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Research published in the International Journal of Drug Policy has discovered that people taking psychoactive medications and drugs for conditions such as chronic pain seem to prefer medical cannabis to other drugs, including sedatives, opioids, and antidepressants.

Many analysts have expressed worry about the use of opioids to treat chronic pain. More than 183,000 people died of prescription opioid overdoses between 1999 and 2015 in the U.S. Some research, such as a recent study that looked at states with medical cannabis laws, suggests access to medical marijuana could reduce opioid abuse. The research used survey data from 271 people registered to purchase medical cannabis. Participants answered 107 questions covering demographic data, use of cannabis, reliance on other drugs, and health history.

Survey respondents had been prescribed drugs for a range of reasons, including chronic pain, mental health conditions, and gastrointestinal issues. Overall, 63% reported using marijuana instead of prescription drugs. The most common drug class for which participants substituted cannabis was opioids, accounting for 30% of the total. Sixteen percent of participants used marijuana to replace benzodiazepines, and 12% used marijuana instead of antidepressants.

Cannabis was also a popular replacement for potentially addictive nonmedical drugs. Twenty-five percent of respondents used cannabis instead of drinking alcohol, 12% used it instead of cigarettes or tobacco, and 3% replaced illicit drugs with cannabis. The study’s authors suggest side effects, concerns about addiction, and level of safety figure prominently among the decision to use cannabis instead of other medications. Some medical marijuana users report cannabis works better than more traditional prescription medications.

The study found individuals often faced challenges to accessing medical cannabis. More than half were charged for their marijuana prescription, with 25% paying more than $300 for the prescription. Some participants still purchased marijuana from unregulated sources in spite of having a prescription.

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Prescription drug prices are still increasing, forcing consumers into more of a struggle. Some older Americans seem to be looking for a different medicine that has been more easily obtainable and legal throughout the country. Research put out on Wednesday showed that some states that legalized medical cannabis, which is common for symptoms such as anxiety or depression, saw a drop in the amount of Medicare prescriptions for drugs used to treat similar conditions as well as a decrease int he amount of spending by Medicare Part D, which covers costs for prescription drugs.

Since the prescriptions for drugs such as opioid painkillers as well as antidepressants dropped in states where cannabis can be legally obtained and used as a replacement, the researchers stated that it seems likely legalization led to a decrease in prescriptions. This is especially noted because prescriptions did not drop for medicines where marijuana can not replace the drug. The study, which was published in Health Affairs, looked at data from Medicare Part D from 2010 to 2013. This is the first study to look at whether or not legalization can impact a doctor’s clinical practice and how it affects health costs.

The results are interesting in terms of the debate as more officials are showing interest in medical cannabis. This year, Ohio, as well as Pennsylvania, passed laws allowing the drug for therapeutic reasons, making it legal in twenty-five states as well as Washington D.C. Ballots in November could increase this number; Florida and Missouri are of the states voting on the issue this autumn. A federal agency is thinking about reclassifying medical cannabis under national drug policy in order to make it more readily available. Medical marijuana saved Medicare approximately $165 million in 2013, the researchers stated. They projected that, if medical cannabis were available throughout the country, Medicare Part D spending would have dropped in the same year by nearly $470 million. That is almost fifty percent of the program’s total spending.

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American political leaders around the country are casting about for a policy response to the widespread abuse of opioid painkillers that doesn’t replicate the mistakes of past punitive approaches to drug use.
Now, Sen. Elizabeth Warren has thrown her clout into that push for solutions – and in a way that underscores the injustices of the War on Drugs over the past several decades.

Warren is asking the Centers for Disease Control and Prevention to research how medical and recreational marijuana might help alleviate the opioid epidemic. In a letter sent Monday to CDC head Dr. Thomas Friedan, Warren urged the agency to finalize its guidance to physicians on the dos and don’ts of prescribing oxycodone, fentanyl, and other popular drugs in this category.

