No evidence for withdrawal symptoms from cannabis based medicinal extracts

February 24th, 2009
SafeAccessNow.org

In a press release issued February 24th 2009, GW pharmaceuticals reported that there is no evidence of withdrawal from long term use of Sativex, an oral cannabis spray. The study looked at 36 MS (Multiple Sclerosis) patients who used the medicine for over 3 years. The patients were divided into two groups for this 4 week investigation. One group kept using Sativex and the other switched to placebo (no drug). Of course, without their medicine, patient’s muscle spasms became worse. The link between cannabis for the treatment of spasms has been established for a long time, over 150 years ago. Yet, this is study may provide some unique evidence that cannabis, if allowed to be researched for medical use, can grow into a safe and effective medicine.

Before we can understand the meaning of these findings, we should take a minute to review how Sativex is made. Sativex is an extract of two cannabis varieties. This isn’t a crude extract, but precise and scientific removal of all the essential plant components. Cannabinoids and terpenes are extracted from soil grown plants which produce a specific ratio of the active ingredients. GW has different types of stable cannabis plants available for their work, such as varieties that have been cultivated to produce a certain cannabinoid or ingredient. Of the more than 70 cannabinoids that can be found on the plant, generally the two most common molecules are THC and CBD. Thus, GW basically combines a THC-rich and CBD-rich plant to maximize specific therapeutic actions (decrease muscle spasms) and minimize negative effects (withdrawal symptoms).

Combining different strains or varieties of cannabis to create a medicine with virtually no withdrawal or side effects may seem counter intuitive to some people or it may even sound like a plot for a Pineapple Express sequel. However, the individual compounds found in cannabis varieties, produce different beneficial effects and sometimes even opposite effects. With the help of science these compounds can be measured, plant materials can be mixed, extracted, and delivered with precision.Furthermore, not only were there no withdrawal symptoms reported but there were little or no negative effects reported that are usually associated with a long term THC treatment. Pure THC and cannabis (or cannabis extracts) have unique properties which separate them from each other.

This surprising detail may be partially due to misconceptions resulting from restrictions on cannabis research in the U.S; most of the public knowledge on the negative effects of cannabis comes from studies looking at the effects of pure THC. For lack of a better analogy, this is like studying the effects of beer by giving research subjects pure alcohol.

When given the opportunity and access to openly investigate cannabis, researchers can readily provide a cannabis medicine with symptom specificity. GW’s ongoing work demonstrates that with proper knowledge and scientific methods, a safe and effective medicine can be made from mixtures of soil grown cannabis plants.

Study Finds No Link Between Medical Heroin and Crime

February 24, 2009
Join Together.org

A researcher studying the effect of supervised injection sites on Montreal and Vancouver communities found no relation between providing heroin to drug addicts at medically supervised clinics and neighborhood crime, the Montreal Gazette reported Feb. 18.

Serge Brochu from the University of Montreal's School of Criminology studied neighborhoods in Montreal and Vancouver that hosted the North American Opiate Medication Initiative (NAOMI) -- a Canadian study in which participants received heroin under the supervision of nurses, doctors, psychiatrists and social workers.

"There's always this 'not in my back yard' attitude," said Brochu, the study's author. "It's good for the patient, but if it's not good for the community, (then) we have a problem."

Brochu and his team conducted repeat site visits, studied crime data, and interviewed residents, merchants, social workers and security guards to ascertain the effect of the NAOMI study on the neighboring community. They reported neither an increase in crime in the neighborhood nor deterioration in the neighboring community.

"This program should live and the government should continue to fund it," Brochu said, citing the beneficial effect on the health of the drug user and the lack of negative neighborhood impact.
Researchers have been advocating for continued funding for the clinic for nearly two years, but the office of Quebec's minister for social services said the final NAOMI report has yet to be analyzed.

Seattle's Top Cop to Be Obama's Drug Czar

February 13, 2009
Join Together.org

Seattle Police Chief R. Gil Kerlikowske will be the Obama administration's nominee as the next director of the Office of National Drug Control Policy (ONDCP), the White House has confirmed.

Multiple sources in the field also expect Tom McLellan, Ph.D., cofounder and CEO of the Treatment Research Institute at the University of Pennsylvania, to be named as deputy director of demand reduction at ONDCP. McLellan is a highly respected researcher who has done groundbreaking work in the areas of treatment quality and outcomes measurement.

