Tag Archives: illness

CDC considers lowering threshold for lead exposure

The CDC is considering lowering its threshold for elevated childhood blood lead levels by 30 percent, a shift that could help health practitioners identify more children afflicted by the heavy metal.

Since 2012, the U.S. Centers for Disease Control and Prevention, which sets public health standards for exposure to lead, has used a blood lead threshold of 5 micrograms per deciliter for children under age 6.

While no level of lead exposure is safe for children, those who test at or above that level warrant a public health response, the agency says.

Based on new data from a national health survey, the CDC may lower its reference level to 3.5 micrograms per deciliter in the coming months, according to six people briefed by the agency.

The measure will come up for discussion at a CDC meeting Jan. 17 in Atlanta.

But the step, which has been under consideration for months, could prove controversial. One concern: Lowering the threshold could drain sparse resources from the public health response to children who need the most help – those with far higher lead levels.

The CDC did not respond to a request for comment.

Exposure to lead — typically in peeling old paint, tainted water or contaminated soil — can cause cognitive impairment and other irreversible health impacts.

The CDC adjusts its threshold periodically as nationwide average levels drop. The threshold value is meant to identify children whose blood lead levels put them among the 2.5 percent of those with the heaviest exposure.

“Lead has no biological function in the body, and so the less there is of it in the body the better,” Bernard M Y Cheung, a University of Hong Kong professor who studies lead data, told Reuters. “The revision in the blood lead reference level is to push local governments to tighten the regulations on lead in the environment.”

The federal agency is talking with state health officials, laboratory operators, medical device makers and public housing authorities about how and when to implement a new threshold.

Since lead was banned in paint and phased out of gasoline nearly 40 years ago, average childhood blood lead levels have fallen more than 90 percent. The average is now around 1 microgram per deciliter.

Yet progress has been uneven, and lead poisoning remains an urgent problem in many U.S. communities.

A Reuters investigation published this month found nearly 3,000 areas with recently recorded lead poisoning rates of at least 10 percent, or double those in Flint, Michigan, during that city’s water crisis.

More than 1,100 of these communities had a rate of elevated blood tests at least four times higher than in Flint.

In the worst-affected urban areas, up to 50 percent of children tested in recent years had elevated lead levels.

The CDC has estimated that as many as 500,000 U.S. children have lead levels at or above the current threshold. The agency encourages “case management” for these children, which is often carried out by state or local health departments and can involve educating families about lead safety, ordering more blood tests, home inspections or remediation.

Any change in the threshold level carries financial implications. The CDC budget for assisting states with lead safety programs this year was just $17 million, and many state or local health departments are understaffed to treat children who test high.

Another concern: Many lead testing devices or labs currently have trouble identifying blood lead levels in the 3 micrograms per deciliter range. Test results can have margins of error.

“You could get false positives and false negatives,” said Rad Cunningham, an epidemiologist with the Washington State Department of Health. “It’s just not very sensitive in that range.”

The CDC doesn’t hold regulatory power, leaving states to make their own decisions on how to proceed. Many have yet to adapt their lead poisoning prevention programs to the last reference change, implemented four years ago, when the level dropped from 10 to 5 micrograms per deciliter. Other states, including Virginia and Maine, made changes this year.

The U.S. Department of Housing and Urban Development is close to adopting a rule requiring an environmental inspection — and lead cleanup if hazards are found — in any public housing units where a young child tests at or above the CDC threshold.

If the CDC urges public health action under a new threshold, HUD said it will follow through. “The only thing that will affect our policy is the CDC recommendation for environmental intervention,” said Dr. Warren Friedman, with HUD’s Office of Lead Hazard Control and Healthy Homes.

To set the reference value, the CDC relies upon data from the National Health and Nutrition Survey. The latest data suggests that a small child with a blood lead level of 3.5 micrograms per deciliter has higher exposure than 97.5 percent of others in the age group, 1 to 5 years.

But in lead-poisoning hotspots, a far greater portion of children have higher lead levels. Wisconsin data, for instance, shows that around 10 percent of children tested in Milwaukee’s most poisoned census tracts had levels double the current CDC standard.

Some worry a lower threshold could produce the opposite effect sought, by diverting money and attention away from children with the worst exposure.