She also went further, asking Friedan “To explore every opportunity and tool available to work with states and other federal agencies on ways to tackle the opioid epidemic and collect information about alternative pain relief options.” Those alternatives should include pot, Warren wrote. She went on the ask Friedan to collaborate with other federal health agencies to investigate how medical marijuana is or isn’t working to reduce reliance on highly addictive prescription pills, and to research

“The impact of the legalization of medical and recreational marijuana on opioid overdose deaths.” Researching marijuana is fraught for federal agencies because the drug remains a schedule 1 controlled substance, the most restrictive category within American drug law.

The classification is reserved for drugs with “No medically accepted use,” a designation that makes less and less sense as more and more states legalize marijuana for medical use.

The federal scheduling also makes it onerous for researchers to work on answering the kinds of questions Warren raised in her letter, a reality that helped drive the centrist Brookings Institute to call for the drug to be reclassified as a schedule 2 drug in a report last October – a schedule that includes prescription drugs like Adderall and Ritalin.

It’s a sign of progress compared to the mandatory minimum sentencing laws and focus on aggressive law enforcement that marked past drug panics, but it’s also got racial overtones that are hard to ignore.

Regardless of the rationale behind the shift toward more benevolent anti-drug policies related to opioids, the crisis will probably help advance the fight to loosen America’s pot laws too. The attention now being paid to opioid abuse “Has been a key factor in opening previously closed minds,” Cannabis Now notes – including Warren’s own.

Rising scrutiny of opioid use is having other, stranger effects too.
With the high-powered painkillers booming in popularity, drug makers have little need to advertise them. Super Bowl viewers were treated to a very expensive promo Sunday night for a drug designed to alleviate the constipation that heavy opioid use can cause. The drug, an AstraZeneca invention called Movantik, may be a sign that doctors are not just overprescribing opioid painkillers in general, but specifically dishing them out to the wrong kind of patients.

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West Virginia Governor Jim Justice signed a bill that makes his state the 29th to allow medical use of marijuana. West Virginia is the sixth state to legalize medical marijuana in the last year and the third (along with Ohio and Pennsylvania) to do so through the legislature. In the other three states: Arkansas, Florida, and North Dakota, voters approved ballot initiatives authorizing medical marijuana last November.

West Virginia’s new law recognizes marijuana as a treatment for patients with terminal illnesses or any of 14 specified conditions, including cancer, HIV/AIDS, epilepsy, multiple sclerosis, Crohn’s disease, post-traumatic stress disorder, and intractable pain. Patients whose doctors recommend marijuana will be able to obtain it in the form of pills, oils, gels, creams, ointments, tinctures, liquids, and vaporizable extracts from state-regulated dispensaries. The dispensaries will not sell buds for smoking or marijuana edibles, although patients can prepare their own at home. The law does not allow home cultivation, and patients can legally possess no more than a month’s supply at a time.

Matt Simon of the Marijuana Policy Project (MPP) stated, “This legislation is going to benefit countless West Virginia patients and families for years to come. Medical marijuana can be effective in treating a variety of debilitating conditions and symptoms. It is a proven pain reliever, and it is far less toxic and less addictive than a lot of prescription drugs. Providing patients with a safer alternative to opioids could turn out to be a godsend for this state.”

One downside to West Virginia’s law is a new standard for driving under the influence of marijuana that erroneously equates impairment with a blood THC level of three nanograms per milliliter. That’s even lower than the unfair and unscientific five-nanogram cutoff that Colorado and Washington adopted when they legalized marijuana for recreational use. As MPP notes, West Virginia’s DUID standard “could make it illegal for some patients to ever drive, since many patients have THC levels at this amount or greater many hours or days after last administering cannabis.”

West Virginia’s rules put it on the less liberal end of a medical marijuana spectrum that ranges from highly permissive (e.g., California) to highly restrictive (e.g., New York). Eight of the 29 medical marijuana states also allow recreational use. Medical use was approved by ballot initiative in 14 of those states, beginning with California in 1996. In the rest, as in West Virginia, medical marijuana laws originated in the state legislature.

