Presented by: QuantumMark, LLC. January 15, 2015

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1 Presented by: QuantumMark, LLC January 15, 2015

2 Discussion Topics Federal Perspective and Current State Status on Medical Marijuana Comparison of Qualifying Conditions Among States Most Cited Pros and Cons Emerging Marijuana Issues

3 Federal Context Schedule I Drug Physicians cannot prescribe Inhibits medical research

4

5 Federal Response Cole Memorandum Guidance Regarding Marijuana Enforcement Federal Priorities Preventing distribution to minors Preventing revenue from going to criminal enterprises Preventing diversion to states where it is still illegal Preventing marijuana activity from becoming a cover for other illegal drug activity Preventing violence and the use of firearms Preventing drugged driving and other adverse public consequences Preventing growing marijuana on public lands Preventing marijuana possession or use on federal lands

6 Potential New Federal Legislation Bill # Initiator Caption H.R Congressman Dana Rohrabacher (4-CA) Co-sponsor Congresswoman Dina Titus Respect State Marijuana Laws Act This bipartisan legislation protects users and businesses from federal prosecution if operating within state laws H.R. 710 H.R H.R. 499 H.R. 689 H.R.784 H.R.1635 Congressman Sam Farr (D-CA) Co-sponsor Congresswoman Dina Titus Congressman Ed Perlmutter (D-CO) Co-sponsor Congresswoman Dina Titus Congressman Jaren Polis (D- CO) Congressman Earl Blumenauer (D-OR) Congresswoman Barbara Lee (D-CA) Congressman Steve Cohen (D- TN) Truth in Trials Act This bipartisan bill would protect legal medical marijuana patients prosecuted due to conflicting state and federal laws, allowing them to bring in evidence that they are complying with state laws. Marijuana Businesses Access to Banking Act This bipartisan legislation updates federal laws to ensure that legitimate marijuana businesses operating under state law can open bank accounts Ending Federal Marijuana Prohibition Act Would replace marijuana prohibition with comprehensive licensing and oversight system to regulate the production, distribution and sale of marijuana States Medical Marijuana Patient Protection Act Would reschedule marijuana and make the Controlled Substances Act inapplicable to those acting in compliance with state medical marijuana laws States Medical Marijuana Property Rights Protection Act Would prevent federal officials from seizing property used by dispensaries to provide medical marijuana to patients National Commission on Federal Marijuana Policy Act of 2013 Would create a blue-ribbon commission to determine the best way to resolve the conflict between federal law and state laws that have removed criminal penalties for the medical or recreational use of marijuana

7 Nevada Qualifying Conditions Medical Condition States Citing the Same Condition 1 Cancer/ Terminal Cancer 21 2 HIV/AIDS 21 3 Cachexia (wasting syndrome) 19 4 Glaucoma 19 5 Muscle Spasms/Spasticity 19 6 Multiple Sclerosis 17 7 Nausea/Severe Nausea 16 8 Pain/ Severe Pain 16 9 Seizures 16

8 NV Cardholders by Condition Cancer/ Terminal Cancer HIV/AIDS Cachexia (wasting syndrome) Glaucoma Muscle Spasms/Spasticity Multiple Sclerosis Nausea/Severe Nausea Pain/ Severe Pain

9 Illinois Qualifying Conditions Alzheimer's Arnold-Chiari Malformations & Syringomyelia Ataxia Cachexia (wasting syndrome) Cancer/ Terminal Cancer Cardiopulmonary Respiratory Syndrome Causalgia Crohn's Disease Dystonia Epilepsy Fibromyalgia Glaucoma Hepatitis C HIV/AIDS Hydrocephalus Interstitial Cystitis Lou Gehrig's Disease Lupus Multiple Sclerosis Muscular Dystrophy Myasthenia Gravis Myoclonus Neurofibromatosis Parkinson' Disease Reflex Sympathetic Dystrophy Sjogren's Syndrome Spinal Cord Disease and Injury Tourette's

