Colorado lawmakers push PTSD bill to address pleas for medical marijuana

2017 brings with it renewed pushes — legislatively and legally — to allow those diagnosed with post-traumatic stress disorder to seek a doctor’s recommendation for medical cannabis

PUBLISHED: JAN 25, 2017,
By Alicia Wallace, The Cannabist Staff

Efforts over the years to add PTSD as a qualifying condition for medical marijuana in Colorado have been met with failure.

The Colorado Board of Health denied multiple petitions for the inclusion, citing the need for more scientific evidence; bills’ trips through the General Assembly have been short-lived; and veterans and PTSD-sufferers’ legal bids were quashed.



2017 brings with it renewed pushes — both legislatively and legally — to establish PTSD as a qualifying condition.

“I’ve met a number of veterans who really feel like it improved their quality of life,” said Sen. Irene Aguilar, a Denver Democrat and physician who co-sponsored a bill to have PTSD and acute stress disorders be considered “debilitating medical conditions” under the state’s medical marijuana law.

In a time when concern is heightened about veterans’ increased risk of suicide, there should be consideration for all potential options to help prevent that, Aguilar said.

Senate Bill 17, co-sponsored by Rep. Jonathan Singer, D-Longmont, is expected to go before the Senate’s State, Veterans and Military Affairs Committee next week. The initial committee hearing scheduled for Tuesday was postponed as lawmakers evaluate whether there is a legislative mechanism to add a qualifying condition or if that is limited to the Colorado Department of Public Health and Environment, Aguilar said.

Some of the initial opposition to the bill has come from members of the medical community, including the Colorado Psychiatric Society.

“Our main concern is really the risk of harm to the individual,” said Dr. Jennifer Hagman, representing the Colorado Psychiatric Society.

And the physicians’ edict of “first, do no harm” is accomplished with knowledge from rigorous studies, research and evidence, she said.

“I would hope that we continue to wait until there’s adequate scientific support for using marijuana for this condition,” she said. “I think it’s premature and the data isn’t there.”


The limited data people are working with around veterans with PTSD and marijuana, she said, has shown negative correlations. She noted a longitudinal study of veterans over a period of 30 years that showed some who started using marijuana following treatment had increased incidences of violent behavior.

Hagman noted that more research is ongoing and that the state of Colorado has put money toward research on marijuana’s effects on those with PTSD. The study, in the works since 2010, received federal approval in 2016, a year and a half after Colorado awarded the grant.

“I think the best thing that could happen is for the federal government to remove marijuana from Schedule I so that research is much easier to do,” she said.

Happening in the background of this latest play from lawmakers is an ongoing appeals case in state court that challenges the board of health’s 2015 decision on PTSD. And nationally, an increasingly growing slate of medical marijuana states — nearly 20 of them — have looked favorably on PTSD as a qualifying condition.

“It’s just an area that they need to permit us to catch up with other states,” said C. Adam Foster, an attorney with Denver’s Hoban Law Group. Foster represents the Colorado residents and military veterans who challenged the board of health’s position on PTSD in district court and subsequently appealed the district court’s denial.

Colorado’s board of health has remained firm on not including PTSD as a qualifying condition, stating that more scientific evidence is required. The board made a similar move in regards to a 2010 petition to add Tourette’s syndrome.

“The board has made this policy decision that they want to see the same type of evidence the (U.S. Food and Drug Administration) looks at to approve new pharmaceutical medicines,” Foster said. “I firmly believe that they have set a standard that just cannot be met in the real world.”

Research related to the potential benefits and detrimental effects of marijuana has been limited, stifled in part by marijuana’s federal listing as a Schedule I substance, researchers and scientists have said.

“You want (veterans and other people diagnosed with PTSD) to be getting treatment from an experienced health care provider and a doctor who understands PTSD and can recommend a treatment plan — that probably will include talk therapy, some pharmaceutical medications — you want those medical providers to be able to have an honest conversation with their patients about medical marijuana,” Foster said.