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Americans think it’s safer to use marijuana than opioids to relieve pain, but they were less comfortable with children and pregnant women using the drug to treat medical conditions, according to a recent Yahoo/Marist poll. Two-thirds of the respondents in the telephone survey said opioid drugs such as Vicodin or OxyContin are “riskier” to use than marijuana, even when the pain pills are prescribed by a doctor. Only one in five said marijuana was riskier than opioids. The rest weren’t sure.

Every day, an overdose of prescription opioids or heroin kills 91 people, and legions more are brought back from the brink of death. Some 2 million Americans are thought to be hooked on the pills. Last month, President Donald J. Trump appointed an opioid commission to look into the problem. Marijuana by itself is not fatal. Doctors technically don’t prescribe it for pain or other purposes but most states that allow medical marijuana do require patients to get a doctor’s written recommendation to purchase it to treat their conditions.

Among those answering the Yahoo/Marist poll, 83% said the drug should be legal nationally for medical treatment. However, 70% said it is not acceptable for pregnant women to use marijuana to reduce nausea or pain. And the survey respondents were about evenly divided on whether marijuana should be recommended for children if it were legal. The survey respondents were deeply divided on how Trump should approach marijuana: 38% said he shouldn’t be as tough about enforcing federal laws against recreational marijuana use as President Barack Obama, whose policy generally was to leave states alone.

Another 30% said Trump should take a harder line than Obama, while the rest weren’t sure or said Trump should treat it about the same as Obama did. Trump’s administration has sent mixed messages to the 28 states and Washington, D.C., in violation of federal drug law when it comes to marijuana. Trump said as a candidate that states should be allowed to tinker with marijuana laws. However, new U.S. Attorney General Jeff Sessions has said marijuana is dangerous and marijuana changes by states should not be allowed. There has been no action yet by the U.S. Justice Department or any other federal agencies to crack down on states violating the Controlled Substances Act, which bans marijuana for any use.

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GW Pharmaceuticals and its U.S. Subsidiary Greenwich Biosciences to Present Data on Epidiolex® (cannabidiol) at the 2017 American Academy of Neurology Annual Meeting

GW Pharmaceuticals plc (GWPH) (“GW,” “the Company” or “the Group”), a biopharmaceutical company focused on discovering, developing and commercializing novel therapeutics from its proprietary cannabinoid product platform, today announced that the Company will present results from three completed Phase 3 studies of Epidiolex® (cannabidiol or CBD) as adjunctive therapy – two in Lennox-Gastaut syndrome (LGS) and one in Dravet syndrome (DS) – at the American Academy of Neurology (AAN) Annual Meeting, April 22-28, 2017, in Boston. Company-sponsored activities at AAN will be conducted under Greenwich Biosciences, Inc., GW’s operating unit in the United States.

“We are very excited to share data from our Phase 3 epilepsy programs with the broader neurology community, particularly new results from the second of our two placebo-controlled studies in Lennox-Gastaut syndrome, which will be featured in the Emerging Science Program during the meeting,” said Justin Gover, GW’s Chief Executive Officer. “We are looking ahead to finalizing and submitting the NDA to the FDA for Epidiolex in the coming months, which will bring us one step closer towards our goal of making this much-needed treatment available to patients.”

Tuesday, April 25, 2017
Clinical Trials Plenary Session
9:15 – 11:30 a.m. (GW Presentation 10:45 – 11:00 a.m.)
Cannabidiol (CBD) reduces convulsive seizure frequency in Dravet syndrome: Results of a multi-center, randomized, controlled trial (GWPCARE1)

Epilepsy/Clinical Neurophysiology (EEG)
1:00 – 3:00 p.m. (GW Presentation 1:00 – 1:12 p.m.)
Presentation 001: Cannabidiol (CBD) significantly reduces drop seizure frequency in Lennox-Gastaut syndrome (LGS): Results of a multi-center, randomized, double-blind, placebo controlled trial (GWPCARE4)

