Big Pharma Round-Up V (#Cannabis edition)

https://twitter.com/DavidLenigas/status/948667879368642562

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CFP Cannabis: Global Histories

19-20 April 2018
University of Strathclyde, Glasgow

In cooperation with Wellcome Trust

The Centre for the Social History of Health and Healthcare would like to invite papers for Cannabis: Global Histories at the University of Strathclyde (Glasgow) on 19-20 April 2018.

One outcome of the recent Alcohol and Drugs History Society meeting (ADHS) in Utrecht was enthusiasm for a ‘histories of cannabis’ workshop/conference to gather together the increasing number of scholars researching the topic.

Paper proposals should be based on unpublished research and should include a 300-word abstract, including a brief CV (2 page maximum). The deadline is 1 September 2017. Participants would then be asked to submit papers of c.7000-8000 words by 15 January 2018. This will enable pre-circulation of papers and also early work on editing a collection of papers for publication.

The geographical location and timeframe are open, while topics may include but are not limited to:

policy and legislation
health outcomes
trafficking and terrorism
comparative approaches
myths
science and evidence
the rise of big cannabis
art and culture

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Deadline for Proposals: 1 September 2017
Deadline for Papers: 15 January 2018

Please send your submissions or queries to :
Caroline Marley: cshhhadmin@strath.ac.uk or
Lucas Richert: Lucas.Richert@strath.ac.uk

Dried Buds

LSD: Insight or Insanity?, 1968

From the NIH. A post by Professor Erika Dyck on the history of LSD.

Circulating Now from NLM

Circulating Now welcomes guest blogger Erika Dyck, PhD, Professor and Canada Research Chair in the History of Medicine at the University of Saskatchewan. Today, Dr. Dyck shares some insights on a recently digitized film in the Library’s collection highlighted in our Medical Movies on the Web project.

For Rebels, it’s a Kick…

It’s the late 1960s. Teenagers, a hip voice clues us in, are always looking for kicks, and today’s teens express themselves with cool fashions, groovy hairstyles, and kooky pranks. Not so long ago, our narrator played the character of “Plato,” a troubled teenager, in the 1955 classic Rebel Without a Cause. In that film, Plato idolizes the reckless machismo of young Jim Stark (played by James Dean). In an epic display of bravado, Jim and another boy play a game of “chickie run” in which they drive their cars in parallel directly toward a cliff. Jim leaps…

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THE FUTURE OF UK MEDICAL MARIJUANA REMAINS BLURRY

BUT THERE ARE LESSONS TO TAKE AWAY FROM CANADA

From 2014–2016, Canadian health authorities were forced to address the issue of medical marijuana, even as activist groups and industry sought to influence the decision-making process and its place in the medical marketplace. First, the system was privatized, then issues of use and access, not to mention the full-on legalization of recreational marijuana, dominated headlines.

In light of last week’s shocking medical marijuana report, the policy debate will certainly grow more heated here in the UK. The All Party Parliamentary Group on Drug Policy Reform stated there is “good evidence” cannabis can help alleviate the symptoms of several health conditions, including chronic pain and anxiety. According to Prof Mike Barnes, a leading consultant neurologist who contributed to the report, “We must legalise access to medical cannabis as a matter of urgency.”

In a recently co-edited series on Canadian cannabis called Waiting to Inhale, it became clear that medical marijuana was a supremely complex policy issue. Some of the questions included, but were not limited to, the tenuous balance between consumers and regulators, Canadian physicians as unwanted gatekeepers, marijuana as a measure (and potential leveller) of inequities, and the major struggles between Big Cannabis and craft cannabis.

Looking ahead, the UK can learn lessons from other countries, including Canada.

Background: Canadian medical cannabis

Medical marijuana has been available in Canada since 2001, after the Canadian Court of Appeal declared that sufferers from epilepsy, AIDS, cancer and other ailments had a constitutional right to light up. Prohibition of this “medicine” was, in short, unconstitutional.