Earlier this month, the Colorado Appeals Court case wrapped up the briefings stage and — barring any call for oral arguments from the judges — now is awaiting an opinion from the court. That opinion could take anywhere from three to six months, Foster said.


Stress e sistema nervoso.

Equilibrio intestinale.

Equilibrio acido/base.

Dott. Alfredo Saggioro, MEDICINA FUNZIONALE Azienda ULSS 12 Veneziana Director Gastroenterology, Hepatology and Clinical Nutrition · Venezia · aprile 1973 – 1 maggio 2013


Dott. Alfredo Saggioro
Medicina Funzionale – Blog rigorosamente scientifico

Questo Blog nasce come luogo di cultura, educazione e interscambio nell’ambito di una medicina nuova, che guarda alla salute e al futuro. Vuole essere, per quanto possibile semplice nei contenuti, che dovranno essere fruibili per tutti, ma allo stesso tempo rigorosamente scientifico. Dott. Alfredo Saggioro




Ansia e Sclerosi Multipla


Cari amici,
oggi torniamo a parlare di disturbi psicologici e sclerosi multipla. In particolare oggi vorrei trattare un argomento di cui si parla tanto: l’ansia.
Rispetto alla depressione, l’ansia associata alla sclerosi multipla, è stata oggetto di un minore numero di ricerche, nonostante anch’essa rappresenti un importante problema per i malati SM. La sua frequenza varia moltissimo a seconda della casistica che viene considerata, ma i dati presenti nella letteratura scientifica, che vanno da un 19 ad un 90%, amplificano probabilmente tale variabilità, forse perché gli studi che li hanno raccolti hanno impiegato metodi diversi per individuare il problema. Prendendo in considerazione il momento della diagnosi, molto critico nella vita delle persone con sclerosi multipla, alcune ricerche hanno dimostrato la presenza dell’ansia nel 34% dei malati e nel 40% dei loro coniugi. Seguendo per due anni persone alle quali è stata comunicata una diagnosi di sclerosi…

View original post 1.485 altre parole

Can marijuana treat MS symptoms? One Colorado researcher makes it his mission to find out

If these studies can demonstrate that cannabis effectively relieves and treats MS symptoms, they could help establish the medicinal value of cannabis

PUBLISHED: JAN 18, 2017, 8:00 AM
By Thorsten Rudroff, Colorado State University

Story via The Conversation

An estimated 400,000 Americans are currently living with multiple sclerosis, an autoimmune disease where the body’s immune cells attack a fatty substance called myelin in the nerves. Common symptoms are gait and balance disorders, cognitive dysfunction, fatigue, pain and muscle spasticity.


Colorado has the highest proportion of people living with MS in the United States. It is estimated that one in 550 people living in the state has MS, compared to one in 750 nationally. The reason for this is unknown, but could be related to several factors, such as vitamin D deficiency or environment.

Currently available therapies do not sufficiently relieve MS symptoms. As a result many people with the condition are trying alternative therapies, like cannabis. Based on several studies, the American Association of Neurology states that there is strong evidence that cannabis is effective for treatment of pain and spasticity.

Although there are many anecdotal reports indicating cannabis’ beneficial effects for treatment of MS symptoms such as fatigue, muscle weakness, anxiety and sleep deprivation, they have not been scientifically verified. This is because clinical trials – where patients are given cannabis – are difficult to do because of how the substance is regulated at the federal level.

To learn more, Integrative Neurophysiology Laboratory at Colorado State University is studying people with MS in the state who are already using medical cannabis as a treatment to investigate what MS symptoms the drug can effectively treat.

Medical marijuana isn’t a prescription drug. Marijuana, or cannabis, contains over 100 compounds, but THC (Tetrahydrocannabinol) and CBD (Cannabidiol) are believed to have the most medical relevance.

However, there is currently no information about the most effective ratio of THC and CBD, which form of ingestion (smoking or eating, for instance) is best, or how often people with MS should use cannabis products.

