A Patchwork of Cannabis Laws Creates Health Risks, Study Finds

 Step back five years.  The only use for Cannabis was for a medical reason and required a doctor's prescription. Its accessibility was very limited.

So, back to the future today. What is new?

A new report calls for public education and closing of legal loopholes to keep the public safe.

The News

As more states have legalized the sale of cannabis, a fractured and inconsistent legal framework has emerged across the country that has prioritized sales income and tax revenue over public health, a new report finds.

The report, issued Thursday by the National Academies of Sciences, Engineering, and Medicine, describes an “urgent need for a coordinated public health response.” The Academies, a nonprofit advisory group of the nation’s leading scientists, said that such a response should include a federally-led campaign to educate parents, children, and others about the risks of an increasingly potent drug.

Among the other suggestions, the report also calls for a lifting of research restrictions on cannabis. In recent years, many claims have been made about the medicinal and other health effects of the drug but often without substantiation from science.

Potency

Currently, 24 states, the District of Columbia, and two U.S. territories have legalized the sale of cannabis for recreational use, according to the National Conference on State Legislatures. In 13 other states, cannabis is legal for medicinal use.

Even as a patchwork of laws and regulations have emerged, the potency of cannabis products has surged, as measured by the growing concentration of THC, the main psychoactive compound in cannabis. 

The rapid increases have left the public unaware of the health risks, particularly to young people, pregnant women and seniors, according to Yasmin Hurd, director of the Addiction Institute at the Icahn School of Medicine and the vice chair of the committee that issued the latest report.

Given the potency changes and the proliferation in varieties of products, “cannabis is no longer the same drug as what people thought they were voting on,” Dr. Hurd said. “There is a consensus that we need educational campaigns.”

Dr. Hurd emphasized a related key finding of the report: There is a booming industry for unregulated products derived from hemp, including ones containing delta-8 THC, another psychoactive substance that some manufacturers have learned to extract from hemp. The report calls on Congress to address what Ms. Hurd called “loopholes” that have led to the spread of such products.

Recommendations

The report was sponsored by the Centers for Disease Control and Prevention, the National Institute on Drug Abuse and the National Cancer Institute, among other funders. The report, in addition to seeking action at the federal level, recommended action at the state level, including the adopting of product standards, like those for food, medicine, and dietary supplements.

States that have decriminalized or legalized cannabis should follow suit by sealing criminal records or expunging cases of prior “low-level” cannabis-related offenses, the report noted. And, the report added, the states should better enforce minimum-age requirements to prevent access to the drug to young people, just as the states “would for alcohol or tobacco sales.”

The report also called for states to require “training and certification” for workers at cannabis retailers. The training, the report said, “should address the effects of cannabis on humans, prevention of sales to minors” and “warnings about cannabis-impaired driving.”

The final incentive is tax revenue, which is considerable.

When purchasing cannabis in California, consumers should be aware that the effective tax rate can be substantial due to the combination of state, local, and excise taxes. Always check local regulations as they can change frequently.  n California, the taxation of cannabis involves several layers, including state excise taxes, sales taxes, and local taxes. Here are the key components:

State Excise Tax

Rate: 15% of the retail price.

Applicable to: All sales of cannabis and cannabis products.

Sales Tax

Rate: Typically ranges from 7.25% to 10.25%, depending on the local jurisdiction.

Applicable to: All cannabis sales.

Local Taxes

Many local governments impose additional taxes on cannabis businesses, which can vary significantly. These can be based on:

Gross receipts: Often a percentage of total sales, ranging from 1% to 10%.

Square footage: A tax based on the size of the facility.

Additional Considerations

Cultivation Tax: There is also a cultivation tax on cannabis flowers, leaves, and immature plants, which varies based on the product type.

With the increased use of Cannabis and its new potency research is indicated. 

Sources of Funding

Government Grants

National Institutes of Health (NIH): Provides grants for research on the health effects of cannabis.

National Institute on Drug Abuse (NIDA): Offers funding specifically for studies related to cannabis and its effects.

