Tag Archives: Marijuana

Medical Marijuana Hits a Speed Bump

After the almost continuous progress of medical marijuana toward legalization by states, the federal government is threatening to use the trump card of federal law to override state laws.

'marijuana joint' photo (c) 2008, Torben Hansen - license: http://creativecommons.org/licenses/by/2.0/
California medical marijuana dispensaries have been told to cease operations within weeks or face federal prosecution. This has always been a possibility and, while many are surprised and yell “unfair,” many more are surprised it has taken so long. Marijuana, for the record, remains an illegal federal schedule 1 drug.

Medical marijuana occupies a curious and singular position as a “quasi pharmaceutical.” Like prescription medications, it has uses in the treatment of certain diseases. Like prescription medications, it has the potential for abuse.

The federal government sees the potential harm from abuse overriding any benefit of medical marijuana. This is not to say there is no benefit, but the therapeutic ratio tilts toward more harm than good.

The unique position of medical marijuana is further demonstrated by the individual state laws that regulate the prescription and dispensing of marijuana. For the rest of the pharmacopoeia, the DEA regulates all aspects of the medication. The drug manufacturer must make the drug of a certain purity level, it must be free of other harmful chemicals, and must be of a certain strength that is measurable and virtually identical batch to batch. It also must be proven effective for the condition for which it is approved. Those prescribing are highly regulated (medical doctors) as are the pharmacists and pharmacies that dispense medications.

Medical marijuana is also unique in its “sig” (medical language for prescribing instructions). If you look at medication bottles you have had, they give specific directions (i.e., take 1 tablet 3 times per day with food). The instructions for medical marijuana are to essentially use as much as you need, as often as you need, for as long as you need. I can think of no other medication either over the counter or prescription that has that latitude of use.

That being said, marijuana does have some benefit as an appetite stimulant for people with diseases like cancer or HIV who can benefit from that stimulant. It also can benefit patients experiencing nausea from such things as chemotherapy. However, experience has shown us that 90% of patrons of medical marijuana dispensaries don’t have cancer, HIV or what the mainstream medical community sees as serious diseases that cannot be successfully treated with conventional medical treatments.

What it comes down to is the present patchwork solution to marijuana legislation is simply unworkable, requiring a resolution at the federal level. It needs to be either treated like a drug, a medication or classified like alcohol.

Treating marijuana like a medication would involve marijuana being produced by licensed drug companies, in a standardized fashion, with frequent inspection and quality assurance programs. Marijuana, the medication, needs to have standardized levels of THC (Tetrahydrocannabinol), ensuring patients get the same effective dose each time they use it. This would be sold and distributed by pharmacies, with licensed and trained pharmacists. This is unlikely for a number of reasons, not the least of which is that smoking anything causes lung cancer and large pharmaceutical companies or large pharmacies don’t want that liability or damage to their reputation.

Treating marijuana like alcohol at least on the surface appears workable.

This would involve some standardization of product, federal or state inspection and presumably paying state and federal taxes.

Restrictions could be placed on the sale or use of marijuana by underage people.

What we have now is not a solution, but an anti-solution. We should start with a clean slate and appoint a blue-ribbon panel of recognized experts to analyze the risk and benefits of marijuana use. These experts could examine or commission serious scientific research and make reasoned decisions based on fact, not opinion.

Take care,
Dr. B

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Answers to Common Questions About K2/Spice

As a follow up to our recent posting about K2/Spice, below is a Q&A on the drug and issues related to testing.

Q: What is K2/Spice?
A: This is a synthetic chemical that is slightly different from THC, the active ingredient in marijuana.

Q: Is K2/ Spice illegal?
A: The Federal Government, through the DEA, made K2/Spice a Schedule 1 Drug, the most restrictive category, identifying the substances as unsafe, highly abused substances with no medical usage. That action placed K2/Spice on par with marijuana, cocaine and heroin. It is illegal to sell, possess or use these drugs.

Q: Is K2/Spice legal under the medical marijuana laws?
A: Spice is a synthetic chemical that is sprayed on a dried plant. There is no marijuana plant in K2/Spice. The synthetic marijuana chemical is different from THC. K2/Spice is not legal under any present medical marijuana law.

Q: How does K2/Spice affect someone?
A: The effects are similar to being intoxicated on marijuana. Because this is a new designer drug, risks from short or long term use are not yet known. Previous designer drugs like Ecstasy have proven to have dangerous medical consequences that were unknown in the early years of use.