The original regulation that allowed patients to access medical marijuana in Canada was enacted in 2001 and called the Marihuana Medical Access Regulations (MMAR). It allowed patients to possess dried marijuana flower/bud with a license issued by the government, provided that the application was signed off by a physician.

One strain of medicine was available for purchase from one single government supplier, Prairie Plant Systems, but optional licenses were available for patients to grow their own plants or to designate a grower to supply medicine to them.

The MMAR was repealed and replaced by the Marihuana for Medical Purposes Regulations (MMPR), enacted on Apr. 1, 2014. With this, medical marijuana was officially opened for business. And the new rules generated a craze as dozens of new entrants jumped into the marketplace.

As of Aug. 24, 2016 the MMPR was replaced with the Access to Cannabis for Medical Purposes Regulation (ACMPR). These new regulations included legislation that satisfied the latest Supreme Court decision to allow patients who possess a prescription from a doctor to grow their own medicine.

During this period, certain problems have hindered the medical marijuana industry’s growth in Canada, and Britain could learn from these.

Dispensaries vs. Big Cannabis

These stores and clubs are illegal because they procure and sell their products outside the federal medical marijuana system, which was overhauled and expanded last year to allow industrial-scale production of pot products that are mailed directly to licensed patients.

The pushback against dispensaries has come from national and local law enforcement as well as the Canadian Medical Cannabis Industry Association. Yet, the Cannabis Growers of Canada, a trade association representing “unlicensed” growers and dispensaries, have fought to be included at the table. Along with several other organizations, the CGC has lobbied the government to be included in the new legal regime.

As the New York Times put it, “a lobbying battle is raging between the new entrepreneurs and the licensed medical marijuana producers, who were the only ones allowed to grow and provide the plant under the old regulations. One side complains about being shut out by a politically connected cartel, while the other complains about unfair and damaging competition from those who are breaking the law.”

Physicians

Medical marijuana has not approved as a medicine by Health Canada, although there is a growing body of clinical evidence regarding its pain-alleviating effects.

As such, physicians in Canada have struggled with the science and ethics of medical marijuana. At the 147th annual meeting of the Canadian Medical Association in Ottawa last August, many doctors expressed serious reservations about prescribing marijuana.

Some doctors said they felt threatened or intimidated into signing prescriptions, whereas others felt as though patients were shopping for doctors. Worst of all, there were reported cases of malfeasance, where doctors charged their patients for a prescription.

The result is that the CMA remains divided on, if not outright opposed to, being the gatekeepers of medical marijuana.

Workplace Safety and Performance

With more relaxed rules around medical marijuana (along with federal legislation looking to legalize cannabis),employers are wondering whether this will grow as an issue when it comes to pre-employment or on-the-job testing.

Aside from certain industries, such as transportation, most provinces don’t have clear policies or precedents for dealing with medical marijuana.

Besides that, workplace screening of marijuana is a mediocre indicator of performance in the workplace as it doesn’t actually test for impairment. Rather, it tests for by-products excreted from the body after the drug’s been ingested.

Looking ahead, human resource departments will be forced to develop a raft of new policies.

Veterans

The core problem rests with the amount of cannabis veterans are authorized to take. In 2014, Veterans Affairs doubled the amount to 10 grams per day for eligible veterans. Yet, this is twice the amount Health Canada considers safe.

An internal Health Canada document showed that more than five grams has the potential to increase risks to the cardiovascular, pulmonary and immune systems, as well as psychomotor performance and has a chance of increasing the risk of drug dependence.

Ferguson’s office could not find any evidence to support this decision to increase the threshold. Veterans Affairs Minister Kent Hehr expressed shock in March that his department lacked an “informed policy” on the use of medical cannabis, even as the number of claims by veterans for medical marijuana grew more than tenfold over the past two years.

Vaping

The intersection of vaping and medical marijuana has also caused tension. As vaping has moved from a niche presence to mainstream practice, its unregulated nature – at the federal level – poses problems to policy-makers.

