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Study: Opioid Abuse Rates Lower In Medical Cannabis States

San Francisco, CA: Rates of prescription opioid abuse are significantly lower in jurisdictions that permit medical marijuana access, according to data reported by Castlight Health, an employee health benefits platform provider.

Investigators assessed anonymous prescription reporting data from over one million employees between the years 2011 and 2015.

In states that did not permit medical cannabis access, 5.4 percent of individuals with an opioid prescription qualified as abusers of the drug. (The study's authors defined "abuse" as opioid use by an individual who was not receiving palliative care, who received greater than a 90-day cumulative supply of opioids, and received an opioid prescription from four or more providers.) By contrast, only 2.8 percent of individuals with an opioid prescription living in medical marijuana states met the criteria.

The findings are similar to those reported by the RAND Corporation in 2015, which determined, "[S]tates permitting medical marijuana dispensaries experience a relative decrease in both opioid addictions and opioid overdose deaths compared to states that do not."

Data published in 2014 in the Journal of the American Medical Association (JAMA) Internal Medicine also reported that the enactment of statewide medicinal marijuana laws is associated with significantly lower state-level opioid overdose mortality rates, finding, "States with medical cannabis laws had a 24.8 percent lower mean annual opioid overdose mortality rate compared with states without medical cannabis laws."

For more information, please contact Paul Armentano, NORML Deputy Director, at: paul@norml.org. Full text of the study, "The opioid crisis in America's workforce," appears online at: http://www.castlighthealth.com/typ/the-opioid-crisis/.

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Cannabis vs. Pills

Medical Cannabis Access Decreases Opioid Use In Chronic Pain Patients

Ann Arbor, MI: Chronic pain patients with legal access to medicinal cannabis significantly decrease their use of opioids, according to data published online ahead of print in The Journal of Pain.

Investigators at the University of Michigan, Ann Arbor conducted a retrospective survey of 244 chronic pain patients. All of the subjects in the survey were qualified under Michigan law to consume medicinal cannabis and frequented an area dispensary to obtain it.

Authors reported that respondents often substituted cannabis for opiates and that many rated marijuana to be more effective.

"Among study participants, medical cannabis use was associated with a 64 percent decrease in opioid use, decreased number and side effects of medications, and an improved quality of life," they concluded. "This study suggests that many chronic pain patients are essentially substituting medical cannabis for opioids and other medications for chronic pain treatment, and finding the benefit and side effect profile of cannabis to be greater than these other classes of medications."

About 40 people die daily from opioid overdoses, according to the US Centers for Disease Control.

Long-term daily use of herbal cannabis has been shown to mitigate analgesia and significantly reduce opioid use in chronic pain patients unresponsive to conventional therapies. Observational studies also show lower levels of opioid-related abuse and mortality in jurisdictions where patients are permitted medical cannabis access.

For more information, please contact Paul Armentano, NORML Deputy Director, at: paul@norml.org. Full text of the study, "Medical cannabis associated with decreased opiate medication use in retrospective cross-sectional survey of chronic pain patients," appears in The Journal of Pain.

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Pain Relief

Study: Long Term Cannabis Use Mitigates Pain, Reduces Opioid Use

Jerusalem, Israel: The daily, long-term use of cannabis is associated with improved analgesia and reduced opioid use in patients with treatment-resistant chronic pain conditions, according to clinical trial data reported online ahead of print in The Clinical Journal of Pain.

Investigators with Hebrew University in Israel evaluated the use of cannabis on pain in a cohort of 176 patients, each of whom had been previously unresponsive to all conventional pain medications. Subjects inhaled THC-dominant cannabis daily (up to 20 grams per month) for a period of at least six months.

A majority of participants (66 percent) experienced improvement in their pain symptom scores after cannabis therapy, and most reported "robust" improvements in their quality of life. Subjects' overall consumption of opioid drugs declined 44 percent by the end of the trial, and a significant percentage of participants discontinued opioid therapy altogether over the course of the study.

Authors concluded, "In summary, this long-term prospective cohort suggests that cannabis treatment in a mixed group of patients with treatment-resistant chronic pain may result in improved pain, sleep and quality of life outcomes, as well as reduced opioid use."

The Israeli results are similar to those reported in a 2015 Canadian trial which concluded that chronic pain patients who use herbal cannabis daily for one-year experienced reduced discomfort and increased quality of life compared to controls, and did not possess an increased risk of serious side effects.

Separate data published in 2014 in The Journal of the American Medical Association determined that states with medical marijuana laws experience far fewer opiate-related deaths than do states that prohibit the plant. Investigators from the RAND Corporation reported similar findings in 2015, concluding, "States permitting medical marijuana dispensaries experience a relative decrease in both opioid addictions and opioid overdose deaths compared to states that do not." Clinical data published in 2011 in the journal Clinical Pharmacology & Therapeutics previously reported that the administration of vaporized cannabis "safely augments the analgesic effect of opioids."

A scientific review published earlier this year assessing the clinical use of cannabinoids for pain in over 1,300 subjects concluded, "Overall, the recent literature supports the idea that currently available cannabinoids are modestly effective analgesics that provide a safe, reasonable therapeutic option for managing chronic non-cancer-related pain and possibly cancer-related pain."

For more information, please contact Paul Armentano, NORML Deputy Director, at: paul@norml.org. Full text of the study, "The effect of medicinal cannabis on pain and quality of life outcomes in chronic pain: A prospective open-label study," appears in The Clinical Journal of Pain.

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Study: Medical Marijuana Laws Linked To Less Prescription Drug Use, Medicare Spending

Legalization nationwide estimated to reduce Medicare costs by nearly half a billion dollars

Athens, GA: The enactment of statewide medicinal cannabis laws is associated with a quantifiable decline in the use of traditional prescription drugs, according to data published in the July edition of the scientific journal Health Affairs.

