Recently I spoke on the phone to a gentleman in Oklahoma who was in the marijuana business – apparently raising it legally for medical purposes. He was considering counseling sessions with me. He reported that he had been smoking marijuana for most of his 50+ years and, until a few years ago, using alcohol as well. He accepted the concepts of AA abstinence for alcohol, but marijuana abstinence was not a concept he was interested in exploring, claiming it’s health benefits as a medical marijuana card holder. (see article below - CBS News, US Approves First Marijuana-based Drug for Seizures.) In our phone conversation he had some problems with emotional control and paranoia, but no obvious psychosis (see Reefer Madness excerpts below.)
He also had serious family issues with his wife of more than 20 years and her grown children that he helped raise. He had complaints of their taking advantage of his free marijuana. He also told me “he couldn’t get anyone in his family or friends to do an honest day’s work on his marijuana farm” (see article below - Trivializing drug use is hurting the working class.) He raised illegal marijuana before it became legal for medical purposes in Oklahoma on July 26, 2018.
He was familiar with the statistics that the Oklahoma county he lived in had the highest production of marijuana in any county in the United States. His stories are similar to many clients I worked with in community mental health and psychiatric hospital settings in the late 90’s and early 2000’s, as well as in an out-patient alcohol/drug treatment agency from 2015-20.
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“Nearly 376,000 Oklahomans – roughly 10% of the state’s population – have medical marijuana cards, by far the highest share in the country, according to the Marijuana Policy Project”. The Journal Record – Aug. 27, 2021. It is no-doubt much higher several months later.
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[Oklahoma] "now boasts more retail cannabis [marijuana] stores than Colorado, Oregon, Washington combined. In October it eclipsed California as the state with the largest number of licensed cannabis farms, which now number more that 9,000 despite a population only a tenth of California's". "How Oklahoma Became a Marijuana Boom State' - NY Times, Dec, 29, 2021
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“CBS News”, US Approves First Marijuana-based Drug for Seizures, June 26, 2018.
“WASHINGTON -- U.S. health regulators on Monday approved the first prescription drug made from marijuana, a milestone that could spur more research into a drug that remains illegal under federal law, despite growing legalization for recreational and medical use. The Food and Drug Administration (FDA) approved the medication, called Epidiolex, to treat two rare forms of epilepsy that begin in childhood. But it's not quite medical marijuana.
“The strawberry-flavored syrup is a purified form of a chemical ingredient found in the cannabis plant -- but not the one that gets users high. It's not yet clear why the ingredient, called cannabidiol, or CBD, reduces seizures in some people with epilepsy. British drugmaker GW Pharmaceuticals studied the drug in more than 500 children and adults with hard-to-treat seizures, overcoming numerous legal hurdles that have long stymied research into cannabis.
“FDA officials said the drug reduced seizures when combined with older epilepsy drugs. "It represents a new chapter, a landmark for therapy in the U.S. for epilepsy," Dr. Orrin Devinsky, of NYU Langone Health's Comprehensive Epilepsy Center, told CBS News. "Many of these children and young adults had significant reductions in their most severe and dangerous seizures." The FDA has previously approved synthetic versions of another cannabis ingredient for medical use, including severe weight loss in patients with HIV.
“Epidiolex is essentially a pharmaceutical-grade version CBD oil, which some parents already use to treat children with epilepsy. CBD is one of more than 100 chemicals found in marijuana. But it doesn't contain THC, the ingredient that gives marijuana its mind-altering effect. Physicians say it's important to have a consistent, government-regulated version. "I'm really happy we have a product that will be much cleaner and one that I know what it is," said Dr. Ellaine Wirrell, director of the Mayo Clinic's program for childhood epilepsy. "In the artisanal products there's often a huge variation in doses from bottle to bottle depending on where you get it." Side effects with the drug include diarrhea, vomiting, fatigue and sleep problems.
“Several years ago, Allison Hendershot considered relocating her family to Colorado, one of the first states to legalize marijuana and home to a large network of CBD producers and providers. Her 13-year-old daughter, Molly, has suffered from severe seizures since she was 4 months old. But then Hendershot learned about a trial of Epidiolex at New York University. "I preferred this to some of those other options because it's is a commercial product that has gone through rigorous testing," said Hendershot, who lives in Rochester, New York.
“Since receiving Epidiolex, Hendershot says her daughter has been able to concentrate more and has had fewer "drop" seizures -- in which her entire body goes limp and collapses. Lili Gilmore stared having seizures when she was 6 months old. "The first three years of her life, I would say, were devastating. I didn't know anything about seizures. I didn't know what life was going to be like," Lili's mother, Natalie Gilmore, told CBS News. It got to the point where Lili, now 17, was having hundreds of seizures a week. After her parents enrolled her in the Epidiolex trial at NYU, her awareness increased and seizures decreased. "For us, any little teenie bit of relief we might get with the seizures is huge," Natalie said.
“CBD oil is currently sold online and in specialty shops across the U.S., though its legal status remains murky. Most producers say their oil is made from hemp, a plant in the cannabis family that contains little THC and can be legally farmed in a number of states for clothing, food and other uses.
“The immediate impact of Monday's approval on these products is unclear. FDA Commissioner Scott Gottlieb suggested the agency would be scrutinizing CBD products with "uncertain dosages and formulations." "We are prepared to take action when we see the illegal marketing of CBD-containing products with serious, unproven medical claims," Gottlieb said in a statement.
