany stands somewhere in the middle when it comes to European weed legislation. While some of its neighbors have yet to broach the subject of medical marijuana in parliament, others such as the Netherlands and Spain have certain cities where recreational consumption is legal.

Although many European states have medical marijuana available, Germany will join the Netherlands, Italy and the Czech Republic as the one of the only countries where weed is produced.

“There is more movement for weed legalization than ever before in the world, and it won’t be long until the first European country fully legalizes it,” Wurth said.

Recreational Smoking Is Still Illegal

Despite creating easy access to medial marijuana, the government has been clear in saying that this law is not to be taken as a step towards legalization of recreational use. The government cites health concerns as the main reason for keeping weed from the general public.

“International studies from the last 10 years show that the use and abuse of cannabis can be associated with a number of serious short-term and long-term risks, particularly among young people,” the German Health Ministry said.  “Psychological and psychosocial disorders (such as schizophrenic psychoses), organ-medical effects (such as cardiovascular diseases) and neuro-cognitive impairments (such as the impairment of learning attention and memory functions) are mentioned.”

Still, those pushing for blanket legalization see the new law as a possible step towards it, looking to countries such as the United States and Canada which progressed to legalization after introduced medical marijuana. Eight states recently legalized marijuana in the U.S., whereas Canada introduced legislation to legalize marijuana throughout the whole country this spring.

“I believe that medical marijuana will relax the attitudes of Germans towards cannabis, especially the older, more conservative generation,” Wurth said. “The decision to legalize it for medical purposes was more or less unanimous, whereas the majority of Germans still don’t think it should be legal for recreational use.”

The latest European Drug Report found that nearly a quarter of Germans have tried marijuana.

Germany may lack the political will for blanket legalization, but there are many initiatives and local governments willing to give it a shot. Groups in Berlin, for example, have expressed an interest in the city being a testing site for possible legalization to see whether a change in law could lead to decreases in crime.

“It will eventually become legal in Germany,” Wurth said. “But for it is good that we are taking care of patients.”

On the topic of legalizing weed, here’s our look at what Portland is like two years after weed was legalized

 

http://www.highsnobiety.com/2017/02/17/germany-marijuana-laws/


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German Government Recognizes Quantum 9’s Cannabis Expertise

German Government Recognizes Quantum 9’s Cannabis Expertise

After engaging Quantum 9, Inc. to learn more about the global cannabis environment, the German Federal Ministry of Health has written a letter of recommendation acknowledging the expertise with which Quantum 9 was able to help their queries. The information received provided guidance on drug policy, in favor of cannabis regulation, allowing the drafting of a bill including a cannabis tax.

Letter of Recommendation_German Government

Quantum 9, Inc. is honored to be considered by the German government for such a project, and has been lucky enough to work with several government entities in similar projects.


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DEA Removes Marijuana Misinformation from Website After Months of Public, Legal Pressure

http://www.safeaccessnow.org/iqa_victory

February 13, 2017 | Anna Zuccaro

Americans for Safe Access Says Not Good Enough, Still in Violation of IQA

WASHINGTON DC — After months of public pressure, the Drug Enforcement Administration (DEA) has removed factually inaccurate information from its website. The change comes after Americans for Safe Access, a national nonprofit dedicated to ensuring safe and legal access to medical cannabis for therapeutic use and research, filed a legal request with the Department of Justice last year demanding that the DEA immediately update and remove factually inaccurate information about cannabis from their website and materials.

Americans for Safe Access argued that the more than 25 false statements on the DEA’s website about cannabis constituted a violation of the Information Quality Act (IQA, aka Data Quality Act) which requires that administrative agencies not provide false information to the public and that they respond to requests for correction of information within 60 days.

One publication, “Dangers and Consequences of Marijuana”, contained 23 of the 25 factual inaccuracies in violation of the Information Quality Act. Such inaccuracies included claims that cannabis was a gateway drug, caused irreversible cognitive decline in adults, and contributed to psychosis and lung cancer.

“The DEA’s removal of these popular myths about cannabis from their website could mean the end of the Washington gridlock” said Steph Sherer, Executive Director of Americans for Safe Access. “This is a victory for medical cannabis patients across the nation, who rely on cannabis to treat serious illnesses. The federal government now admits that cannabis is not a gateway drug, and doesn’t cause long-term brain damage, or psychosis. While the fight to end stigma around cannabis is far from over, this is a big first step.”

But the fight is not over. As of February 13th, the government is one week beyond the required deadline to respond to the Americans for Safe Access’ legal petition and the group claims that the DEA is still spreading false information about cannabis.

