Medical Marijuana — A COMBAT Series Part 1

  1. » Part 1 · July 8
    Opportunity & Cause For Concern
    What is seen as an opportunity by some is causing concern for others.
  1. » Part 2 · July 11
    How Close Is Too Close?
    Kansas City Council decides to permit dispensaries 300 feet from schools.

  1. » Part 3 · July 15
    When Federal & State Laws Clash
    Using medical marijuana while living in federally-subsidized housing might result in eviction.
  1. » Part 4 · July 18
    This Ain't Candy
    "Who eats just one Gummy Bear?" Overeating edibles can cause severe reactions due to THC levels.
  1. » Part 5 · July 22
    Just A Coincidence?
    Overdose deaths have been on the rise during the same time states have been legalizing marijuana use.
Medical Marijuana: Opportunity & Cause For Concern
Legalization In Missouri Seen As An Opportunity
But Also Cause For Concern In Jackson County

MONDAY, JULY 8, 2019

Missourians left little doubt about their feelings toward amending the state constitution to legalized medical marijuana. 

Nearly two-thirds—65.5% to be precise—voted “yes” last November for Missouri Amendment 2, allowing marijuana for medical purposes and taxing medical marijuana sales at 4% to fund healthcare services for veterans. Support for the measure was even higher in Jackson County, topping 70%.

The Missouri Department of Health & Senior Services (DHSS) recently completed its initial rules regulating medical marijuana in the state. DHSS began vetting medical marijuana Patient Registration Applications last week. The department’s formal review of business applications to grow, manufacture and dispense medical marijuana begins Aug. 3. 

Through June 26 Jackson County led the entire state in the number of business applications submitted to DHSS, according to The Kansas City Star

Kansas City Star Article About Jackson County

Clearly, medical marijuana legalization is being seen as an opportunity by many. But there are also causes for concern.

‘What Legalizing Might Lead To’



“This is something I thought I’d never see in Missouri, but it passed with overwhelming support across the state,” said Randy Hudspeth, Major/Interim Chief for the Raytown Police Department. “I know there’s a lot of people worried about what legalizing medical marijuana might lead to, especially those of us in law enforcement.”

Those concerns range from security in and around the licensed dispensaries to medical marijuana being exploited illegally like other prescription medications.

“Personally, I don’t have an issue with medical marijuana,” Jackson County Drug Task Force Officer-In-Charge (OIC) Dan Cummings said. “If it helps one child with seizures, I am all for it.

“What I have an issue with is the abuse of medical marijuana that is going to happen. And it’s going to happen. A lot of prescription drugs are obtained legally, then resold illegally. We’ll see that with medical marijuana, too.”

What About Kids?



Beyond the legal ramifications are legitimate worries about medical marijuana’s possible adverse impact on some individuals’ health—from negative reactions among those exceeding recommended dosages, to the effects on a child’s developing brain. (The DHSS website includes a Parent/Legal Guardian Consent Form “for a minor’s use of marijuana for medical use.”)

Kids Smoking Joint
MIXED MESSAGE — Studies have shown that regular marijuana use can stunt the development of a teenager's brain, but according to many researchers, cannabis may be an effective treatment option for children with some medical conditions.

Earlier this year TIME magazine published a special edition dedicated entirely to “Marijuana: The Medical Movement.” One article—"Keeping Kids Safe”—pointed out “some of the strongest research backing up marijuana as medicine involves treating children.” Cannabis has reduced seizures in children with a severe form of epilepsy and studies are being conducted to  determine its effectiveness helping kids with autism. 

“Still,” TIME reported, “experts stress that more study is needed on safe use in kids.”

The article cited a 2012 study linking regular marijuana use before age 18 with an average drop in IQ of eight points. “There are studies showing that the earlier you start [using marijuana], the worse your cognitive growth becomes,” Dr. Yasmin Hurd told TIME.

Hurd, a neuroscientist, runs the Addiction Institute at the Mount Sinai School of Medicine in New York City. The human brain doesn’t reach full development until a person is in his or her mid- to late 20s—a fact that prompted TIME’s Jeffery Kluger to write, “Mixing any intoxicating chemical into the soft clay of an unfinished brain can alter forever the way it works.” 

From Medical To Recreational



In alignment with American Academy of Pediatrics (AAP) policy, Lee’s Summit CARES opposes marijuana use in anyone under 21 years old. The non-profit agency is dedicated to preventing youth substance abuse and violence.

“One concern of parents and pediatricians, noted by AAP, is whether the legalization of medical marijuana results in increased use of recreational marijuana by adolescents?” Lee’s Summit CARES  indicated in a statement.

Gummies Packaging
RESTRICTIONS IN PLACE — Medical marijuana facilities in Missouri must follow packaging restrictions that include rules against designs that might appeal to a minor.

The statement quoted AAP studies that concluded “marijuana alters brain development, with detrimental effects on brain structure and function, in ways that are incompletely understood.” Lee’s Summit CARES also poses multiple questions and raises other issues related to the shifting attitudes—and legal limits—regarding marijuana:

  • Could “legitimizing marijuana as a medication” lead adolescents to believe marijuana, whether prescribed or not, is safe?

  • Access to marijuana will likely become more widespread.

  • Will there be provisions to prevent youths from being targeted by marketing that promotes marijuana and the possible full decriminalization of its use recreationally, not just medically? 

The DHSS general guidelines (PDF) governing all medical marijuana facilities restricts packaging marijuana “in a false or misleading manner; in any manner designed to cause confusion between a marijuana product and any product not containing marijuana; or in any manner designed to appeal to a minor.”

