- Associated Press - Wednesday, July 15, 2015

The Aurora Sentinel, July 9, on vaccinating children:

It’s time for Colorado to join California in solving an ailing public health problem that’s easy to cure. Last week, California Gov. Jerry Brown signed into law a measure that virtually eliminates all exemptions to that state’s childhood vaccination policy.

“The science is clear that vaccines dramatically protect children against a number of infectious and dangerous diseases,” Brown wrote as part of his bill-signing ceremony. “While it’s true that no medical intervention is without risk, the evidence shows that immunization powerfully benefits and protects the community.”

What was once a quirky curiosity among some Colorado residents - who, for no good reason, became leery of childhood disease vaccinations - has now become a public health menace that seriously threatens all of us.

A woman in Washington died of measles last week because she had a compromised immune system and was exposed to the virus by people who were not vaccinated. This followed a measles outbreak at Disneyland earlier this year that sickened 100 people, all because foolish, misled, selfish people have avoided childhood vaccination rules regarding public schools.

Real scientists and medical professionals have been unequivocal: The purported danger of childhood vaccines are lies. Dangerous lies.

So California now requires every child who attends a public school or college to undergo vaccination. Colorado must do the same thing to prevent death and disease caused by irresponsible and reckless parents who willingly or passively seek to get around the program.

The state cannot command these vaccinations, but lawmakers certainly can compel scofflaws to stay away from public programs and venues to protect the rest of us. Schools, rec centers, colleges, day cares and employers should all demand that people comply with vaccination programs.

Right here in Colorado, one of the most “educated” states in the union, we rank right at the bottom of vaccination rates. It now looks that in some places, only 80 percent of kids are current on their shots.

The sorry response by Colorado state lawmakers is nothing to sneeze or cough at. Succumbing to fake science and political pressure, they let Colorado parents off the hook when it comes to vaccinating their children. Anybody can opt-out just by saying, “I don’t believe in vaccination” and checking off a box that’s easier than proving your kid did get vaccinated.

It’s almost unthinkable that a country like the United States would slide back decades in health care progress, risking the lives of millions of Americans potentially exposed to diseases we nearly eradicated - because of lies, laziness or ignorant fear.

The media deserves much of the blame. A discredited study run by a discredited doctor tried to tie autism to childhood vaccinations and the U.S. media bought the hoax hook, line and sinker, helping to legitimize it. The groundless claim and fake study have since been debunked endless times for several years. There is not one reputable pediatrician, pediatric organization, hospital, clinic or researcher that does not vehemently work to debunk the autism lie, and beg parents to vaccinate their children.

But parents still won’t listen and comply. So the only answer is to change the law. Follow California’s lead here and prevent needless death and disease here in Colorado.

Editorial: http://bit.ly/1gAcN8T

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The Greeley Tribune, July 11, on allowing grocery stores to sell beer and wine:

Sometimes the best intentions deliver the worst results.

We’re worried that may describe an effort in Colorado to allow grocery store chains to sell full beer and wine. Right now, state law essentially only allows grocery stores, such as King Soopers or Safeway, to sell beer with 3.2 percent alcohol or less, and they can’t sell wine. A group called Colorado Consumers for Choice is working to change that. Organizers say they’ll likely look to gather signatures and get a measure on the 2016 ballot asking voters to allow grocery stores to sell beer and wine, but not liquor. Of course, it’s early in the process and no paperwork has been filed. In fact, organizers say they may seek to work through the Legislature next year to get the law changed. They contend doing so would be a boon for consumers because it would open up options.

And the group’s message has resonated with some. More than 43,000 people like its Facebook page and 5,629 people signed their online pledge so far, according to spokesman Rich Coolidge.

We’re not opposed to consumer choice. In fact, we like it. And we can understand why the movement would draw some initial support.

Still, we worry about unintended consequences. There’s good reason to believe that if the proposal became law, consumers would soon find fewer choices instead of more. That’s because the proposal would likely squeeze the kind of small beer and wine producers that have built a burgeoning craft brewing industry in northern Colorado and Weld County.