“We are pleased that in the face of our request the DEA withdrew some of the damaging misinformation from its website” said Vickie Feeman, of Orrick, Herrington & Sutcliffe. “However, the DEA continues to disseminate many damaging facts about the health risks of medical cannabis and patients across the country face ongoing harm as a result of these alternative facts. We are hopeful the DEA will also remove the remaining statements rather than continue to mislead the public in the face of the scientifically proven benefits of medical cannabis.”

“If the DEA does not take the necessary action to comply with the binding time lines in the IQA, petitioners can always seek an intervention by OMB as the Department of Justice so informed the court in W. Harkonen v. USDOJ or in the courts as demonstrated in Prime Time v. USDA” stated Jim Tozzi, the father of the Information Quality Act and member of ASA’s Patient Focused Certification Reviewboard.

Americans for Safe Access argues that correcting false information about cannabis is especially important now that the Department of Justice is led by newly-confirmed Attorney General Jeff Sessions. Sessions has been a staunch supporter of the DEA and cites their publications and opinions about marijuana to justify his opposition to medical cannabis policy reform. Today, Americans for Safe Access delivered a letter to the DEA explaining:

“It is crucial that the DEA correct it’s inaccurate statements, especially in light of Senator Jeff Sessions’  confirmation as Attorney General of the United States.  Attorney General Sessions has made several statements demonstrating his beliefs that cannabis is a gateway drug and that its psychological effects are permanent.  These beliefs are verifiably false, as confirmed by the DEA in its “Denial of Petition to Initiate Proceedings to Reschedule Marijuana.”[1]  As the top law enforcement official in the nation, Mr. Sessions must have access to accurate information based on current scientific data in order to make informed decisions regarding the enforcement (or non-enforcement) of federal drug laws.  Allowing Mr. Sessions to make law enforcement decisions based on biased, out-of-date information does a tremendous disservice to ASA’s members and the American people at large. Therefore, ASA respectfully requests that the DEA respond to its Request, and/or remove the remaining inaccurate statements from its website.”

For more information, or for interviews with Americans for Safe Access, please contact Anna Zuccaro at anna@unbendablemedia.com, 914-523-9145


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Congressional Cannabis Caucus’ new law for Medical Marijuana patients introduced by California Congressman Rohrabacher

The Respect State Marijuana Laws Act of 2017 Has Been Introduced
By Julia Granowicz on Feb 11, 2017 07:18 am
respect-state-marijuana-laws-act-of-2017-has-been-introduced

About a week ago, a handful of lawmakers who call themselves the “Congressional Cannabis Caucus” announced that they intend to introduce legislation that would help protect the cannabis industry from a Department of Justice run by Attorney General Jeff Sessions. Their announcement was just prior to his confirmation – but they believe that his being Attorney General could actually help push some lawmakers into feeling the same urgency to pass such legislation.

As promised, one of those congressmen  – Dana Rohrabacher of California  – has introduced the Respect State Marijuana Laws Act of 2017. This bill was previously introduced twice before, in 2013 and 2015, and didn’t gain enough support either time to make it very far. This time, however, with the uncertainty surrounding how the federal government is going to move forward in handling the cannabis industry – the bill may find more support.

“This is common sense legislation that is long overdue,” said Robert Capecchi, director of federal policies for the Marijuana Policy Project. “It is time to end marijuana prohibition at the federal level and give states the authority to determine their own policies.

There is hope that more legislators will be more inclined to protect an industry that improves lives for patients in medical marijuana states and has entirely ended prohibition in others. Both types of industries have created countless jobs and brought in millions in tax revenue that would have gone straight into the black market otherwise. If the government isn’t ready to change their minds on prohibition, they should at least protect the states’ rights to enact their own laws.

“States throughout the country are effectively regulating and controlling marijuana for medical or broader adult use,” Capecchi said. “Federal tax dollars should not be wasted on arresting and prosecuting people who are following their state and local laws.”

Basically, the Respect State Marijuana Laws Act would prevent the Department of Justice from pursuing cannabis-related cases in states where marijuana is legal, as long as people are operating within the laws in their respective state. With everything that’s going on, many of us are hoping that this piece of legislation will gain the support it needs to be passed – and that, if it does pass, Trump would be ready and willing to sign it into law.

If that were to happen, states could continue to operate as they have – and others would be able to consider legalization with less worries since there will be something binding in place that says the federal government will keep their opinions to themselves and let the states make their own decisions when it comes to cannabis.