The main reason for the limited scientific evidence about how well cannabis can treat MS symptoms is because it is a Schedule 1 substance. This means that it has “no currently accepted medical use and a high potential for abuse.” This classification makes it very difficult to study cannabis in clinical trials.

Because cannabis is on Schedule 1, doctors can’t prescribe it, even in the states with medical marijuana laws, like Colorado. In those states doctors can provide patients with a “permission slip” for cannabis, which has to be approved by a state agency.

Because of the lack of scientific evidence, doctors can’t recommend a specific strain and dosage of cannabis to patients. Patients are left to choose on their own. Moreover, a recent study in the Journal of the American Medical Association showed that out of 75 cannabis products, only 17 percent were accurately labeled. And 23 percent contained significantly more THC than labeled, possibly placing patients at risk of experiencing adverse effects.

How we are studying cannabis and MSMy lab’s long-term goal is to determine whether cannabis can safely and effectively treat MS symptoms. But because of current federal regulations our lab can conduct only observational studies at this time. To conduct clinical trials with a Schedule 1 substance, investigators much have a special license, which my lab is in the process of applying for. At the moment, this means we study only people who are or are about to use cannabis and we do not provide cannabis to anyone for our studies.

We recently completed an online survey of 139 MS patients currently using cannabis to learn what types of products they used, how often they used those products and for how long.

Our results, which have not yet been published, found that 91 of our respondents (66 percent) reported that they currently use cannabis, and 56 percent of the cannabis users reported using either smoked or edible products. Seventy-eight percent of the cannabis users also indicated that they reduced or even stopped other medications as a result of their cannabis use.

The survey respondents who are using cannabis reported lower disability scores on the Guy’s Neurological Disability Scale, a clinical scale used to evaluate neurological disability in people with MS, and they seem less likely to be obese. However, these data are self-reported, which means objective longer clinical trials are required to confirm these results.

We are also conducting an ongoing observational study, set to be completed in mid-2017, on the effects of regular cannabis use on physical function and activity levels in people with MS. There are many studies on the influence of cannabis on cognitive function in healthy and diseased populations. However, no study to date has used objective measures of motor function in people with MS who are using cannabis, such as muscle strength and fatigue tasks, walking performance and postural stability tests.

Our preliminary results indicate that people with MS using cannabis have greater physical activity levels, leg strength and walking speed, while also having less spasticity, fatigue and a lower perceived risk of falling. It is of note that these individuals are rarely using only cannabis to help control their symptoms. They are often using cannabis alongside traditional medications.

Importantly, cannabis users did not perform worse than nonusers on any of our measurements. These are very promising results, and we are expecting significant positive effects of cannabis at the end of this observational study.

Randomized control trials are neededThe outcomes of these observational studies will be the foundation for larger randomized clinical trials, where some patients are treated with cannabis and others aren’t. These types are studies are needed to truly show the benefits and risks of consequences of cannabis use in this population.

Applying for the special license that investigators must have to conduct clinical research with a Schedule 1 substance is a lengthy process. Once granted, the DEA requires on-site inspections of the investigator’s facilities. Furthermore, it is also very difficult for these types of experiments to be approved and performed. These policies make conducting research on the medical benefits and side effects of cannabis in the United States extremely hard. As a sad result, top researchers are looking to export their ideas outside the country.

Assessing the scientific evidence: What is known about cannabis and health effects

We want to conduct clinical research to understand what cannabis products MS patients should use, in what dosage and in what form of ingestion. We also want to find out whether long-term cannabis use is safe, and if the effectiveness changes overtime due to increased tolerance. Fortunately, our first intervention study, which will investigate the effects of different marijuana strains on motor and cognitive function in people with MS, has been approved by the CSU Institutional Review Board. This means that my lab can begin this research once our license is approved.

The answers to these questions will provide guidelines for health care providers and people with MS on cannabis use. If these studies can demonstrate that cannabis effectively relieves and treats MS symptoms, they could help establish the medicinal value of cannabis. That could make a case for rescheduling cannabis, making it easier for physicians and researchers to establish cannabis’ true benefits and risks.