Emerging Science Session
5:45 – 7:15 p.m. (GW Presentation 6:06 – 6:09 p.m.)
Poster 008: Cannabidiol (CBD) significantly reduces drop seizure frequency in Lennox-Gastaut syndrome (LGS): results of a dose-ranging, multi-center, randomized, double blind, placebo controlled trial (GWPCARE3)

Wednesday, April 26, 2017
Poster Session 4: Epilepsy/Clinical Neurophysiology (EEG)
11:45 a.m. to 12:35 p.m. (GW Presentation 12:20 – 12:25 p.m.)
Poster 108: A dose ranging safety and pharmacokinetic study of cannabidiol (CBD) in children with Dravet syndrome (GWPCARE1)

Sunday, April 23, 2017
Poster Session 1: Epilepsy and Clinical Neurophysiology: Basic Science
8:30 a.m. to 5:30 p.m. (GW Presentations between 4:00 – 5:30 p.m.)
Poster 224: Cannabidiol does not convert to Δ9- tetrahydrocannabinol (THC) in an in vivo animal model
Poster 228: The effect of cannabidiol on human CNS-expressed voltage-gated sodium channels

About GW Pharmaceuticals plc

Founded in 1998, GW is a biopharmaceutical company focused on discovering, developing and commercializing novel therapeutics from its proprietary cannabinoid product platform in a broad range of disease areas. GW is advancing an orphan drug program in the field of childhood epilepsy with a focus on Epidiolex® (cannabidiol), which is in Phase 3 clinical development for the treatment of Dravet syndrome, Lennox-Gastaut syndrome, Tuberous Sclerosis Complex and Infantile Spasms. GW commercialized the world’s first plant-derived cannabinoid prescription drug, Sativex® (nabiximols), which is approved for the treatment of spasticity due to multiple sclerosis in 31 countries outside the United States. The Company has a deep pipeline of additional cannabinoid product candidates which includes compounds in Phase 1 and 2 trials for glioma, schizophrenia and epilepsy. In the United States, GW operates as Greenwich Biosciences Inc. For further information, please visit www.gwpharm.com.

Forward-looking statements

This news release contains forward-looking statements that reflect GW’s current expectations regarding future events, including statements regarding financial performance, the timing of clinical trials, the timing and outcomes of regulatory or intellectual property decisions, the relevance of GW products commercially available and in development, the clinical benefits of Epidiolex® and the safety profile and commercial potential of Epidiolex. Forward-looking statements involve risks and uncertainties. Actual events could differ materially from those projected herein and depend on a number of factors, including (inter alia), the success of GW’s research strategies, the applicability of the discoveries made therein, the successful and timely completion of uncertainties related to the regulatory process, and the acceptance of Epidiolex and other products by consumer and medical professionals. A further list and description of risks and uncertainties associated with an investment in GW can be found in GW’s filings with the U.S. Securities and Exchange Commission, including the most recent Form 20-F filed on 5 December 2016. Existing and prospective investors are cautioned not to place undue reliance on these forward-looking statements, which speak only as of the date hereof. GW undertakes no obligation to update or revise the information contained in this press release, whether as a result of new information, future events or circumstances or otherwise.

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Medical marijuana advocates who came up empty at the South Dakota Legislature and ballot box are emboldened to try again after an overwhelming vote in North Dakota to make marijuana available to patients there.

Supporters of the South Dakota effort hope to soon gather enough signatures to put the question on the November 2018 ballot after the strong showing last fall in North Dakota, where 64% of voters supported a similar plan. Melissa Mentele, founder and director of the group advancing the measure stated, “If North Dakota can pass it at that great of a margin, I’m absolutely positive South Dakota can also. It definitely looks good for us.”

New Approach South Dakota’s proposal would allow patients with serious medical conditions and a health practitioner’s recommendation to use marijuana. Qualifying patients would be able to get a registration card to possess up to 3 ounces of the plant. The group also plans to pursue a recreational marijuana initiative.

