Cannabis

Dear Doctors, who are mandated to do 'No Harm'!

My name is Karen Randall.  I am an emergency physician (also residency trained in pediatrics and family medicine).  

I spent numerous years as an academic teaching physician at Henry Ford Hospital in Detroit.  I moved to Colorado to be back home.  I moved here in 2013.  I moved just in time to see this town I live in, Pueblo, go from a blue collar working town to a drug infested town that is not safe.  

I appreciate your article about brain sizes, https://www.nbcnews.com/storyline/legal-pot/even-little-marijuana-may-change-teen-brain-study-finds-n95853, but I need you to stand with me and let kids know that this high dose highly concentrated THC is NOT alright for them.  Our kids here are, without a doubt, using younger and using a lot more concentrated THC.  We, medically, almost nothing about what high dose, high concentration THC products (without CBD - ? maybe some protection) will do to a person.  I can tell you firsthand what I am seeing and experiencing and we, as physicians need to get the facts out.

1)  I have seen way more youth using than ever before.  You must know that these middle schoolers and high schoolers are getting vape pens to vape marijuana, right?  There is open concern about the vaping - which in itself will lead to lung damage, but, at least here, they are vaping pot.

2)  Many are using earlier - emulating what the adults in their lives are doing and are dropping out of school.  Our school district has a 38% chronic absenteeism rate.  Imagine that for your school district and imagine, if you have children, how that might affect them.

3)  I have seen numerous acutely and frankly psychotic young people who have only done cannabis.  The youngest acutely psychotic person I have seen so far - 13 yo. I am not talking about seeing a child or youth on occasion who is psychotic, it has become routine.  That is the saddest aspect of all of this.  The industry has pummelled our community with retail and “medicine” stores.  Pueblo has about 160,000 people, we have nearly 50 retail stores.  Our community is predominantly a community of colour.  I would hazard a guess that there are not 50 retail stores in Aspen, Vail or Breckenridge.  These kids use younger and then drop out of school, they have no skills, no education, and due to chronic cannabis use, they have no motivation to change their lives.  Those who have supportive families, who want to change, find that there are minimal resources for kids who become addicted to cannabis.  These families (69% of our community is on medicaid) most of the time, have no resources or finances to send them to a long term rehab facility.  These kids end up on the streets.  Sadly, their drug usage doesn’t stop at cannabis.  I recently saw a high school kid (18) who had been using cannabis with his friends.  He told me his parents were “ok” with that because it was just cannabis.  He and his senior in high school friends, moved on to LDS and cocaine.  These are kids.  The child in question was living with his grandmother who has no resources other than what medicaid will cover to get him treatment.  Those children who use, whose parents are sober and want their children help, often tap every financial resource they have - including retirement, home equities, savings, etc. This leaves parents - at a time when they should be saving for retirement, destitute, needing to live on a hopeful social security.

4) There is no question that maternal use of cannabis while pregnant leads to fetal harms - the full picture of those harms won’t be apparent for another 5-10 years, until these babies being born now start school.  A recent University of Colorado study found that a huge percentage of medical dispensaries in Colorado were recommending cannabis for pregnant women.  https://www.denverhealth.org/-/media/denver-health-marijuana--pregnancy-study.pdf?la=en&hash=7CF1182B6937B9E4267378A1E5F04D8ED221DC6C

5)  The cannabis industry has commercialized and weaponized all aspects of THC and CBD.  Did you know that you can purchase a THC infused tampon?  Did you know that many irresponsible cannabis companies promise that cannabis will cure their cancer?  Did you know that, based on that alone, patients in our community are being placed straight from the ED to hospice when their cancer is too extensive to provide anything but comfort care?  I recently saw a 39 y/o male who elected the “cannabis cure” for his brain cancer.   It did not work.  Who do we hold at harm for that?  The patient, who was clearly misled by the industry?  The doctors, who can’t save him when he presents with end stage/terminal cancer?  The industry?  I will enclose a few ads to support this claim at the end.

Finally, please, as a physician - do no harm.  Do not promote a product that is so damaging and has so many consequences.  Know that what the industry is selling now, in no way, shape or form, resembles the pot of Woodstock.  This is supercharged high potency THC - a hallucinogen.  You do not have to take my word.  You are a physician.  Come work a day in my ED with me.  We are the 3rd busiest ED in Colorado.   I have a longitudinal study and data base at my hospital. Not only did cannabis use go up, but in the last 5  years, all drug usage has gone up and in the last 8 months, methamphetamine use has tripled.  Help inform the public that there are significant harms.

