04/23/17 David Bradford

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This week: Professor David Bradford on his research that show billions of dollars and countless lives are saved in the US because of medical marijuana, and we look at the Secretary of Homeland Security, Marine General (Ret.) John Kelly.

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APRIL 23, 2017


DEAN BECKER: The failure of drug war is glaringly obvious to judges, cops, wardens, prosecutors, and millions more now calling for for decriminalization, legalization, the end of prohibition. Let us investigate the Century Of Lies.

DOUG MCVAY: Hello, and welcome to Century Of Lies. Century Of Lies is a production of the Drug Truth Network for the Pacifica Foundation Radio Network, on the web at DrugTruth.net. I'm your host Doug McVay, editor of DrugWarFacts.org.

W. David Bradford is the Busby Chair in Public Policy in the Department of Public Administration and Policy at the University of Georgia. Doctor Bradford, you've just published some research in the journal Health Affairs, talking about Medicaid spending and medical marijuana laws. It's not the first time you've been looking at this, at this particular topic. But, tell me about your new article first, I guess.

PROFESSOR W. DAVID BRADFORD, PHD: Yes, so, thanks for having me, by the way. My co-author Ashley, who's also my daughter, and I, have done a series of papers on this related question of what happens to government funded insurance spending for prescription drugs when states approve medical cannabis laws. The most recent study that we're talking about came out this week in the journal Health Affairs, and for that, we asked a relatively straightforward question, which was, how do state spending for prescription drugs under their Medicaid programs, that's the insurance for low income individuals in the United States, how does that change for prescriptions that are used to treat conditions where marijuana might be thought to be a possible treatment option.

And we found that when states turned on medical marijuana laws, that prescriptions for depression, and nausea, and pain, and psychosis, and seizures, actually fell significantly for -- in the Medicaid program, and so there is, there seems to be behavior consistent with patients shifting away from prescription drugs and presumably to marijuana, but also saving the states and the federal government quite a bit of money in the process.

DOUG MCVAY: Yeah, in fact, I think a billion dollars is what you -- yeah, it's right in front of me. In 2014, estimated total savings, fee-for-service Medicaid, could have been $1.01 billion. That's a nice chunk of change.

PROF. DAVID BRADFORD: That is, and, so, if all the states had turned on medical cannabis laws by 2014, that's what we estimate would have been saved just for fee-for-service, and I think I should emphasize that fee-for-service is only about twenty-six percent of Medicaid nationally, so if you think that managed care patients, being patients like fee-for-service patients, would react similarly, then spending, not necessarily programmatic savings, but spending on these drugs, would fall, you know, somewhere between three and four billion dollars.

I mean, this would be anywhere from one to three percent of Medicaid spending, and on -- for prescription drugs, and that's absolutely not a trivial amount of money.

DOUG MCVAY: Oh indeed. Now, okeh, how many of the states did you look at, in terms of these prescriptions?

PROF. DAVID BRADFORD: So, at the time that we were doing, we were doing this analysis, we had, as I recall, there were twenty states that had medical marijuana laws turned on, in 2014. Now, this is again, if a state had turned on the law but hadn't done anything that would allow patients to get access to cannabis, we didn't count them as being turned on. But there were 20 states at that point in time that had laws that were in place.

As you know, 28 states do currently, so it's been -- there's been a lot of movement in this policy, even over the last two to three years.

DOUG MCVAY: Right on. And, well, the other thing about the medical cannabis laws in this country, medical marijuana laws, is that we've become more and more restrictive as states have medicalized, the conditions, I mean, starting with California, which was very broad, and then in Oregon, which was a little more restricted, but still fairly broad, any of 7 or 8 different categories, and the more states that have gotten into it, the more restrictive some of these laws have become, so it's -- it's not like you're just looking at California. You're looking at all of these states. And, --

PROF. DAVID BRADFORD: No, that's right, we are looking at states, as you say, like California, that, I mean, to the extent that California has a list of qualifying medical conditions it's an extremely long list, right? But states that have approved medical cannabis more recently are more restrictive in that sense. But, all of them are looking at -- have approved the conditions that we studied, and we studied nine different broad areas of clinical diagnoses, areas that the states had pretty much uniformly included in their lists of approved conditions, and that the clinical evidence was strong that there was in fact reason to believe marijuana could be an effective therapy.

DOUG MCVAY: Now, your earlier article back in June of 2016 on Medicare Part D -- remind us of the results you had in that.

