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Doctors Group Pushes For Legalizing Marijuanafrom NY State of Politics, Spectrum News, 6/12/2019.

As medical professionals and healthcare providers, our first and foremost obligation is to protect the health of our patients. Our lifelong commitment to improving public health and patients’ quality of life has compelled us to offer our informed support for the legalization of adult-use cannabis in the state of New York.

Decades of prohibition have failed to control cannabis use while disproportionately harming communities of color, preventing cannabis research, limiting patient access, and restricting efforts to combat opioid addiction. With each passing month of legislative inaction, countless families across New York are destroyed by draconian criminal penalties, opioid use, and limited access to adequate healthcare.

In 2016, the most recent year for which data is available, more than 35,000 individuals in New York were arrested for cannabis possession, costing taxpayers millions of dollars in the process.[1,2] Nationwide, blacks are arrested at nearly four times the rate of whites for cannabis possession, despite both groups having similar rates of cannabis use.[3] An arrest for cannabis possession results in lifelong impediments to employment and economic security, creating a cycle of poverty that ultimately reduces healthcare access and damages public health.[4,5,6]

Meanwhile, thousands of New York residents are dying each year due to opioid addiction and overdose, and thousands more struggle with insufficient chronic pain management due to bureaucratic obstacles within New York’s Medical Marijuana Program (MMP).[7,8] In the absence of effective regulatory controls, adult cannabis consumers are forced to rely on the illicit marketplace. This has led to greater exposure to dangerous synthetic cannabinoids and prevents the implementation of standardized product labeling and childproof packaging.[9]

It doesn’t need to be this way. In Denver, adult-use cannabis legalization has led to a 79% decrease in total arrests for possession and an 80% decrease in the arrests of African- American and Latinx individuals.[10] Legalization corrects social equity gaps with a greater potential impact than decriminalization alone.[11,12]

In states that have legalized cannabis for adult-use, opioid fatalities have notably declined. This is promising foundational data, given that research has shown that legalization is associated with more informed doctor-patient conversations on the topic of medical cannabis treatment.[13] By removing barriers to patient access and reducing the stigma of cannabis as a prospective treatment option, policymakers in certain legal states have been able to present a legitimate and low-risk therapeutic alternative to opioids.[14,15,16,17]

Regulatory oversight of the production, packaging, and sale of cannabis protects consumers while shielding them from risks present in the illicit marketplace.[18] Generated tax revenue from adult-use cannabis regulations can be allocated for medical research, substance abuse treatment, and community reinvestment efforts.[19] Collectively, responsible regulatory controls and additional tax revenue can reduce socioeconomic gaps and improve public health outcomes across New York’s communities.

Contrary to the claims of adult-use opponents, youth consumption rates have remained stable or declined in states following legalization.[20,21] A closer examination of the data substantiates that reputable regulatory controls, rather than prohibition, is the best way to reduce youth cannabis use. Informed and measured educational campaigns have successfully reduced tobacco and alcohol use among minors, while teen cannabis use has risen under prohibition.[22] Prohibition has failed to combat youth use, and instead has strengthened an illicit marketplace that targets minors as customers.

While medical cannabis expansion and decriminalization offer positive benefits, the continued failure to legalize and regulate adult-use cannabis will undermine overall public health. Legalization will facilitate responsible regulatory controls, expand patient access, most effectively advance social justice, protect adult consumers, combat the opioid crisis, reduce youth consumption, and improve health outcomes.

As medical professionals, we urge New York lawmakers to prioritize our communities’ health and public welfare by legalizing cannabis for adult-use.