Investigators at the University of Georgia assessed the relationship between medical marijuana legalization laws and physicians' prescribing patterns in 17 states over a three-year period (2010 to 2013). Specifically, researchers assessed patients' consumption of and spending on prescription drugs approved under Medicare Part D in nine domains: anxiety, depression, glaucoma, nausea, pain, psychosis, seizures, sleep disorders, and spasticity.

Authors reported that prescription drug use fell significantly in seven of the nine domains assessed.

"Generally, we found that when a medical marijuana law went into effect, prescribing for FDA-approved prescription drugs under Medicare Part D fell substantially," investigators reported. "Ultimately, we estimated that nationally the Medicare program and its enrollers spent around $165.2 million less in 2013 as a result of changed prescribing behaviors induced by ... jurisdictions that had legalized medical marijuana."

Investigators estimated that prescription drug savings would total more than $468 million annually were cannabis therapy to be accessible in all 50 states.

They concluded, "Our findings and existing clinical literature imply that patients respond to medical marijuana legislation as if there are clinical benefits to the drug, which adds to the growing body of evidence suggesting that the Schedule I status of marijuana is outdated."

Survey data compiled from medical marijuana patients reports that subjects often reduce their use prescription drug therapies, particularly opioids, when they have legal access to cannabis. According to a 2015 RAND Corporation study, opiate-related abuse and mortality is lower in jurisdictions that permit medical cannabis access as compared to those that outlaw the plant.

For more information, please contact Paul Armentano, NORML Deputy Director, at: paul@norml.org. Full text of the study, "Medical marijuana laws reduce prescription medication use in Medicare Part D," appears in Health Affairs.

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Happy New Year

NEW AND IMPROVED MISSOURI MARIJUANA LAWS TAKE EFFECT ON NEW YEAR’S DAY

                On New Year’s Day, the new Missouri Criminal Code will become effective!  Contained in that massive reorganization of all of Missouri’s criminal laws are several changes which will reduce the penalties for a wide variety of marijuana law violations.

            I was honored to serve on the Missouri Bar Association’s Criminal Law Subcommittee which drafted the new Criminal Code.

            The change affecting the largest number of people is the elimination of the possibility of a jail sentence for the first offense possession of ten grams or less of marijuana.  While relatively few such cases result in jail sentences now, there are at least two counties in Missouri where every single misdemeanor marijuana or paraphernalia guilty plea results in a sentence of five days served in jail.  That will no longer happen starting January 1.

            In addition, the laws prohibiting the cultivation and distribution of marijuana will carry reduced penalties in the future.  Currently, any distribution or cultivation of marijuana, or even the attempt to do so, carries a range of punishment of five to fifteen years in the Missouri Department of Corrections.  Under the new Criminal Code, the maximum punishment for first such offenses will be ten years.

            Perhaps most importantly, the new Criminal Code eliminates the “prior and persistent drug offender” law.  This law allows prosecutors to charge defendants who have two or more prior drug felonies in such a manner that they face a range of punishment of ten to thirty years or life in prison.  That sentence must be served without the possibility of probation or parole!

            This is the law under which Jeff Mizanskey was sentenced to serve life without parole in prison for his third small marijuana law violation.  Jeff has no other criminal convictions whatsoever, but he was ordered to serve life without possibility of ever leaving prison under the law which will be repealed January 1.

            In 2015, marijuana law reform advocates, including NORML and Show-Me Cannabis, were able to persuade Governor Nixon to grant Jeff a commutation of his sentence which made him eligible for parole.  I had the privilege of representing Jeff in his parole hearing.  He was released from prison only a few days after that hearing took place, on September 1, 2015.         

            NORML, Show-Me Cannabis, ACLU and others will continue to work in 2017, both in the legislature and through the Initiative process, to continue the progress we have made in recent years.  Now is an excellent time to make a monthly pledge of support to NORML in the coming year at http://monorml.com/donation/.

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Barry Grissom

FORMER US STATES ATTORNEY FOR THE STATE OF KANSAS ADVOCATES FOR MARIJUANA LEGALIZATION

Mr. Barry Grissom, nominated by President Obama to be the chief federal prosecuting attorney and law enforcement official for the state of Kansas, and confirmed by the United States Senate for that position, recently resigned from that office and has become an outspoken and passionate advocate for the legalization of marijuana. Mr. Grissom will be the featured guest on tonight’s edition of “Sex, Drugs and Civil Liberties”, the weekly program on KOPN, 89.5 FM, hosted by Dan Viets, Columbia attorney and Missouri Coordinator of NORML, the National Organization for the Reform of Marijuana Laws.

Mr. Grissom was the U.S. Attorney for the state of Kansas for six years. Since leaving that office six months ago, he has spoken at national NORML legal seminars in Aspen, Colorado and Key West, Florida.

He is firmly committed to the principle that marijuana prohibition is a social evil which causes far more harm than good.

Mr. Grissom is believed to be the highest-ranking former Department of Justice official to actively advocate for the repeal of marijuana prohibition. His unique experience as the chief federal law enforcement officer for the state of Kansas for six years gives his advocacy a special credibility which has drawn the attention of legislators and other policymakers around the country. Please tune for this unique and newsworthy interview.

Tonight’s interview with Mr. Grissom commences shortly after 7:00 p.m. on KOPN. The program is live-streamed around the globe at KOPN.org.

For More Information contact:
Dan Viets at 573-819-2669 or DanViets@gmail.com

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Sex, Drugs and Civil Liberties

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