PROF. DAVID BRADFORD: Well, the results were remarkably similar. We had studied the same nine categories, so we actually wanted to have a consistent methodology across the two, so that in some sense you could combine the numbers into some -- a meaningful number. And there we found that of the nine areas, not only did depression, nausea, pain, psychosis, and seizure seem to respond, those drugs seemed to respond to medical cannabis, anxiety and sleep disorder drugs did as well.

And there we found, you know, and that data actually only went to 2013, and we found that states could have -- that the federal government in that case could have saved approximately half a billion dollars if all the states had turned on medical marijuana.

I will say that we've actually replicated that analysis with another year, that would allow us to also distinguish between dispensary and home cultivation states. Once we get the additional year we could do that.

And while these results aren't published yet, they're in a paper that's under review, it looks like once you control for the dispensaries and add the additional year, for 2014, even Medicare Part D would have saved just over a billion dollars, had all the states been turned on.

So, you know, we're looking at, between the -- between these two, as I said, between these two government sponsored insurance programs, something between two and four billion dollars potential savings, if cannabis were approved nationwide.

DOUG MCVAY: Now, I realize it's not in the articles you've done, but the implications are pretty clear, I mean, we've seen other research that the overdose rates in states which have medical marijuana laws have -- seem to have, you know, shown a, you know, at least a slower rate of increase, if not, you know, and potentially decreases. There does seem to be a good kind of an impact from medical marijuana laws on the overdose. Would you care to speculate, I mean, looks like your -- your research seems to show the evidence of how that's happening. Would you care to speculate about that?

PROF. DAVID BRADFORD: Yeah, I think that -- I think it's, I mean, that's a conclusion that we think is, you know, reasonably supported by our findings as well. So, we're finding that most Medicare Part D and in fee-for-service Medicaid, that one of the biggest categories of response is pain medication, and a large portion of pain medications are of course opiates.

And so one one of the benefits that come from -- that we're finding from medical marijuana laws are in fact that, to the extent that people are shifting away from opiates as we find that they do, and to marijuana, you know, we can't actually see that they adopt marijuana, but we've see them shifting away from opiates. Then they would be shifting from products -- a product, you know, opiates, that kill 34,000 Americans, in the last year that we actually have statistics, that's as many people as two 747s a week crashing, each and every week.

Opiates are dangerous, they're, they can be easily misused and abused, and they can kill people. Marijuana doesn't kill people, there, I believe that it's the case that there's not a single documented case of a person dying from certainly inhaled whole plant marijuana. And so, diverting people towards marijuana and away from opiates, when appropriate, could definitely save lives.

The National Academies of Sciences, Engineering, and Medicine just in January issued a report where they found conclusive evidence that, in their own words, that the evidence is conclusive, that cannabis is useful for treating chronic pain and nausea associated with chemotherapy and a number of other conditions. So it's clear that there's medical benefit, which means that the Schedule One status of marijuana is currently completely inappropriate, even by the plain reading of the Controlled Substances Act.

But we do definitely see evidence of pain medications, many of which are going to be opiates, going down. And I will tell you that we have other work that we just presented at an international conference in London back in January that looked at this question of what happens when, to opiate related deaths at the county level for all the counties of the US, from 2000 to 2014, and we found that when states turn on dispensary based systems, it's not true for home cultivation, but when they turn on dispensary based medical marijuana access, opiate related deaths fall significantly.

So, I think that it is absolutely fair to take a look at our work and, as you mentioned, the many other papers that have been published and released in the last few years, and suggest that marijuana could be an effective tool in our arsenal at fighting opiate abuse and death in the United States.

DOUG MCVAY: Well, this is all, this is some great stuff, and I'm looking forward to hearing you speak next month, you're going to be at the Patients Out of Time National Clinical Conference on Cannabis Therapeutics down in Berkeley this May, correct?

PROF. DAVID BRADFORD: That's right, Ashley and I will both be there, and I'm not sure which of us will speak, I certainly hope it will be her, that way I can just enjoy the experience. But we're looking forward to being there and meeting with many people who are engaged at, you know, sort of all levels of understanding and promoting evidence based cannabis policy around the United States. So it should be very interesting, and we're certainly looking forward to it.

DOUG MCVAY: Well, terrific, I'm looking -- I'll be there, and I'm looking forward to meeting you.

PROF. DAVID BRADFORD: Hey, I look forward to it as well.