To get their product to consumers, most of these small brewers rely on the personal relationships they build with individual liquor store owners, who also generally operate with a small economy of scale. To get shelf space in grocery stores alongside massive brands such as Coors and Budweiser, these smaller brewers would likely need to drive, or fly, to the corporate headquarters of a chain store just to make their pitch. It’s a good bet, too, that folks who make purchasing decisions for corporate supermarkets would have different demands than mom and pop liquor stores.

Weld-based craft brewers, such as Wiley Roots and WeldWerks Brewing Co., have already expressed concerns about how such a move would affect their businesses.

On top of that, there’s reason to worry about how all this change would affect locally owned liquor stores.

“We’d have to close. Our employees would all be out of jobs,” said Cindi Feit-Clark, co-owner of Bittersweet Liquors.

If the proposed rule change does hamper craft brewers and drive a significant number of local liquor stores out of business, consumers will find fewer choices for adult beverages, not more. And hardworking members of our community would lose their livelihoods.

For their part, organizers of Colorado Consumer for Choice contend these concerns are overblown.

“Bottom line, liquor laws don’t seem to impact the success of craft brewers as much as the entrepreneurial spirit of those who start them,” Coolidge said in an email.

We’re not sure. And we’ll reserve any final judgment on changes in the law until we see a firm proposal. But with a growing number of brewers providing jobs - and suds - in Weld, it seems like Colorado’s current system is working well. It’s tough to see a reason to change.

Editorial: http://bit.ly/1I0ddl3

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The Gazette, July 12, on medical marijuana and post-traumatic stress disorder:

For every military veteran appearing in a Colorado public meeting to advocate for the right to use marijuana to treat post-traumatic stress disorder, mental health professionals throughout Colorado estimate they’ve worked with thousands whose pot use made their PTSD - and their lives in general - much worse.

“I have seen marijuana use create so many more problems than it solves,” said Brian Lanier, a licensed clinical social worker and Army reservist in Colorado Springs who has worked more than 15 years with veterans and active-duty service members. “If nothing else, these people are just numbing themselves, which is definitely not appropriate treatment for PTSD. Telling someone to use marijuana for PTSD or any mental health problem is like telling them to go get drunk.”

His sentiments are shared by mental health professionals nationwide, as physicians most qualified in the treatment of PTSD and mental illness have mounted protests against a recommendation by the Colorado Department of Public Health and the Environment to add PTSD to the list of conditions qualifying for access to “medical marijuana.” A rule-making hearing that includes public testimony is set for Wednesday in Denver. The Colorado Psychiatric Society and the Colorado Child and Adolescent Psychiatric Society lodged letters of protest - as did Dr. Kenneth Finn, a Colorado Springs physician who specializes in pain medicine.

“(PTSD) is complex and not easily treated by physicians, particularly those with no psychiatric background,” Finn stated in his letter to the CDPHE. “As a pain medicine physician, I see many patients with the diagnosis who are being co-treated by a psychiatrist. I would not feel comfortable trying to manage a patient’s medications with this diagnosis. If PTSD reaches the bar of a ‘disabling condition’ in Colorado, it will give free reign to any physician or any doc-in-the-box with no background in psychiatry to recommend cannabis for these patients. The potential negative sequelae (corollaries) are huge.”

And they move far beyond serious questions about physicians who practice outside the scope of their training and the potential liabilities they face should something go wrong.

Marijuana, dried parts of the cannabis plant that are typically smoked, and extracts of concentrated THC, the leading active ingredient of cannabis that produces a euphoric high and commonly is infused in foods and drinks and vaporized through electronic cigarette devices, aren’t shaping up to be so medical, researchers say. In June, the Journal of the American Medical Association published reports from an international team of researchers who conducted a comprehensive review of dozens of clinical trials testing marijuana, a psychoactive drug, for 10 conditions. They found very little reliable evidence to support the drug’s medicinal use and warned that users are at greater risk of having psychiatric disorders and other health problems.

