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to 25 speakers who have indicated they want to talk
to us after lunch, so we will see you in an hour.
(Lunch recess.)
LLOYD JESSEN: Okay, Welcome back,
think we're ready to continue, and our next
scheduled speaker is Gary Young from the Iowa Elks
Association. Gary, are you here?
GARY YOUNG: It's really set up to
address the audience, not the board. Who would you
prefer I speak to?
GARY YOUNG: My name is Gary Young,
and I retired about two and a half years ago after
a 35-year career with the Polk County Health
Department. I worked as an environmentalist, and I
continue to maintain national professional
registration as an environmental health specialist
emeritus.
I'm here today representing the Iowa
Elks Association as a volunteer. The Iowa Elks
Association is an association of 33 local Elks
lodges in Iowa with about 12,000 members.
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The Benevolent and Protective Order of
Elks nationally has the largest volunteer youth
drug awareness program in the nation. We are
committed to help our youth make informed choices
about drug, alcohol, and tobacco use.
Recently the Iowa legislature banned
tobacco smoking in public places. This action was
to protect employees and the public from the
harmful effects of secondhand smoke.
Redefining smoked marijuana as a
medicine would allow users to smoke in places where
tobacco smoking is currently prohibited. If
someone is taking medicine, you cannot prohibit
them from where and when they take it.
A study published in 2001 in the
British Journal of Psychiatry stated "Actions on
specific brain receptors cause dose-related
impairment of psychomotor performance with
implications for car and train driving, airspace
piloting, and academic performance. Other
constituents of cannabis smoke carry respiratory
and cardiovascular health risks similar to those of
tobacco smokers."
The study concluded "Cannabis is not,
as widely perceived, a harmless drug but poses
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risks to the individual and to society."
Another study published in June 15 --
in the June 15, 2009, issue of Chemical Research
and Toxicology stated "The smoking of three to four
cannabis cigarettes a day is associated with the
same degree of damage to the bronchial mucus
membranes as twenty or more cigarettes a day."
The research was based on tests that
look scientifically at acetylate, a suspected
cancer-causing chemical known to effect human DNA
that is found in both kinds of smoke.
The study concluded "These results
provide evidence for the DNA-damaging potential of
cannabis smoke implying that the consumption of
cannabis cigarettes may be detrimental to human
health with the possibility to initiate cancer
development."
There are no -- currently no
FDA-approved medications that are smoked. Smoking
is a poor delivery system. It is difficult to
administer safe regulated dosages of medicines in a
smoked form. The harmful chemicals and carcinogens
that are by-products of smoking create additional
health problems. There is three to five times the
level of tar in a marijuana cigarette, for example,
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as in a tobacco cigarette.
Morphine has proven to be a medically
viable drug, but the FDA does not endorse the
smoking of opium or heroin.
Scientists have extracted active
ingredients from opium which are sold as
pharmaceutical products like morphine, codeine,
Hydrocodone, oxycodone. The FDA has not approved
smoking marijuana for medical purposes but has
approved the active ingredient THC in the form of
scientifically regulated Marinol.
Unlike smoked marijuana, which
contains more than 400 different chemicals,
including most of the hazardous chemicals found in
tobacco smoke, Marinol has been studied and
approved by the medical community and the Food and
Drug Administration.
The FDA mandates that any drug
marketed in the United States must undergo rigorous
scientific testing to ensure compliance with the
Pure Food and Drug Act.
If this board redefines smoked
marijuana as medicine, what agency will fill the
role of the FDA to ensure dosage levels and purity
of the marijuana? Does the State of Iowa have the
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resources to establish such an agency?
On April 20, 2006, the FDA issued an
advisory concluding that no sound scientific
studies have supported medical use of smoked
marijuana for treatment in the United States. And
no animal or human data support the safety or
efficacy of smoked marijuana for general medical
use.
A number of states have passed voter
referendum or legislative actions making smoked
marijuana available for a variety of medical
conditions upon doctor's recommendation. According
to the Food and Drug Administration, these measures
are inconsistent with efforts to ensure medications
undergo rigorous scientific scrutiny of the FDA
approval process until they are proven safe and
effective under the standards of the FD&C Act.
Experiences in other states which have
redefined marijuana as medicine have shown that not
only does THC content vary in marijuana, there is
no process in place to guarantee that the product
remains unadulterated, does not fall into the hands
for those which it was not prescribed --
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GARY YOUNG: --and no protection
from
secondhand smoke from the public was provided.
