05/18/14 Doug McVay

Doug McVay with more from the Patients Out of Time clinical cannabis therapeutics conference; Senate Narcotics Caucus looks at heroin and other opiate use; and Minnesota passes a limited medical cannabis bill.

Program: 
Century of Lies
Date: 
Sunday, May 18, 2014
Guest: 
Doug McVay
Organization: 
Drug War Facts
Download: Audio icon COL051814.mp3
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Century of Lies May18, 2014

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DEAN BECKER: The failure of Drug War is glaringly obvious to judges, cops, wardens, prosecutors and millions more. Now calling for decriminalization, legalization, the end of prohibition. Let us investigate the Century of Lies.

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DOUG McVAY: Hello and welcome to Century of Lies. I'm your guest host, Doug McVay, editor of Drug War Facts dot org. Century of Lies is a production of the Drug Truth Network, and is brought to you through the Pacifica network's radio station KPFT-fm in Houston, Texas. Find us on the web at drug truth dot net, where you can find past programs and you can subscribe to our podcasts. You can follow me on twitter, where I'm at drug policy facts, and also at doug mcvay. The Drug Truth Network is on Facebook, be sure to give its page a Like, you can find Drug War Facts on Facebook as well, please give it a like and share it with friends.

Before we start, I want to say hello to a few of the stations out there that carry Century Of Lies, including KOWA-LP 106.5 FM in Olympia, WA; WIEC 102.7 FM in Eau Claire, WI;Â and Valley Free Radio WXOJ-LP 103.3 FM in Northampton, MA. You can hear Century Of Lies via 420 Radio dot org on Mondays at 11 am and 11 pm, and Saturdays at 4 am. If you're listening to Century of Lies via any of our affiliates, thank you! You can license or syndicate Century of Lies or any Drug Truth Network content through your radio station or web service, get in touch with Executive Producer Dean Becker through the website at drug truth dot net.

Now, let's get to the news.

Earlier this week there was a hearing on opioid use, both legal and illegal, before the US Senate Caucus on International Narcotics Control. Anyone who believes that merely because a couple of states have changed their laws to allow a limited level of adult social possession and use of cannabis, reform is winning the drug war, needs to get a dose of reality. Listening to this hearing might prove an overdose. Here is just a snippet, and it's arguably the only encouraging item heard that day. This is the prepared testimony of Dr. H. Westley Clark, director of the Center for Substance Abuse Treatment at the Substance Abuse and Mental Health Services Administration. Dr. Clark talks about effective, serious moves to address opiate addiction and misuse. Dr. Clark does not pander nor engage in fear-mongering here, and for that he has my utmost respect.

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[submitted written testimony available @ http://www.drugcaucus.senate.gov/hearing-5-14-14/Clark%20Testimony.pdf]

WESTLEY CLARK: Good Afternoon Chairman Feinstein and Senator Kubacha and Senator Grassley had to leave but I want to thank you for inviting the Substance Abuse and Mental Health Services Administration to participate in this panel.

I echo the testimony of my colleagues regarding the importance of the topic for this hearing. I will focus on SAMHSA’s programs and activities though we work with our federal partners, states, tribes and local communities.

According to the 2012 National Survey of Drug Use and Health (NSDUH), which SAMHSA conducts annually, 6.8 million people (aged 12 and older) reported nonmedical use of psychotherapeutics during the past month. That equals 2.6 percent of the U.S. population. In addition, 335,000, or 0.1 percent of the population, reported past month use of heroin. Although the total number reporting heroin use is significantly lower than reported nonmedical use of psychotherapeutics, the numbers have been increasing fairly steadily since 2007 -- both for past month use, as well as past year use. In fact, past month heroin use has more than doubled in six years, going from 161,000 in 2007 to 335,000 in 2012.

One challenge in combatting the misuse of pain relievers is educating the public on the dangers of sharing medications. According to our national survey 54% of those who obtain pain relievers for nonmedical use in the past year received them from a friend or relative for free. Another 14.9% either bought them or took them from a friend or relative thus we have both a public health problem intertwined with a cultural problem.

SAMHSA has several programs focused on educating the public including the “Not Worth the Risk, Even If It’s Legal” education campaign, which encourages parents to talk to their teens about preventing prescription drug abuse. Another educational program, “Prevention of Prescription Abuse in the Workplace,” is designed to support workplace-based prevention of misuse and abuse of prescription drugs for employers, employees, and their families.

