Monday, January 28, 2013

"Advocacy 101" training

Want to advocate for prevention but don't know how?

In 2011, Nancy Amidei of the Civic Engagement Project conducted an "Advocacy 101" training for the Engage Seattle project.  The City of Seattle posted handouts and a video of her presentation on their website.  These resources are a great place for substance abuse and violence prevention advocates to learn more about the legislative process, the important role they play in law-making, and how easy it is to be an advocate.  Among the handouts is an advocacy guide for public employees and people who are funded by government dollars.

Here is a video clip from the training:

Using the National Prevention Strategy to guide WA marijuana policy

As our state moves forward with implementing I-502, policies that prevent underage and excessive marijuana use should be part of the new legal marketplace. Since a highly regulated marijuana marketplace has never been established before, we can look to what has worked and not worked for underage drinking and tobacco use prevention. With alcohol and tobacco, many regulations have proven to prevent youth use.

Links to a few public health websites are included in the WASAVP Marijuana Education Toolkit. One of the public health resources to which we may refer is the National Prevention Strategy's priority of Preventing Drug Abuse and Excessive Alcohol Use. Policies that are recommended include:
  • Reduce days and hours of alcohol sales.
  • Limit the number of places that sell alcohol.
  • Enforce the legal minimum drinking age (21).
  • Restrict alcohol marketing.
  • Expose youth to counter-marketing messages.
 All of these policies are among those recommended by WASAVP for addressing legal marijuana.

Sunday, January 27, 2013

Listen to I-502 public forums online

The Liquor Control Board is hosting public forums across the state to gain public input about the implementation of I-502.  Last week, forums were hosted in Olympia and Seattle.  Video and audio recordings of these forums are posted online

Here is a recording of the Olympia public forum.


The Seattle forums may be viewed online via the Seattle Channel

Wednesday, January 23, 2013

U.S. Appeals Court: More medical evidence needed to reclassify marijuana


A U.S. Appeals Court this week refused to overrule the Drug Enforcement Administration’s (DEA) classification of marijuana as a dangerous drug with no accepted medical uses.

A marijuana advocacy group had sued the government, arguing the DEA had a duty to reexamine the medical evidence, and to reclassify marijuana as a drug with benefits for those suffering and in pain.

The three judges on the court deferred to the judgment of federal health experts, who said they required more evidence before they could reclassify the drug. “To establish accepted medical use, the effectiveness of a drug must be established in well-controlled, well-designed, well-conducted and well-documented scientific studies [with] a large number of patients. To date, such studies have not been performed,” according to a DEA document that was quoted in the court decision.

Judge Harry Edwards wrote the judges did not dispute that “marijuana could have some medical benefits,” but added they were not willing to overrule the DEA because they had not seen large “well-controlled studies” that proved the medical benefits of marijuana.

Wednesday, January 16, 2013

Tobacco controls unenforced, prevention funds diverted

To be filed under "lessons learned" about funding for substance abuse prevention, here is an excerpt from a recent American Lung Association press release "Tobacco Industry Continues to Spend Billions While Public Health Shortchanged":

Follow the trail of money misused by policymakers and strategically invested by Big Tobacco in the American Lung Association's "State of Tobacco Control 2013" report released today to discover how the leading cause of preventable death is often entangled in a financial web of neglect and deceit.

The Lung Association's "State of Tobacco Control" report tracks annual progress on key tobacco control policies at the federal and state level, assigning grades based on whether laws are adequately protecting citizens from the enormous toll tobacco use takes on lives and the economy.

"We are faced with a deep-pocketed, ever-evolving tobacco industry that's determined to maintain its market share at the expense of our kids and current smokers," said Paul G. Billings, American Lung Association Senior Vice President for Advocacy and Education. "State and federal policymakers must battle a changing Big Tobacco and step up to fund programs and enact policies proven to reduce tobacco use."

The federal government's progress on tobacco control over the past several years nearly ground to a halt in 2012. Most notably, the Food and Drug Administration (FDA) failed to exercise its oversight authority allowing for the proliferation of a new generation of tobacco products aimed at hooking youth smokers.

