Medical Cannabis in Maryland Presentation to University of Maryland Medical School Quarterly Meeting October 8, 2015 by Deborah Miran Commissioner

Transcription

1 Medical Cannabis in Maryland Presentation to University of Maryland Medical School Quarterly Meeting October 8, 2015 by Deborah Miran Commissioner Maryland Medical Cannabis Commission

2 Medical Cannabis An Update Milestones of the Twen.eth Century Cannabidiol (CBD) was iden.fied as a cons.tuent of the plant Tetrahydrocannabinol (THC) iden.fied and synthesized in Israel Two cannabinoid receptors discovered-proof of endocannabinoid system in body Two endocannabinoids discovered

3 Func5on of the Endocannabinoid System Regula.on of func.ons which control ea.ng, sleeping, relaxa.on, memory and movement Endocannabinoid system is basic to all other systems in the body Evidence that the endocannabinoid system begins to form within days aqer fer.liza.on.

4 Overview of Endocannabinoid System Cannabinoid receptors Type 1 -These are the most extensive receptors -Found in the brain, spinal cord, peripheral nervous system, organs, and.ssues. Cannabinoid receptors Type 2 -Found in immune system

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7 NIH Statement 2006 In the past decade, the endocannabinoid system has been implicated in a growing number of physiological func.ons Modula.ng the ac.vity of the endocannabinoid system turned out to hold therapeu.c promise in a wide range of disparate diseases Ranging from mood and anxiety disorders, movement disorders such as Parkinson s and Hun.ngton s disease, neuropathic pain, mul.ple sclerosis and spine cord injury, to cancer, atherosclerosis, myocardial infarc.on, stroke, hypertension, glaucoma, obesity, and osteoporosis.

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9 Pa5ent Experiences In 2015, hundreds of comments have been received from pa.ents Condi.ons range from ALS, fibromyalgia, epilepsy, mul.ple sclerosis, neuropathy, cancer, chronic back pain, leukemia, and PTSD Some pa.ents are military veterans who are desperate to reduce their dependency on strong opioid pain killers

10 Safety Profile of Cannabis LD 50 is the Lethal dose which will kill 50% of the popula.on Ibuprofen 636mg/kg Caffeine 192mg/kg Nico.ne 50mg/kg Heroin 22mg/kg Cannabis Essen.ally Zero* *It would take 70kg man to smoke 1500 pounds in 15 minutes Data from CDC on drug induced deaths Total 43,982 Prescrip.on analgesics 16,235 Heroin - 6,235 Cannabis - 0

11 Cannabis for the Management of Pain Assessment of Safety Study COMPASS Study Dr. Mark Ware J. of Pain September year Prospec.ve Cohort Study among subjects with chronic non-cancer pain. Risk of having at least 1 SAE was not significantly different between groups Risk of having at least 1 AE did not differ significantly between cannabis user & controls Conclusion: Study suggests AES of medical cannabis are moderate and compare to prescrip.on cannabinoids. Results suggest that cannabis at an average dose of 2.5 g/d in current users may be safe as part of a carefully monitored pain management program

12 Evidence of Decreased Opioid Overdose Mortality in U.S. States with medical cannabis laws had a 24.8% lower mean annual opioid overdose mortality rate. (Bachhuber, M.A. (2014) Journal American Medical Associa.on)

13 Evidence of Decreased Use of Cannabis by Adolescents American Journal of Public Health and American Academy of Pediatrics California District reported no increased use and actual decreased use in states with well regulated medical cannabis laws.

14 What Makes Maryland Different Growing & Processing Standardiza.on of growing phase Controlling valuables in the process Documenta.on of the process Valida.on of the process Tes.ng Independent accredited laboratories Independent sampling required Requirements include tes.ng for potency, purity, and microbiology Inspec.on & Compliance Extensive pre-license inspec.on by ASA trained team Requirements for periodic as well as for cause inspec.ons. Commission has authority to suspend distribu.on and request product recall

15 Evidence of Physician Support 2013 New England Journal of Medicine poll of medical use 76% of all votes* favor use of cannabis for medical condi.ons *1,446 votes represen.ng 72 countries an 56 states and provinces in North America

16 Evidence of Growing Support from the Leukemia and Lymphoma Society LLS supports the medical use of marijuana by pa.ents with serious medical condi.ons when it is prescribed by a health-care provider and permiked by state law. In a state where pa.ents are permiked to use marijuana medically for serous and /or chronic illnesses and a pa.ent s physician has recommended its use in accordance with that state s law and that state s medical prac.ce standards, LLS strongly urges that pa.ents should not be subject to federal criminal penal.es for such medical use.

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