Feel free to contact me.  You have my email.  I am asking you as a physician, to speak up for our youth.  Do not promote a product that does and will have devastating consequences.

Sincerely

Dr. Karen Randall, FAAEM

VP Case Management SCEMA

Chairman of the Board, SCEMA

The work carried out by the Neuropharmacology Laboratory highlight the influence of environmental factors such as stress on the harmful effects of the exposure to cannabis during early ages

A new study conducted on laboratory animals shows that exposure to cannabis and stress during adolescence may lead to long-term anxiety disorders characterized by the presence of pathological fear. The work carried out by the Neuropharmacology Laboratory-NeuroPhar at Pompeu Fabra University, was led by the researchers Fernando Berrendero, now at Francisco de Vitoria University, and Rafael Maldonado, and has been published in the journal Neuropharmacology.

For complete article

The Independent - January 2019 

Teenagers who use cannabis just once or twice may end up with changes to the structure of their brain, scientists have warned.

A study, conducted by researchers at Swinburne University of Technology in Melbourne, Australia, found that there were clear differences on brain scans between teens who said they had smoked cannabis a couple of times and those who had never tried it.

For  complete article

Children born to moms who smoked or ingested marijuana during pregnancy suffer higher rates of depression, hyperactivity, and inattention. Yet, Seventy percent of women in the United States believe that there is “slight or no risk of harm” in using can­nabis during pregnancy.

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The documents offer unprecedented insight into the challenges of establishing and regulating an industry where the product is traditionally ­illegal. Picture: AFP

SEAN PARNELL 12:00AM JANUARY 7, 2019

High demand for a stake in Australia’s medicinal cannabis industry — including from people with links to organised crime — has caught the regulator unprepared and under-resourced, an internal audit has found.

Documents obtained under Freedom of Information laws show independent auditors hired by the Department of Health found the level of resourcing for the Medicinal Cannabis Section in the Office of Drug Control was “unsustainable”.

The federal government anticipated there would be between one and 20 cultivators under the scheme, but in the first two years more than 30 licences have been granted and many more appli­cations have been considered.

The MCS spent much of its time over the first 18 months ­assessing applications. The documents reveal this was not only a regulatory function but also crime prevention, with “several cases where assessments have uncovered connections to ­organised crime”.

Amid a backlog of appli­cations, the auditors were not convinced that the MCS had enough resources to perform its current or future roles effectively.

“It is likely there will be further pressure on the limited resources in the future with the commencement of compliance inspections, permit application processing, regulatory adjustments, and a forecast reduction in staff as a result of department-wide funding allocations,” the auditors warned.

“MCS may not be able to effectively implement all of its roles in managing the scheme in the ­future within current resource ­restraints.”

The auditors did not comment on any risk of organised crime connections not being detected in the application process, or of drugs otherwise being diverted to the illicit market.

The department only partly accepted the auditors’ recommendation that the MCS have more clarity over its future resourcing: “Given the present fin­ancial situation of the department, it is unlikely that the effort in closely mapping the resourcing required would lead to an increase in resources for the medicinal cannabis program.”

Last month, however, the government quietly allocated a further $4.4 million over two years for “assessment and compliance activities”. It also flagged changes to cost recovery arrangements.

The department had grappled with the auditor’s suggestion that the MCS divert effort from applications assessment to other areas: “Given the end result that the number of compliance inspections, and/or the level of rigour put into application assessments, must necessarily fall under any rebalancing, there is a heightened risk of criminal diversion and criminal infiltration of the medicinal cannabis scheme.”

The documents offer unprecedented insight into the challenges of establishing and regulating an industry where the product is traditionally ­illegal.

Separate concerns that pat­ients faced unreasonable delays obtaining products prompted the Council of Australian Governments’ Health Council to agree to streamline processes.

The Therapeutic Goods Administration has approved 2339 applications under a special access scheme for medicinal cann­abis. Patients have cancer pain, chemotherapy-induced sickness, neuropathic pain, spasticity, paediatric epilepsy or terminal illnesses, conditions for which there is evidence medicinal cannabis might be of benefit.

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THE DRUG ADVISORY COUNCIL OF AUSTRALIA SUPPORTS

More detoxification & rehabilitation that gets illicit drug users drug free.
Court ordered and supervised detoxification & rehabilitation.
Less illicit drug users, drug pushers and drug related crimes.

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