“A lower reference level may actually do harm by masking reality – that significant levels of lead exposure are still a problem throughout the country,” said Amy Winslow, chief executive of Magellan Diagnostics, whose blood lead testing machines are used in thousands of U.S. clinics.

CDC report: Drug-resistant salmonella outbreak linked to Wisconsin calves

The U.S. Centers for Disease Control and Prevention is working with Wisconsin health, agriculture and laboratory agencies, several other states, and the U.S. Department of Agriculture Animal and Plant Health Inspection Service to investigate a multi-state outbreak of multidrug-resistant Salmonella Heidelberg infections.

Here are some details from the CDC report:

Twenty-one people infected with an outbreak strain of Salmonella Heidelberg have been reported from eight states. A list of states and the number of cases in each can be found on the Case Count Map page.

Among 19 people with available information, illnesses started on dates ranging from Jan. 11- Oct. 24. Ill people range in age from less than 1 year to 72, with a median age of 21. Sixty-two percent of ill people are female. Among 19 ill people with available information,  eight  reported being hospitalized and no deaths have been reported.

Isolates from ill people are closely related genetically to one another. This close genetic relationship means that people in this outbreak are more likely to share a common source of infection.

Epidemiologic, traceback and laboratory findings have identified dairy bull calves from livestock markets in Wisconsin as the likely source of infections, according to the CDC.

Dairy bull calves are young, male cattle that have not been castrated and may be raised for meat. Dairy bull calves in this outbreak also have been purchased for use with 4-H projects.

In interviews, ill people answered questions about any contact with animals and foods eaten in the week before becoming ill. Of the 19 people interviewed, 79 percent reported contact with dairy bull calves or other cattle. Some of the ill people interviewed reported that they became sick after their dairy bull calves became ill or died.

One ill person’s dairy calves were tested for the presence of Salmonella bacteria. This laboratory testing identified Salmonella Heidelberg in the calves.

Further testing showed that isolates from ill people are closely related genetically to isolates from these calves. This close genetic relationship means that the human infections in this outbreak are likely linked to ill calves.

As part of routine surveillance, the Wisconsin State Laboratory of Hygiene, one of seven regional labs affiliated with CDC’s Antibiotic Resistance Laboratory Network, conducted antibiotic resistance testing on clinical isolates from the ill people associated with this outbreak.

These isolates were found to be resistant to antibiotics and shared the same DNA fingerprints, showing the isolates were likely related to one another.

Traceback information available at this time indicates that most calves in this outbreak originated in Wisconsin. Wisconsin health and agriculture officials continue to work with other states to identify herds that may be affected.

Wisconsin’s lead poisoning rate among kids close to Flint’s

A new analysis shows the lead poisoning level for children in Wisconsin is lower than in recent years, but is nearly as high as Flint, Michigan, where lead contamination caused a drinking water crisis.

Wisconsin Public Radio reports that the analysis released this week by the Wisconsin Council on Children and Families includes data from the Wisconsin Department of Health Services that shows 4.6 percent of children under the age of 6 who were tested in 2015 had lead poisoning. The rate in Flint was 4.9 percent.

Analysis author Leland Pan said the state’s rate of lead poisoning among children is a serious issue because it can negatively affect a child’s development.

“Lead poisoning is correlated with increased rates of learning disabilities, intellectual disabilities, it hampers with brain development, it’s correlated with increased aggression and juvenile incarceration,” Pan said.

The report suggests that many children are exposed to lead-based paints in older homes. The state also has at least 176,000 lead service lines that carry drinking water to homes and businesses.

A disproportionate number of African-American children living in Wisconsin were also diagnosed with lead poisoning. The analysis referenced 2014 data from the Wisconsin DHS that showed 10 percent of the 16,221 black children under 6 who were tested had lead poisoning. Out of the 27,984 white children who were tested, only 2.9 percent had high blood lead levels.

The analysis provides recommendations for prevention, such as increased state supporting for public health departments and providing funding to restore accountability initiatives to increase the number of children tested for lead.

Researchers ID E. Coli bacteria with superbug genes

New Jersey researchers said on Aug. 29 they had identified perhaps the first strain of E. Coli bacteria in the United States with mobile genes that make it resistant to two types of antibiotics now considered the last line of defenses against superbugs.

