Cannabis and the environment

Community and Patients alike will be interested to see medical cannabis come to Missouri without harming the environment. Cannabis could have similar downsides as traditional agriculture unless producers are responsible with their cultivation practices.

Pesticide use and bad farming practices that induce erosion could apply to cannabis as well. Although most responsible producers will avoid the use of pesticides, it is still possible that some will attempt to use these product and that toxins may find their way into water supplies. Your local legitimate cannabis operation should be held to high standards in this regard.

Odor is a surprising problem for the cannabis business operator. Cannabis contains a host of volatile organic compounds (VOCs) that can be very odoriferous. You can literally smell the business from blocks away depending on the wind. A community should not have to deal with this issue, however. Odor controls should be put in place so that these businesses can do business without stinking up the neighborhood.

A real issue with indoor cultivation is the potential to impact electricity consumption. While there is good reason for the preference to cultivate in a controlled environment, the high-intensity lighting that is used for indoor cultivation along with the air conditioning required to cool it puts forward a huge demand for electricity. Cultivation operations will need to adopt newer technology to lessen these costs if they expect to meet community expectations.

Further reading:
ScienceDirect.com (1)
ScienceDirect.com (2)
ScienceDirect.com (3)
TheGuardian.com

Medical cannabis does not create public safety issues

Studies indicate that tobacco and alcohol specific retail stores invite higher rates of crime than do medical cannabis dispensaries. Overall, medical cannabis dispensaries may actually see less crime.

We believe that a strong security posture and close relationship with local law enforcement are keys to ensuring a cannabis operation does not have a direct impact on public safety. After all, who would want to commit a crime of any sort in full view of an array of security cameras?

Studies do show that there are increased instances of impaired driving and visits to emergency rooms due to cannabis. However, these finding are specific to locales that have legalized all adult-use cannabis, not medical cannabis. This makes sense given that medical patients already deal with the possibility of impairment with other medications coupled with the fact that medical patients generally do not seek the intoxicating effects that are possible with cannabis. Not all cannabis products cause intoxication.

It would also seem that ‘perception’ is important, as much of the community will conflate criminal-market cannabis crime activity with the operations of legally licensed cannabis facilities. With medical cannabis legalized, a large criminal-market will still exist for those folks seeking to use cannabis recreationally. Provided the legitimate business is adhering to compliance standards it is unlikely that it will contribute to the illegal-market.

Further reading:
TheStranger.com
Voice of San Diego
DrugAbuse.gov
SaveOurCity.org
CannaSafeSolutions.com

Missouri’s first medical cannabis conference was a success

Over the last two days I attended Missouri’s first medical cannabis conference at Union Station in St. Louis. I’m an experienced conference go-er, though this was my first cannabis conference. I can say that this conference was well produced and had value for most every attendee.

I was impressed with the keynote delivered by Department of Health and Senior Services, Medical Marijuana Program Director, Lyndall Fraker. Lyndall confirmed that the state’s mission at this point is to uphold the the letter of the constitution (Article 14) by both implementing the program as outlined therein, as well as doing so in the timeline set forth by the people of Missouri. The mantra of ‘patients first’ was repeated once again for everyone to hear.

The informational sessions did provide nuggets of information for me here and there, but that was the extent of new information I received there from the presentations. I believe I learned more from the vendors who had gathered at the show’s expo. Networking was also a highlight as I met many other prospective business owners including a rare Lab Testing hopeful.

By the end of the first day I saw a great number of folks with downcast eyes and pages full of notes they’d taken through the day. The vendors I talked to could feel the dejection as it dawned on hopeful business owners just how expensive and complicated it was going to be to get into this business. This mood was so pervasive that one consultant group decided to change their entire presentation into something more upbeat. It was a regular pep-talk for those attending.

Though I didn’t like to see other folks in that state, it did give me a little confidence. I had similar revelations months ago as I was doing my own research. Hopefully these folks will bounce back as I did. But, if not, I suppose that will be a little less competition in the field. This is, after all, a competitive market for limited licenses.