State-level initiatives: Some states allocate funds for cannabis research, particularly in contexts of medical use.

Private Foundations

Various non-profit organizations and foundations are dedicated to cannabis research, funding studies on its medical benefits, social impacts, and economic effects.

Universities and Academic Institutions

Many universities are establishing dedicated centers or programs for cannabis research, often funded through grants, donations, and partnerships with private sectors.

Pharmaceutical Companies

As the market for cannabis-derived products grows, pharmaceutical companies are investing in research to develop cannabis-based medications.

Crowdfunding

Some researchers turn to crowdfunding platforms to finance specific projects or studies related to cannabis.

Areas of Research

Funding supports a wide range of research areas, including:

Medical applications (pain management, epilepsy, mental health).

Social and economic impacts of legalization.

Agricultural practices related to cannabis cultivation.

Public health studies focusing on consumption patterns and effects.

Challenges

Despite the increasing funding, challenges remain:

Regulatory Barriers: Cannabis research is often hindered by federal regulations and the classification of cannabis as a Schedule I substance.

Stigma: Ongoing stigma can affect the willingness of some institutions and funders to support cannabis research.

Conclusion

The landscape of cannabis research funding is evolving, with more opportunities arising as societal views shift. Researchers interested in this field should stay informed about funding opportunities and regulatory changes.

THE WAR ON IVERMECTIN

Desperate times call for desperate measures.

During 2020 through 2023 the COVID-19 pandemic tore through most of the world.

The COVID-19 Pandemic: A Timeline from 2020 to 2023

The COVID-19 pandemic, caused by the SARS-CoV-2 virus, profoundly impacted the world from early 2020 through 2023. This article provides a brief overview of the key events and developments during this period.

2020: The Emergence of a Global Crisis

In December 2019, the first cases of a novel coronavirus were reported in Wuhan, China. By March 2020, the World Health Organization (WHO) declared COVID-19 a pandemic. Countries around the globe implemented lockdowns, travel restrictions, and social distancing measures to curb the virus's spread. The global economy was severely impacted, requiring government subsidies to offset decreased income for businesses. The infusion of billions of dollars fueled inflation which lasted well into 2004 and beyond. Healthcare systems faced unprecedented challenges, and misinformation about the virus proliferated online. 

2021: Vaccination Rollouts and Variants

The year 2021 marked a turning point with the rapid development and distribution of vaccines. The Pfizer-BioNTech, Moderna, and Johnson & Johnson vaccines received emergency use authorization in many countries. Mass vaccination campaigns began, significantly reducing hospitalizations and deaths. However, the emergence of variants, such as Delta and later Omicron, posed new challenges, leading to renewed restrictions and public health measures. Early on the manufacturing process using mRNA techniques was questioned, as some batches of vaccines were contaminated with DNA and questions arose about nanoparticles and lipids included in vaccines to increase absorption.  Severe side effects, although rare (myocarditis, clotting disorders, and neurologic effects became apparent.

Epidemiology of vaccine‐related myocarditis

Until recently, vaccine‐associated myocarditis has been reported in the literature as a very rare adverse event predominantly in the context of live attenuated smallpox vaccine and has only been described in case reports for other vaccines. 14 The implementation of the COVID‐19 vaccine using novel medical technology (i.e. RNA‐based vaccines) into phase 3 trials and their clinical implementation was followed by population‐based tracking of outcomes and complication rates. For example, the United States deployed the passive reporting Vaccine Adverse Event Reporting System (VAERS) that tracked outcomes in about 200 million individuals and similar systems are in place in numerous other countries, in particular the United Kingdom and Israel. Using information from this large database, it was quickly recognized that there was a low, but consistent rate of patients presenting with post‐vaccination myocarditis and/or pericarditis. For example, data obtained from VAERS have shown that the incidence peaks in young males of 15–17 years with 105.9 cases per million doses administered and identified the second dose as the highest risk compared to the first dose.2022: Adaptation and Living with COVID-19

By 2022, many countries began to adapt to living with the virus. Vaccine booster shots were recommended, and public health strategies shifted toward managing COVID-19 as an endemic virus. Many regions relaxed restrictions, allowing economies to reopen. However, disparities in vaccine access remained a significant issue, particularly in low-income countries.