This article was originally published on The Conversation. Read the original article.

Assessing the scientific evidence: What is known about cannabis and health effects

Conclusions in ‘Health Effects of Cannabis and Cannabinoids’ report
PUBLISHED: JAN 12, 2017, 6:38 PM 
By Alicia Wallace, The Cannabist Staff


A sweeping assessment on marijuana research by the National Academies of Sciences, Engineering and Medicine published Jan. 12 analyzed 10,000 studies conducted since 1999. A team of researchers for the U.S. scientific academy quantified the weight of current scientific evidence, with recommendations for future study. The report made the following conclusions about what is known about cannabis:

Conclusive evidence
Defined as: Many supportive findings from good-quality studies with no credible opposing findings. A firm conclusion can be made, and the limitations to the evidence, including chance, bias, and confounding factors, can be ruled out with reasonable confidence. Therapeutic effects: Strong evidence from randomized controlled trials to support the conclusion that cannabis/cannabinoids are an effective or ineffective treatment. Other health effects: Strong evidence from randomized controlled trials to support or refute a statistical association between cannabis/cannabinoid use and the health endpoint.

• Effective in treating chronic pain in adults

• Effective as antiemetic properties to prevent and treat chemotherapy-induced nausea and vomiting

• Effective in improving multiple sclerosis spasticity symptoms

Substantial evidence
Defined as: Several findings from good- to fair-quality studies with very few or no credible opposing findings. A general conclusion can be made, but limitations, including chance, bias, and confounding factors, cannot be ruled out with reasonable confidence. Therapeutic effects: Some evidence to support the conclusion that cannabis/cannabinoids are an effective or ineffective treatment. Other health effects: There is some evidence to support or refute a statistical association between cannabis/cannabinoid use and the health endpoint.

• Long-term cannabis smoking and worse respiratory symptoms and frequent chronic bronchitis episodes (statistical association)

• Increased risk of motor vehicle crashes (statistical association)

• Maternal cannabis smoking contributes to lower birth weight of the offspring (statistical association)

• Development of schizophrenia or other psychoses, with the highest risk among the most-frequent users (statistical association)

• Stimulant treatment of attention deficit hyperactivity disorder in adolescence is not a risk factor for problem cannabis use

• Being male and being a smoker are risk factors for cannabis use to progress to problem cannabis use

• Cannabis use at an earlier age is a risk factor for the development of problem cannabis use

Moderate evidence
Defined as: Several findings from good- to fair-quality studies with very few or no credible opposing findings. A general conclusion can be made, but limitations, including chance, bias, and confounding factors, cannot be ruled out with reasonable confidence. Therapeutic effects: Some evidence to support the conclusion that cannabis/cannabinoids are an effective or ineffective treatment. Other health effects: Some evidence to support or refute a statistical association between cannabis/cannabinoid use and the health endpoint.

• Effective in improving short-term sleep outcomes in people with sleep apnea, fibromyalgia, chronic pain and multiple sclerosis

• No statistical association between cannabis use and incidence of lung, head and neck cancers

• Improved respiratory airway dynamics among cessation from acute cannabis smokers but not chronic use (statistical association)

• Cannabis smoking leads to higher forced vital capacity (statistical association)

• Cannabis use has increased risk of overdose injuries — including respiratory distress — among pediatric population in U.S. states where cannabis is legal (statistical association)

• Acute cannabis use impairs cognitive functions such as learning, memory and attention (statistical association)

• Individuals with psychotic disorders and a history of cannabis use have better cognitive performance (statistical association)

• Cannabis use and increased symptoms of mania and hypomania in individuals with bipolar disorders (statistical association)

• Small increased risk for development of depressive disorders (statistical association)

• Increased incidence of suicidal thoughts and attempts with higher incidence among heavier users (statistical association)

• Increased incidence of suicidal completion (statistical association)

• Increased incidence of social anxiety disorder (statistical association)

• No statistical association between cannabis use and worsening of negative symptoms of schizophrenia among individuals with psychotic disorders.

