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Places with More Marijuana Dispensaries
Have More Marijuana-Related Hospitalizations

In a first analysis of the impact of marijuana dispensary locations on health, researchers mapped California hospital discharge data that had a primary or secondary code for marijuana dependence or abuse to patients’ zip codes. Then they cross-referenced the data to the number of dispensaries in those zip codes.
 
Hospital marijuana codes increased from 17,469 in 2001 to 68,408 in 2012 in the state. More than 85 percent were coded as abuse rather than dependence. Nearly all (99.2 percent) were secondary codes, meaning patients were hospitalized for something other than marijuana (like someone hospitalized with internal injuries after crashing while driving under the influence of alcohol.)
 
“Each additional dispensary per square mile in a zip code was associated with a 6.8 percent increase in hospitalizations linked to marijuana abuse and dependence.” The density and location of dispensaries paralleled the density and location of liquor stores, which tend to be located in areas with lower household income and lower educational attainment.
 
Read Science Daily summary of the study here.
 
Q&A: Interview with the Director of the
National Institute on Drug Abuse

Nora Volkow, MD,  is director of a National Institutes of Health agency, the National Institute on Drug Abuse, which funds most of the world’s marijuana research. She knows more than almost anyone else about the harms of marijuana and the potential medical use of some of its components. The Colorado Gazette interviews her here.
 

18 Flaws in Study Finding No Health Problems
in Young Adult Males Who Were
“Chronic” Marijuana Users as Teens 

 
A new study has caused quite a stir among would-be marijuana cognoscenti because it contradicts major research about the impact of marijuana on physical and mental health. We asked Harvard University neuroscientist, Bertha K. Madras, to analyze the study for readers of The Marijuana Report. Dr. Madras served as Deputy Director for Demand Reduction in the White House Office of National Drug Control Policy from 2006 to 2008, is a pre-eminent researcher in the field of drug abuse and addiction, and is professor of psychobiology in the department of psychiatry at Harvard University. The Marijuana Report will publish a link to her full paper in next week's issue. 
 
A recent manuscript by Bechtold et al1, describes a longitudinal assessment of four groups of marijuana users (non-users and low use; adolescent-limited; late-increasing; early onset-chronic), from adolescence into young adulthood. Study authors then assessed their health outcomes in their mid-thirties, ten years after the last determination of marijuana use. They found no evidence for physical or mental health problems in these cohorts that had used different amounts of marijuana during adolescence and young adulthood, when they reached an average age of 35.8 years. A hasty perusal of the study and the authors’ stated caveats in the manuscript reveal significant weaknesses in this report, in design, in what was measured, in the anachronistic data set of marijuana use patterns, and in data presentation. The validity of the sweeping conclusions is questionable. Apparently the majority of the subjects were not heavy marijuana users (daily or near daily), whereas studies suggest that the impact of marijuana on mental and physical health is most robust among heavy users and those with a cannabis use disorder.    

1. All findings are self-reported, an inadequate method of research because of potential bias and recall errors in self-reporting.
2. Authors did not question whether study participants had visited a physician during the past year, past five years or ten years since the last contact, or ever. Confirmation of medical conditions by a medical record would strengthen the conclusions.
3. Mental and physical diagnoses were based on questionnaires, not on biometric testing or long term assessment (mental diagnoses require long term evaluation).  
4. Data, 46%, is missing.
5. The chart showing marijuana use over time divides the subjects into four groups, but provides no error bars or statistical analysis to show whether these groups are significantly different at all time points during the study.
6. No life outcomes were measured (employment, educational achievement) at the end of the study.
7. Addiction (cannabis use disorder) was neither tested for, nor interrogated.
8. Cognitive testing, a major consequence of heavy marijuana use, was not performed.  
9. Many health problems (e.g. cancer, high blood pressure, heart attacks, strokes) arise later than the time these subjects were interrogated.
10. No questions were asked about acute effects: intoxication, accidents, emergency department mentions.
11. The sample size was too small to detect a marijuana effect on psychotic disorders or on a number of other conditions.
12. By including only subjects who chose to use marijuana, the study does not have a non-marijuana using population to compare results.
13. The populations and use patterns investigated in this study are anachronistic and conceivably irrelevant for 2015. The study, initiated in 1987-1988, recruited a majority of users that did not fall into the heavy use range (daily or near daily use).
14. Marijuana potency was far lower (1980’s to 1990’s) during the period of marijuana consumption of this population. This conceivably affected outcomes and consequences.
15. Quantity and potency of marijuana use is a critical measure and was not measured.
16. Important recent longitudinal studies are left out.   
17. The rate of concussions (27.7%) is inordinately high in this population, yet no explanations are offered.  
18. The authors attempt to support their conclusions by dismissing well designed reports by others. 
 