Researchers said the strain of bacteria was found in a 76-year-old man who was treated in 2014 for a complicated urinary tract infection. Further analysis in 2016 showed the bacterium carried mcr-1, a gene that creates resistance to the last-ditch antibiotic colistin. It was also shown to carry blaNDM-5, a gene that blocks the effectiveness of carbapenems, which are considered medicine’s most reliable current antibiotics now that bacteria have found ways of outwitting other families of antibiotics.

Results of the study were reported on Monday in mBio, an online open-access journal of the American Society for Microbiology.

Although the patient was treated successfully with other antibiotics, researchers said the bacterium had the potential to spread and become a powerful superbug.

“The good news is that this did not cause a major outbreak of drug-resistant infection,” said senior study author Barry Kreiswirth, director of the Public Health Research Institute Tuberculosis Center at Rutgers University in Newark, New Jersey.

(Reporting by Ransdell Pierson in New York; Editing by Jeffrey Benkoe)

Cellphone radiation study raises concerns despite low risk

A new federal study of the potential dangers of cellphone radiation, conducted in rats, found a slight increase in brain tumors in males and raised long-dormant concerns about the safety of spending so much time with cellphones glued to our ears.

But the study had enough strange findings that it has caused other federal scientists to highlight flaws in the research, and experts said these findings and those from other studies continue to suggest the potential risk from cellphone radiation is very small.

The National Institutes of Health study bombarded rats with cellphone radiation from the womb through the first two years of life for nine hours a day. It found tumors in 2 to 3 percent of male rats, which the study’s authors called low. But females weren’t affected at all and, strangely, the rats not exposed to the cellphone radiation died much faster — at double the rate — of those that were.

The results were preliminary, and only part of what will ultimately be released. They were made public before they were officially published — and despite strong criticism from other NIH scientists — because the results were similar to other studies that hint at a potential problem, said study author John Bucher.

The study is part of a seven-year, $25 million effort conducted by the National Toxicology Program at the request of the Food and Drug Administration. It looked at the specific type of radiation that cellphones transmit, called non-ionizing radiofrequency.

“This is the first study to actually show that non-ionizing radiation (causes) cancer,” said Dr. Otis Brawley, the American Cancer Society’s chief medical officer. The cancer society in a statement praised the study for “evidence that cellphone signals could potentially impact human health” but notes that it doesn’t quite address real risk to people.

“If cellphones cause cancer, they don’t cause a lot of cancer,” he said in an interview. “It’s not as carcinogenic as beef.”

He said people should be far more concerned about “distraction caused by cellphone,” which he said causes more deaths.

Both Brawley and Bucher said this would not change how they use their own personal cellphones.

While the study found what Bucher called a likely cause of cancer in rats, he cautioned that how that applies to humans “is not currently completely worked out. This may have relevance. It may have no relevance,” he said.

Since about 1986, U.S. brain cancer deaths have not increased or decreased, Brawley said. That suggests that whatever effect cellphones may have it is so small as to be undetectable amid regular cases of brain cancer.

Also, Brawley and others point out that cellphone technology has improved so much in recent years to emit less radiation than medical studies simulate. Bucher said the levels the rats were subjected to would be considered “heavy.”

The study also found a slight increase in a very rare type of heart tumors in the male rats exposed to cellphone radiation. The same NIH scientists looked at mice, but those results won’t be ready until next year.

Some of the study’s own reviewers had trouble accepting the results because of the odd factors, such as rats in the group that wasn’t exposed didn’t contract what would be the normal number of brain tumors for that population.

“I am unable to accept the authors’ conclusions,” wrote outside reviewer Dr. Michael Lauer, deputy director of NIH’s office of extramural research. “I suspect that this experiment is substantially underpowered and that the few positive results found reflect false positive findings.”

The fact that the rats exposed to radiation survived longer than those that weren’t “leaves me even more skeptical of the authors’ claims,” Lauer wrote. Four other study reviewers — three from NIH — also raised questions about the way the study was conducted and its conclusions.

Bucher said he couldn’t explain that strange factor, nor could he explain why females were not affected. Brawley said it could be the female hormone estrogen is offering some cancer protection as has been seen in some other cancers.

George Gray, a risk and environmental health expert at the George Washington University School of Public Health, said one key part of the study is not the data itself, but how it is being interpreted. And he said the study seems to focus on the small increase in tumors in males, not the absence of them in females “and does not reveal the level of scientific uncertainty in applying these data to people using their phones.”