Q; Will someone who smokes K2/Spice test positive on a drug screen for marijuana?
A: No. The active chemical in K2/Spice is slightly different from THC. It is different enough that it won’t test positive on a marijuana drug screen. That is why K2/Spice was invented – to avoid detection but still get the same effects as smoking marijuana.

Q: Is there a drug screen for K2/Spice?
A: Yes. CRL has created a test that will detect K2/Spice. CRL is the largest lab in the country and is federally licensed. The K2/Spice test is of the same high and accurate standards as present drug screens for marijuana. U.S. HealthWorks recommends MRO review of any positive drug screen. Each positive urine test will be confirmed by a second GC/MS test, as is the current standard practice on all drug screens.

Q: Is the collection procedure any different for K2/Spice?
A: No. Normal drug screen collection procedures are followed. No additional urine is needed. The test for K2/Spice can be administered by itself (separately) or added to any non-DOT drug screen panel.

Q: Can K2/Spice be done on a DOT test?
A: No. DOT Part 40 specifies the exact drugs to be tested in federal DOT testing. K2/Spice is not currently permitted on a DOT test.

Q: Why is there an additional charge to test for K2/Spice?
A: It is an additional and separate test from marijuana and, therefore, an additional cost is applied.

Dr. B

K2 — Not Just A Mountain Anymore

Synthetic cannabis first appeared about 8 years ago in Europe. It goes by the names Spice and K2. It is a designer drug, which means the basic marijuana molecule was altered to change its behavior. Often the goal is to increase the strength of a drug as in Ecstasy – made on the amphetamine blueprint. In the case of marijuana, the characteristic altered was the recognition that it was marijuana. A minor structural change can make a molecule unrecognizable. This was a marijuana that can’t be tested for.

It is not so much surprising that an enquiring mind could come up with a variation on the basic THC molecule, but that it was considered worth doing. Marijuana has not become an endangered species in recent years with various medical marijuana laws in 14 States.

While pot “scientists” were busy creating in their labs, the pharmaceutical laboratories were working on spoiling their plans. Tests specifically designed to recognize the synthetic marijuana molecule were developed. That isn’t too arduous a process as the initial screening test is an antibody test. An antibody to identify the new synthetic marijuana molecule is easily made. The confirming test, GCMS, only needs some synthetic marijuana to analyze, and it can happily identify synthetic marijuana down to the nanogram amount.

Of course getting around pesky government laws was the goal of this designer drug. The government simply wrote new laws outlawing this drug.

If you are concerned about the use of K2 or Spice, these can be included in your drug testing panel. Call your U.S. HealthWorks representative to enquire.

Take care.

Dr. B

Phoenix Business Journal: Legalized Marijuana and Workplace Drug Policies

Arizona will vote next week on Proposition 203, which would legalize medical marijuana. Dr. Donald Bucklin, who oversees all drug testing for U.S. HealthWorks, shared his insights in last week’s Phoenix Business Journal on how this could affect businesses’ drug testing policies.

My View: Legalized marijuana – Will drug testing go up in smoke?

By Dr. Donald Bucklin
October 18, 2010

Juggling the need for a drug-free workplace with the rights of employees may get a lot more complicated in Arizona after the November election.

They say those who don’t understand history are doomed to repeat it.

The state of Arizona has a rich and interesting relationship with medical marijuana. The current Proposition 203 is the most recent of four similar propositions that have been on the ballot in the past 14 years.

To read the rest of the article, click here.


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Sacramento Business Journal: Office Policy Could Go Up in Smoke

By Dr. Donald Bucklin

Juggling the need for a drug-free workplace with the rights of employees might get a lot more complex in California after Nov. 2.

That’s when Proposition 19, the initiative to legalize marijuana for recreational use — not just medical reasons — will be voted on by Californians. Polls show it could very well pass.

Should the measure become law, every employer will be asking, “How does this impact my drug testing policies and my hiring process?”

As it’s currently written, Proposition 19 says that employers would retain all existing rights to address consumption of marijuana that impairs employees’ work performance.

But legalized marijuana could create significant conflicts, particularly if an employer is unprepared and doesn’t have a clear drug use policy. That’s because many employers have a zero-tolerance stance when it comes to employee drug use, conducting drug testing before and during employment.

