Apr 2, 2018 - The anti-cannabis campaign was full of incendiary sloganeering which strongly implied that cannabis use by
FOR IMMEDIATE RELEASE DATE: April 2, 2018
CONTACT: Christine Stenquist EMAIL:
[email protected]
TRUCE Utah Responds to UMA’s Critique of the Utah Medical Cannabis Initiative UMA’s March 30 press release contains numerous undocumented assertions and accusations, any of which could be responded to at length. This is TRUCE’s initial response to a number of the most egregious remarks: The Association misidentifies the initiative in their release’s title, not just in one, but two key ways. It’s the “Utah Medical Cannabis Initiative,” not the “Utah Marijuana Initiative.” The initiative is entirely medical in nature, and saying otherwise is meant to alarm the public by evoking the idea it is “recreational.” Further, deliberately changing “cannabis” to “marijuana” is not minor. UMA uses it selectively throughout their release to reinforce the negative cast of all their claims. Such bald misstatements are beneath a professional group purporting to be the state’s leading physicians’ organization, as the only logical purpose is to delegitimize the initiative before citing a single fact. TRUCE never uses “marijuana” to refer to medicinal cannabis – for reasons worth clarifying at some length before turning to UMA’s claims. The same name change was a key tactic used in justifying the prohibition of medicinal cannabis in 1937. Prior to this, the plant was universally known – to the public and in the US Pharmacopoeia to the many physicians who used it as a first line remedy – simply as cannabis. Those behind the prohibition campaign – a coalition of special interests described in many histories - deliberately began referring to cannabis by the little known slang term “marijuana” which (not accidentally) sounded vaguely Spanish – in order to associate personal recreational use of the plant with Mexico and Mexican immigrants. The anti-cannabis campaign was full of incendiary sloganeering which strongly implied that cannabis use by Mexican and African Americans (called something less complementary at that time) was infecting the country’s culture with hard narcotics for nefarious purposes. The 1937 law used an even more Spanish-sounding spelling: “marihuana,” so the UMA is borrowing from an old and discredited playbook from the very beginning. The release goes on to make numerous demeaning and even inflammatory accusations. The legally constituted Political Interest Committee (PIC) sponsoring the initiative, the Utah Patients Coalition (UPC) is labeled “so-called.” This is an uncalled for slur on the same level as the misnaming.
The UMA further asserts that none of the backers of the initiative speak “for the majority of .. patients.” We’ll allow that this is true, although most of TRUCE’s work involves frequent contact with actual patients, or patients who would qualify to use the medicine if the measure is enacted, and most TRUCE members are such patients. So we would ask what outreach UMA has made to this whole class of potential patients, and what valid conclusions have they reached via this outreach? We suspect the answer is very little to none. We also question whether the UMA universally speaks “for the physicians of Utah” – as a) to our knowledge, a majority of Utah physicians are not members, b) according to the medical director of TRUCE’s Advisory Board, Dr. Andrew Talbott, a pain medicine practitioner, most of the board of the UMA practice in specialties where they would not normally see or be asked to recommend for many medical cannabis candidates, and c) as for their scientific opinion of cannabis medicine, the UMA is not primarily a research or clinically-focused organization. According to their own website, “Over the decades since its inception, UMA has evolved into the state's foremost advocacy arm for the profession, protecting and enhancing the environment in which medicine is practiced in Utah, while providing membership benefits to assist in the day to day practice of the profession.” Please note also that the press release was written not by physicians, but UMA’s nonphysician Executive Director. The next paragraph contends that “Supporters have used images and stories of suffering patients to disguise their true aim: opening another market for their products and paving the way for recreational use of cannabis in Utah.” Neither TRUCE nor UPC has ever advocated for legal personal use of cannabis in Utah. TRUCE has often quoted polls showing ¾ of Utahns do not favor this, and we are aligned with the will of Utahns. To aver otherwise is basically a libelous contention about our organization. UMA also asserts “this initiative is not about medicine,” when in fact it is all about introducing a valuable new form of medicine backed by thousands of scientific publications which is being successfully used by between two to three million patients in the US. The paragraph also refers to “FDA-approved cannabis medicines” (the one instance where UMA deigns to use the word cannabis when it has the FDA seal of approval, further showing it well knows the term “marijuana” is one of disparagement). Hundreds of scientists, many at prestigious institutions continue to pursue serious research even without the imprimatur of the FDA and despite unconscionable hindrance in their academic and medical pursuits by the DEA, which keeps cannabis in a “Catch 22” where it lacks FDA-approved research, to determine whether the FDA feels it’s safe and effective, but where the antiquated drug schedules of the DEA are employed to