• Anxiety, personality disorders, bipolar disorders, ADHD are not risk factors for the development of problem cannabis use

• Individually, major depressive disorder, being male, having exposure to combined use of abused drugs are risk factors for the development of problem cannabis use

• On their own, alcohol and nicotine dependence are not risk factors for the progression of cannabis use to problem cannabis use.

• In adolesence, the frequency of cannabis use, oppositional behaviors, a younger age of first alcohol use, nicotine use, parental substance use, poor school performance, anti-social behaviors and childhood sexual behaviors are risk factors for the development of problem cannabis use.

• Persistence of problem cannabis use and history of psychiatric treatment (statistical association)

• Problem cannabis use and increased severity of post-traumatic stress disorder symptoms (statistical association)

Former U.S. Marine Sgt. Ryan Begin smokes medical marijuana at his home in Belfast, Maine on November 21, 2014. (Robert F. Bukaty, The Associated Press)
Former U.S. Marine Sgt. Ryan Begin smokes medical marijuana at his home in Belfast, Maine on November 21, 2014. (Robert F. Bukaty, The Associated Press)
Limited evidence
Defined as: Supportive findings from fair-quality studies, or mixed findings with most favoring one conclusion. A conclusion can be made, but there is significant uncertainty due to chance, bias, and confounding factors. Therapeutic effects: Weak evidence to support the conclusion that cannabis or cannabinoids are an effective or ineffective treatment. For other health effects: Weak evidence to support or refute a statistical association between cannabis or cannabinoid use and the health endpoint.

• Increasing appetite and decreasing weight loss associated with HIV/AIDS

• Improving clinician-measured multiple slcerosis spasticity symptoms

• THC capsules improve Tourette syndrome symptoms

• Cannabidiol improves anxiety symptoms, as assessed by public speaking test, in people with social anxiety disorders

• Improves symptoms of PTSD (nabilone, one single, small fair-quality trial)

• Better outcomes after a traumatic brain injury or intracranial hemorrhage (statistical association)

• Cannabinoids are ineffective for improving symptoms associated with dementia

• Cannabinoids are ineffective in improving intraocular pressure associated with glaucoma

• Cannabinoids are ineffective in reducing depressive symptoms in individuals with chronic pain or multiple sclerosis

• Cannabis smoking and non-seminoma-type germ cell tumors (statistical association)

• Cannabis smoking triggers acute myocardial infarction (statistical association)

• Ischemic stroke or subarachnoid hemorrhage (statistical association)

• Decreased risk of metabolic syndrome and diabetes (statistical association)

• Increased risk of pre-diabetes (statistical association)

• Occassiaonal annabis smoking and an increased risk of developing chronic obstructive pulmonary disease (statistical association)

• Decrease in the production of several inflammatory cytokines in healthy individuals(statistical association)

• No statistical association between daily cannabis use and the progression of liver fibrosis or hepatic disease in individuals with Hepatitis C

• Maternal cannabis smoking and pregnancy complications (statistical association)

• Maternal cannabis smoking and admission of the infant to the neonatal intensive care unit (statistical association)

• Impaired academic achievement and education outcomes (statistical association)

• Increased rates of unemployment or low incomes (statistical association)

• Impaired social functioning and engagement (statistical association)

• Sustained abstinence from cannabis use and impairments in learning, memory and attention (statistical association)

• Increase in schizophrenia symptoms such as hallucinations among individuals with psychotic disorders (statistical association)

• Likelihood of developing bipolar disorder, especially among regular or daily users (statistical association)

• Development of any type of anxiety disorder except social anxiety disorder (statistical association)

• Increased symptoms of anxiety among near daily users of cannabis (statistical association)

• Increased severity of PTSD symptoms (statistical association)

• Childhood anxiety and childhood depression are risk factors for the development of problem cannabis use

• Initiation of tobacco use (statistical association)

• Changes in the rates and use patterns of other licit and illicit substances (statistical association)

No or insufficient evidence to support or refute
• Effective treatment for cancers, including glioma