A White House official confirmed Kerlikowske's nomination but not McLellan's; Kerlikowske and McLellan have both declined to comment.

Kerlikowske, 59, has served as chief of police in Seattle since 2000, and during his 36-year career in law enforcement was police commissioner in Buffalo, N.Y., and police chief in Fort Pierce, Fla., and Port St. Lucie, Fla. He is the current president of the Major Cities Chiefs Association.

If confirmed, Kerlikowske would replace interim ONDCP Director Ed Jurith, and succeed Bush administration drug czar John Walters.

"He has been very supportive of community-policing activities, human services and chemical-dependency programs," said Ken Stark, former director of the Washington Division of Alcohol and Substance Abuse and current head of the Snohomish County Human Services Department. "He is a team player and collaborative. Obviously his focus is in the law-enforcement arena, but he clearly understands the need for a healthy community and that that means more that just law enforcement -- it needs to include other parts of the system, including chemical-dependency treatment."

"The one thing I can say about Gil Kerlikowske is that he'll be a far better drug czar than his predecessor," said Norm Stamper, Kerlikowske's immediate predecessor as Seattle police chief and currently the head of the drug-policy reform group Law Enforcement Against Prohibition (LEAP). "He's an intelligent, thoughtful guy ... the jury's out on his views on the drug war. He opposed Seattle's I-75, which made simple marijuana possession the lowest enforcement priority in the city, but he's respected the law."

Kerlikowske is better known for his work on gun control than drug control, but has worked with local drug courts and recently backed a Seattle program that allows police officers to divert drug users to treatment or job programs rather than jail. He has been honored for his work in preventing youth crime and violence, and chairs the board of directors at Fight Crime: Invest in Kids, a law-enforcement group that supports effective youth crime-prevention efforts.

Washington State Rep. Roger Goodman, a member of the American Bar Association Standing Committee on Substance Abuse, has worked with Kerlikowske on the King County Bar Association's drug-policy project. "As a practical and nonideological person, he's going to allow rational reforms to proceed," said Goodman. "He understands that we can reform some criminal-justice practices to make them more humane and cost-effective without compromising public safety."

Drug-policy reformers noted that Seattle has taken a progressive tack on issues like needle exchange, medical marijuana, and overdose prevention. The Obama administration has expressed support for needle-exchange programs and reportedly is reining in Drug Enforcement Administration raids against medical-marijuana providers.

Ethan Nadelmann, executive director of the Drug Policy Alliance, called Kerlikowske's selection as drug czar a "potentially transformative moment."

"Kerlikowske is clearly familiar with drug policy reforms, and has not been a forceful opponent," according to Nadelmann. "Although a police chief may not be an ideal pick, given President Obama's call for 'shifting the paradigm, shifting the model, so that we focus more on a public health approach,' we remain hopeful that he has the potential to provide much needed national leadership in implementing the president's campaign commitments."

Harm Reduction Coalition Policy Update: The Obama Administration, Federal Ban on Syringe Exchange

Dear Colleagues:

Here is the first issue of the Harm Reduction Coalition Policy Newsletter.

It features an update on the Mental Health and Substance Use Professionals Sign-on Letter to President Obama that many of you signed. I have heard through the grapevine that politicians and drug policy people on all sides of the debate and at the highest levels were very aware of our efforts and the letter may have played a role in Rep. Ramstad not being selected for the Drug Czar position. You may have heard that Gil Kerlikowske, former police chief of Seattle was just selected for the Drug Czar position. While not a public health or substance use treatment specialist, there seem to be many good things to say about him including that while he was Seattle's police chief, he policed a city with some of the most progressive drug policy in the country turning from a criminal justice to a public health approach to substance use.

For those of you who haven't yet, there is still time to sign on to the letter to put in a vote for science and rationality rather than ideology at the helm of SAMHSA. The director of SAMHSA has not yet been selected. Visit my blog accessed on my website on the lower left of the homepage to read letters and journalists' opinions about this issue.

Sign the letter if you agree with our position! And, please forward this to others whom you think may be interested in the issue. This is an ongoing work in progress. As Russell Simons said at a recent conference at the New York Academy of Medicine, We elected them on their promises and now we need to keep the heat up to make them follow through!