If people are truly worried, they should use Bluetooth or headsets, Brawley said.

In 2011, a working group of the International Agency for Research on Cancer said cellphones are possibly carcinogenic. But numerous studies over the years, before and after that listing, have found little evidence of a problem. Among the largest, a survey of 13,000 people in 13 countries found little or no risk of brain tumors, with a possible link in the heaviest users that the study’s authors found inconclusive. And a large Danish study that linked phone bills to a cancer registry found no risk even in longtime users.

Gray said a study like this needs to stand up to challenge and fit in with other research.

“This is a high profile topic that hits close to home for most of us,” Gray said in an email. “It is really important to realize that a single study like this does not provide ‘the answer.’”

AP Medical Writer Lauran Neergaard contributed to this story.

Perinatal dolphin deaths likely result of oil exposure

The increased number of stranded stillborn and juvenile dolphins found in the Gulf of Mexico from 2010 to 2013 were likely caused by chronic illnesses in mothers who were exposed to oil from the Deepwater Horizon spill.

A new paper, published in the journal Diseases of Aquatic Organisms, is part of an effort to explain the unusual mortality event in the Gulf of Mexico involving bottlenose dolphins between early 2010 and continuing into 2014.

The investigations into both the fetal dolphin and the overall the effects of the Deepwater oil spill are continuing. The long-term effects of the spill on dolphin reproduction are still unknown.

The study found a higher rate of illness in dead fetuses and newborns after the Deepwater Horizon oil spill in the Gulf of Mexico.

“Our new findings add to the mounting evidence from peer-reviewed studies that exposure to petroleum compounds following the Deepwater Horizon oil spill severely harmed the reproductive health of dolphin living in the oil spill footprint in the northern Gulf of Mexico,” said Dr.Teri Rowles, veterinarian, co-author on the study, and head of NOAA’s Marine Mammal Health and Stranding Response Program, which is charged with determining the causes of these events.

“In contrast to control populations, we found that Gulf of Mexico bottlenose dolphins were particularly susceptible to late-term pregnancy failures, signs of fetal distress and development of in utero infections including brucellosis,” said Dr. Kathleen Colegrove,  the study’s lead author and veterinary pathology professor at the University of Illinois Chicago-based Zoological Pathology Program.

Scientists saw higher numbers of stranded stillborn and juvenile dolphins in the spill zone in 2011 than in other years, particularly in Mississippi and Alabama.

“The young dolphins, which died in the womb or shortly after birth, were significantly smaller than those that stranded during previous years and in other geographic locations,” said Dr. Stephanie Venn-Watson, study co-author and veterinary epidemiologist from the National Marine Mammal Foundation.

Bottlenose dolphins are pregnant for about 380 days, so stillborn and juvenile dolphins found in the early months of 2011 could have been exposed in the womb to petroleum products released the previous year.

“Pregnant dolphins losing fetuses in 2011 would have been in the earlier stages of pregnancy in 2010 during the oil spill,” said Colegrove.

The researchers report that 88 percent of the stillborn and juvenile dolphins found in the spill zone had abnormal lung, including partially or completely collapsed lungs. That and their small size suggest that they died in the womb or very soon after birth – before their lungs had a chance to fully inflate. Only 15 percent of stillborn and juvenile dolphins  found in areas unaffected by the spill had this lung abnormality, the researchers said.

A previous study revealed that non-perinatal bottlenose dolphins that stranded in the spill zone after the spill were much more likely than other stranded dolphins to have severe lung and adrenal gland damage “consistent with petroleum product exposure.”

The study team included researchers from the University of Illinois; National Marine Mammal Foundation; NOAA; the Dauphin Island Sea Lab and University of South Alabama; the Institute for Marine Mammal Studies in Mississippi; the Louisiana Department of Wildlife and Fisheries; Animal Health Center in British Columbia; the Mote Marine Laboratory in Florida; the University of Georgia; and the University of North Carolina.

This study was conducted in conjunction with the Natural Resource Damage Assessment for the Deepwater Horizon oil spill, as well as the investigation into the northern Gulf of Mexico unusual mortality event.

