Medical Marijuana Fact Versus Fiction - ACOI PDF Free Download

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MEDICAL MARIJUANA FACT VERSUS FICTIONThomas F. Jan, DO, FAOCPMRSubspecialty Certified– Pain MedicineDiplomate – American Board of Addiction MedicineMASSAPEQUA PAIN MANAGEMENT AND REHABILITATIONADMINISTRATIVE DIRECTOR-CHRONIC PAIN MANAGEMENT4200 SUNRISE HIGHWAYMATHER HOSPITAL-NORTHWELL HEALTHMASSAPEQUA, NY 11758PORT JEFFERSON, NY516-541-1064

THE I LOVE ME SLIDE:THOMAS F. JAN, DO, FAOCPMR, FKIA 20 years private practice, board certified in pain medicine and addiction medicine Current Chair, American Osteopathic Pain Medicine Conjoint Exam Committee Administrative Director for Chronic Pain Management, John T. Mather Hospital, Port Jefferson, NY Core faculty, PM&R residency program, Mercy Medical Center, Catholic Health System Leadership Council, Long Island Council on Alcoholism and Drug Dependence (LICADD) Medical Director, LICADD Opioid Overdose Prevention Program Member, Nassau County, NY, County Executive's task force on Heroin and Prescription drug abuse Former Medical Director, Town of Babylon Drug and Alcohol ProgramDisclosures: Speaker Bureau, US WorldMeds, Lucemyra

OBJECTIVES A brief history of marijuana and its medical uses throughout history How does one get certified to prescribe medical marijuana Discussion about the endocannabinoid system (ECS) What receptors are there and what are they purported to do How do the various options affect the body through the ECS What are the risks involved and some discussion about the science

MEDICAL MARIJUANA FOR OPIATE ADDICTION“I prescribed the cannabis simply with a view to utilizing a well-knownremedy for insomnia, but it did much more than procure sleep. I think it willbe found that there need be no fear of peremptorily withdrawing thedeleterious drug, if hemp is employed.”Edward Birch, MD, 1889, The Lancet

2018-STATE MARIJUANA cal-marijuana-laws.aspx

2018STATE ational.html

2018STATE MARIJUANA LAWS Thirty states and the District of Columbia currently have laws broadly legalizing marijuana in some form. Eight states and the District of Columbia have adopted the most expansive laws legalizing marijuana forrecreational use. Most recently, sales of recreational-use marijuana in California kicked off on Jan. 1 of this year In Massachusetts, retail sales of cannabis were legalized as of July 1st The Cannabis Control Commission, the new state agency tasked with overseeing the burgeoningindustry, has started issue the licenses needed for retail pot shops to open in Massachusetts On July 9th, US Attorney Andrew Lelling, the top federal prosecutor in Massachusetts, stated thatthe three areas for potential marijuana prosecutions will include "overproduction," "targeted salesto minors," and "organized crime and interstate transportation of drug proceeds." Maine legalized recreational marijuana January 30th of this tml

2018STATE MARIJUANA LAWS (CONT’D) The vast majority of states allow for limited use of medical marijuana under certaincircumstances Some medical marijuana laws are broader than others, with types of medical conditions thatallow for treatment varying from state to state Louisiana, West Virginia and a few other states allow only for cannabis-infused products, such as oilsor pills Louisiana is considered to have legalized marijuana butit cannot be used in a form that can be smoked -only oils, topical applications and other types. Other states have passed narrow laws allowing residents to possess cannabis only if they sufferfrom select rare medical illnesses. A number of states have also decriminalized the possession of small amounts of onal.html

2018STATE MARIJUANA LAWS (CONT’D)Federal law, however, prohibits doctors from prescribing tional.html

THE NEW YORK STATEMEDICAL MARIJUANA PROGRAMOn July 7, 2014, Governor Cuomo signed a medical marijuana bill into law.