Our Partnership for Success grant includes prescription drug abuse prevention as one of the capacity building activities of communities of high need. Our Screening, Brief Intervention and Referral to Treatment (SBIRT) program provides screening for illicit drugs, including heroin and other opioids. We’ve also developed programs to help physicians maintain a balance between providing appropriate pain management and minimizing the risk of pain medication misuse. Our SBIRT Medical Residency training programs includes modules for prescription opioids for pain management and opioid misuse. Over 6,000 medical residents and over 13,000 nonresidents have been trained nationally.

Physician Clinical Support System for Medication Assisted Treatment (PCSS-MAT). Training is available via live in person, live on-line and recorded modules accessible at any time.

SAMHSA also funds the Prescribers’ Clinical Support System for Opioid Therapies (PCSS-O). PCSS-O is a collaborative project led by American Academy of Addiction Psychiatry with the six other leading medical societies. We will be funding a Providers Clinical Support System on the appropriate use of opioids in the treatment of pain and opioid-related addiction this fiscal year.

At the end of April in an article in the Union Journal of Medicine authored by HHS leadership including Dr. Volkow and SAMHSA’s administrator Pam Hyde describes the underutilization of vital medications in addiction treatment services and discusses ongoing efforts by major public health agencies to encourage their use.

Medication assisted treatment includes three strategies; agonists therapy which uses methadone maintenance, partial agonists therapy which uses buprenorphine and antagonists therapy which uses Vivitrol or extended release injectable naltrexone.

SAMSHA is responsible for overseeing the regulatory compliance of Opioid Treatment Programs (OTPs) which use methadone and/or buprenorphine for the treatment of opioid addiction and are being encouraged to use naltrexone.

We estimate there are approximately 300,000 people receiving methadone maintenance. There are currently 26,000 physicians with a waiver to prescribe buprenorphine....

DIANE FEINSTEIN: Can I stop you? 300,000 people receiving what?

WESTLEY CLARK: methadone.

DIANE FEINSTEIN: methadone and that’s throughout the United States?

WESTLEY CLARK: .Yes.

There are currently 26,000 physicians with a waiver to prescribe buprenorphine – of these 7,700 are authorized to prescribe 100 patients. We estimate that 1.2 million people receive buprenorphine.

SAMHSA also issued an advisory encouraging drug courts to utilize Vivitrol in their treatment programs. We estimate between 7,000 and 10,000 people are on Vivitrol – an unfortunately low number because naltrexone is useful for both alcohol dependence and opioid dependence.

In August of 2013 we published the an Opioid Overdose Toolkit to educate individuals, families, first responders, prescribing providers, persons in recovery from substance abuse, and community members about steps to take to prevent opioid overdose and to treat overdoses (including the use of naloxone). When administrated quick, clean and effectively naloxone restores breathing to a victim in the throes of opioid overdose. This can be a teachable moment to access treatment need and refer a person to the appropriate resources.

We inform states and jurisdictions that the Substance Abuse Prevention Block Grant primary set-aside funds may be utilized to support overdose prevention education and training. In addition we notify jurisdictions that block grants other than their primary prevention set-aside funds may be used to purchase naloxone and the necessary material to assemble overdose kits and to cover the costs associated with the dissemination associated with such kits.

SAMHSA continues to focus on our mission of reducing the impact of substance abuse and mental illness in America’s communities. We thank you and the members of this caucus for convening this important hearing and providing SAMHSA with the opportunity to address this very critical issue.

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DOUG McVAY: Turning now to medical cannabis: On March 29, California NORML reported that “For the first time, a federal judge has granted a hearing on a motion to declare unconstitutional the continued classification of marijuana in Schedule I. The evidentiary hearing is currently set for June 2, 2014, at 9:00 a.m. before Judge Kimberly Mueller in Sacramento.”

For a fuller explanation of the case and its implications, let's hear from a very good friend of mine, the brilliant attorney and NORML national legal committee member Alan Silber. Alan spoke at the Patients Out of Time conference, at a preconference legal workshop.

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ALAN SILBER: Allow me to give one more exciting recent development which is not quite medical necessity but it is back to “know your science”.

The case is United States v. Schweder out of the eastern district of California. Has anybody heard about this? I know Mike has.