Best,

Andrew Tatarsky, PhD
Harm Reduction Psychotherapy and Training Associates
New York City
212-633-8157

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Harm Reduction Coalition Policy Update, February 2009

Special Federal Edition

A new administration and a new Congress promise new opportunities for harm reduction advocates. This inaugural edition of the Harm Reduction Coalition Policy Update will map out some of the possibilities.

Inside This issue:

• The Obama Administration
• Federal Ban on Syringe Exchange
• Harm Reduction In the News

Click here to view online PDF of newsletter w/ photographs

THE OBAMA ADMINISTRATION

Sign of the times: “The President also supports lifting the federal ban on needle exchange, which could dramatically reduce rates of infection among drug users.”-- posted on the White House website as soon as President Obama was sworn in to office.

Officials and key staff in federal agencies charged with tackling drug user health issues have for years kept harm reduction at arms length, with issues such as syringe exchange treated as politically radioactive. The Obama administration offers hope that harm reduction will finally have a place in the policies and priorities of federal government, after years of dismissal, silence, distortion, and suppression.

At this time, permanent appointments to key posts – the directors for the CDC (Centers for Disease Control and Prevention), SAMHSA (Substance Abuse and Mental Health Services Administration), and the ONDCP (Office of National Drug Control Policy), and the U.S. Global AIDS Coordinator – have not been announced.

An early rumor that the Obama transition team was considering former Congressman James Ramstad (R, MN) for ONDCP Director (commonly known as the “Drug Czar”) sparked a petition drafted by Dr. Andrew Tatarsky of Harm Reduction Psychotherapy and Training Associates challenging Ramstad’s qualifications based on factors including his voting record against syringe
exchange. The petition has been signed by over 450 substance abuse and mental health treatment professionals to date.

For now, ONDCP counsel Edward Jurith has been named interim director. Of particular
concern to harm reduction advocates is a letter that he wrote to the New York Times, published
October 9, 2001, when he was last acting ONDCP director under the Bush administration, in response to an article on DanceSafe ‘’Harm reduction’ is a political movement, not sound policy
based on science. Far from reducing harm, its advocates promote policies that lead to increased usage rates and a false sense of security for Ecstasy users.

“Research, not rhetoric, should be used to educate potential drug users. So-called harm reduction programs only obfuscate the truth: Ecstasy has been proven to cause longterm
brain damage resulting in memory loss, depression, paranoia and confusion. At best, harm reduction is an approach that concedes drug abuse prevention is impossible.Pretending harmful activity will be reduced if it is passively condoned is irresponsible."

“Increasing help for those dependent on drugs is better than decreasing harm”

HRC will continue to monitor these appointments and demand that officials in key roles at federal agencies and offices demonstrate an understanding of the role and value of harm reduction, a respect for science and evidence in guiding policy, and a commitment to rejecting the previous administration’s politicization of harm reduction.

FEDERAL BAN ON SYRINGE EXCHANGE

Momentum continues to increase towards lifting the ban prohibiting the use of federal funds for syringe exchange. Rep. Jose Serrano (D, NY) has reintroduced The Community AIDS and Hepatitis Prevention Act (H.R. 179), which would eliminate all restrictions on use of federal funding for syringe exchange. The bill currently has 39 cosponsors, listed here (http://thomas.loc.gov/cgibin/bdquery/z?d111:HR00179:@@@P).

HRC is asking everyone to contact your member of Congress and urge them to cosponsor the bill. Take action here.

HRC is also leading a grassroots campaign to lift the ban, and seeking coordinators in every state. If you’re interested in spending a few hours a week volunteering, contact Hilary McQuie at (510) 444-6969 or mcquie@harmreduction.org later in February, and work to make sure that language extending the ban is removed from the annual spending bills (known as Appropriations). Background materials and advocacy documents are available on HRC’s website here.