prevent that very research from going forward, despite cannabis’ unmatched profile among all clinical agents for low toxicity. UMA notes: “Anyone could avoid prosecution simply by saying (whether true or not) they have some illness that they are using marijuana to treat as an affirmative defense” is at best highly exaggerated, and in practice would simply not be the case. Further, any ambiguities could be simply tweaked in the 2019 legislature. The paragraph following this resorts to fear-mongering imagery as well as mischaracterization. Consider: “The initiative language also allows marijuana use by anyone, even children, for whom there is no safe level of THC (the main active ingredient in most cannabis products) for their developing brains.” Cannabis will only be recommended for patients who have qualifying conditions by licensed medical professionals operating under strict professional standards of practice. The majority of minors who receive treatment will fall in one of a few categories: for example, a) epilepsy patients facing permanent brain damage, b) juvenile cancer patients who are experiencing debilitating pain syndromes and chemotherapy side effects, where survival, rather than a relatively low risk of moderate (and generally reversible) neurological syndromes is the primary and overriding concern, c) juvenile Crohn’s patients and others. And frankly, we take umbrage at the implication that advocates are some sort of monsters willing to endanger children with high-THC cannabis products for the purpose of profiteering, i.e., this is yet another low blow which reflects poorly on a professional group relying on its aura of expertise. This same “loaded” paragraph stoops to characterize doctors who would recommend cannabis medicine as money-grubbing, carpet-bagging charlatans, i.e., according to the UMA, the initiative “also sets up the state for an influx of less than honorable practitioners who will be happy to ‘recommend’ cannabis to anyone who asks, regardless of need, so long as they get their cut of the action.” We trust we don’t have to further deconstruct this statement, other than to point out that the initiative specifies that no more than 20% of any physician’s practice could be devoted to recommending cannabis medicines, meaning that any “influxing” doctors looking to emulate a “pill mill” practice (as has happened with opioid medications) would have to attract four non-cannabis candidate patients for every actual cannabis candidate, i.e., would have to build a full-service medical practice. Further, the UMA denies that the initiative sets up one of the most conservative programs in the nation, calling the notion “blatant deception.” Actually, the respected non-profit Americans for Safe Access (ASA) has graded every program in the country, and their rating shows that the proposed Utah program would be one of the most, if not the most limited in the US.
The same paragraph goes further claiming backers are preying on “Utahn’s innate sympathy for suffering” (their punctuation error) “as a means to profit off a product that in the end will do more harm than good.” Again, TRUCE is a non-profit - and - the great majority of research shows the “product” does far more good than harm. The UMA next questions the expertise of physicians themselves: “People assume that physicians would have some idea of how to prescribe or recommend it safely, for which diagnoses, and understand the contraindications, drug interactions and dosing guidelines for a plant that is wildly diverse …. None of this is the case with what is being proposed...” We agree that most Utah physicians are not currently prepared to begin an expert medicinal cannabis practice on day one. This is partly because the medical education system has resisted offering education on the topic. However, there are a growing number of CME programs ready and available to begin to remedying the situation. ASA offers such a program and our own medical advisor, Dr. Talbott has completed it. The next paragraph avers a) that “medical doctors would have little say in what a patient eventually receives” and b) that “the initiative also allows various non-physician practitioners to recommend marijuana for clients.” In the first case, that is up to the physician and their own level of expertise, and as noted, training programs exist. In the second case, the “non-physician practitioners” are those who have been granted prescribing privileges by the state, e.g., nurse practitioners and physician assistants among others. So we ask the UMA another question: Are they suggesting the prescribing privileges of these professionals are somehow questionable and need to be taken away? Getting into the particulars of dispensary systems and how they’re working in over half of the states is well beyond the scope of a press release, but we will say that UMA’s assertions about this system are as accurate as the rest of what we’ve analyzed. UMA further says, “Real science takes time and careful, unbiased research,” and here we agree. But a) as noted, far more than enough “careful unbiased research” has already been done to justify passage, and b) Utah is not able to replicate what’s taken many millions of dollars to establish, and current research is accelerating dramatically everywhere.” This is simply another impractical delaying tactic. As Dr. Talbott notes, “This medicine needs to be available now, not after further decades of research to prove what centuries have already told us: that cannabis is a safe, effective treatment for symptoms of many serious illnesses.” We support Utah’s participating in ongoing cannabis research within the growing body of such work, but “going it alone” makes zero scientific or fiscal sense.
Finally, the UMA asserts that many other states which have legalized medicinal cannabis are experiencing “buyers’ remorse” which is “now obvious.” TRUCE knows there are no perfect medicines and protocols, however, in the real world, no state which has legalized is seriously moving to change directions and re-prohibit medical cannabis, and in fact, the programs in many states are being judiciously expanded to cover more conditions and deal with matters like physician and patient education among other refinements. TRUCE Executive Director Christine Stenquist notes: “We’re happy to engage in constructive dialog about how to improve existing proposals, but this document offers no opening for such a mutually respectful conversation.”