State laws sanctioning marijuana for medical reasons have “relied on low-quality scientific evidence, anecdotal reports, individual testimonials, legislative initiatives and public opinion,” two psychiatrists at Yale University wrote in a supporting editorial. “Imagine if other drugs are approved through a similar approach.” Drs. Deepak Cyril D’Souza and Mohini Ranganathan noted that state approvals of marijuana for medical use have outpaced research and should wait for stronger evidence of efficacy and safety. Federal and state governments should support and encourage such research, they added.

“Perhaps it is time to place the horse back in front of the cart,” the doctors wrote.

Where the treatment of PTSD is concerned, the State of Colorado certainly has opportunity and reason to do so. It has awarded a research grant to evaluate marijuana’s effects on PTSD treatment, and the work is just getting underway. That is “all the more reason for officials with the CDPHE, Colorado Board of Health and state lawmakers to reserve judgment about marijuana’s efficacy (for PTSD) until that work is complete and also evaluated within the larger context of the world body of medical literature by professionals with appropriate formal training and expertise to do so,” wrote Dr. Christian Thurstone on his website. An associate professor of addiction psychiatry at the University of Colorado, who directs medical training for the addiction psychiatry fellowship program, Thurstone serves as a major in the U.S. Army Reserves and on the board of Smart Approaches to Marijuana (SAM) - which he joined after seeing increasingly detrimental effects marijuana had on his patients.

“If we’re genuinely concerned about the mental health of our service members and veterans, we should demand nothing less than easy, affordable access to the psychotherapies and pharmacotherapies that have proven to be safe and effective - and we should reject marijuana until it meets those standards,” Thurstone added.

The world has seen the manipulation of military service members for drug-industry gain in the past. Tobacco smoking’s close ties to the American military started during World War I. At the time, national smoking rates were low. To gain market traction, tobacco companies targeted military personnel, even setting up funds where Americans could express their support for the war effort by purchasing smokes for soldiers.

Fast forward to Jan. 1, 2014, when the first purchase of state-sanctioned, recreational marijuana - carefully staged for reporters and cameras - was made by a Denver-based Iraq War veteran who claimed to have PTSD and said he needed marijuana to alleviate his symptoms.

Intensive therapy is hard work - and it is a core component of PTSD treatment, psychiatrists and other PTSD treatment specialists say. Marijuana users mask problems without addressing the underlying causes of the stress, anxiety, fear and anger that keep them in a continual state of emotional distress. If they’re under the drug’s influence, therapy is nearly impossible, and the symptoms of PTSD - a condition that in most cases lasts less than a year with rigorous therapy - worsen, said Dr. Stuart Gitlow, immediate past president of the American Society of Addiction Medicine.

“Psychoactive substance use will generally lead to a deteriorating course and treatment failure,” Gitlow said.

That is why many mental health specialists working for Veterans Affairs treatment centers across the country prioritize the care of sober veterans ahead of active users of illicit drugs, including marijuana. A few such specialists spoke with The Gazette on the condition of anonymity because they fear professional discipline for sharing their views of an issue they say is used more now to advance drug-legalization politics than patient care.

“There are too many people coming in here who sincerely want the help, and they’re sober, and they’re ready to do whatever it takes to be well,” said one VA psychologist working in California. “When I’m dealing with a marijuana user, I have to be honest from the start and tell them I’m not going to waste my time, theirs or the American taxpayers’ money on weeks of therapy that is set up for failure. I’m going to work with that vet however I can, but I’m not going to pretend their marijuana use is medicine.”

Neither will Lanier, a psychotherapist in Colorado Springs.

“I want to give people good, quality treatment and not just a drug that makes them go away,” he said. “Supporting people in their efforts to remain in a constant state of sedation is not helping them. It’s hurting them.”

The CDPHE has given several reasons to justify its recommendation that PTSD be added to the list of qualifying conditions for medical marijuana use - and none of them sit well with Dr. Doris Gundersen, a Denver psychiatrist with extensive experience in PTSD treatment. For example, the department rightly notes there are only two drugs approved by the U.S. Food and Drug Administration for treating PTSD, and several other FDA-approved drugs are used “off label.” This, the department asserts, shows that “conventional treatments are not all subject to the same rigorous process of review and approval.”