The Republican-held Legislature has been reluctant to support medical cannabis. However, legislators this year did approve a law to allow people with a prescription to use a non-intoxicating compound found in marijuana if it’s approved by the U.S. Food and Drug Administration. Medical marijuana initiatives in South Dakota have failed at the ballot box at least twice since 2006. Last year, the secretary of state’s office said backers didn’t turn in enough valid signatures to get on the ballot.

Mentele said volunteers have jumped from about 25 six months ago to more than 190. She said the group now has a petition training system with a test at the end for volunteers and is hoping to raise about $25,000 for signature gathering. They would have to submit nearly 14,000 valid signatures to the secretary of state by November 2017 to get on the ballot. Fargo financial planner Rilie Ray Morgan headed the shoestring North Dakota initiative campaign. He said supporters used press reports, Facebook and a couple small television advertising buys to help get their message out.

North Dakota legislators are working on new rules governing the use of medical marijuana after the citizen initiative passed. Morgan said that if South Dakota advocates show how medical marijuana can help patients and their neighbors and relatives, even people in rural, more conservative communities will vote for it. He said, “I don’t think South Dakota is all that dissimilar to North Dakota.”

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A recent proposal aims to legalize medical marijuana in North Carolina. The bill lays out the development of a medical marijuana supply system and aims to create a program administered by the UNC system called the North Carolina Cannabis Research Program. The program would conduct studies to determine the safety and efficacy of cannabis as medical treatment and then develop guidelines for the appropriate physician administration and patient use of medical cannabis.

The political director of the marijuana advocacy group NORML, Justin Strekal, said the proposal is comprehensive and includes a long list of conditions that doctors could prescribe marijuana to treat. He stated, “Some other states have gone a much more conservative approach in terms of what they will consider marijuana to be a treatment for.” Strekal said there are states that only legalize cannabidiol, or CBD (oil derived from a strain of marijuana without psychoactive effects).

Strekal said, “The CBD-only is really great at treating the kids with refractory epilepsy, but as far as the much more holistic approach that can be used to treat a whole host of ailments, it’s important to have access to the whole plant. So, as far as medical marijuana bills go, we’re very happy with what’s being introduced in North Carolina.” But the federal administration and U.S. Attorney General Jeff Sessions have been increasingly critical of states legalizing marijuana in recent months.

He recently said, “I, as you know, am dubious about marijuana. States can pass whatever laws they choose, but I’m not sure we’re going to be a better, healthier nation if we have marijuana being sold on every corner grocery store.” Whether Sessions and the new administration will actually enforce the federal status of marijuana remains unclear. Strekal said data suggests legalization of medical marijuana could reduce opioid dependency in the state.

Research from the Johns Hopkins Bloomberg School of Public Health and the Philadelphia Veterans Affairs Medical Center found the annual number of deaths from prescription drug overdose is 25% lower in states that have legalized medical marijuana. Strekal said, “The data is very conclusive that marijuana can be a pathway out of addiction rather a gateway in.”

Executive director of Drug Free America Foundation Inc., Calvina Fay, said she doesn’t think the proliferation of marijuana reduces drug-related deaths and overdoses. “Is there a state that has reduced their opioid problem and legalized marijuana? Yeah, I’m sure there is,” she said. “But there’s no proof that marijuana is the cause of that.”

In a speech to Virginia law enforcement in March, Sessions said marijuana proliferation will not staunch the effects of the opioid crisis. Sessions stated, “I am astonished to hear people suggest that we can solve our heroin crisis by legalizing marijuana; so people can trade one life-wrecking dependency for another that’s only slightly less awful.”

However, criticisms of medical marijuana are outdated and not based on scientific fact, Strekal said. He stated, “To maintain the same classification of marijuana in the realm of heroin is absolutely absurd. It’s unfounded, and it’s unfathomable to deny patients access to a substance that will alleviate their suffering.”

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NFL players are banned from using the marijuana for any purposes under the existing collective bargaining agreement, even in states where it is legal. Under that agreement, players who test positive for marijuana must enter a substance abuse program. Multiple violations lead to fines, game suspensions, and banishment from the league.