DOUG MCVAY: And, any closing thoughts for the listeners? And, once again, this was published in the new edition of, or it's the web-first, I guess, for Health Affairs journal. But any way people can keep up on you, do you have a twitter or website or something? And as I say, your closing thoughts for our listeners.

PROF. DAVID BRADFORD: Sure. So, my closing thoughts for your listeners is that I do hope that they do keep track of the evidence that's coming to the fore about medical cannabis and calls their representatives. There are a number of laws in front of the US Congress, both on the House and the Senate side. There are bills with sponsors, Republican and Democratic sponsors, to reschedule and liberalize cannabis policy. Making phone calls to your representatives matters. And, you know, if you want to call your representative, the thing to do is pick up the phone, get through, say your name, say your zip code, say you're a constituent, and just say what you want your representative to do. The people on, you know, the staff there will take your name down and your -- on the call sheets, and those call sheets matter.

So I do strongly encourage your listeners to get involved and to make their local and their federal representatives know, make sure they hear their voices, because the more evidence we can bring to bear for policy, the better the policies are going to be.

DOUG MCVAY: You know, people forget about phone calls because, you know, it's all email these days, but, you know, a telephone call is the thing that the staffer has to stop what they're doing and answer. Emails, hey, you can just do an automatic -- they just get automatic responses, they just get tallied up, and the phone calls, they actually have to talk to somebody. They remember phone calls.

PROF. DAVID BRADFORD: Absolutely. And you know, I think people don't -- people think email, and actually email is exactly the wrong thing. If you talk to anybody who's worked in the staff, whether on the Hill or actually in the local offices, and sometimes you can't get through to the Hill office but you can call the local office. Those phone logs make a huge difference, and I think if you really want to have an impact on how your representative thinks about policy, it's getting on those phone logs that are going to do it.

DOUG MCVAY: Absolutely, absolutely. David -- Professor Bradford -- Doctor Bradford -- ah, heck, David.


DOUG MCVAY: David, thank you so much for your time.

PROF. DAVID BRADFORD: Absolutely, thank you for having me.

DOUG MCVAY: All right. Cheers.

PROF. DAVID BRADFORD: All right. Thanks.

DOUG MCVAY: That again was Professor W. David Bradford, he and his daughter Ashley Bradford have just published an article in the journal Health Affairs, the title is Medical Marijuana Laws May Be Associated With A Decline In The Number Of Prescriptions For Medicaid Enrollees. It was published online April 19, 2017.

I mentioned the Patients Out of Time conference in our interview with Doctor Bradford. I should mention, in the interest of full disclosure, that I do social media and web work for Patients Out of Time, and I am working with them on this conference, coming up in May, the 18th, 19th, and 20th in Berkeley, California. The Eleventh National Clinical Conference on Cannabis Therapeutics. Registration is open at the Patients Out of Time website, PatientsOutOfTime.org.

A lot of great speakers will be in attendance, and in fact, on the 17th, the day before the pre-conference sessions and all the rest of it kick off, we'll have a screening of a brand new documentary that one of our good friends, Ervin Dargan, has put together about a medical cannabis patient named Cathy Jordan, who has been surviving for more than 30 years with ALS. And, she is an outstanding spokesperson, and just an amazing individual. Again, we'll be having that screening on May 17th there in Berkeley. Admission to that screening is by donation, so, more information again at PatientsOutOfTime.org. You're listening to Century of Lies, a production of the Drug Truth Network for the Pacifica Foundation Radio Network, on the web at DrugTruth.net. I'm your host, Doug McVay, editor of DrugWarFacts.org.

Department of Homeland Security Secretary John Kelly appeared before the Senate Homeland Security and Governmental Affairs Committee on April Fifth. He was being questioned about border security, and of course drugs were part of the discussion. Here he is, the first voice you hear will be Senator Steve Daines, Republican from Montana.

US SENATOR STEVE DAINES (R-MT): Yeah, well, I think you're also demonstrating in my opinion the experience you are bringing from your Southern Command leadership. I think it's having already a significant impact on our country in protecting our southern border.


SEN. STEVE DAINES: So, no, thank you, truly. And also I appreciate your compassion, as you're looking at the effect it's having on very poor people, who are being taken advantage of, as they're seeking to come into our country.

I'm from Montana, we think about our northern border, but the southern border and the methamphetamines that are coming in to Montana, and they're coming in from our southern border, having a huge impact on our state. Mitigating the flow of drugs long before they reach our border, as you are well aware, from your time in command of SouthCom, is very important. We discussed this concept at the confirmation hearing. What steps have you taken on the job to stymie the flow of drugs as well as violence into our country?