For example, the Ontario government exempted medical marijuana users in mid-November from a law that bans the use of e-cigarettes anywhere regular cigarettes are prohibited. These regulations were set to come into effect Jan. 1. This exemption meant medical marijuana users could vape in restaurants, at work or on playgrounds. However, Ontario’s associate health minister Dipika Damerla stated that the government would remove the exemption.

Local governments in various cities recently voted to implement a vaping bans in public spaces, with only a vape shop exemption predicated on “safety” concerns, specifically for the uninitiated e-cigarette user who doesn’t know how to install batteries in the device. But it was also predicated on the notion that buyers should be able to see what they’re getting, which is the same argument made by authorized medical cannabis users about the value of a local pot dispensary.

The Future

Marijuana remains a highly contested medicine for various scientific, political and social reasons. That is obvious.

Policy makers from government, industry leaders, and physicians will face considerable question marks. Cutting through all the haze won’t be an easy task, yet all participants, including the public, would be wise to use recent examples from Canada to light the way.

 

Vape Fear – Updated

November 25, 2016 – CBC NEWS

Vaping, e-cigarettes to be regulated by Health Canada

The federal government plans to regulate e-cigarettes to make vaping products less accessible to young people.

“The proposed act amends the Tobacco Act to regulate vaping products as a separate class of products,” Health Canada said in a statement on Tuesday November, 22.

The aim is to protect young people and non-users from nicotine addiction while allowing adults access to e-cigarettes.

“We know that there is some evidence to suggest that the use of vaping products can be used as a harm-reduction tool for people who are current smokers,” Health Minister Jane Philpott told reporters in the Commons.

“But at same time, they have [been] shown to be an enticement for young people to take up smoking and become addicted to nicotine.”

The government aims to regulate the manufacture, sale, labelling and promotion of e-cigarettes and vaping products.

A key part of the legislation introduced in the Senate is to regulate health claims, such as that a vaping product will help smokers quit.

The legislation would cover vaping products with and without nicotine.

Other measures in the proposed legislation include:

  • A ban on the sale and promotion of all vaping products to those under age 18.
  • Prohibiting the promotion of flavours that appeal to youth, such as candy flavours.
  • Creating regulatory authority to display health warnings on vaping devices.

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Here’s my original article.

In Martin Scorsese’s 1991 remake of Cape Fear, Robert De Niro plays sociopathic Max Cady, who has recently been released from prison. Years earlier, his attorney, Sam Bowden portrayed by Nick Nolte, deliberately withheld evidence during a criminal trial which would have seen Cady acquitted.

This of course enraged Cady and fueled a desire for revenge. As punishment, he stalked and brutalized the Bowden family. Yet, being a true believer, he also felt that by carrying out his terrible deeds he was helping Bowden achieve a type of moral and spiritual redemption. In short, he felt his actions were serving Bowden’s interests.

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In 2016, consumers, politicians, and health officials are going through Vape Fear. Due to lack of evidence, we are being tested by a product in the marketplace with a potential to improve health outcomes and cause other, if unknown, health problems.

It’s a dual-purpose product, in that it has recreational and medical applications. And in the public arena, opponents and supporters of e-cigarette regulations have contested the best approach to it.

Supporters of stiff regulation declare that children and young people need to be shielded from products that imitate smoking and might encourage nicotine addiction. (Think Mrs. Lovejoy in the Simpsons.) They favour regulation that might guarantee product safety and quality. These individuals also usually advocate on behalf of a precautionary approach – at least until there is sufficient evidence that e-cigarettes don’t undermine recent successes at controlling tobacco.

Opponents of stiff regulation, by contrast, argue that vaping is significantly less harmful than conventional cigarettes and beneficial in helping smokers to quit. They want minimal restrictions on availability and often absolute freedom for advertising, promotion and the use of e-cigarettes in public. (Think Charlton Heston and guns being pried from his cold dead hands.) Restrictions, this camp argues, might put off smokers from swapping to safer alternatives and limit the opportunity of curbing tobacco consumption. Here harm reduction trumps all other suits.

