Marinol and Syndros synthetic THC Max daily 20mg168mg and Cesamet THC analog anorexia associated with weight loss in patients with Acquired Immune Deficiency Syndrome AIDS nausea and vomiting associated with cancer chemotherapy in patients who have failed to respond adequately to ID: 1043341
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1. FDA Approved Cannabis ProductsMarinol and Syndros (synthetic THC Max daily 20mg/16.8mg) and Cesamet (THC analog) - anorexia associated with weight loss in patients with Acquired Immune Deficiency Syndrome (AIDS), nausea and vomiting associated with cancer chemotherapy in patients who have failed to respond adequately to conventional antiemetic treatments. Epidiolex (CBD) - treatment of seizures associated with Lennox-Gastaut syndrome, Dravet syndrome and tuberous sclerosis in patients 1 years of age and older6/2/20211Medical Benefits of Cannabis
2. Limited evidence that cannabis may alleviate neuropathic pain in some patients Insufficient evidence exists to demonstrate analgesic effects in patients with other types of chronic painUse of Cannabis for chronic pain is under studied Sativex (nasal spray 2.7mg THC/2.5 mg CBD) – modest short-term improvements in pain related to rheumatoid arthritis. Max 16.2 mg / day. Approved outside of US for spasticity associated with MS.6/2/20212Medical Uses of Non-medical Cannabis
3. Cannabis dependence: 9-10% lifetime risk, 17% with initiation during adolescence20 year prospective study: Persistent and dependent users lost 6 IQ points and Nonusers gained 1 IQ pointConclusive or Substantial Evidence for a statistical association between cannabis smoking*: More frequent chronic bronchitis episodes (long-term cannabis smoking)Increased risk of motor vehicle crashesLower birth weight of offspring (maternal cannabis smoking)the development of schizophrenia or other psychoses, with the highest risk among the most frequent users *National Academy of Sciences6/2/20213Known Potential Harms Cannabis (THC)
4. Health Concerns among Cannabis UsersAlcohol - alcohol use disorder were six times more likelyTobacco (nicotine) use disorder about six times more likely4.6 x more likely to abuse opioidsHigher risk of cocaine and methamphetamine use2-3 x increased risk of depression2-3 x increased prevalence of schizophrenia compared with nonusers. Stronger with earlier age of onset of use (eg, early adolescence), more intense cannabis use.
5. Hospitalizations Associated with Substance Abuse6/2/20215Alcohol OpioidsCannabisCocaineStimulants201617,0045,1969,9824,3693,991201716,8965,82811,0304,8795,101201816,8255,25110,6594,8075,673201916,8724,93810,5704,6776,0932020 (Q1-Q3) 12,1623,4398,0253,3204,651
6. Neonatal Hospitalizations6/2/20216Neonatal Hospitalizations Related to Maternal Drug Use by Types of Drugs, Mississippi, 2019Type of DrugHospital Stays PercentUnknown/other drugs of addiction40547%Cannabis25530%Cocaine587%Opiates546%Amphetamines415%Neonatal withdrawal syndrome13916%These groups are not mutually exclusive and their sum is higher than the total number of discharges.
7. Demographics 55.2% Caucasians; 85.5% covered by Medicaid and 8.1% uninsured 6/2/20217
8. MSDH Board Objectives of MS Medical Marijuana ProgramEnable availability of MM for qualifying patientsProtect vulnerable populations (youth, pregnant women) Community Impact MitigationCompliance (prevent fraud/unintended effects)Communicate with public program development processPrevent drug diversion Prevent criminal involvement Minimize equity issues Prevent substance abuse / adverse consequencesFiscal sustainability Ensure Product Safety
9. Enable availability of MM for qualifying patientsRun program efficientlyActive involvement of physician community and Medical LicensureProtect vulnerable populations (youth, pregnant women) Limit THC to medicinal levelsNon-smoking formatsEnsure parental approval / extra safety Limit advertising and restrict to packaging not appealing to kids or for recreational useCommunity Impact MitigationLimit advertisingSmart zoningFund support services (ie mental health, law enforcement)Compliance (prevent fraud/unintended effects)Seed-to-sale tracking essentialLimit to indoor/greenhouse growing6/2/20219What we learned along the way…
10. Communicate with public program development processRegular broadcasted board meetingsCommunity town-hallPrevent drug diversionSeed-to-sale trackingNon-smoking formatsRestrict certain felonies from businessIndoor/greenhouse growing only Prevent criminal involvement Seed-to-sale trackingRestrict certain felonies from businessIndoor/greenhouse growing only Minimize equity issues Very difficult – high barriers to entryRisks of low licensing feesPermit non-violent drug possession felonies to participateAncillary service opportunities6/2/202110
11. Prevent substance abuse / adverse consequencesUse medicinal THC dosesNon-smoking formatsEnsure physician accountabilitySupport mental health servicesAdvertising and packaging regulationsFiscal sustainabilityAdequate fees to support operations Ensure Product Safety Robust lab safety programProper packaging and labelling6/2/202111