DHS SECRETARY JOHN KELLY: Great question. One of the things we know about the flow of hard drugs, marijuana comes in vast amounts but it's also produced in the United States in vast amounts. But methamphetamine, heroin, and cocaine are the big killers, and along with that are opiates that are counterfeited, if you will, and of course not a lot of quality control, so, but you don't know, the average person abusing opiates in the United States doesn't know that a lot of it is not produced by, you know, credible -- they're produced in labs in Mexico or in other places, but the point is, most of that comes into the United States in ten, fifteen, twenty kilo loads, via the ports of entry, in trucks and things like that.

So, what have I done. We're now looking very, very hard at the ports of entry, which are not really part of the wall, if you will, effort, but look at the ports of entry. If there is better technology out there, and I think there is, to look into vehicles without, without unloading the vehicle, particularly tractor-trailers, to get after it that way, but I will tell you, methamphetamine, helping, working with the Mexicans, they're good partners in law enforcement. My folks, I'm proud to say, my HSI, Homeland Security Investigation, working with the Mexicans, led them to, I'll just put it that way, to two huge methamphetamine labs that were destroyed by the, by the Mexican marines, I think in that case.

Working with them in identifying the poppy fields, in, primarily in the south, the Pacific southwest of their country, and helping, offering them, perhaps, help in how to eradicate those, much as we've done for so many years in Colombia with coca, that's what we're doing. But the big issue really, right now on drugs coming to the United States, is the ports of entry, and a part of that as well is what goes south. We don't look as much at going south out of our country. The Mexicans don't look at that very well, either. I'd like to extend the effort to look in vastly more vehicles going south, because bulk money in unbelievable amounts travels south out of the United States into the rest of the hemisphere to get laundered. I mean, billions and billions of dollars, and guns.

If the, if we point a finger at the Mexicans, or people who produce, countries that produce drugs, we produce, point our finger at them about the production of drugs, they will point their finger right back and say, what about guns? So we need to do better in the southward flow, to go after the money, and to go after the flow of guns, and that will take some time, some money, some effort, but I think that there's a next step, and a next step after that, in technology. The stuff we have now is pretty good, I was up with Senator Peters looking at the busiest traffic point between Detroit and Canada, technology that looks into trucks, tractor-trailers, is pretty good, but I know there's better stuff out there and we'll just get after it.

But mostly, the drugs come in, we believe, we know, comes in in relatively small amounts, ten, fifteen kilos at a time, in automobiles, and in those kind of conveyances.

DOUG MCVAY: Kelly appeared on Meet The Press Sunday April 16th. He was talking about, oh, immigration, and drug war, and terror, and one of the questions that he was asked was about marijuana. Kelly had in the past said that, well, if it's medicine, then that's medicine, doesn't like marijuana, thinks it's a gateway drug. But, in this interview, Kelly told the host, Chuck Todd, that he didn't consider marijuana to be a factor in the war on drugs, and he said that arresting a lot of users wasn't the right solution to the country's drug problem.

This is a pretty realistic, pretty straightforward thing. He is a retired Marine Corps general, you'd expect pretty straightforward, pretty direct kind of statement from General Kelly. Then a couple of days later, General Kelly made an actual policy speech at George Washington University, at the Center for Cyber and Homeland Security at GW. And on April 18th, General Kelly presumably had been instructed by the administration what the administration's line is on all these things. This is what General Kelly had to say.

DHS SECRETARY JOHN KELLY: But the damage TCOs do in violence and potential terror is only part of the story. It is also that they move vast tonnages of marijuana and hard drugs -- cocaine, heroin, counterfeit opiates, fentanyl, and methamphetamines -- they move these vast tonnages across our borders to feed both the recreational and the addictive US drug demand.

US Customs and Border Protection CBP, U.S. Immigration and Customs Enforcement ICE, ICE’s Homeland Security Investigations, and the US Coast Guard, all bear witness to the massive quantity of drugs that these organizations traffic into the United States every day, with devastating consequences.

In 2015, which is the most recent data we have, there were over fifty-two thousand deaths from these drugs in the United States caused by these drug overdoses. It’s the highest number of drug-related deaths our country has ever seen. It’s more deaths than the peak of the AIDS epidemic in 1995. It's -- in a single year, we’ve lost nearly as many Americans to drug overdose as we lost in the entire World War One. It's almost as many as was lost in twelve years of fighting in Vietnam.

