#19: State-Legal Marijuana Use

As of August of 2019, the following states/district have made marijuana fully legal:  Alaska, California, Colorado, District of Columbia, Illinois, Maine, Massachusetts, Michigan, Nevada, Oregon, Vermont and Washington.  Fully legal is just what it sounds like, medicinal and recreational use is legal.  Another 27 states have legalized it for medicinal purposes, and in 13 states it is still 100 percent illegal.   These statistics present the basis for some rather passionate and maybe heated discussions.  Currently the Federal Government still classifies marijuana as a Schedule 1 drug, therefore making it illegal at the federal level.  This classification is what forces state-legal marijuana businesses to operate on a cash only basis.  Banks are extremely nervous about violating Federal law and therefore no credit card or check transactions are allowed.  Additionally, a business can’t file a Federal tax return for deductions that other businesses not in the pot business do with impunity and can pay up to 90% of their income in taxes.    

There is a difference between legalization and decriminalization.  Legalization is the lifting or abolishment of laws banning the possession and personal use of marijuana.  If done federally this would allow the government to regulate and tax marijuana use and sales.  Those in favor of legalizing “pot” make the case that taxpayers would save millions of dollars by removing hundreds of thousands of offenders caught with small amounts of marijuana, thus unburdening the judicial system. 

Decriminalization is a loosening of criminal penalties imposed for personal marijuana use even though the manufacturing and sale of the substance remain illegal.  Essentially law enforcement is instructed to look the other way when it comes to the possession of small amounts of pot for personal use.  The production and sale of marijuana remain unregulated under decriminalization and those caught using it face civil fines verses criminal charges.    

Proponents of legalization argue that allowing the manufacturing and sale of the substance removes the industry from the hands of criminals.  They also propose regulation of the sales would make it safer for consumers who choose to use marijuana and that it would increase revenue in cash-strapped states.  Opponents claim marijuana is a gateway drug that leads users to other, more serious and addictive substances.  Proponents of decriminalization argue that it makes no sense to give the federal government the authority to legalize the use of pot on one hand while attempting to regulate it on the other, much the way it sends conflicting messages about alcohol and tobacco use.  

As you can see this issue is as clear as mud.  Lines have been drawn in the sand from both schools of thought.  There are valid arguments on both sides, however the only thing we know for certain is you must know your individual state law if you choose to partake in the use of marijuana, and Federal law trumps (no pun intended) State law.  Thank you for your business.

Lance Benedict

President/CEO Industry Lab Diagnostic Partners  

9/20/2019

#18: Drug Madness is Global!

In Thailand the word “yaba” stands for madness drug and is used to describe Methamphetamine.  July of this year, the UNODC (United Nations Office of Drugs and Crime) reported that the Meth trade is now worth between $30 and $61 BILLION per year in East and Southeast Asia, Australia, New Zealand and Bangladesh.  Yes, that is BILLION with a B!!  Can you say epidemic!?  From the 70’s through the 90’s it was opium and heroin (sound familiar?) however once the traffickers realized it was easier and more profitable to produce synthetic drugs, the tide turned. 

The country of Myanmar is the region’s meth factory.  From the lawless Shan State, within Myanmar, the production of Meth has exploded and is invading most of Southeast Asia.  As the saying goes, “Follow the money.”  A gram of crystal meth sells for $560 in Japan and $390 in South Korea.  According to the US Drug Enforcement Agency, as of March of 2017 a pure gram of Meth sold for about $70 in the United States.     

Some interesting news, and a possible light on the horizon, is the company InterveXion who is attempting to develop a monoclonal antibody directed against methamphetamine.  If successful this antibody would act by re-partitioning Meth away from its sites of action within the central nervous system.  The antibody (IXT-m200) has been fast tracked by the FDA and is currently in a proof of concept study.  Where this will lead in regards to the prevention of Meth addiction is a discussion for another day.

The purpose of highlighting this Meth scourge is to once again remind everyone polypharmacy is alive and real in the drug abuse world.   Testing cannot be limited to just opioids, or other controlled substances the patients are prescribed, with the expectation that the provider will know all the controlled substances the patient is truly taking.  There are a few providers we conduct testing for who only test for the drug they prescribe for the patient. That is entirely their choice, and may well be appropriate depending upon the patient, however the potential risks of adverse drug reactions have to be considered when ordering testing.

 As much as it grates me to say it, in addition to the safety of the patient, in today’s litigious society, providers also have to practice with a calculated amount of self-preservation.  Insurances and governing bodies have done a great job instilling the fear of reprisals for over testing.  I do not advocate over testing; however, I am a huge proponent of letting health care providers make the health care decisions, not the peanut gallery!!!  Yes, there will be some who will continue to abuse the system for their benefit (Name one form of business or career where that doesn’t occur,) as well as some who do not have the training. (That is what continuing education is for!)   Regardless, we were the ones who paid the price, physically, emotionally and economically for our training.  It is up to us to help prevent “Yaba” or other drugs from dominating the US market.  Perhaps if he was still active today Fred Flintstone wouldn’t have said do, but instead would have said, “YABA, DABA, DON’T!!”

Thank you for your business.

Lance Benedict

President/CEO Industry Lab Diagnostic Partners  
9/06/2019