• Effective treatment for cancer-associated anorexia cachexia syndrome and anorexia nervosa

• Effective treatment for symptoms of irritable bowel syndrome

• Effective treatment for epilepsy

• Effective treatment for spasticity in patients with paralysis due to spinal cord injury

• Effective treatment for symptoms associated with amyotrophic lateral sclerosis

• Effective treatment for chorea and certain neuropsychiatric symptoms associated with Huntington’s disease

• Effective treatment for motor system symptoms associated with Parkinson’s disease

• Effective treatment for Dystonia

• Effective treatment for achieving abstinence in the use of addictive substances

• Effective treatment for mental health outcomes in individuals with schizophrenia or schizophreniform psychosis

• Incidence of esophageal cancer from cannabis smoking (statistical association)

• Incidence of prostate cancer, cervical cancer, malignant gliomas, non-Hodgkin lymphoma, penile cancer, anal cancer, Kaposi’s sarcoma or bladder cancer (statistical association)

• Subsequent risk of developing acute myeloid leukemia/acute non-lympoblastic leukemia, acute lymphoblastic leukemia, rhabdomyosarcoma, astrocytoma, or neuroblastoma in offspring (statistical association)

• Increased risk of acute myocardial infarction (statistical association)

• Hospital admissions for COPD (statistical association)

• Asthma development or asthma exacerbation (statistical association)

• Other adverse immune cell responses in healthy individuals from cannabis smoking (statistical association)

• Adverse effects on immune status in individuals with HIV (statistical association)

• Increased incidence of oral human papilloma virus (statistical association)

• All-cause mortality (statistical association)

• Occupational accidents or injuries (statistical association)

• Death due to cannabis overdose (statistical association)

• Changes in the course or symptoms of depressive disorders (statistical association)

• Development of PTSD (statistical association)

This Sept. 15, 2015 file photo shows marijuana plants with their buds covered in white crystals at a medical marijuana cultivation center in Albion, Ill. (Associated Press file)
This Sept. 15, 2015 file photo shows marijuana plants with their buds covered in white crystals at a medical marijuana cultivation center in Albion, Ill. (Associated Press file)
Challenges and barriers in conducting cannabis and cannabinoid research
• Regulatory barriers, including the classification of cannabis as a Schedule I substance, that impede the advancement of cannabis and cannabinoid research

• Difficulty for researchers to gain access to the quantity, quality and type of cannabis product necessary to address specific research questions on the health effects

• Lack of a diverse network of funders to support research that explores the beneficial and harmful effects of cannabis use.

• Lack of conclusive evidence for the effects of cannabis use on short- and long-term health outcomes, improvements and standardization in research methodology.

Ind. Veteran Pushing For Legalization Of Medical Marijuana

U.S. Marijuana Party of Kentucky

By Barbara Brosher
Posted January 13, 2017

The American Legion of Indiana could consider a resolution this weekend that would encourage state lawmakers to develop a medical marijuana program.

The proposal comes from a Kokomo veteran who hopes medical marijuana could help veterans struggling with opioid addiction.

But, similar proposals have failed to gain traction at the statehouse.

Veteran Hopes Medical Marijuana Could Help Treat Physical, Emotional Pain

Veterans gather on a daily basis at the bar or around tables at the American Legion post in Martinsville to catch up with each other. The talk revolves around their families, politics and, lately, a proposal from another veteran to make medical marijuana legal in Indiana.

“People don’t know what kind of pain old men have. You can explain it to them, but nobody knows”

—James Ritter, Veteran

“If marijuana is medically available for older veterans that have a need for pain…

View original post 407 altre parole

Just eight individuals, all men, own as much wealth as the poorest half of the world’s population, Oxfam said on Monday in a report calling for action to curtail rewards for those at the top. As decision makers and many of the super-rich gather for this week’s World Economic Forum (WEF) annual meeting in Davos,…

via The World’s 8 Richest Men Are Now as Wealthy as Half the World’s Population — Fortune