“The FDA previously issued warnings to CBD producers that claimed their products could treat specific diseases, such as cancer or Alzheimer's. Only products that have received formal FDA approval can make such claims, typically requiring clinical trials costing millions. Most CBD producers sidestep the issue by making only broad claims about general health and well-being. Industry supporters downplayed the impact of the FDA approval. "I don't know a mom or dad in their right mind who is going to change what's already working," said Heather Jackson, CEO of Realm of Caring, a charitable group affiliated with Colorado-based CW Hemp, one of nation's largest CBD companies. "I really don't think it's going to affect us much."
“Jackson's group estimates the typical family using CBD to treat childhood epilepsy spends about $1,800 per year on the substance. A GW Pharmaceuticals spokeswoman said the company would not immediately announce a price for the drug, which it expects to launch in the fall. Wall Street analysts have previously predicted it could cost $25,000 per year, with annual sales eventually reaching $1 billion. For their part, GW Pharmaceuticals executives say they are not trying to disrupt products already on the market. The company has pushed legislation in several states to make sure its drug can be legally sold and prescribed.
“The FDA approval for Epidiolex is technically limited to patients with Dravet and Lennox-Gastaut syndromes, two rare forms of epilepsy for which there are few treatments. But doctors will have the option to prescribe it for other uses. The new medication enters an increasingly complicated legal environment for marijuana. Nine states and the District of Columbia have legalized marijuana for recreational use. Another 20 states allow medical marijuana, but the U.S. government continues to classify it as a controlled substance with no medical use, in the same category as heroin and LSD.
“Despite increasing acceptance, there is little rigorous research on the benefits and harms of marijuana. Last year a government-commissioned group concluded that the lack of scientific information about marijuana and CBD poses a risk to public health. Before sales of Epidiolex can begin, the Drug Enforcement Administration must formally reclassify CBD into a different category of drugs that have federal medical approval. GW Pharmaceuticals makes the drug in the U.K. from cannabis plants that are specially bred to contain high levels of CBD. And the company plans to continue importing the medicine, bypassing onerous U.S. regulations on manufacturing restricted substances.”
https://www.cbsnews.com/news/fda-approves-epidiolex-first-marijuana-based-drug-for-seizures/
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Excerpts From Reefer Madness – “National Review”, March 7, 2022.
“Dr. Robin MacGregor Murray, professor of psychiatric research at King’s College London, is sitting in his living room in Wimbledon, London. Upstairs, his wife and colleague, Dr. Marta Di Forti, is talking with a patient over Zoom. The husband-and-wife team are two of the world’s leading researchers on cannabis and psychosis.
“In 2004, the pair launched the Genetics and Psychotic Disorder study, examining the genetic and environmental causes of psychosis. …
“Throughout the ’70s and ’80s, the idea that cannabis might be contributing to mental-health problems never occurred to Murray and his colleagues. In 1996 the Lancet — Britain’s top medical journal — editorialized that cannabis was a safe drug. When psychotic patients’ families would ask whether there was any link, since their loved one “smoked marijuana morning, noon, and night,” Murray would answer no. …
“By the 1990s, however, the question had been raised so many times that he began to wonder. …
“By 2003, they were convinced that cannabis was a “component cause” of psychosis. In other words, while a person may already have a genetic vulnerability, or other risk factors, heavy cannabis use can also trigger and exacerbate psychosis in those without an obvious predisposition. …
https://www.nationalreview.com/magazine/2022/03/07/reefer-madness/#slide-1
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Excerpts From Trivializing drug use is hurting the working class - Job seekers are increasingly testing positive on drug tests. Legalizing marijuana could increase its use at work. – Naomi Schaefer Riley – “American Enterprise Institute” – Apr 3, 2022
“What jobs are OK to do while you’re high? It’s a question that employers are having to ask themselves a lot more these days, even as Congress considers decriminalizing marijuana.
“A recent report found that the percentage of working Americans testing positive for drugs hit a two-decade high in 2021. Quest Diagnostics, one of the largest drug testing companies in the nation, screened 6 million workers for marijuana last year; 3.9% of the tests came back positive. Many of those tests were “pre-employment,” meaning that the worker wasn’t even clean for the job interview.
“Given the labor shortage and the fact that more and more states have legalized recreational marijuana, maybe this isn’t surprising. But it should still be concerning. Of course there are federal regulations requiring companies to test employees who are responsible for operating heavy machinery. But exactly which jobs are OK to do while high?...
“In a review of Carl Hart’s 2021 book, “Drug Use for Grown-Ups,” my American Enterprise Institute colleague Sally Satel noted, “The vexing paradox is that the very individuals who feel compelled to use intoxicants to excess are often those least psychologically equipped to handle them.”
“For those who already find themselves on the lower end of the economic spectrum or dealing with other challenges — including violent neighborhoods, dysfunctional family life and poor educational options — drugs present an out they can ill afford to use.
“When we say that drug use is not a big deal, that it can be easily managed to not interfere with a productive life, we are not telling the truth about what it takes to live a middle-class life in America. Though it is out of fashion to suggest that working hard can lead to upward mobility, the truth is that drug use will make that journey even less likely.