Further reading:
Associated Press

Public health windfall found in medical cannabis

The research seems to be clear at this point. Public Health will improve via medical cannabis. While arguments can be made against this notion in adult-use (so called “recreational”) markets, it seems clear that medical cannabis specifically has little downside.

Experts mainly cite the potential for underage abuse, but there doesn’t seem to be any evidence of this in a medical market. This seems reasonable given that medical patients will understand the medical value and be less likely to divert their allotment of medical cannabis to non-medical patients.

Cannabis has a very wide window of therapies and can replace or reduce a great number of prescriptions; most notably among them are opioids. While cannabis has a relatively small 9% change for creating dependence, opioids prescribed for only a 5-day treatment has over a 10% chance of leading to dependence. This number only climbs the longer one takes opioids.

It doesn’t stop with opioids either. Patients surveyed are using less NSAIDs, SSRIs, and Benzodiazepenes. Reducing the use of addictive substances and substances with severe side effects is a clear win. It also makes it clear why pharmaceutical companies are very much against cannabis as a medicine.

Further reading:
Doctors for Cannabis Regulation
DrugAbuse.com
HealthAffairs.org
UPMC Health Beat

Medicinal Marijuana
by HealthCentral.

From Visually.

Positive economic impacts will come with medical cannabis

It is hard to deny the positive economic impacts that medical cannabis can bring to a community. As soon as a new cannabis business comes to town there will be a flurry of building.

Hopefully the business owner has a preference for using builders who are local, as this will keep the money spent for construction in the pockets of local laborers. However, even if outside contractors are brought in they will spend a portion of their earning at local businesses while they are in town. Further, the finished construction project is certain to increase real estate value.

A local medical cannabis wholesaler or retailer will pay hundreds of thousands of dollars in local sales and real estate taxes, not to mention the state and federal taxes to be paid. Municipalities who budget wisely can see a boost to their revenues allowing for additional street repairs and even additional staff. Most commonly an additional police officer is brought on board to further ensure public safety.

Ongoing maintenance must be completed on any facility, and medical cannabis is no exception. HVAC and Electrical tradesmen may be among the most common visitors to a facility such as this. However, a cannabis business will also need CPA’s, custodial services, security services, and a staff of their own. Medical cannabis businesses often pay higher than minimum wage for their employees as well. In all, the variety of wages work well to add economic value to the local community, especially if that business makes it a priority to hire locally.

Less talked about are the investors in medical cannabis businesses. There is great interest nationally, so large investors aren’t too difficult to come by. That said, if local investors are brought to the table as well this will further add value locally. If dividends are paid or the business sells, large sums of money may be injected into the local economy via those investors.

It seems clear that medical cannabis has great potential for local economies across the state of Missouri. As is our custom, below you will find some additional reading that is specific to medical cannabis. We’ve also included an older (2010) info-graphic that paints the picture from that time period and shows that some projections have come true.

Further reading:
420Intel.com
Missouri Medical Cannabis Trade Association
The Missourian

Economy of Medical Marijuana
Via: Rehabs.com

MoCIA holds its first cannabis business seminar

The Missouri Cannabis Industry Association (MoCIA) held its first seminar last weekend (February 23, 2019) in St. Charles, Mo at the Grand Opera House Banquet Center. They had an assortment of professionals covering a broad range of topics including; an overview of Article 14 of the Missouri State Constitution, accounting advice specific to cannabis businesses, as well as business owners (from states that already have legal medical cannabis programs) sharing their experiences.

The highlight of the day was a Q&A session led by Dr. Randall W. Williams, Director of the Missouri Department of Health and Senior Services (DHSS). Dr. Williams shared that over 30,000 suggestions for the rule making process had already been received. He then encouraged attendees to continue to make suggestions.

