Kentucky and Medical Marijuana:

1.9% Must Get Stoned

Jaclyn Engelsher

Should Kentucky Enact Legislation to Legalize the Use of Medical Marijuana?

Why Consider Considering?

Need for research, not anecdotes

KY leads the nation in non-medical use of controlled pain relievers and tranquilizers

We are loosing millions of dollars in potential revenue

We are spending millions of dollars in prohibition

If all the other states jumped off a bridge . . .

Effective: CA, AK, OR, WA, ME, CO, NV, HI, VT, MT, RI, NM, MI

Workable: MD Research: AL, GA, IL, MA, MN, NJ, NY, SC,

TX Symbolic: AZ, CT, DC, IA, LA, NH, TN, VA,

WI Expired/Repealed: AR, FL, NC, OH, WV

(MPP, 2008)

Current KY Law

218A.1421 - trafficking marijuana. < 8 oz: Class A misdemeanor 1st, Class D felony

2ed & subsequent offence >8oz <5lbs: Class D felony 1st, Class C felony

2nd & subsequent 5+lbs: Class C felony 1st, Class B 2nd &

subsequent Possession >8z + intent to sell/transfer

902 KAR 55:020 - MJ and THC schedule I; Marinol schedule III

Getting Around

Federal Law Illegal to possess, grow, or distribute since

1937 Can be enforced anywhere in the US Cannot force state authorities to enforce

federal law Cannot force state to have identical federal

law 99% of MJ arrests are by state & local, not

federal, authorities States determine drug scheduling class

Marijuana Basics

Pharmacokinetics Pharmacodynamics Short term effects Delivery methods

Smoke Vapor Ingestion

Current “Recommended” Medical Uses

Chemotherapy related N/V AIDS/HIV Wasting Disorder Terminal Illness/ChronicPain Glaucoma

Other “Recommendations”(“but it really works, doc”)

Alzheimer's Agitation/Prevention Asthma & Breathing Disorders GI Disorders Epilepsy and Seizure Disorders Hepatitis C Migraines Multiple Sclerosis Psychological Disorders (including PMS) Tourette's syndrome

But . . . We Already Have Medical Marijuana!

Marinol Synthetic delta-9-Tetrahydrocannabinol (THC)

approved by FDA for n/v & appetite stimulant Low diversion & abuse led DEA to move from

schedule II to schedule III in 1998 Patch & inhaler under development Safe, regulated dose without chemicals or tar

Longer onset & effect, increased psychoactive effects, only one active ingredient

Metabolized by CP450 3A4/2C9

(USDEA, 2010 )

Coming Soon . . . Sativex

Approved in Europe & Canada In Phase III in US clinical trial Indicated for neuropathic pain relief in MS

and cancer Natural extract THC & CBD Spray delivery Less intoxication Statistically significant improvement

compared to placebo/existing medications

GO vs NO Provides alleviating

therapy for multiple disorders

Lower addiction potential than opioid analgesics

Regulations ensure potency & purity

Generates state revenue & decreases spending

Benefit>Risk

Efficacy of existing & emerging pharmaceuticals

No reliable field sobriety test

“Recommended” use is a farce

Risk>Benefit

Lack of reliable clinical research

Recommended Model Legislation for KY

MD in certain specialties may certify MJ for use in specific, pre-determined conditions for maximum 1 year

Register with health department for ID tracking card Possess up to 6oz and 12 plants State-regulated, non-profit dispensaries Prohibit public use and driving Medical necessity defense not permissible Employers and insurers may restrict

How Would You Vote?

Sources Consulted AMA Policy: Medical Marijuana (2009). Retrieved from

http://medicalmarijuana.procon.org/sourcefiles/AMA09policy.pdf Gettman, John (2009). Marijuana arrests in the United States (2007):

Arrests, usage, and related data [Electronic version]. The bulletin of cannabis reform, 1-24. Retrieved from http://www.drugscience.org/Archive/bcr7/Gettman_Marijuana_Arrests_in

_the_United_States.pdf Marijuana Policy Project (2008). State-by-state medical marijuana

laws:How to remove the threat of arrest [PDF document]. Retrieved from http://www.mpp.org/assets/pdfs/download-materials/SBSR_NOV2008_1.pdf

Net Resources International (n.d.). Sativex: Investigational cannabis-based treatment for pain and multiple sclerosis. Retrieved from http://www.drugdevelopment-technology.com/projects/sativex/

Sources Consulted Net Resources International (n.d.). Sativex: Investigational cannabis-

based treatment for pain and multiple sclerosis. Retrieved from http://www.drugdevelopment-technology.com/projects/sativex/

Office of National Drug Control Policy Drug Policy Information Clearinghouse (2008). State of Kentucky: Profile of drug indicators [PDF document]. Retreived from http://www.ondcp.gov/statelocal/ky/ky.pdf

U.S. Department of Health and Human Services, (2005). Prescription drugs abuse and addiction. National Institute on Drug Abuse Research Report Series [Electronic version]. Retrieved from http://www.drugabuse.gov/PDF/RRPrescription.pdf

U.S. Drug Enforcement Administration (n.d.). “Medical” marijuana - The facts. Retrieved from http://www.justice.gov/dea/ongoing/marinol.html