Read the rest of the column here (subscription required).


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“Fooling” the Drug Test System

The following question was posted on the website Marijuana.com (as the National Medical Review Officer for U.S. HealthWorks, I could hardly resist posting a reply):

Will I be observed at Healthworks Medical Group?

I have a drug test that is supposed to be at “US Healthworks Medical Group” through my school in Los Angeles, CA.

I am wondering if I will be in the room alone or is it possible I can be observed?

I assume that only probation type tests would have someone standing behind the individual doing the test, but I just wanted to confirm that as I would rather sneak in a sample than take my chances with a detox drink.

The test is due by next Friday. I have smoked high quality chronic since 2004 for about everyday and I have stopped since last Thursday.

I am 5’8 and 150, probably average metabolism and dont work out too much.

Anyways, confirmation of the legality/possibility of being observed would really relieve some of my stress. Its bad enough not smoking!

Thanks for your help!

While in general, I applaud preparation for any test, this is not the type of preparation that assures a positive outcome. This is one test you can’t study for.

1) Let’s start with the “detox drink.” If there is still someone on the planet that believes this clean-out business is real, I’m surprised. THC is the active ingredient in marijuana, and it is a fat soluble chemical. So a clean-out drink would have to dissolve all the fats in the body to actually have a chance of getting rid of the marijuana. Unfortunately you need some of that fat – it insulates your nerves; short circuits are called seizures. It also pads your feet; try walking on unpadded foot bones. Dissolving all the fat would be invariably fatal. From a purely economic standpoint, if this were even possible, the market would be in the weight-loss industry, not some tiny Internet company trying to beat drug screens.

2) What’s to stop someone from bringing in someone else’s clean urine for the test? Actually plenty. Urine is stored in the middle of the body. It comes out at body temperature, and we immediately check that. If you can prove you’re dead, and your body is room temperature, we might consider accepting a room temperature specimen. Otherwise, no way. So, like Goldilocks, the urine’s temperature has to be “just right.”

3) If you somehow manage to smuggle in someone else’s urine and it is positive, you, as the official “donor,” are stuck with the results. This is not without some humor.

4) Lastly, there is the issue of the observed collection. Observation is not usually needed to prevent fraud; we’re pretty good at catching donors trying to pass off somebody else’s specimen.

I close with a nod toward the eternal struggle between opposing forces. As long as there are drug screens, there will be people trying to beat them. Many of the people trying to beat them are on drugs, which probably lessens their success rate. Simultaneously, the labs are working on technologies that prevent this undermining of the system. Oral fluid testing is becoming more popular as every test is observed, and saliva is a good fluid to perform drug testing on.

The only truly effective way to pass a drug test is to stop using drugs and have enough time pass for them to be out of your system. Every unemployed person should seriously consider this as part of their plan to return to the world of the employed.

Good luck,

Dr. B


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Businesses, Employees, Marijuana and the State of California

California now finds itself with hundreds of Medical Marijuana Dispensing Clinics and is set to vote on legalizing it completely in November.

Yet its citizens still lose jobs over marijuana positive drug screens.

So is a Medical Marijuana Card a “Get out of Jail Free Card”; or is it worth about as much as me giving you permission not to pay your taxes?

The only straight forward part of this is the law.  It starts with the Federal Government, and the DEA.   Marijuana is still listed as a Class 1 drug with LSD, Heroin and several others.  That means a doctor can’t prescribe marijuana under federal law.  Despite all arguments, unless that changes the whole California initiative may be a bit of a moot point.

Marijuana is compared to alcohol all the time.  But this is fundamentally a false comparison.  Alcohol does a lot of bad things, but is a legal drug.

The big difference between alcohol and marijuana is verifiability.  A breath alcohol or blood alcohol test can easily determine if you are impaired by alcohol.  It is inexpensive and very reliable technology.  There is no way to reliably determine if someone is impaired by marijuana.  And there lies the rub.

Everybody agrees marijuana distorts the sensorium, otherwise what’s the point.  Right this minute most large employers, private and federal, state and local, fear most that an employee can’t be proven to be impaired or unimpaired.  This uncertainty clouds this issue like uncertainty affects the stock market (negatively, with a vengeance).

So the future of marijuana is not dependent on its many physiologic effects.  Rather it is dependent on the development of technology to monitor its use.

– Dr Don Bucklin, National MRO, AKA “Dr B”


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