HM668 Final Presentation - FINAL

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Slide 1

Hello! Our final presentation topic for HM668 Legal Aspects of Healthcare Delivery is on The Impact of Medicinal Marijuana on Healthcare Delivery. Our team members include Nick Odell, Nisha Patel, and Sonam Shah.

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Marijuana has been around for thousands of years. The first known record of marijuana dates back to 2727 BC in China. It later spread to other Asian countries, and finally made its way to North America and the rest of the Western Hemisphere by 1545. Restrictions on the use of marijuana were not created until recently in the 1900s. However, in recent years the laws surrounding the use of marijuana have become a hot topic of debate, and states are fighting for the restrictions that were put in place to be lifted.

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In this presentation, we are going to cover the various topics surrounding the issue of legalizing both medical and recreational marijuana. We’ll cover the difficulty in proving the benefits of medical marijuana, case law on marijuana (and we’ll specifically take a look at case law in Connecticut), and the public concerns on the use of marijuana.

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We’ve all heard the terms medical marijuana and recreational marijuana, but what’s the difference? There’s really only one big difference between the two. Medical marijuana is marijuana that has been prescribed by a licensed and practicing physician for a specific medical condition. Recreational marijuana, on the other hand, is only used for leisure. Neither is legal under federal law, though some states have started to legalize both medical and recreational marijuana. Recreational marijuana, however, has taken longer to legalize.

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The Marijuana Tax Act of 1937 was the first law passed in the US to place any restrictions on the use of Marijuana. The act aimed to decrease the use of marijuana by placing a tax on any marijuana-related purchases. The Boggs Act, which was established in 1952, put in place set punishments for anyone that was convicted of drug possession In 1970, the Controlled Substances Act was passed. This was enacted by the Drug Enforcement Administration, or DEA. It categorized all drugs into 5 schedules, number one through five.

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According to the DEA, marijuana is considered to be a schedule I drug. This means that they have high potential for abuse and the potential to create psychological and/or physical dependence. The categorization of marijuana as a schedule I drug has presented problems for the medical research industry. The DEA is required to approve research on drugs with this classification. Without the DEA’s permission to perform research, medical marijuana cannot become an approved drug under the Food and Drug Administration, or FDA.

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Although the federal government still considers marijuana an illicit drug, many states have started legalizing it for both medical and recreational purposes. Marijuana was first legalized for medicinal purposes in 1995, and for recreational purposes in 2012.

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There are a number of chronic medical conditions that marijuana may be prescribed for. The most common conditions that marijuana can alleviate the symptoms of are chronic pain, multiple sclerosis, irritable bowel disease, glaucoma, schizophrenia, chemotherapy-related symptoms, epilepsy, anorexia and other eating disorders, and anxiety disorders

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In this section we will cover the following areas:

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Here is a current snapshot of which states have passed Medical Marijuana. Currently it is 27 States and the District of Columbia

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So after seeing the map, it leads to questions:

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Within Medical Marijuana Federal Legislation we will cover three areas:

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What is the Path for a Drug Going Through the FDA Process:

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Once Approved, the patient is assured the products’ life cycle:

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Along with product life cycle, the patient is assured rights protecting them….

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So that was for drugs that are FDA approved. For Drugs that are not FDA approved they are not protected…..

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Why do States Make the Laws?......

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Most State Laws are Similar in Structure…..

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There are differences however…….

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So as mentioned earlier there are 27 states and the District of Columbia who have passed medical marijuana laws however the rates are very different

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Here we will look briefly at Connecticut’s Medical Marijuana Program…… 2012 Passed Laws Legalizing Medical Marijuana; State Department of Consumer Protection regulates and oversees Program

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So going forward what are the challenges for Federal Legalization…..

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In the End what does this mean for the Healthcare Industry?....Unfortunately a lot of questions and potential issues…….. This concludes our presentation and we look forward to your feedback; Thank you.

Slide 1

The Impact of Medicinal Marijuana on Healthcare Delivery HM668 – Legal Aspects of Healthcare Delivery Spring I 2018 By Nick Odell, Nisha Patel, and Sonam Shah

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2 The Existence of Marijuana Earliest known use of marijuana dates back to 2727 B.C. in China (Cannibis, Coca, & Poppy, n.d.) Brought to North America in 1545 During the 1900’s, restrictions on marijuana slowly started being implemented into federal and state law

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Legalization of Marijuana Medical vs. recreational marijuana Difficulty in proving the benefits of medical marijuana Case law on marijuana Public concerns on the use of marijuana

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4 Medical vs. Recreational Marijuana Medical marijuana is prescribed by a physician for a chronic condition Recreational marijuana is used for leisure Recreational marijuana has taken longer to become legalized Neither is legal under federal law

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History of Marijuana in the U.S. Marijuana Tax Act of 1937 Boggs Act (1952) Controlled Substances Act (1970)

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6 Schedule I drugs have high potential for abuse and the potential to create severe psychological and/or physical dependence.”