WHAT IS IT ALL ABOUT?Requirements to become a registered medical marijuana physician: Be licensed physician and practicing in New York State The NYS Health Commissioner has the option of including nurse practitioners based onpatient need and access Be qualified to treat the serious condition for which medical marijuana is beingrecommended Have completed a 2-4 hour training course approved by the NYS Department of Health Have registered with the NYS DOH as a recommending physician.The NYS MMP overview;Compassionate Care New York 347.781.5435 voice compassionatecareny@gmail.com www.compassionatecareny.org

WHAT IS IT ALL ABOUT?How does the physician recommendation work? Rather than write a prescription, the physician will issue a recommendation orcertification that an eligible patient can obtain and use medical marijuana. A certification is good for one year (or less if the physician specifies a shorter timeframe) or, if the person is deemed to be terminally ill, until their death. Once a patient has obtained a physician certification, s/he applies to the DOH for apatient registry card, which allows him or her to legally purchase and use medicalmarijuana obtained from a state-licensed dispensary.The NYS MMP overview;Compassionate Care New York 347.781.5435 voice compassionatecareny@gmail.com www.compassionatecareny.org

WHAT IS IT ALL ABOUT?Qualifying conditions: Cancer Epilepsy HIV infection or AIDS Inflammatory bowel disease Amyotrophic lateral sclerosis (ALS) Neuropathy Parkinson's disease Huntington's disease Multiple sclerosis Post-traumatic stress disorder Spinal cord injury with spasticity Chronic painThe NYS MMP overview;Compassionate Care New York 347.781.5435 voice compassionatecareny@gmail.com www.compassionatecareny.org

WHAT IS IT ALL ABOUT?Must have one of the following clinically associated conditions,symptoms or complications: Cachexia or wasting syndrome severe or chronic pain resulting in substantial limitation of function severe nausea seizures severe or persistent muscle spasms such other conditions, symptoms or complications as added by the commissionerTitle 10, Department of Health10 NYCRR §1004.2(a)(9)(i-vi)

WHAT IS IT ALL ABOUT?Chronic pain as defined by NYS: Any severe debilitating pain that the practitioner determines degrades health andfunctional capability where the patient has contraindications, has experienced intolerable side effects, or hasexperienced failure of one or more previously tried therapeutic options and where there is documented medical evidence of such pain having lasted threemonths or more beyond onset, or the practitioner reasonably anticipates such pain tolast three months or more beyond onsetTitle 10, Department of Health10 NYCRR §1004.2(a)(8)(xi)

THE HISTORY

2900 BC - CHINESE EMPEROR FU HSIREFERENCES MARIJUANA AS APOPULAR MEDICINE"The Chinese Emperor Fu Hsi (ca. 2900 BC), whom the Chinesecredit with bringing civilization to China, seems to have madereference to Ma, the Chinese word for Cannabis, noting thatCannabis was very popular medicine that possessed both yin andyang."Robert Deitch Hemp: American History Revisited: The Plant with a Divided History, 2003Source: php?timelineID 000026

1450 BC - BOOK OF EXODUSREFERENCES HOLY ANOINTING OILMADE FROM CANNABIS"Holy anointing oil, as described in the original Hebrew version of therecipe in Exodus (30:22-23), contained over six pounds of kaneh-bosem, asubstance identified by respected etymologists, linguists, anthropologists,botanists and other researchers as cannabis, extracted into about sixquarts of olive oil, along with a variety of other fragrant herbs. Theancient anointed ones were literally drenched in this potent mixture.“Chris Bennett "Was Jesus a Stoner?," High Times Magazine, Feb. 10, 2003"Marijuana proponents suggest that the recipe for the anointing oil passedfrom God to Moses included cannabis, or kaneh-bosm in Hebrew. Theypoint to versions calling for fragrant cane, which they say was mistakenlychanged to the plant calamus in the King James version of the Bible."Shannon Kari "Cannabis Involved in Christ's Anointment?," National Post, Apr. 22, 2010Source: php?timelineID 000026