State governments continued their years of inaction by again failing to invest income from tobacco taxes and tobacco settlement payments into programs proven to keep youth off tobacco and help current smokers quit. According to the U.S. Surgeon General's report, if states begin to invest in tobacco prevention programs, youth tobacco use could be cut in half in just six years.

Smoking costs the American public almost $200 billion every year in healthcare costs and lost productivity and wages – a staggering bill that the country can ill afford.

In 2009, the Washington State Legislature diverted tobacco dedicated funds away from prevention programs and into the general fund.  State funding for tobacco prevention is now virtually non-existent. 

Tuesday, January 15, 2013

Liquor Control I-502 public forums

The Washington State Liquor Control Board will hold six evening public forums across Washington regarding the implementation of Initiative 502. The forums are an opportunity for interested citizens to meet WSLCB staff involved in implementation, be updated on implementation and to provide input to the Board for it to consider as it develops rules.

“Clearly there is passion about what Washington’s system of legal marijuana will look like when fully implemented,” said Board Chair Sharon Foster. “This is an opportunity for the public to meet the Board and staff involved in implementation, learn about our role in implementation, and to provide testimony. We appreciate the cooperation of the Association of Washington Cities for their help in arranging these forums.”

  • 1/22: WSLCB Headquarters, Conference Room 201
    3000 Pacific Ave SE, Olympia, WA 98501
  • 1/24: Seattle City Hall, Bertha Knight Landes Room
    600 Fourth Ave, Seattle, WA 98104
  • 02/7: Clark College, Vancouver, Foster Auditorium
    1933 Fort Vancouver Way, Vancouver, WA 98663
  • 02/12: Spokane City Hall, Council Chambers
    808 W Spokane Falls Blvd, Spokane, WA 99201
  • 02/19: Skagit Valley College, Mt. Vernon, Theater
    2405 East College Way, Mount Vernon, WA 98273
  • 02/21: Yakima City Hall, Council Chambers
    129 North Second St, Yakima, WA 98901
Agenda
  • 6:00 – 7:00 p.m. Open house with Board and staff
  • 7:00 – 7:05 p.m. Board welcome
  • 7:05 – 7:15 p.m. Overview of Board’s role in implementation and timeline
  • 7:15 – 10:00 p.m. Public testimony

Thursday, January 10, 2013

New national marijuana policy alliance formed

A new national alliance, Project SAM, was launched today in Denver.  Following is their from press release:

A new national alliance, Project SAM (Smart Approaches to Marijuana) is launching today in Denver, Colorado to start a new national dialogue on marijuana policy based on public health. Chaired by former Congressman Patrick J. Kennedy, Jr., Project SAM is a bipartisan alliance of lawmakers, scientists, and other concerned citizens who want to move beyond simplistic dichotomies of “incarceration versus legalization” and instead focus on practical changes in marijuana policy that neither demonizes users nor legalize drugs. Former George W. Bush Speechwriter, Newsweek/Daily Beast columnist David Frum, Harvard Professor Sharon Levy, University of Kansas public health specialist Kimber Richter, and former Obama and Bush advisor Kevin Sabet will also serve on the board of SAM. SAM focuses on a “third way” approach to marijuana, and will be working with state partners to reach the local level. The first state partnership will be Smart Colorado, chaired by Bob Doyle.

“I have devoted my life to mental health awareness and the establishment of a modern health system that recognizes the importance of preventing and treating mental illness,” remarked Patrick J. Kennedy, Jr. “I am extremely concerned about how America’s current rush toward marijuana legalization, however, could increase our health problems by allowing a permissive environment for addiction.”

Project SAM, funded through volunteers, will focus on four main goals:

1. To inform public policy with the science of today’s marijuana

2. To have a conversation about reducing the unintended consequences of current marijuana policies, such as lifelong stigma due to arrest

3. To prevent the establishment of “Big Marijuana” — and a 21st-Century tobacco industry that would market marijuana to children. Those are the very likely results of legalization

4. To promote research of marijuana’s medical properties and produce pharmacy-attainable medications

“A world of legal drugs will be a world in which the fates of the top one third of Americans and the lower two thirds will diverge even more than they already do. We have opened more and more roads to self-harm. Must we now open another?" remarked David Frum, former presidential speechwriter.

While Project SAM will work on getting information to lawmakers and the public about the perils of marijuana addiction and legalization, it will also focus on cost-effective solutions to marijuana use such as the expungement of records for those with arrests for small amounts of marijuana.