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7 State Legalization States started legalizing medical marijuana since 1995 In 2012, recreational marijuana started being legalized in various states

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8 Uses of Medical Marijuana Chronic pain and pain management Multiple sclerosis Irritable bowel disease Glaucoma Schizophrenia and other mood disorders Chemotherapy-related symptoms Epilepsy Anorexia and other eating disorders Anxiety disorders

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9 CURRENT STATUS OF MEDICAL MARIJUANA LEGISLATION STATE LAW STATISTICS & TRENDS CONNECTICUT MEDICAL MARIJUANA PROGRAM CURRENT CHALLENGES TO FEDERAL LEGALIZATION

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MEDICAL MARIJUANA MAP – CURRENT STATE 2018

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11 What is Medical Marijuana Legislation at Federal Level? Why are States Making Laws on Medical Marijuana? What does this mean for the Healthcare Industry?

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12 Medical Marijuana Federal Legislation Approval Process Associated Protections Product Safety & Patients’ Rights

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13 FDA Approval Process Product Research Testing User Restrictions Safety Monitoring Labeling & Marketing

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14 FDA Rights & Protections PRODUCT LIFE CYCLE Raw Material Production Supply Chain Quality Consumption

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15 FDA Rights & Protections PATIENTS RIGHTS Patient Privacy Registration Process Anti-Discrimination

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16 DRUGS NOT FDA APPROVED Compromised Quality Supply Chain of Drug Unaccounted For Patients’ Subject to Discrimination School, Work, Residence

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17 STATE LEGISLATION Provides the Protections Product Safety / Quality Patients’ Rights Identifies Qualifying Diseases

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18 STATE LAW COMPARISONS - SIMILARITIES 100% Protect Patient Privacy 85-95% Agreement on Qualifying Diseases 89% Protect Supply Source

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19 STATE LAW COMPARISONS - DIFFERENCES 50% Protect Against Patient Discrimination 14 – 56% Agreement on Other Qualifying Diseases

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20 STATE LAW STATISTICS - TRENDS Currently 27 States and DC are Legal 1996 – 2008 (12 States or 1/year Avg) 2009 – Current Day (16 States or 1.77 Avg)

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21 CONNECTICUT MEDICAL MARIJUANA PROGRAM Regulated by Department of Consumer Protection Physician Rights & Responsibilities Patient Rights & Responsibilities Dispensaries - Business

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22 CURRENT CHALLENGES FOR FEDERAL LEGALIZATION RESEARCH Lack of Research in Favor Abundance of Research Against PROMISE OF BENEFITS LACK DOCUMENTATION Medical Benefits for Patients Financial Benefits for Governments Research Proves Rising Costs (eg car accidents & ER visits)

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Which Healthcare Providers Can Prescribe? Not legal for doctors to prescribe schedule I substances A ”prescription” for medical marijuana is illegal under federal law Carries significant penalties for physicians Physicians are allowed to make recommendations to patients Cases

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Public Health Effects 1 in 10 marijuana users will become addicted Short and long term effects on patients Short term Attention Memory learning Long term

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Public Safety Increase in emergency room visits In Colorado, they found 639 teenagers who went to one hospital system in 2015 had either cannabis in their urine or told a doctor that they were using. Increased from 146 in 2005 before the use of marijuana was legalized In 2016, average rate of marijuana-related visits to hospital doubled after legalization Poison center calls went from nine in 2009 to 47 in 2015

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Public Safety Increase in number of motor vehicle accidents Decreases reaction time Those under the influence are twice as likely to be involved in motor vehicle accidents Increased risk of fatal outcomes of MVAs Increase in number of work related accidents Impacts the ability of someone to operate heavy machinery

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27 CONCLUSION WHAT DOES THIS MEAN FOR HEALTHCARE? MANY UNKNOWNS FOR LEGALIZATION SOME FACTORS TO CONSIDER - CURRENT FEDERAL ADMINISTRATION MESSAGE - TIMELINE TO CHALLENGE ON BEHALF OF STATE LAWS - TIMELINE & PROCESS TO CHALLENGE

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