And that’s just overdose deaths. That number, as high as it is, says nothing about the long-term health damage to our citizens who survive, to say nothing about the human misery, the families ripped apart, and the extremes of crime and violence inherent in the illegal drug enterprise.

And let me be clear about marijuana. It is a potentially dangerous gateway drug that frequently leads to the use of harder drugs. Additionally, science tells us that it is not only psychologically addictive but can also have profound negative impacts on the still developing brains of teens and people up into their mid-20s. Beyond that, however, its use and possession is against federal law and until the law is changed by the United States Congress, we in DHS, along with the rest of the federal government, are sworn to uphold all the laws that are on the books.

DHS personnel will continue to investigate marijuana’s illegal pathways along the network into the United States, its distribution within the homeland, and will arrest those involved in the drug trade according to federal law. CBP, our customs professionals, will continue to search for marijuana at sea, air and land ports of entry and when found take similar and appropriate actions.

When marijuana is found at aviation checkpoints and baggage screening TSA personnel will also take appropriate action. Finally, ICE will continue to use marijuana possession, distribution, and convictions as essential elements as they build their deportation removal apprehension packages for targeted operations against illegal aliens living in the United States. They have done this in the past, are doing it today, and will continue into the future.

While we’ve seen a drop in human smuggling, agencies across our Department continue to seize vast amounts of dangerous drugs.

At the midpoint of this fiscal year, the Coast Guard is combating a sharp uptick in cocaine flow, and has already removed nearly 243,000 pounds that were headed to the United States. CBP has also reported a 39 percent increase in cocaine seizures, for a total of over 43,000 pounds. They’ve also seen an increase in heroin and methamphetamine seizures -- and again, it’s only halfway through the fiscal year.

When you consider that CBP seized an average of four tons of drugs every day in 2016 -- and that number’s going up -- you see our nation has a serious, serious drug problem.

We need a national and comprehensive drug demand strategy and a commitment to reduce drug demand in the United States, and I don't mean arresting our way out of this. I mean, it's a comprehensive plan to reduce drug demand.

A focused effort that not only employs the full resources of the federal, state, and local governments, but also Hollywood, professional sports figures and teams, high school coaches, Boy and Girl Scout leaders, and community activists, as well as law enforcement like the FBI and DEA and their “Chasing the Dragon” program, as well as priests, pastors, rabbis and imams to lead their flocks, and, finally, ladies and gentlemen, it all begins at home. Parents have got to be more engaged in what their children are doing, whether it's on the internet, or taking drugs, experimenting with drugs.

The time is now, because the president -- this president -- has recognized this problem and he has signed an Executive Order establishing the President’s Commission on Combating Drug Addiction, of which I am part.

DOUG MCVAY: There's much more of that speech available, the entire thing is online at DHS.gov. You probably saw in some of the industry-sponsored marijuana media, and some of the different marijuana businesses, touting the fact that an administration official said something that was not lock 'em up and throw away the key, that he was expressing some kind of a soft opinion about drugs. Wasn't that wonderful? So don't worry, investors, everything is fine.

Except for what happened two days later. I'm not here to tout a marijuana business. I'm not here to reassure investors. I'm here to give you, our listeners, the truth. The simple, plain, unvarnished truth. It ain't going to be pretty, but it is at least going to be accurate.

This new administration does not have a good drug policy. They may not yet be cracking down on states which have legalized or medicalized, but there's no question, these people are not friends of drug policy reform. As I was saying with Professor Bradford earlier in the show, contacting your representatives, your senators, let them know you are a supporter of medical marijuana, that you're a supporter of marijuana legalization, and that in fact drug policy reform is one of your main topics of interest. They need to know this, because that's really what it's all about. That's why I'm here. I am Doug McVay, the editor of Drug War Facts, and this is Century Of Lies.

We're a production of the Drug Truth Network for the Pacifica Foundation Radio Network, on the web at DrugTruth.net. The executive producer of the Drug Truth Network is Dean Becker. Drug Truth Network programming is also available via podcast, the URLs to subcribe are on the network home page at DrugTruth.net. You can follow me on Twitter, I'm @DougMcVay and of course also @DrugPolicyFacts.

We'll be back next week with thirty minutes of news and information about the drug war and this Century Of Lies. For now, for the Drug Truth Network, this is Doug McVay saying so long. So long!

For the Drug Truth Network, this is Doug McVay asking you to examine our policy of drug prohibition: the century of lies. Drug Truth Network programs archived at the James A. Baker III Institute for Public Policy.

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