10 Frequently Cited Pros and Cons Proponents Safe and effective treatment for the symptoms of cancer, AIDS, multiple sclerosis, pain, glaucoma, epilepsy, and other conditions. Opponents: Too dangerous to use, Lacks FDA-approval and various legal drugs make marijuana use unnecessary. Is addictive, Leads to harder drug use, Interferes with fertility, Impairs driving ability Injures the lungs, immune system, and brain

11 Summary of 105 Peer-Reviewed Studies Type of Study Pro for the specific purpose being investigated in the study Not Clearly Pro or Con for the specific purpose being investigated in the study Con for the specific purpose being investigated in the study Totals # of studies % of total # of studies % of total # of studies % of total # of studies % of total I. Double-Blind Human Studies % % % % II. Human Studies % % % % III. Animal Studies 4 100% 0 0% 0 0% 4 100% TOTALS % % % %

12 Review of FDA Adverse Events Reports DRUG CLASSIFICATION Primary Suspect of the Death Secondary Suspect (Contributing to death) Total Deaths Reported 1/1/97-6/30/05 A. MARIJUANA also known as: Cannabis sativa L B. ANTI-EMETICS (used to treat vomiting: Compazine, Reglan, Marinol, Zofran, Anzemet, Kytril, Tigan ) C. ANTI-SPASMODICS (used to treat muscle spasms: Baclofen, Zanaflex) D. ANTI-PSYCHOTICS (used to treat psychosis: Haldol, Lithium, Neurontin) E. OTHER POPULAR DRUGS (used to treat various conditions including ADD, depression, narcolepsy, erectile dysfunction, and pain: Ritalin, Wellbutrin, Adderall, Viagra, Vioxx) , ,295 8, ,593 TOTAL DEATHS FROM MARIJUANA TOTAL DEATHS FROM 17 FDA-APPROVED DRUGS 10,008 1,679 11,687

13 20 Drugs Ranked by "Harm to Users" and "Harm to Others"

14 How Addictive is Marijuana? Jack E. Henningfield, PhD Neal L. Benowitz, MD 1. Heroin Heroin Nicotine 2. Alcohol Cocaine Alcohol 3. Cocaine Alcohol Heroin Daniel M. Perrine, PhD 4. Nicotine Nicotine Cocaine (Nasal) 5. Marijuana / Caffeine Caffeine Caffeine Marijuana Marijuana Scale of 1 being most addictive Experts: Jack E. Henningfield, PhD, Associate Professor of Behavioral Biology at Johns Hopkins University School of Medicine Neal L. Benowitz, MD, Chief of the Division of Clinical Pharmacology and Experimental Therapeutics at the University of California at San Francisco Daniel M. Perrine, Phd, Associate Professor of Chemistry at Loyola College in Maryland, in his 1996 book The Chemistry of Mind-Altering Drugs: History, Pharmacology, and Cultural Context

15 Driving After Marijuana Use

16 Average Past Month Teen Marijuana Use (%) State (year legalized) ( ) Alaska (1999) (-2.14%) California (1996) Colorado (2000) Hawaii (2000) (-1.19%) (-2.86%) (-1.26%) Maine (1999) (+3.79%) Montana (2004) Nevada (2000) Oregon (1998) Vermont (2004) (-0.84%) (-4.03%) (-1.24%) (+1.68%) Washingto n (1996) ProCon.org created the above table using data for past month teen marijuana use from the Substance Abuse and Mental Health Services Administration (SAMHSA) National Household Surveys on Drug Abuse (NHSDA), (-2.20%

17 Policy of the AMA Calls for further adequate and well-controlled studies of marijuana and related cannabinoids Urges that marijuana s status as a federal Schedule I controlled substance be reviewed with the goal of facilitating the conduct of clinical research and development of cannabinoid-based medicines, and alternate delivery methods Urges the National Institutes of Health (NIH) to implement administrative procedures to facilitate grant applications and the conduct of well-designed clinical research AMA believes that effective patient care requires the free and unfettered exchange of information on treatment alternatives and that discussion of these alternatives between physicians and patients should not subject either party to criminal sanctions.

18 Emerging Issues Driving under the influence criteria Marijuana in the workplace Educating patients appropriately Edibles and dosing requirements

19 Thank You Kelly Bown Kim West To learn more about QuantumMark please visit us at:

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