“To be against legalization is not to be anti-reform,” remarked Kevin A. Sabet, former advisor to the Obama Administration. “Marijuana arrestees should be referred to brief health interventions or treatment, if appropriate, and given opportunities to find a way out of drugs as opposed to a way into the criminal justice system.”

Project SAM will be particularly focused, however, on preventing a 21st-century tobacco industry focused on a new product line – marijuana.

”The tobacco industry is a worldwide public health disaster. We should learn from our mistakes, not repeat them with marijuana,” remarked Kimber Richter, a renowned tobacco researcher at the University of Kansas.

SAM will also focus on the impact of marijuana on children. “As a physician for kids, I know marijuana legalization would be a disastrous public health policy for them,” said Christian Thurstone, child and addictions psychiatrist and researcher, University of Colorado Denver. “The developing brain should be shielded from harm, not exposed to it.”

Finally, there will be a push to increase research into the medicinal properties of marijuana that does not involve ingesting the whole drug, as per “medical” marijuana by state referenda. “Cannabis-based drugs dispensed by pharmacists and prescribed by doctors represent an exciting area of current research,” remarked Kennedy. “But more can be done to incentivize researchers and the government to focus on this area. Our coalition looks forward to helping with that agenda.”

Wednesday, January 9, 2013

State representatives voice concerns about the implementation of I-502

In a January 7 letter to the Chair of the Liquor Control Board, Washington State Representatives Hurst, Carlyle, and Hunter request that they "change their approach towards implementation" of I-502 to "ensure that precious state resources are not wasted and that our valuable state employees not be exposed to any criminal liability."

Specific concerns that they identify include "many unresolved questions regarding the federal government and marijuana's continued listing as a Schedule I controlled substance, taxation policy, impacts on local governments, LCB appropriations for implementation and other public policy considerations such as the role of the LCB itself."

Though I-502 states that the LCB has until December 1, 2013 to have a regulatory system in place for growing, producing, and selling marijuana, the representatives consider this timeline "aggressive".  They state that that the current timeline for the implementation of I-502 "could lead to significant state resources being wasted on an effort that could ultimately be shut down due to . . . the Federal government."

In the meantime, a marijuana business group will host a meeting of marijuana business interests with Seattle Mayor Mike McGinn later this month to, no doubt, lobby for a marijuana business-friendly environment in the city regardless of what happens on the state level.

More marijuana business lobbyists

Over at Cannabis Wire, they have been tracking the development of marijuana business groups and their hiring of lobbyists.  Here's the latest:

On Monday, we posted on the formation of the Northwest Producers and Processors Association (NWPAPA), and their lobbyist hire. The NWPAPA spokesperson and lobbyist commented that they see the state’s craft beer industry as “a good model” for cannabis retail business.

In December, the Cannabis Business Group (CBG) was formed and the first registered lobbyist was hired to work on I-502 implementation. Today the paperwork is complete, the mission is set, and CBG has announced they are ready to represent a broad base of producers, processors and retailers of MMJ. The group sees tremendous industry opportunity under recreational use regulations.


Although focused on public policy affecting patients and their use of cannabis, the eighteen month old Cannabis Coalition for Standards and Ethics (CCSE), is not shy about working the legislative and regulatory process hard. CCSE has established an open channel with the LCB, and informally is sought out as an experienced resource of growers, processors and users.

Here is an excerpt from a letter that the newly-formed Cannabis Business Group sent out:   We are proud to announce the formation of The Cannabis Business Group (CBG) for cannabis business professionals seeking to operate as I-502 producers, processors, and retailers. We would like to invite you to join the CBG to help cultivate (pun intended) the future of cannabis here in Washington and, eventually, on a national scale. We want to work with you to seize this once-in-a-lifetime opportunity to build a new cannabis industry based on meaningful and intelligent regulations that we can help mold.

It remains to be seen if marijuana business lobbyists will work with the substance abuse prevention community to ensure that "meaningful and intelligent regulations" include those that will keep marijuana out of the hands of minors.  This is a "once-in-a-lifetime opportunity" for creating a marijuana industry that is tightly regulated so that only adults will have increased access to marijuana.  This is the opportunity for public health and safety advocates to be in on the ground floor influencing policy making for an industry that could have serious affects on youth health and development. 

