August 26
Presented to Governor’s Council on Alcohol and Drugs
by Sandee Burbank

Thank you very much for the opportunity to speak to you today.   As you know I am Chair of the Advisory Committee on Medical Marijuana (ACMM) and I am also the Executive Director of Mothers Against Misuse and Abuse (MAMA).

I first came to the meetings of this body in the middle 80’s when MAMA was new. We were concerned about inadequate treatment slots in Wasco County, where I reside.  MAMA is concerned about reducing the harm from all drug use and though we focus more on prevention then treatment, we believe that both are necessary to ensure the best opportunity for individuals who want to avoid problems with drugs or get help when they have a problem.

Sandee Burbank and Tawana Nichols present to the Governor's Council on Alcohol and Drugs

MAMA, working with Mark Miller, former director of the University of Oregon Drug Information Center, has developed a program called “Drug Consumer Safety”. It teaches people a method to evaluate all drug use for its benefits versus its risks, showing where to get accurate information, how to recognize potential problems and when it is important to seek help. I have attended these Council meeting periodically for about 25 years. I can only imagine how difficult it is to try to meet your mission when there is never enough money available to adequately fund the programs that are needed. How exasperating it must be to see so much of the tobacco settlement money, intended for prevention of tobacco use, taken to help balance the budget for DHS. How frustrating to know that although Oregon has one of the highest rates of adult use of alcohol in the nation, neither the OLCC nor the beer and wine industry pay their fair share to help mitigate the known problems caused by the use of alcohol.

I am here today to talk to you about the Oregon Medical Marijuana Program. It has been legal under Oregon law for 10 years for Oregon patients, who function within very strict guidelines, to grow and ingest cannabis for relief from specific conditions. With over 20,000 patients now registered in the Program we haven’t witnessed any significant health problems. Most problems for patients are caused by inadequate access to this medicine, trouble working with some law enforcement agencies that still don’t understand the Program, or the risk of violence and crime as a result of the black market for those who do not qualify for the Program, but still choose to use cannabis.

Before the Program existed, due to its illegality, the definition of ‘abuse’ of cannabis was ‘use’.  Now things are not so simple.  It has taken almost 10 years for this Council to actually try to understand how this program works and the lack of comprehension is alarming. This is very sad to me. Here was an occasion to do some serious harm prevention through education, but the Council chose to ignore this opportunity. It seems like the interest in how much money can be generated by the OMMP is of interest. Remember, the Department of Human Services took $900,000 from the OMMP to help balance the DHS budget.  That was money intended only to administer the Program and paid for by seriously ill patents. As a result the fee patient pay had to be raised.

We have heard from some on the Council that cannabis is addicting. The Institute of Medicine, Division of Neuroscience and Behavioral Health issued a report, Marijuana and Medicine, Assessing the Science Base, in 1999.  This report was the result of a comprehensive assessment undertaken at the direction of the Governing Board of the National Research Council, which includes the Institute of Medicine, the National Academy of Sciences, and the National Academy of Engineering.  On the topic "Marijuana Dependency and Withdrawal", here is the entire content of the Conclusion from the Executive Summary:

"CONCLUSION: A distinctive marijuana withdrawal syndrome has been identified, but it is mild and short-lived.  The syndrome includes restlessness, irritability, mild agitation, insomnia, sleep EEG disturbance, nausea, and cramping."

Stepping back from the Executive Summary to the body of the report itself, the summary statement is as follows:

"In sum, although few marijuana users develop dependence, some do. But, they appear to be less likely to do so than users of other drugs (including alcohol and nicotine), and marijuana dependence appears to be less severe than it is for other drugs. If marijuana or cannabinoid drugs were approved for therapeutic uses, it would be important to consider the possibility of dependence, particularly for patients in high risk groups for substance dependence. Certain controlled substances that are approved medications produce dependence after long term use. This is, however, a normal part of patient management and does not generally present undue risk to the patient."

It is instructive to compare this with the symptoms of caffeine withdrawal – which are:

headache; fatigue or drowsiness; dysphoric mood including depression and irritability; difficulty concentrating; and flu-like symptoms of nausea, vomiting and muscle pain or stiffness.  In experimental studies, 50 percent of people experienced headache and 13 percent had clinically significant distress or functional impairment -- for example, severe headache and other symptoms incompatible with working.  Typically, onset of symptoms occurred 12 to 24 hours after stopping caffeine, with peak intensity between one and two days, and for a duration of two to nine days.

MAMA teaches that no drug is safe and that all drug have side effects. Some worry that children will think, “If marijuana is medicine how can it be bad for me?” This underscores one of the problems MAMA has been fighting all these years. We have failed our children if they think all medicine is safe. We MUST do a better job of teaching our children the dangers of all drug use. Over-the-counter drugs such as Ibuprofen, aspirin and acetaminophen kill over 17,000 yearly, yet are readily available to youngsters, with little education of this hazard. Only those who are uneducated about drugs could think any drug is safe. It is advertising and the magic bullet approach that put so many at risk. Individuals can only protect themselves by treating all drug use as though it is a serious decision that requires careful thought and accurate scientific information.

Most people will make decisions that will keep them from harm, in fact isn’t that the basis of a free society? To maintain credibility we must avoid misleading people, especially youngsters, with half-truths or mistruths in an effort to scare them away from drug use. Federal law says cannabis has no medicinal value. Yet Marinol is synthetic THC and is available with a prescription. It contains much more THC than any natural form of cannabis, but we rely on reports that say cannabis is dangerous with statements that are not conclusive or scientific. Cannabis is medicine and research is showing this truth. With 12 states now allowing medicinal use, patients themselves have proven that cannabis works to provide relief from many conditions, without the debilitating side affects of many commonly used prescription drugs. Why else would all these seriously ill people jump through all the hoops, at risk of federal intervention and prosecution, so that they can get the relief they find from cannabis? The federal law is a lie. Cannabis is a very effective medicine.

The conflict between Federal and State Law is clearly exhibited by the issue of drug testing in the workplace. Impairment in the workplace is an issue that concerns all of us.; No one wants to be a risk due to the impairment of fellow employees. But impairment comes from many causes such as sleep deprivation, emotional problems, and physical pain, especially back pain. Using drug testing to determine impairment doesn’t begin to address all the causes of impairment. It has become increasingly clear that drug testing for cannabis does not show impairment, only that someone has used cannabis within an extended period of time. Law enforcement and the military have used impairment testing for years. True impairment testing does exist and is readily available to show general impairment, which would cover all forms of impairment and leave all workers in a safer environment.

Is it not the duty of this Council to speak the truth? If so, then it is your responsibility to say that the Federal law is wrong and to call for acknowledgement of the medicinal benefit of cannabis. Then we can get on with teaching people how to avoid problems with cannabis. It can interact with other drugs, causing some drugs to be more effective and others to be less effective. We need to inform people about where to get this information. We can teach patients that cannabis medicine can be consumed in many forms, not just by smoking. Tinctures, oils, capsules, edibles, and vaporization are very effective for those suffering from qualifying conditions and often with little or no intoxication. Due to the Federal law, patients in states that allow medicinal use are responsible for rediscovering and making these forms for themselves. If the Federal Government were to revise the cannabis laws based on science, then doctors could prescribe these forms and patients could get them from the pharmacies. ; This would be much better for those seriously ill people who have a hard time providing for themselves.

I urge you to consider carefully how to support this program, which will not quietly go away, and serve the best interests of Oregon patients by providing the educational assistance that is needed to keep medical cannabis users safe.

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