Respectfully submitted,

Julia Arnsten, MD, MPH
Chair, New York Campaign Committee, Doctors for Cannabis Regulation
Internal Medicine
New York, NY
Professor, Albert Einstein College of Medicine
Chief, Division of General Internal Medicine
Director, Center for Comparative Effectiveness Research

Tanya Adams, DO
Family Practice
East Sekauket, NY
Physician, Setauket Primary Medical Care

Craig D. Blinderman, MD, MA, FAAHPM
Family Medicine, Hospice and Palliative Medicine
New York, NY
Fellow, American Academy of Hospice and Palliative Medicine
Director, Adult Palliative Care Service at Columbia University Medical Center
Associate Professor, Department of Medicine at Columbia University College of Physicians and Surgeons

Richard Carlton, MD
Integrative Psychiatry
Port Washington, NY
Co-Author, Type 2 Diabetes: Cardiovascular and Related Complications, and Evidence-Based Complementary Treatments

Stephen Dahmer, MD, Board-Certified in Family Medicine
Family Medicine
New York, NY
Chief Medical Officer, Vireo Health
Fellow, Arizona Center for Integrative Medicine
Former Assistant Clinical Professor, Icahn School of Medicine at Mount Sinai

Lynda Geraci, DO
Family Medicine
Stony Brook, NY
Member, American Osteopathic Association
Physician, Private Practice

James Goodrich, MD, Board-Certified in Internal Medicine
Internal Medicine
New York, NY
Clinical Instructor, Department of Medicine at NYU Langone Health
Attending Physician, The Mount Sinai Hospital

Roger Green, MD, FAAP
Pediatrics
Woodstock, NY
Fellow, American Academy of Pediatrics
Retired Clinical Assistant Professor of Pediatrics, the Children’s Hospital at Albany Medical Center
Retired Attending Physician, Northern Dutchess Hospital; Vassar Brothers Medical Center

Julie Holland, MD
Psychiatry
New York, NY
Fellow, New York Academy of Medicine
Former Assistant Clinical Professor, NYU School of Medicine
Editor, The Pot Book
Medical Monitor, Clinical Cannabis PTSD Research

Dara Huang, MD, MMSc
Internal Medicine & Nephrology New York, NY
Attending Physician, Lenox Hill Hospital – Northwell Health; Mount Sinai; Beth Israel Hospital
Member, Chinese American Medical Society (CAMS)
Member, Coalition of Asian American Independent Physicians Association (CAIPA)

Barry Newman, MD, CEMP
Anesthesiology
New York, NY
Founder, Practice Transformation

Amy Piperato, MD
Internal Medicine Stony Point, New York
Primary Care Physician, Stony Point Medical
Mother, child with Dravet’s Syndrome

Eugene Tinelli, MD, PhD
Psychiatry
Syracuse, NY
Associate Professor, Psychiatry and Behavioral Science, State University of New York, Upstate Medical University
Honorary Member, Law Enforcement Against Prohibition

Stacia Woodcock, PharmD
Pharmacy
New York, NY
Education Chair, Association of Cannabis Specialists