1213 BC - EGYPTIANS USECANNABIS FOR GLAUCOMA,INFLAMMATION, AND ENEMASCannabis pollen is found on the mummy of Ramesses II,who died in 1213 BC. Prescriptions for cannabis inAncient Egypt include treatment for the eyes (glaucoma),inflammation, and cooling the uterus, as well asadministering enemas.Lise Manniche, PhD An Ancient Egyptian Herbal, 1989Source: php?timelineID 000026

1000 BC - BHANG, A DRINK OFCANNABIS AND MILK, IS USED ININDIA AS AN ANESTHETICBhang, a cannabis drink generally mixed with milk, is usedas an anesthetic and anti-phlegmatic in India. Cannabisbegins to be used in India to treat a wide variety ofhuman maladies.US National Commission on Marihuana and Drug Abuse"Marihuana, A Signal of Misunderstanding," druglibrary.org, 1972Source: php?timelineID 000026

700 BC - MEDICAL USE OFMARIJUANA IN THE MIDDLE EASTRECORDED IN THE VENIDADThe Venidad, one of the volumes of the Zend-Avesta, theancient Persian religious text written around the seventhcentury BC purportedly by Zoroaster (or Zarathustra),the founder of Zoroastrianism, and heavily influenced bythe Vedas, mentions bhang and lists cannabis as the mostimportant of 10,000 medicinal plants."Martin Booth Cannabis: A History, 2005Source: php?timelineID 000026

1621 - POPULAR ENGLISHMENTAL HEALTH BOOKRECOMMENDS CANNABIS TOTREAT DEPRESSIONEnglish Clergyman and Oxford scholarRobert Burton suggests cannabis as atreatment for depression in his influentialand still popular 1621 book The Anatomyof Melancholy.Lester Grinspoon, MD"History of Cannabis as a Medicine,“Statement for hearing by DEA Law Judge, Aug.16, 2005Source: php?timelineID 000026

1850 - MARIJUANA ADDEDTO US PHARMACOPEIA"By 1850, marijuana had made its way into the United StatesPharmacopeia [an official public standards-setting authorityfor all prescription and over-the counter medicines], whichlisted marijuana as treatment for numerous afflictions,including: neuralgia, tetanus, typhus, cholera, rabies, dysentery,alcoholism, opiate addiction, anthrax, leprosy, incontinence,gout, convulsive disorders, tonsillitis, insanity, excessivemenstrual bleeding, and uterine bleeding, among others.Patented marijuana tinctures were sold."Cover of the 1851 United States PharmacopeiaRichard Glen Boire, JD and Kevin Feeney, JD Medical Marijuana Law, 2007Source: php?timelineID 000026

1906 - PURE FOOD AND DRUGSACT REQUIRES LABELING OFMEDICINE, INCLUDING CANNABIS"An Act for preventing the manufacture, sale, or transportation ofadulterated or misbranded or poisonous or deleterious foods, drugs,medicines, and liquors, and for regulating traffic therein, and for otherpurposes.That for the purposes of this Act an article shall also be deemed tobe misbranded. if the package fail to bear a statement on the label ofthe quantity or proportion of any alcohol, morphine, opium, cocaine,heroin, alpha or beta eucaine, chloroform, cannabis indica, chloralhydrate, or acetanilide, or any derivative or preparation of any suchsubstances contained therein.“Pure Food and Drug Act (1906)National Center for Biotechnology Information website, June 30, 1906Source: php?timelineID 000026

OCT. 1937 - "MARIHUANA (SIC)TAX ACT" LEADS TODECLINE IN MARIJUANAPRESCRIPTIONS"By the time the federal government passed the MarihuanaTax Act in [Oct.] 1937, every state had already enacted lawscriminalizing the possession and sale of marijuana. Thefederal law, which was structured in a fashion similar to the1914 Harrison Act, maintained the right to use marijuanafor medicinal purposes but required physicians andpharmacists who prescribed or dispensed marijuana toregister with federal authorities and pay an ann

medical marijuana fact versus fiction massapequa pain management and rehabilitation 4200 sunrise highway massapequa, ny 11758 516-541-1064 administrative director-chronic pain management