According to the National Institute on Drug Abuse,
marijuana is the most frequently used illicit drug
in the United States with over 14 million Americans
over the age of 12 reporting past month usage in
2006.
The Harvard School of Public Health
conducted three surveys between '93 and '99
examining the drug and alcohol USe of
44,265 college students nationwide. According to
the Harvard study, factors associated with smoking
of marijuana includes spending more time at parties
and socializing with friends, spending less time
studying, and perceiving religion and community
service activities as not important.
Marijuana was also associated with
poorer academic performance. Students who use
marijuana were less likely than those who did not
to study for two hours a day and were more likely
to have a grade paint average of B or less.
The most consistently reported
cognitive defects from chronic marijuana smoking
are memory deficits. Physically it's the
hippocampus in the brain where the researchers
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located the actions that convert information into
short-term memory, and perhaps also long-term
episodic memory negates the information from memory
consolidation as well as coding spatial and
temporal relations among stimuli. Researchers also
noted a high number of cannabinoid receptors exists
in the hippocampus.
Professional --Professor Samuel
Deadwyler from the North Carolina Bowman Gray
School of Medicine gave a speech in 1995 in which
he said regarding the hippocampus, "In this area
when damaged --it is this area when damaged that
renders patients literally incapable of remembering
new information for more than a few minutes, and it
is undoubtedly critically involved in the
well-known memory deficits in Alzheimer's disease."
Long-term exposure to marijuana has
dual consequences for the memory. First, repeated
exposure to marijuana in animals makes them more
and more tolerant of this memory disruptive effect.
However, this also means continued use of the drug
requires higher and higher doses before the
euphoric or high state is achieved. Hence, even
though memory is not impaired at the time -- at the
same dose as before, it will be impaired just as
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much because the individual will take more drugs to
obtain the original euphoric state.
Hence, though the memory is not
impaired, it does take more drugs, which means that
the chronic use will eventually produce permanent
effect on memory since the hippocampus will adjust
its memory storage mechanisms to handle the lower
capacity volume of information flow provided by the
drugs. This may also be the basis for the
well-known memory deficits that are present in
chronic marijuana.
Children and young adults in
particular depend on their short-term memory since
they are learning and receiving new input
constantly.
While smoking marijuana may allow
patients a temporary feel better, the medical
community makes an important distinction between
inebriation and the controlled delivery of pure
pharmaceutical medicine. The raw leaf form of
marijuana contains a complex mixture of
concentrations, the majority of which have unknown
pharmacological effects.
The American Academy of Ophthalmology
stated based on a review by the National Eye
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Institute and the Institute of Medicine and on
available scientific evidence, "The task force on
therapies believes that no scientific evidence has
been found that demonstrates increased benefits
and/or diminished risks of marijuana use to treat:
glaucoma compared with a variety --wide variety of
pharmaceutical agents now available."
American Medical Association
recommends that marijuana be retained in Schedule
of the Controlled Substances Act and that research
should be done to provide THC in a hatch or in a --
the Institute of Medicine also gave a
recommendation against it.
The National Multiple Sclerosis
Society does not believe that there's any evidence
that marijuana or its derivatives provides
substantial benefits.
And finally, in closing, I'd like to
quote Reverend Scott Imler who was a cofounder of
Proposition 215, which is California's medical
marijuana law. The reverend stated "We created
Proposition 215 so that patients would not have to
deal with black market profiteers, but today it is
all about the money. Most of the dispensaries
operating in California are little more than dope
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dealers in storefronts."
I urge the board to make its decision
based on scientific evidence and not anecdotal
evidence. Thank you for your time.
LLOYD JESSEN: Thank you, Gary.
Do we
have Audrey Harshbarger? Audrey? Okay. Dr. Alan
Koslow.
ALAN KOSLOW: I don't know if you want
a copy of my curriculum vitae.
everybody. The pharmacy board and ever/body else
here in the audience, I know this is a very
important topic for everybody.
I first want to kind of talk about my
background, why I'm here and my experience and who
I am. I'm a vascular surgery --surgeon in the
community. I also am fairly politically active, as
some of you know. ran for the state legislature.
I -- as a vascular surgeon, probably
about 15 or 20 percent of my patients have
neuropathic pain. Besides for that, vascular
surgeons have within their domain the treatment of
several pain syndromes including thoracic outlet
syndrome, complex regional pain syndrome or --