Here is possibly one of the most exciting developments in our jurisprudence that I know of. These two young San Francisco women lawyers who are fighting an 846 marijuana conspiracy case – large conspiracy case, many, many co-defendants. They filed a motion with this judge, Kimberly Mueller to dismiss the indictment on equal protection grounds – on the grounds that marijuana was just different than the other substances that were banned by 846 and that there is so much science that says it is not harmful, is good medically (and the medical is part of this motion).

Matt and I were doing the case in the 9th circuit trying to rejoin the US Attorneys from their attacks on medical marijuana. Truthfully in the year and one-half of litigation we never hit a loud foul. These people got a hearing.

They are going to be allowed to produce medical evidence on June 2nd and the government went slightly nuts and moved to reconsider and Judge Mueller denied the motion to reconsider on varied grounds and decided to treat the motion as a motion to clarify. What she said was and what she asked for a briefing on and I think the first brief is scheduled to be filed Friday by these 2 young, wonderful lawyers from San Francisco and the issue is first what is the level of scrutiny? Are we going to do strict scrutiny because we have a fundamental righted issue or are we just doing rational basis? Which, truthfully, we’re not going to win this issue unless we have strict scrutiny on a fundamental right.

The judge asked the government for a briefing on the topic on first, does she have to decided which level of scrutiny it is before the hearing and, secondly, if she does what are the criteria? So the first brief is due...and the last brief is due the 16th. It’s a very tight briefing schedule and the hearing is due to start on June 2nd.

Both of those young lawyers are going to be here. They couldn’t be here for this CLE mostly because they are working on the brief that is due Friday but they will be here. If nothing more than just to bask in the glow of the idea of “learn the science, be audacious.” Unless somebody tells you you can’t do it – do it.

Everything that Jeff said is embodied (it seems to me) in this spectacular litigation and you can see by the way this judge is moving that this case is going ...the government is going to race this case to the 9th circuit. Their motion to reconsider was for the soul purpose of seeing if they couldn’t get to the 9th circuit before the hearing and the judge just cut them off at the pants pocket.

It will be really exciting. At some point maybe on Saturday when they are all here at the medical conference maybe we’ll get to introduce them and have them talk a little bit but I thought that was a really exciting development that was worth sharing with all of you.
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DOUG McVAY: Next, we'll hear from directly from the attorneys in this case, Zenia Gilg and Heather Burke, who spoke to a luncheon audience at the Patients Out of Time conference held May 8th through 10th in Portland, Oregon. They're first introduced by Alan Silber:

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ALAN SILBER: In the eastern district of California these two women were defending two out of twelve defendants in a marijuana conspiracy case and with ten other lawyers not paying any attention they filed probably the most brilliant and certainly the most successful motion to date which is a motion to have the statute declared unconstitutional on 2 grounds. The real important thing - we’ve all made motions like that with getting the usual results – but they didn’t get the usual results. They’ve got a hearing.

Zenia Gilg is going to tell you briefly what is going on and why this is so important and why we thought it was so important that these two wonderful lawyers from San Francisco attend this conference and really get a grounding in the medical properties of this wonderful drug.

ZENIA GILG: Thank you everyone. I’m humbled and honored to have been invited to this conference and be in the company of so many wonderful people – in particular the doctors who are involved in the medical marijuana movement. I see Dr. Mesido there.

I think that the doctors are on the frontlines of this and they have been since before Conant v. McCaffrey, before they had even a remnant of protection. They were on the frontlines risking their entire professional careers in order to help patients such as the other people who are here today. They did so without thought of all of the hard work that they had put into becoming a medical doctor because they cared about their patients.

Now Heather and I are doing our job and we are doing our part, too, as lawyers but we’re not taking any risks of losing our license by doing what we’re doing so I just want to applaud those doctors and thank you for inviting us here.

[applause]

Also to thank them for giving Heather and I some of the tools we are going to need to proceed with what Alan described as this evidentiary hearing. For the first time in...I believe since 1972 – marijuana is going to be put on trial. We’re going to be defending the rationality of having marijuana as a medicine.

I’ve been able to hear throughout the course of this conference the science that I need and also have been able to connect to some of you who have helped us immensely. This is a joint effort – all of our hearing and all of our victory in the end.

The thrust of the argument that we are making and Alan wanted me to explain this. It’s kind of ironic that one of the issues that we’ve raised is called a “violation of the doctrine of equal sovereignty”. This is a doctrine that was established 200 years ago but it was reaffirmed in the voting rights case of last summer where Justice Roberts struck down portions of the Voting Rights Act.