Politicization of the COVID-19 pandemic

The effects of social media and mainstream media became conflicted. 

2023: Ongoing Challenges and Future Outlook

As of 2023, COVID-19 continued to circulate, but the severity of the illness for most vaccinated individuals decreased. Public health agencies emphasized the importance of vaccination and booster shots, particularly for vulnerable populations. The pandemic highlighted the need for robust healthcare systems and global cooperation in responding to health crises.

The Crisis in Treatment

Early on patients were placed on ventilators and steroids. The outcomes were poor.

In desperation, other drugs were suggested, even though they were off-labeled by the FDA. 

The Use of Ivermectin for COVID-19

Ivermectin is an antiparasitic medication traditionally used to treat various infections, including those caused by parasites such as river blindness and scabies. During the COVID-19 pandemic, ivermectin gained attention as a potential treatment. Here’s an overview of its use in this context:

1. Initial Interest

Early in the pandemic, laboratory studies suggested that ivermectin might inhibit the replication of SARS-CoV-2, the virus responsible for COVID-19. This led to speculation about its effectiveness in treating COVID-19.

2. Clinical Trials and Studies

Numerous clinical trials were conducted to evaluate the efficacy of ivermectin for COVID-19. However, many of these studies had limitations, including small sample sizes, methodological flaws, and inconsistent results.

Major health organizations have reviewed the available evidence. The World Health Organization (WHO) and the U.S. Food and Drug Administration (FDA) have stated that there is insufficient evidence to support the use of ivermectin for treating COVID-19 outside of clinical trials.

3. Regulatory Stance

In February 2021, the FDA issued a warning against the use of ivermectin for COVID-19 outside approved uses, highlighting potential risks, especially when taken in doses meant for animals.

The WHO also recommended against the use of ivermectin for COVID-19, advising that it should only be used in clinical trials.

4. Public Perception and Controversy

Despite the lack of strong evidence, ivermectin became a focal point in discussions about alternative treatments for COVID-19. Some individuals and groups advocated for its use, leading to polarized views.

Misinformation regarding the drug's efficacy and safety spread widely, complicating public understanding.

Conclusion

The COVID-19 pandemic reshaped societies globally, leaving lasting effects on public health, economies, and daily life. The lessons learned from this crisis will be crucial in preparing for future pandemics and improving global health resilience.

Censorship by Social Media. (Facebook, and Twitter) banned some scientists from posting evidence of untoward side effects and even death from vaccinations in certain groups of people . Young healthy adolescents were succumbing to cardiac sudden death.

The COVID-19 vaccination rollout has led to various medicolegal cases and issues, primarily revolving around the following areas:

1. Vaccine Adverse Effects

Injury Claims: Some individuals have reported severe adverse reactions to vaccines, leading to claims for compensation. In the U.S., the Countermeasures Injury Compensation Program (CICP) was established to address these claims.

Legal Actions: Lawsuits have emerged from individuals alleging that they suffered long-term health issues as a result of vaccination.

2. Mandates and Employment

Discrimination Claims: Employees have filed lawsuits against employers mandating vaccines, claiming violations of personal liberties or discrimination based on medical or religious exemptions.

Wrongful Termination: Some cases involve employees who were terminated for refusing to get vaccinated, leading to disputes over employment rights. These cases even occurred in the military resulting in discharges other than honorable.

3. Informed Consent

Lack of Information: Legal actions have been initiated based on claims that individuals were not adequately informed about the risks and benefits of the vaccines, challenging the principle of informed consent.

4. Vaccine Distribution and Equity

Negligence Claims: Some cases focus on allegations of negligence in vaccine distribution, particularly in underserved communities, raising issues of equitable access.