Now, against this messy backdrop, governments have taken action.

New EU regulations in May imposed standardised quality control on liquids and vaporisers across the union. They also required disclosure of ingredients in vaping liquids and child-proofing and tamper-proofing for liquid packaging.  And the NHS has backed e-cigarettes as a quitting aid.

In March, the Scottish government’s Health Bill banned under-18s from both buying the devices and limiting their advertising, which followed Health Scotland’s position paper in March 2015 that “NHS Boards must balance the benefits of e-cigarettes use to smokers with any potential concerns about impact on non-smokers.”

Meanwhile, the U.S. government has also taken broad steps to crack down for the first time on e-cigarettes, which have been growing in popularity among teens and is projected to be a 4 billion dollar industry this year.

The Food and Drug Administration’s move in May brought regulation of e-cigarettes in line with existing rules for cigarettes, smokeless tobacco and roll-your-own tobacco. This had been highly anticipated after the FDA issued a proposed rule two years ago on how to supervise the e-cigarette industry.

“Millions of kids are being introduced to nicotine every year, a new generation hooked on a highly addictive chemical,” U.S. Secretary of Health and Human Services Sylvia Burwell stated during the announcement of the new rules. She asserted too that health officials still don’t have the scientific evidence showing e-cigarettes can help smokers quit, as the industry asserts, and avoid the known ills of tobacco.

In all of this, though, a Vape Fear persisted.

Similarly, heart experts recently found that vaping damages key blood vessels in the heart in a similar way to normal cigarettes, and it’s “far more dangerous than people realize.” University College London heart expert Professor Robert West noted, “It would certainly be fair to say the study shows electronic cigarettes are not without any risk.”

Researchers at the European Society of Cardiology Congress in Rome thus decided to call the NHS decision to support e-cigarettes “premature.”

Added to all this is the idea of vaping garage labs, a part of e-cigarette mythology that’s difficult to shake. While no one has been publicly exposed for mixing juice in an actual garage, many in the industry have confessed privately that some set-ups that are only marginally better. It was and remains the nascent industry’s dirty little secret.

In my home country of Canada, Vape Fear is certainly present. According to the CBC’s celebrity doctor Brian Goldman, “my sense is that key thought leaders in Canada are alarmist about e-cigarettes.” They “ignore evidence,” “cling to the notion that nicotine addiction, as opposed to combusted tobacco products, is the paramount health problem,” and “overestimate concerns that e-cigarettes act as a gateway to regular tobacco use.”

For Goldman, it’s well past time that his colleagues “look up the facts” and stop “dissing a smoke cessation tool with a lot of potential.” It can serve the interests of public health. Jesse Kline for the National Post has likewise told Canadians, “Don’t believe the fear campaign — e-cigarettes can save millions of lives.”

In Cape Fear, Sam Bowden’s teenage daughter – played by Juliette Lewis – was tormented and assaulted by De Niro’s Max Cady, but she manages to survive. She tells the audience that her holiday in North Carolina had been so peaceful beforehand, “when the only thing to fear on those enchanted summer nights was that the magic would end and real life would come crashing in.”

With vaping, we know this won’t occur until all multitudinous studies have been completed. And regulators and health authorities reach consensus.

Until that point, the regulation and use of e-cigarettes in Canada, the United States, and Scotland will continue to spark serious challenges and health concerns.

Without reliable data and hard evidence, and in a state of affairs where no one has a claim to the unassailable truth, regulations that curtail access and promotion to young people appears to be the surest policy in overcoming Vape Fear.

Weed in the Workplace

The newest issue of Canadian HR Reporter discusses ‘weed in the workplace’ and focuses on drug screening. There are some vital ideas here about on-the-job safety, the legalities of drug testing, and impairment. Basically – drugs during ‘9 to 5.’ Also, I get my two cents in there! Check it out at Increasing use of marijuana could cause problems on the job