We’ve turned Justice Roberts words to our benefit which is always fun to do as a lawyer especially as a ...what did the doctor call herself the other day? “A liberal, pinko lawyer”. We’ve used that to argue that you can’t be treating people in one state one way and then facilitating the distribution of recreational marijuana in a state such as Colorado.

The judge will probably be evaluating both that and our equal protection argument. We actually have an extensive comparison between marijuana and over-the-counter medications. We don’t even have to go to alcohol and tobacco and prescription drugs because if you just compare it over-the-counter medications it’s clear that marijuana is far more efficacious and far more safe. So that’s one of our arguments.

The other one is that they are treating the states different. It looks like the judge is probably going to be applying what is called a “rational basis test” so what she’ll have to do is look at the evidence that we’ll be presenting and look at the government’s evidence (whatever that may be) and decide whether or not there is any conceivable reason to have marijuana be listed as the most dangerous drug in the nation.

[applause]

Because of what the Department of Justice has been doing and because of what the Department of Health and Human Services have been doing and because of what the Department of Treasury has been doing they have basically handed us our argument on a silver platter.

I can think of no conceivable reason that the federal government would be authorizing banks to accept money from the proceeds of distributing for recreational use the most dangerous drug in the nation. That’s the definition of irrational.

I can see no conceivable reason why the Department of Health and Human Services would authorize the release of marijuana for studies to treat war-torn veterans coming back from Iraq with PTSD with the most dangerous drug in the nation.

I can see no conceivable reason why the federal government would deprive children like Charlotte in Colorado and Jenny’s son in New Jersey of a life-saving medication.

I don’t think they’ll win. Once we get the hearing I don’t see how they can possibly justify keeping marijuana on Schedule I.

[applause]

So I’m putting myself out of business so if anybody has any openings I’m available. Thank you.

HEATHER BURKE: I just want to say one really quick thing. We appreciate so much the support of the folks here. So many people when I came into the lawyering scene – particularly the marijuana lawyering scene – were not that supportive. They were jaded. We’ve been through so many losses getting here and now we may have a win.

Even if it’s just a “may” the group energy, the supportiveness and the lack of the jadedness and compartmentalizing that, squashing that, and being a team to move forward for this nation I think we really need to do.

I appreciate those of you here who are feeling that way and keep it up. Spread the love.

ALAN SILBER: How about one big round of applause for these very great and creative lawyers.

[applause]

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DOUG McVAY: The Patients Out of Time clinical cannabis conference offered continuing education credits for physicians, nurses, other healthcare professionals, and this year for the first time to attorneys. We're only able to present you small portions of the program. The full conference audio and video will be made available through Patients Out of Time. Doctors and attorneys can still earn credits, go to the Patients Out of Time website at medicalcannabis dot com for full details.

A highlight of the conference was the launch of an appeal for an international declaration for access to medical cannabis as a human right. Here's Patients Out of Time director Mary Lynn Mathre to tell us about it:

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MARY LYNN MATHRE: I do want to make a couple of announcements and the big one is Patients Out of Time since 2000 we’ve had our bi-annual conference series. As I said earlier I think it about 20% of the public thought believed in the medical use of cannabis and now it’s pretty much reversed. The science has been exploding ever since the discovery of the endocanabinoid system.

That means 2 years is too long to wait so 2015 we’ll have our 9th conference which will also mark our 20 th anniversary. We’ve been around since 1995. It took us 5 years to get a conference going but we’ll be celebrating our 20th anniversary. I’ve got to keep you in suspense. Stay tuned. We will get back to all of you to let you know exactly where. We’re having a little battle as to where it will be. We know it will be on the east coast. We’ve got to bring it over there. We’ve got to wake up some folks and we have been on the west coast quite a bit. Please share that with everyone. We will have this as an annual event.

The other thing is to make sure you get an evaluation. There are two different ones. The physicians fill out a CME evaluation specifically for continuing education credits and they have to get what we call the ADR form (the Attendance Verification Record) – that’s for physicians. All others (the nurses, the general population, students) there’s another evaluation form. Please fill that out. We really need the feedback. If you’ve got suggestions for what you would want differently, speakers, give us that feedback – what you liked, what you didn’t like.

Finally I want to announce the fact that Patients Out of Time is very happy to announce a declaration we have coming out....I shouldn’t say “we”. It’s an international declaration of cannabis for therapeutic purposes as a human right. You can see it on the screen there so we can all read along.