Public Health Policies: Legal challenges have been made against government policies perceived as discriminatory or inequitable.

5. Liability of Manufacturers

Product Liability: Discussions around the liability of pharmaceutical companies for adverse reactions have gained traction, even with protections afforded by legislation like the PREP Act in the U.S.

Conclusion

The legal landscape surrounding COVID-19 vaccinations is complex and continues to evolve. As the pandemic progresses, ongoing litigation may further shape the intersections of public health, personal rights, and legal accountability.

 Other Treatments

Several medications have been recommended or authorized for the treatment of COVID-19, particularly for those at higher risk of severe illness. Here’s an overview of key options:

1. Antiviral Medications

Remdesivir (Veklury): An antiviral drug that has been shown to reduce the duration of hospitalization in some COVID-19 patients.

Paxlovid (Nirmatrelvir/ritonavir): An oral antiviral treatment that has been effective in reducing the risk of severe illness and hospitalization in high-risk patients when taken early in the course of infection.

Molnupiravir (Lagevrio): Another oral antiviral that may reduce the risk of hospitalization for certain patients, although its use is less common than Paxlovid.

2. Monoclonal Antibodies

Bamlanivimab and Etesevimab: These monoclonal antibodies were authorized for emergency use but have been less effective against certain variants of the virus.

Casirivimab and Imdevimab: Another combination of monoclonal antibodies that was previously used but may also be affected by variants.

Tixagevimab and Cilgavimab (Evusheld): Used for pre-exposure prophylaxis in individuals who are immunocompromised or cannot be vaccinated.

3. Corticosteroids

Dexamethasone: A corticosteroid shown to reduce mortality in hospitalized patients requiring supplemental oxygen or mechanical ventilation. It helps by reducing inflammation in the lungs.

4. Other Supportive Treatments

Baricitinib: An oral Janus kinase (JAK) inhibitor that may be used in combination with remdesivir for hospitalized patients requiring supplemental oxygen.

Tocilizumab: An immunosuppressive drug used to treat severe cases of COVID-19 by reducing inflammation.

5. Supportive Care

Oxygen Therapy: For patients with low oxygen saturation, supplemental oxygen is critical.

Fluids and Electrolytes: Ensuring hydration and correcting any electrolyte imbalances is essential for recovery.

Conclusion

The treatment landscape for COVID-19 is continually evolving, with ongoing research and updates from health authorities. It's crucial for individuals to consult healthcare professionals for personalized treatment plans and to stay informed about the latest recommendations. Vaccination remains the primary tool for preventing severe illness from COVID-19.

As time evolved our understanding of COVID has improved. Will we do better for the next pandemic?

The resulting chaos reduced trust in the FDA and public health authorities.

In 2024 only 20% of Americans signed up for a booster.

THE DISINFORMATION PLAYBOOK

MEDICAL GASLIGHTING

Ready to read the shocking tell-all about medical gaslighting?! 🫣🔥

Well, you *almost* can! Just nine more days until MEDICAL GASLIGHTING: How to Get the Care You Deserve in a System That Makes You Fight For Your Life is released. But you can pre-order your copy now— or pick up a copy anywhere books are sold on October 1st. 

Do you often feel dissatisfied with your recent visit to your doctor? Whether it is your primary care doctor or a specialist, you need to ask questions and not be passive about your diagnoses and treatments. If your physician is truly good, he/she will gladly answer your questions. Most physicians are on a tight schedule and sometimes only spend ten to fifteen minutes with each patient. Don't let them leave until you are satisfied with your questions. A quality physician will always take time to answer important questions.   If they don't it is time to find a new doctor.

Medical Gaslighting by Ilana Jacqueline offers her excellent new book.

For women, the possibility of experiencing medical gaslighting—having a health care provider dismiss or ignore their concerns without considering appropriate testing or creating a treatment plan—has always been a very real and present danger, with consequences ranging from self-doubt and emotional stress to delayed diagnosis and death. And being a woman of color, transgender, or disabled only compounds the risk.