Dr. Williams mentioned several times that his intention was to uphold the Missouri Constitution by enabling patient access to medical cannabis within the given time frames. He also shared that he was encouraged to find that legal medical cannabis does not lead to increased crime rates. Dr. Williams went on to field questions for over an hour before the seminar was brought to a close.

In all, I’m encouraged that DHSS seems to have the patients’ best interests in mind. It also felt like the infant industry in this state is starting to build a little momentum. Let’s hope Missouri’s medical cannabis program is put together in the right way.

Legal cannabis leads to less crime

As I began to seriously consider starting a cannabis business in my home town, I was left to consider if it would be good for the community, or not. One of my first concerns had to do with crime.

After researching a growing number of studies, it seems that the clear answer is that the presence of a cannabis business does not increase crime. In fact, evidence is mounting that it actually reduces crime.

This makes sense to me given that cannabis businesses are required to bristle with cameras and other security devices. While many studies focus on legal adult-use scenarios, I believe it translates to the legal medical markets as well. However, I leave it to the reader to make their own decisions.

Further Reading:
Journal of Economic Behavior & Organization
The Independent
Foundation for Economic Education
The Pacific Standard
Snopes.com

Public forum to be held on Medical Marijuana Regulations

On the evening of Wednesday, February 13, 2019, the Missouri Department of Health and Senior Services (DHSS) will hold a forum to collect feedback on the regulation process for the state’s fledgling medical marijuana program. The meeting will be held Govenor’s Office Building, Room 450, from 6-9pm. I suspect this meeting will draw a crowd, as it should. It is important to be involved.

Click here for the official news release

State refuses to provide personally identifiable information

The Missouri Department of Health and Senior Services (DHSS) has refused requests aimed at identifying individuals who have applied for cannabis facility licenses. While Article 14 could be interpreted otherwise, I think it is excellent that DHSS is erring on the side of caution. I also take this as a positive sign that DHSS will go to lengths to protect patient privacy.

Further Reading:
St Louis Post Dispatch

Chronic Pain is #1 condition treated with medical cannabis

A recent study by the University of Michigan, published in the February 2019 edition of Health Affairs, reports that 62.2% of medical cannabis patients were issued medical cards due to their chronic pain. This study also found that there is substantial evidence to support cannabis as a treatment for chronic pain in addition to nausea and vomiting due to chemotherapy as well as multiple sclerosis muscle spasticity symptoms. A large number of scholarly articles support this claim as well.

I’ve already been asked what a treatment plan for chronic pain might look like. This could depend on a lot of factors (e.g. height, weight, age, other medications) and even some personal preferences. We’ll also need to have potential treatment plans verified by licensed physicians and/or pharmacists.

Our preference is to effectively treat the patient’s symptoms with a minimal dose. This keeps costs low for patients, avoids psychoactivity, and keeps tolerance low (which translates back to lower cost).

A good starting point would be a 2:1 ration of CBD:THC. Something on the order of 5mg:2.5mg. Delivery by sublingual drops every 3-6 hours as needed. We would probably leverage a 2:1 ratio edible around bedtime if sleep is an issue due to pain. We’ll advise doubling that dose every few days until the most effective dose is found.

This 2:1 ratio of CBD:THC should ensure that the intoxicating effects of THC are minimal. CBD tends to block, or moderate those effects in THC. Those two cannabinoids both have pain relieving and anti-inflammatory effects. However, when combined, these compounds generally have a much higher effectiveness against pain and inflammation.

Finally, although most patients will want to avoid the mind-altering effects of THC, those effects can have therapeutic value on their own. Those suffering with chronic pain often have indications of depression as well. After all, living with pain sucks! With this in mind, feeling ‘uplifted’ by a small extra dose of THC probably won’t hurt anything when work is done for the day.

Whatever path you choose, we plan on being here to help you try to achieve a higher quality of life.

Further reading:
Dr. Russo
University of Michigan
Cannabis and Pain: A Clinical Review