This declaration is going to be on the website. We’ll have that up for you, too - http://medicalcannabisdeclaration.org/. Write that down. Keep it. We’ll try to have some iPads out here so people during the conference can actually go to this declaration. It’s an online declaration to sign.

We’ve got organizations who’ve signed on – the American Cannabis Nurses Association, the American Academy of Cannabinoid Medicine and the Society for Cannabis Clinicians, Americans for Safe Access, Patients Out of Time. As well as our partners on the other side of the ocean...in fact it was Franjo Grotenhermen from the International Association for Cannabinoid Medicine. It changed the name a little. It started in Germany but it grew into international.

But we do believe that this is a human right and I’m just going to read it so that we have it here.

Declaration of Human Rights for Medical Access to Cannabis and Cannabinoids

According to the Universal Declaration of Human Rights adopted by the United Nations in 1948:

“Everyone has the right to life, liberty and security of person” (Article 3).

“Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control” (Article 25, Paragraph 1).

Whereas this Declaration applies to everyone and all people, whereas many doctors are banned by legal requirements from treating their patients with cannabis-based medicines and whereas many people cannot afford access to cannabis-based drugs we thus declare that:

1.Every medical doctor has the right to treat his or her patients with cannabinoids and cannabis products according to the rules of good medical care.

2.Every patient has the right to access cannabis and cannabinoids for medical treatment supervised by a medical doctor, regardless of social status, standard of living or financial means.

This is a declaration that we want individuals to sign on. If you have organizations we’d like you to sign on. It’s going to be available in 6 different languages. It truly is an international effort.

We’ll have some iPads so people can sign up but we want to really make a splash so spread the word on your Facebook – wherever you can – and get people to sign up.

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DOUG McVAY: Finally, breaking news from the state of Minnesota. The legislature there has passed a compromise bill that would allow extremely limited access to some cannabis medicines for some patients in extreme need.

As explained by the St. Paul Pioneer Press on Friday, “The compromise agreement would let patients with any of eight medical conditions obtain cannabis in liquid and pill form. Patients would not be able to smoke marijuana, nor would they be allowed to use plant materials in vaporizers. The bill would let patients could vaporize liquids. Patients who want to use medical cannabis would need to have their qualifying health condition certified by a doctor, physician assistance or advanced practice nurse. After receiving a patient's application, the Health Department would enroll the patient in a research registry to track the benefits of treatment.”

The news website Politics In Minnesota reported that, “Under the terms of the original Senate bill, an estimated 38,000 people were expected to become eligible for treatment. Following the removal of qualifying medical conditions such as post-traumatic stress disorder and intractable pain, that figure was revised downward to about 5,000. The bill makes the Commissioner of the Minnesota Department of Health responsible for selecting two medical cannabis manufacturers to supply the product. The manufacturers will cultivate and harvest the marijuana at two secure, indoor sites, where it will be refined into pills, oil and whole plant extracts. The packaged product will then be distributed at a total of eight locations, also operated by the manufacturers. In a major concession to the law enforcement lobby, the smoking of marijuana, as well as possession of the actual plant, is forbidden. Patients will be allowed to ingest whole plant extract or oil using a vaporizer. In the conference committee, Petersen said the smoking prohibition will likely shrink the pool of potential patients, meaning the estimate of 5,000 patients could be high. That figure was extrapolated from Arizona’s medical marijuana program, which, like the other 21 states with medical marijuana laws, permits conventional smoking. In addition to paying a $20,000 application fee, manufacturers will be required to employ a licensed pharmacist to distribute the product.”

There is ongoing debate within the drug policy reform community as to whether this highly restrictive law should be counted as what activists refer to as effective, it's even been suggested that a law of this sort might need its own category. The question is becoming, how far shall we redefine victory?

That's it for this week. I'm Doug McVay and this was Century of Lies. Thank you for listening. You can find a recording of this show and past shows at the website drug truth dot net, where you can check out our other programs and subscribe to our podcasts. Follow me on Twitter, where I'm @ Drug Policy Facts. The Drug Truth Network is on Facebook, be sure to give its page a Like, you can find Drug War Facts on Facebook as well, please give it a like and share it with friends. Spread the word. Remember: Knowledge is power.

For the drug truth network, this is Doug McVay saying so long. So long!

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For the Drug Truth Network, this is Dean Becker asking you to examine our policy of Drug Prohibition.

The Century of Lies.

This show produced at Pacifica Studios at KPFT, Houston.

Transcript provided by: Jo-D Harrison of www.DrugSense.org