However, Gundersen said, the crucial difference is that marijuana is not FDA approved. She’s backed up by the physicians whose analyses of marijuana’s efficacy were recently published in JAMA. “Unlike most FDA- approved drugs that typically have one or two active constituents, marijuana is a complex of more than 400 compounds . including . cannabinoids that have individual, interactive and even entourage effects . that are not fully understood,” the researchers wrote. And also unlike FDA- approved drugs, cannabis’ strains and preparations vary wildly, making it very difficult, if not impossible, to replicate marijuana exactly and dose it precisely.

The CDPHE also claims adding PTSD to the list of qualifying medical conditions would allow it to “obtain more accurate information from applicants (for medical marijuana), and will improve the department’s understanding of . patients’ medical marijuana needs.”

“That is not a very scientific method for examining the needs of patients,” Gundersen said.

“?. If the states’ initiatives to legalize medical marijuana is merely a veiled step toward allowing access to recreational marijuana, then the medical community should be left out of the process and instead marijuana should be decriminalized,” researchers wrote in the JAMA editorial. “Conversely, if the goal is to make marijuana available for medical purposes, then it is unclear why the approval process should be different from that used for other medications.”

Editorial: http://bit.ly/1HsBME0

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The Durango Herald, July 13, on the state’s new laws:

The Colorado Legislature’s work for the 2015 session wrapped up in May, but some of the lawmakers’ decisions did not go into effect until July 1. This year’s crop of late-blooming laws include key public safety measures and continued refinement of marijuana laws and policy. Stiffened penalties for sexual assaults on children, and allowing more time for prosecutors to file hit-and-run charges are scattered among more mundane provisions that include: sunsetting obsolete laws, and reorganizing the State Historical Society’s funds, along with measures providing services for children with autism, banning amateur hash-oil manufacturing with explosive materials, and aiming to reduce accidental needle-sticks for law enforcement and emergency responders. In all, the new laws run a broad spectrum of responsive and practical measures.

As Colorado proceeds through its experiment with legal marijuana for adults older than 21, a number of issues has arisen that require response - at both the policy and practical levels. At-home, hash-oil production is one such niche of the marijuana economy. The process often involves combustible materials such as butane, and explosions have ensued. Those licensed to manufacture the oil are still allowed to do so, but amateurs now face felony charges for the explosives and the drugs.

There are compelling public-safety reasons to ban the dangerous production methods among those not trained to use them: More than 30 hash-related explosions occurred in Colorado in 2014. That the marijuana that was initially legal to possess but, once used for the hash oil, could now bring felony drug charges, along with those for explosives, sets up a potential conundrum under state law that will be interesting to observe in its implementation. Nevertheless, preventing dangerous explosions caused by those who lack the knowledge and equipment to safely conduct the hash-oil-making process is in the state’s interest.

So, too, is keeping police officers and emergency responders safe from infection when assisting with arrests and emergencies. To that end, the Legislature offered immunity from charges of drug paraphernalia to individuals who reveal they have a hypodermic needle in their possession when dealing with law enforcement or medical responders. The law’s goal is to prevent responders from discovering the needle accidentally after being stuck by it. This is a reasonable measure for all involved, and though it may not have far-reaching implications, those it does affect will benefit nonetheless.

The same is true for a measure that allows prosecutors 10 years to file charges in hit-and-run vehicular homicide cases - double the current five-year statute of limitations. If new evidence arises that could spur action in a cold case that results in a death, prosecutors should be empowered to use it. A decade is an appropriate time period to gather that evidence, and law enforcement should be encouraged to pursue such cases. Five years was not adequate for the task.

The Legislature had a productive year, with 367 bills passed - three of which Gov. John Hickenlooper vetoed - and a number of significant bipartisan achievements, including a growing state budget for the upcoming fiscal year. The July 1 bills exemplify that productivity.

Editorial: http://bit.ly/1HImqbp

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