Friday, January 4, 2013

DEA proposes rule changes to expand options for collecting unused medicines


The Drug Enforcement Administration (DEA) published its Notice of Proposed Rulemaking for the Disposal of Controlled Substances in the Federal Register Dec. 21.  The proposed regulations seek to implement the Secure and Responsible Drug Disposal Act of 2010.
According to the 2011 Substance Abuse and Mental Health Services Administration’s National Survey on Drug Use and Health, more than six million Americans abuse prescription drugs.  That same study revealed more than 70 percent of people abusing prescription pain relievers got them through friends or relatives, a statistic that includes raiding the family medicine cabinet. Medicines that languish in home medicine cabinets are highly susceptible to diversion, misuse, and abuse. Rates of prescription drug abuse in the U.S. are alarmingly high—more Americans currently abuse prescription drugs than the number of those using cocaine, hallucinogens, and heroin combined. 
This rule proposes requirements to govern the secure disposal of controlled substance medications by both DEA registrants and what the Controlled Substances Act refers to as “ultimate users” of these medications (patients and animals).  The proposed regulations seek to expand the options available to collect these medications from ultimate users for the purpose of disposal, to include take-back events, mail-back programs, and collection box locations.  The proposed regulations contain specific provisions that:
  • Continue to allow law enforcement agencies to voluntarily conduct take-back events, administer mail-back programs, and maintain collection boxes;
  • Allow authorized manufacturers, distributors, reverse distributors, and retail pharmacies to voluntarily administer mail-back programs and maintain collection boxes;
  • Allow authorized retail pharmacies to voluntarily maintain collection boxes at long term care facilities.
The public can review an electronic copy of this document at http://www.gpo.gov/fdsys/pkg/FR-2012-12-21/pdf/2012-30699.pdf and has 60 days to submit comments, until February 19, 2013.  DEA encourages interested parties to comment on this important proposed rule.  

Thursday, January 3, 2013

Marijuana dependence and treatment

As we, as a state, move forward with creating a commercial marijuana market, it is important that we understand marijuana, its use, and consequences.  While this blog mostly focuses on substance abuse prevention, it's useful to take a look at intervention, harm reduction, and treatment, too.  A 2007 article from the Addiction Science and Clinical Practice journal entitled "Marijuana Dependence and Its Treatment" is a good starting point.

Here are a few excerpts:

Adolescent marijuana use
Approximately half of the individuals who enter treatment for marijuana use are under 25 years of age. These patients report a distinctive profile of associated problems, perhaps due to their age and involvement in other risky behaviors (Tims et al., 2002). Adolescents who smoke marijuana are at enhanced risk of adverse health and psychosocial consequences, including sexually transmitted diseases and pregnancy, early school dropout, delinquency, legal problems, and lowered educational and occupational aspirations.


Racial disparities
During the past decade, marijuana use disorders have increased in all age groups. Contributing factors may include the availability of higher potency marijuana and the initiation of use at an earlier age. Among adults, marijuana use disorders increased despite stabilization of rates of use. An increased prevalence of disorders among young adult African-American and Hispanic men and African-American women appears to account for the overall rise among youth ()

Is marijuana unique? A large part of the general population has had personal experience with marijuana, and most have not become addicted. (Ten percent of the U.S. population reports using marijuana in the past year and 6% report using within the past month.) Many find it perplexing to contemplate how someone else could become addicted to a drug they themselves have tried and can easily set aside or stop using. Accordingly, they think marijuana dependence must qualitatively differ from dependence on other drugs, such as heroin and cocaine, and require unique treatment approaches.

People who develop problems with marijuana may indeed be different from those who do not, but this phenomenon has been observed with other substances of abuse. A comparison with alcohol use and dependence provides a case in point. The great majority of Americans have tried alcohol and continue to drink alcoholic beverages regularly. However, only an estimated 10 to 15 percent of alcohol drinkers develop problems, and only some of these problem drinkers seek treatment. This is also true of those who have tried cocaine or heroin (Anthony, Warner, and Kessler, 1994).


Note: Two of this article's authors conduct research with the University of Washington's Teen Marijuana Check-Up.