Today, more women are aware of medical gaslighting than ever—but awareness isn’t enough. In Medical Gaslighting, you’ll equip yourself with the tools you need to be fully heard at every step of the process, including:

Mastering the ability to request, revise, and read your electronic medical records so you and your medical team are on the same page. Responding effectively when you recognize the signs, language, and scenarios associated with medical gaslighting. Give yourself a fighting chance against common medical bias by being mindful of how you present yourself as a patient.

With expert advice and stories from women across the medical spectrum who fought medical gaslighting and lived to tell their stories, patient advocate (and rare disease patient), Ilana Jacqueline provides a combat guide for increasing your confidence—and success—when advocating for your health. You might have to get naked in the exam room, but you don’t have to walk in unarmed. 

Medical Gaslighting is your guide to taking control of your healthcare.

Effective treatments for COVID-19 that have been supported by scientific evidence

Effective treatments for COVID-19 that have been supported by scientific evidence include:

Antiviral Medications:

Paxlovid (nirmatrelvir/ritonavir): An oral antiviral treatment that effectively reduces the risk of severe illness in high-risk patients.

Remdesivir: An antiviral drug administered intravenously that is used for hospitalized patients and has been shown to reduce recovery time.

Monoclonal Antibodies:

Bamlanivimab and Etesevimab: These monoclonal antibodies can help reduce viral load and the severity of illness in certain patients.

Casirivimab and Imdevimab: Another combination of monoclonal antibodies used for treatment in non-hospitalized patients at high risk.

Corticosteroids:

Dexamethasone: This steroid has been shown to reduce mortality in hospitalized patients requiring oxygen or mechanical ventilation.

Supportive Care:

Oxygen therapy, fluids, and other supportive measures are critical for managing patients with severe symptoms.

Vaccination:

While not a treatment for active infection, vaccines have been shown to significantly reduce the severity of illness, hospitalization, and death.

Other Treatments:

Baricitinib: An oral medication that can be used in combination with remdesivir for hospitalized patients.

Tocilizumab: An anti-inflammatory drug that may be used for patients with severe COVID-19 to reduce inflammation.

These treatments are only recommended for severe illness.

CDC recommendations

Clinical Trials for COVID

Medline (National Library of Medicine) (NIH)

Federall Trade Commission Sues Pharmacy Benefit Managers fo Price Collusion

The @FEDERAL TRADE (FTC) has filed a complaint against the three largest pharmacy benefit managers (PBMs)—CVS Caremark, Express Scripts by Evernorth, and Optum Rx—for inflating insulin prices and restricting access to affordable medications.

Key Allegations in Complaint:

▶ PBMs Inflated Insulin Prices: Caremark, Express Scripts, and OptumRx created a rebate system prioritizing high list prices, causing insulin prices to soar. According to the FTC, these PBMs "systematically excluded" lower-cost insulins in favor of higher-priced options to "drink down the tasty…rebates."

▶ Patients Pay the Price: Vulnerable patients, particularly those with deductibles or coinsurance, were forced to pay more out of pocket. “Millions of Americans with diabetes need insulin to survive, yet their insulin drug costs have skyrocketed…thanks in part to powerful PBMs and their greed,” said Rahul Rao, FTC Deputy Director.

▶ Artificial Price Inflation: The average list price of insulin skyrocketed from $21 in 1999 to over $274 by 2017. The FTC accuses the PBMs of driving this increase through their "chase-the-rebate strategy."

▶ Exclusion of Lower-Priced Insulins: Despite more affordable insulin options, the PBMs blocked them from formularies, prioritizing products with higher rebates. The FTC alleges this behavior "forced patients to pay more for life-saving medication."

▶ The FTC aims to end these exploitative practices. “Caremark, ESI, and Optum…have extracted millions of dollars off the backs of patients who need life-saving medications," said Rao. The FTC's action is a step towards "fixing a broken system" and restoring competition to lower consumer drug prices.

 

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