David B. Weiss, MD, MPH
Family Medicine
New York, NY

Arielle Gerard, MD, MS
Family Medicine
New York, NY

Richard Allen, MD
Emergency Medicine, Addiction Medicine
Ithaca, NY

Kelsey Wilson-Henjum, MD
Family Medicine
New York, NY

Jamie Loehr, MD
Family Medicine
Ithaca, NY

Michael Pappas, MD
Family Medicine
New York, NY

REFERENCES

  1. Guion, Payton. “N.J. wants to erase marijuana charges, but weed arrests have massively spiked. What’s going on?” NJ.com. May 4, 2018. https://www.nj.com/ marijuana/2018/05/nj_could_start_erasing_marijuana_arrests_but_for_n.html
  2. Drug Policy Alliance. “The Cost of New York City’s Marijuana Possession Arrests.” http://www.drugpolicy.org/resource/75-million-year-cost-new-york-citys-marijuana-possession-arrests   
  3. American Civil Liberties Union. The War on Marijuana in Black and White. New York, NY: June 2013. p. 17. https://www.aclu.org/report/war-marijuana-black-and-white
  4. Laird, Lorelei. “Ex-offenders face tens of thousands of legal restrictions, bias and limits on their rights.” American Bar Association Journal. June 1, 2013. http://www.abajournal.com/magazine/article/ex- offenders_face_tens_of_thousands_of_legal_restrictions
  5. Csete, Joanne, et al. “Public health and international drug policy.” The Lancet special report. March 24, 2016. http://dx.doi.org/10.1016/S0140-6736(16)00619-X
  6. Mercado, Susan, et al. “Urban Poverty: An Urgent Public Health Issue.” Journal of Urban Health 84. May 2007. pp. 7-15. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1891652/
  7. National Institute on Drug Abuse. “New York Opioid Summary.” March 2019. https://www.drugabuse.gov/opioid-summaries-by-state/new-york-opioid-summary
  8. Cressen, Rob. “ Marijuana expansion must address needs of disabled.” Asbury Park Press. July 9, 2018. https://www.app.com/story/opinion/columnists/2018/07/09/medical-marijuana-disabled-new- jersey/769329002/
  9. Fantegrossi, William E., et al. “Distinct pharmacology and metabolism of K2 synthetic cannabinoids compared to Δ9-THC: Mechanism underlying greater toxicity?” Life Sciences (97)1. February 27, 2014. pp. 45-54. http://www.sciencedirect.com/science/article/pii/S0024320513005523
  10. Colorado Department of Public Safety. “Impacts of Marijuana Legalization in Colorado.” October 2018. http://cdpsdocs.state.co.us/ors/docs/reports/2018-SB13-283_Rpt.pdf
  11. American Civil Liberties Union of Washington State. “Court Filings for Adult Marijuana Possession Plummet.” March 19, 2014. https://aclu-wa.org/news/court-filings-adult-marijuana-possession-plummet
  12. Fertig, Beth. “Still Too High? Marijuana Arrests Barely Budge in NYC.” WNYC. January 16, 2018. https://www.wnyc.org/story/still-too-high-marijuana-arrests-barely-budge-nyc/
  13. Mary Lynn Mathre R.N., M.S.N. (1988) A Survey on Disclosure of Marijuana Use to Health  Care Professionals, Journal of Psychoactive Drugs, 20:1, 117-120. https://www.researchgate.net/publication/19762960_A_survey_on_disclosure_of_marijuana_use_to_health_care_professionals
  14. Pacula, Rosalie, et al. “Words Can Be Deceiving: A Review of Variation among Legally Effective Medical Marijuana Laws in the United States.” Journal of Drug Policy Analysis 7(1), 2014. pp. 1-19. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4314612/
  15. Alcohol and Drug Abuse Institute. “Learn About Marijuana: Adult Recreational Marijuana Consumers.” University of Washington, March 2015. http://learnaboutmarijuanawa.org/consumers.htm
  16. Joy, Janet E., et al. Marijuana and Medicine: Assessing the Science Base. Washington, DC: National Academy Press, 1999. pp. 100-101. http://www.nap.edu/read/6376/chapter/5#100
  17. Levitan, Dave. “Is Marijuana Really a ‘Gateway Drug’?” FactCheck: A Project of the Annenberg Public Policy Center. April 23, 2015. http://www.factcheck.org/2015/04/is-marijuana-really-a-gateway-drug/
  18. California Medical Association. “ Cannabis and the Regulatory Void: Background Paper and Recommendations.” 2011. https://www.safeandsmartpolicy.org/wp-content/uploads/2015/04/CMA_Cannabis_TAC_White_Paper.pdf
  19. Pabon, Rep. Dan, Chair. “Use of Recreational Marijuana Sales Tax Revenues Interim Study Committee.” October 2014. https://www.colorado.gov/pacific/sites/default/files/14%20MarijuanaSummaryReport.pdf
  20. Coley, Rebekah Levine, et al. “A quasi-experimental evaluation of marijuana policies and youth marijuana use.” The American Journal of Drug and Alcohol Abuse, 45:3. February 15, 2019. pp. 292-303. https://www.tandfonline.com/doi/full/10.1080/00952990.2018.1559847
  21. Colorado Department of Public Safety. “Impacts of Marijuana Legalization in Colorado.” October 2018. http://cdpsdocs.state.co.us/ors/docs/reports/2018-SB13-283_Rpt.pdf
  22. Ingraham, Christopher. “Teen marijuana use falls as more states legalize.” Washington Post. December 16, 2014. https://www.washingtonpost.com/news/wonk/wp/2014/12/16/teen-marijuana- use- falls-as-more-states-legalize/