RELATED LINKS – THE NATIONAL INSTITUTE ON DRUG ABUSE: 

THC Levels On The Rise



Judge Susan Watkins, Executive Director for the Independence Youth Court, worries not enough studies have been conducted about possible “long-term health hazards associated with [marijuana].” Many marijuana edibles, she points out, have a high concentration of tetrahydrocannabinol (THC), the psychoactive component in cannabis that triggers a “high.”

THC CBD


“In the 1960s and 1970s, the marijuana people would get their hands on had a THC level of between 3% and 6%. Now everything is over 20%—at the low end,” said Judge Watkins. “In the dispensaries out in Colorado, the THC levels are 30% or higher. The marijuana they’re growing legally has a higher THC concentration level.”

The Drug Task Force has confiscated marijuana edibles that exceeded 60% THC levels. “We’ve come across these pods for vaping that were 100% liquid THC,” Cummings said.

Eating More Than Supposed To



Finding the DHSS regulations restricting THC levels—among the many pages of medical marijuana rules posted on the department’s website—can be a daunting task. The Division of Regulation and Licensure chapters regarding Cultivation, Dispensary and Infused Products facilities make no references to “THC” or “tetrahydrocannabinol.”

But Page 4 of the Testing Facility Rules (PDF) states “testing of the cannabinoid profile of the final medical marijuana product” allows for an “acceptable [THC] limit” of 15%— “or less.”

UPDATE: DHSS is continually updating the Medical Marijuana Section of its website, editing, adding and deleting information. Guidelines about "acceptable [THC] limits" are now listed on these Emergency Rules (PDF) published July 1.

“The problem they’ve had in other states and we’ll probably see here is people exceeding the recommend dosage,” Cummings said. “A lot of people are likely going to eat more of the edibles than they’re supposed to and end up with more THC in their system.”

THC can trigger anxiety attacks, paranoia and hallucinations. Among younger people, a major side effect can be respiratory insufficiency—the inability to simply get enough air.

Marijuana Still Being Sold Illegally
BLACK MARKET TRADE CONTINUES — Even in states that have legalized marijuana for recreational use the drug continues to be sold illegally.

Illegal Sales Won’t Go Away



Raytown Interim Police Chief Hudspeth appreciates that the state is capping how many dispensary licenses will be issued. “In some other states, it was a bit of a free-for-all.”

Hudspeth has been attending multiple training sessions about what he and others in law enforcement can expect once medical marijuana sales commence sometime in 2020. Recently, he went to a special seminar the Missouri Highway Patrol sponsored, Colorado: Lessons Learned.

“Really, the concerns I have now aren’t going to change much with the legalization of medical marijuana,” Hudspeth continued. “I do know the black market is not going away. We’re going to have people continue growing marijuana in their homes, using it or selling it illegally.”

Cummings agrees.

“Pot is still sold illegally in Colorado,” the Drug Task Force OIC said. “The dispensaries are heavily regulated. They can only sell so much, and their prices are higher than what marijuana is being sold for illegally in Colorado.”

NOTE: COMBAT funds Lee’s Summit CARES (LSC) Resilience Building for Youth and Families prevention program but provided no input regarding the writing of the Lee's Summit CARES statement cited in this article. 

"Legalizing medical marijuana is the right thing to do for the people who can benefit from it."

'The Right Thing To Do’

John Mitchell, Attorney General under President Richard Nixon, “temporarily” designated marijuana a Schedule 1 drug in 1970. It has remained classified as such ever since. 

That means from the federal government’s perspective marijuana is still categorized alongside heroin and other dangerous narcotics. Schedule 1 drugs are deemed as having “no valid medical purpose,” while also posing a high risk for abuse.


The People Who Need It



The notion marijuana has “no valid medical purpose” is absurd, declared Dr. Kelvin Walls.

“I think legalizing medical marijuana is the right thing to do for the people who can benefit from it,” Dr. Walls, a COMBAT Commissioner, said. “Legalizing it is the best way to get it to those people who need it. For some people it is the correct medicine to prescribe.”

TIME Medical Marijuana Special Edition

In its special “Marijuana: The Medical Movement” edition this spring, TIME magazine summarized multiple studies about the medical “potential” of cannabis: 

As consensus grows among experts that this 12,000-year-old plant has a place in treating a range of conditions, we are, for the first time in nearly a century, taking meaningful steps toward realizing its potential. Science has shown that low doses of marijuana are able to help control the painful, disabling muscle spasms of multiple sclerosis; that cannabidiol, or CBD, the non-psychoactive component of cannabis, is an effective treatment for children with Dravet syndrome, an epileptic disorder that produces drug-resistant seizures; that pot can reduce nausea and improve appetite in cancer and AIDS patients, keeping them healthier and more comfortable as they go through treatment; and that, thanks to its anti-inflammatory qualities, cannabis may alleviate the symptoms of irritable bowel syndrome and Crohn’s disease.

Not  A Miracle Drug



TIME cautioned, however, “medical marijuana may bring risks—although in some cases the rewards might outweigh them.”

Judge Susan Watkins doesn’t want marijuana being sold as a cure-all miracle drug. The Executive Director for the Independence Youth Court visited a marijuana dispensary during a trip to Colorado, where cannabis can be legally used both medically and recreationally.

She didn’t like what she saw or was told: “My husband and I went in there out of curiosity. I’m a judge. He’s a police detective. Every wall in the place was covered with these signs about the health benefits of marijuana. We talked to the people running the store, and they are all in their 20s, but apparently all medical experts. They are telling us marijuana can cure this and that—cure whatever ails you.”

"The problem they've had in other states and we'll probably see here is people exceeding the recommended dosage. A lot of people are likely to eat more of the edibles than they're supposed to and end up with more THC in their system."