Harm Reduction in the News

HRC’s Executive Director Allan Clear has been blogging about harm reduction policy and the
Obama administration at Alter-Net and the Huffington Post

Obama's HIV Fix: Syringe Exchange Is a Major Component
(posted January 17, 2009)

Obama's Choice: Sane U.N. Drug Policy or the Same Old Failed War-on-Drugs Routine?
(posted January 27, 2009)

Addiction and Babies (1 Letter): Letters to the Editor, NY Times

Dr. Andrew Tatarsky will be presenting on a panel at the full day training conference, Drugs, Pregnancy, and Parenting: What the Experts in Medicine, Social Work and the Law Have to Say, for legal and mental health professionals sponsored by National Advocates for Pregnant Women. He will make a plea for the need for a complex, individualized, multi-faceted understanding of the relationship between drug use and a parent's capacity to parent in making decisions about when children are best served by staying with drug-using parents and when they should be removed. He will also be discussing the implications of this understanding of substance use for our view of indications of positive change and appropriate treatment for substance-using parents.

---

Published: February 2, 2009
NY Times, Letters to the Editor

To the Editor:

“The Epidemic That Wasn’t” (Jan. 27) brings important attention to an area where media hype and junk science have provided the basis for counterproductive interventions into the lives of pregnant women and their families. The story, however, suggests that it was only in the 1990s that many women were prosecuted and jailed based on this medical misinformation. National Advocates for Pregnant Women has documented more than 100 arrests since 2000, many resulting in incarceration.

Many women who love their children cannot overcome an addiction, whether to cigarettes or an illegal drug in the short term of pregnancy. Junk science that exaggerates the risks should not provide the basis for transforming their health problems into crimes.

Lynn M. Paltrow

New York

The writer is executive director of National Advocates for Pregnant Women.
Science Times welcomes letters from readers. Those submitted for publication must include the writer’s name, address and telephone number. E-mail should be sent to scitimes@nytimes.com. Send letters to Science Editor, The New York Times, 620 Eighth Avenue, New York, N.Y. 10018.

Crack - The Epidemic That Wasn’t

Dr. Andrew Tatarsky will be presenting on a panel at the full day training conference, Drugs, Pregnancy, and Parenting: What the Experts in Medicine, Social Work and the Law Have to Say, for legal and mental health professionals sponsored by National Advocates for Pregnant Women. He will make a plea for the need for a complex, individualized, multi-faceted understanding of the relationship between drug use and a parent's capacity to parent in making decisions about when children are best served by staying with drug using parents and when they should be removed. He will also be discussing the implications of this understanding of substance use for our view of indications of positive change and appropriate treatment for substance-using parents.

In a 1988 photo, testing a baby addicted to cocaine.

By SUSAN OKIE
Published: January 26, 2009
The New York Times

BALTIMORE — One sister is 14; the other is 9. They are a vibrant pair: the older girl is high-spirited but responsible, a solid student and a devoted helper at home; her sister loves to read and watch cooking shows, and she recently scored well above average on citywide standardized tests.

There would be nothing remarkable about these two happy, normal girls if it were not for their mother’s history. Yvette H., now 38, admits that she used cocaine (along with heroin and alcohol) while she was pregnant with each girl. “A drug addict,” she now says ruefully, “isn’t really concerned about the baby she’s carrying.”

When the use of crack cocaine became a nationwide epidemic in the 1980s and ’90s, there were widespread fears that prenatal exposure to the drug would produce a generation of severely damaged children. Newspapers carried headlines like “Cocaine: A Vicious Assault on a Child,” “Crack’s Toll Among Babies: A Joyless View” and “Studies: Future Bleak for Crack Babies.”

But now researchers are systematically following children who were exposed to cocaine before birth, and their findings suggest that the encouraging stories of Ms. H.’s daughters are anything but unusual. So far, these scientists say, the long-term effects of such exposure on children’s brain development and behavior appear relatively small.

“Are there differences? Yes,” said Barry M. Lester, a professor of psychiatry at Brown University who directs the Maternal Lifestyle Study, a large federally financed study of children exposed to cocaine in the womb. “Are they reliable and persistent? Yes. Are they big? No.”

Cocaine is undoubtedly bad for the fetus. But experts say its effects are less severe than those of alcohol and are comparable to those of tobacco — two legal substances that are used much more often by pregnant women, despite health warnings.

Surveys by the Department of Health and Human Services in 2006 and 2007 found that 5.2 percent of pregnant women reported using any illicit drug, compared with 11.6 percent for alcohol and 16.4 percent for tobacco.

Click here to continue reading article at The New York Times