Charlotte’s Web Oil Expands Marketing
Despite Lack of FDA Approval  

 
The Stanley Brothers, makers of Charlotte’s Web oil, are now selling their products on their new CW Botanicals website and on Amazon. They made two announcements this week. This week, they partnered with Mary’s Nutritionals to sell a new product, Charlotte’s Web Infused Topical Gel Pen, which can be applied directly to the skin. And they have partnered with UK CBD, a British Company, to sell Charlotte’s Web products in England. All of this marketing energy is taking place for a drug that has not been approved by FDA as safe or effective for human use.
 
The Stanleys rebranded their products as “hemp,” claiming it is legal to ship hemp out of Colorado and even the US. They may be right; the state and federal hemp laws are confusing at best. But hemp is defined by both the US and Colorado as a marijuana plant that contains 0.3 percent THC or less. Colorado’s law clearly states that any plant containing 0.4 percent THC or more is marijuana, not hemp. It is illegal to ship marijuana across state lines, abroad, or to sell it on the Internet.
 
Earlier this year, Jesse Stanley appeared as an expert witness before a committee of the Georgia House of Representatives. He testified that patients need CBD with such “low” levels of THC as 5 percent, claiming that 5 percent THC won’t make you high. We note that Americans were getting high on marijuana with less than 5 percent THC in the 60s, 70s, 80s, and 90s. THC is dangerous to developing brains, particularly to the brains of infants, children, and teens who are healthy, let alone sick. Yet Colorado suppliers of CBD products are now shipping CBD with up to 5 percent THC directly to Georgia patients who hold a card from the state health department giving them immunity from prosecution for possessing it.
 
At least two pharmaceutical companies have developed CBD products that they are testing for safety and efficacy under FDA protocols. One, Epidiolex, is available for people with epilepsy in clinical trials and through FDA’s expanded access program. It is expected to be approved by early next year. Epidiolex contains 98 percent CBD and less that 0.3 percent THC. As such, it is by far the safer drug to give to children. If FDA approves Epidiolex, it will likely be placed in a lower schedule of the Controlled Substances Act like other schedule I drugs are after FDA approval. Doctors will be able to legally prescribe it and pharmacists will be able to legally dispense it nationwide.
 
Visit CW Botanicals website hereVisit Charlotte’s Web products sales on Amazon here.
Visit Mary’s Nutritionals website here. Visit UK CBD here. View Jesse Stanley’s Georgia testimony hereRead Stanley Brothers/Mary’s Nutritionals announcement hereRead Metro.co.uk story here. 

To Our Subscribers
 
July 1 marked the first-year anniversary of The Marijuana Report e-newsletter. A huge thank you to all our readers who share their copy of The Marijuana Report with others in their networks!
 
Please note: Until further notice, please ignore any email you might receive from TheMarijuanaReport@gmail.com. The address has been appropriated by a group of legalization proponents in Canada who are using it to impersonate various staff members and volunteers of National Families in Action. Their goal is to intimidate those who oppose legalization but are reaching for other policy solutions based on science and public health. We are working with Google and the Internet Crime Complaint Center to stop this illegal behavior and will let readers know when we gain possession of this G-mail address. If you receive an email from anyone using TheMarijuanaReport@gmail.com, it would be helpful if you would forward it to srusche@nationalfamilies.org. Thank you for helping us reclaim our organizational identity. 
National Families in Action and partners, Project SAM and the Treatment Research Institute, welcome our new readers. We hope you enjoy this weekly e-newsletter to keep up-to-date with all aspects of the marijuana story. Visit our website, The Marijuana Report.Org, and subscribe to the weekly e-newsletter The Marijuana Report to learn more.

National Families in Action is a group of families, scientists, business leaders, physicians, addiction specialists, policymakers, and others committed to protecting children from addictive drugs. We advocate for:
  • Healthy, drug-free kids
  • Nurturing, addiction-free families
  • Scientifically accurate information and education
  • A nation free of Big Marijuana
  • Smart, safe, FDA-approved medicines developed from the cannabis plant (and other plants) 
  • Expanded access to medicines in FDA clinical trials for children with epilepsy
What is our call to action?
  • Ask your leaders to establish FDA expanded access to Epidiolex® for children with epilepsy.
  • Ask your leaders to find a middle road between incarceration and legalization of addictive drugs.
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