Former NFL players have been increasingly vocal in their criticism of the ban in recent years, saying that medical marijuana is a safe alternative to the powerful prescription opiates routinely prescribed to NFL players for pain. Documents obtained by The Post earlier this year show that NFL teams are heavy users of prescription pain medications, averaging about “six to seven pain pills or injections a week per player over the course of a typical NFL season.”

There’s little evidence that opiates work for the chronic aches and pains often suffered by football players. But there’s strong evidence that anyone, NFL pro or otherwise, who uses opiates on a long-term basis is putting themselves at serious risk for drug dependency, overdose, and death. A 2014 review of 39 studies investigating the efficacy of opiate painkillers for chronic pain found that “evidence on long-term opioid therapy for chronic pain is very limited but suggests an increased risk of serious harms that appear to be dose-dependent.” In other words, there’s little evidence of benefit for treating chronic pain with opioids, but a there is a real risk of harm.

The implications of this finding shouldn’t be understated, for either NFL players or the public. Opiate painkillers, like the ones prescribed in bulk by the NFL, kill over 15,000 people a year via overdose. No death from a marijuana overdose has been reported, according to the DEA. On the other hand, chronic pain is one of the conditions that marijuana has been shown to be effective at treating. Earlier this year the National Academies of Sciences, Engineering and Medicine published an expansive literature review, spanning decades of research, showing “substantial evidence that cannabis is an effective treatment for chronic pain in adults.”

The NFL, in other words, is pumping its players full of highly addictive and deadly substances that are of dubious use for treating the long-term, chronic pain suffered by so many players, and fining and suspending players who choose instead to self-medicate with a less-addictive and non lethal substance. The disproportionality of the league’s substance abuse policy was put into stark relief in 2015, when the Browns’ Josh Gordon received a year-long suspension for multiple violations of the league’s marijuana ban. When Ravens running back Ray Rice was charged with aggravated assault for beating his then-fiancee, his initial suspension from the league was only two games.

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A new proposal is being considered by legislators in Nebraska that would allow for the use of medical marijuana, which would make it the first heartland state to do so. A traditionally red state, Nebraska joined Oklahoma in suing Colorado after the Rocky Mountain State approved adult-use marijuana in 2014. The two states argued that growers in Colorado were illegally selling marijuana in their states. However, Nebraska now could potentially join the list of states where medical marijuana is allowed. Legislators are currently considering a proposal from State Senator Anna Wishart called the Medical Cannabis Act, which would allow use of medical marijuana in certain cases.

Wishart, a freshman member of the senate who won election last November, represents the Lincoln area. The proposal passed out of committee in March and will now go to the Senate floor. Opposition is expected by members of the Senate. The head of the Nebraska State Patrol has already testified against the bill, as has a representative of the state attorney general’s office. Governor Pete Ricketts also opposed a similar measure last year. Wishart stated she is “optimistic that members will listen to their constituents who are desperately asking them to legalize this form of treatment.”

As with many states that have legalized medical marijuana, the Nebraska proposal would permit those suffering from certain chronic or severe diseases and conditions to use medical marijuana with a doctor’s prescription. They include glaucoma, HIV/AIDS, Tourette’s syndrome, amyotrophic lateral sclerosis, seizures and severe and persistent muscle spasms. Those with cancer or a diagnosis of having less than a year to live who also experience chronic pain or nausea would also qualify.

Patients would need to submit all the required paperwork to the state along with a physician’s prescription. The program would be open only to Nebraska residents who enroll in a state registry. The program would be overseen by the Department of Health and Human Services. In a departure from many states, the Nebraska law would not allow patients to smoke marijuana. Instead, it would require use through pills, liquids, lotions, or a vaporizer.

However, the details of the proposal, which mostly mirror those in other states, seems less relevant in the national picture than the political and geographical position of Nebraska. More than half of American states have some form of legalized marijuana. However, despite polls showing support nationwide for medical marijuana, the legalization effort has, to date, skipped two large sections of the country: the midwest and the south.

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