Bottlenose dolphins have been dying in record numbers in their mothers' womb or shortly after birth in areas affected by the 2010 Deepwater Horizon oil spill in the Gulf of Mexico. — PHOTO: NOAA
Bottlenose dolphins have been dying in record numbers in their mothers’ womb or shortly after birth in areas affected by the 2010 Deepwater Horizon oil spill in the Gulf of Mexico. — PHOTO: NOAA

EPA announces new protections for farmworkers

The U.S. Environmental Protection Agency announced today increased protections for the nation’s 2 million agricultural workers and their families.

Each year, thousands of potentially preventable pesticide exposure incidents are reported that lead to sick days, lost wages and medical bills but with changes to the Agricultural Worker Protection Standard the risk of injury or illness resulting from contact with pesticides on farms and in forests, nurseries and greenhouses can be reduced.

“President Obama has called closing gaps of opportunity a defining challenge of our time. Meeting that challenge means ensuring healthy work environments for all Americans, especially those in our nation’s vulnerable communities,” EPA Administrator Gina McCarthy said in a news release. “We depend on farmworkers every day to help put the food we eat on America’s dinner tables — and they deserve fair, equitable working standards with strong health and safety protections.  With these updates we can protect workers, while at the same time preserve the strong traditions of our family farms and ensure the continued the growth of our agricultural economy.”

U.S. Secretary of Labor Thomas E. Perez said, “No one should ever have to risk their lives for their livelihoods, but far too many workers, especially those who work in agriculture, face conditions that challenge their health and safety every day.”

He continued, “Workplace illness and injury contribute greatly to economic inequality, and can have a devastating impact on workers and their families. By promoting workplace safety, these provisions will enhance economic security for people struggling to make ends meet and keep more Americans on the job raising the crops that feed the world, and we are proud to support the EPA in this effort.”

EPA’s updates reflect comment federal and state partners and the agricultural community including farmworkers, farmers and industry.

The EPA said the provisions will help ensure farmworkers nationwide receive annual safety training; that children under the age of 18 are prohibited from handling pesticides; and that workers are aware of the protections they are afforded under today’s action and have the tools needed to protect themselves and their families from pesticide exposure.

These revisions will publish in the Federal Register within the next 60 days. 

In Minnesota, medical marijuana is now legal but not easy to get for some

It’s a 400-mile, seven-hour, $100 or more journey from Maria Botker’s home in tiny Clinton, Minnesota, to the nearest clinic where she can buy medical marijuana — the only drug that does the trick for her daughter’s rare and aggressive seizure disorder.

In addition to the medicine’s high cost, the short list of qualifying conditions and the difficulty in getting a doctor’s approval to sign up, there’s one more thing making the program difficult for Minnesota patients. Some have to come an awfully long way to get it, with only two of eight dispensaries opening since the July 1 launch.

The law doesn’t require all eight to be open until July 2016. A third location is slated to open Thursday in Rochester. A Bemidji clinic for the northeast corner of the state likely won’t be running until sometime next year.

And even after all eight facilities open, Botker and others from southwestern Minnesota will still face five-hour trips or longer.

“The southwest part of the state is completely neglected,” she said. “I fear that there’s patients out there that could qualify but can’t make the trip. Those are huge burdens on people with chronic illnesses.”

Shaving two hours off their monthly trip for medicine when a Moorhead clinic opens later this summer sounds like “a treat,” Botker said. But after moving to Colorado to get her daughter, Greta, the medicine she needs, then back to Minnesota to see through a new law that disappointed many advocates, Botker doesn’t mince words about the long list of improvements needed to Minnesota’s medical marijuana program.

Adding more dispensaries is at or near the top of the wish list.

“There’s a long way to go until this system is perfect, or better,” Botker said.

Minnesota’s medical marijuana law passed in the waning days of its 2014 legislative session after some last-minute wrangling to get skeptical law enforcement agencies on board. Sen. Scott Dibble called the tight restrictions, including the limited number of dispensaries, a response to law enforcement’s “artificial concerns.”

After giving the state some time to digest its new medical marijuana program, Dibble said he’ll look to revive that debate in the name of adding more distribution centers.

“I’m very interested in lowering the barriers to people who are sick and are in need,” the Minneapolis Democrat said.

Until then, parents like Dawn Baker will have to spend hours in the car.

Baker and her fiancΘ are eyeing medical marijuana as a last recourse to treat her 4-year-old son Brayden’s epilepsy before brain surgery, but she estimates the six-hour drive to the nearest clinic in Minneapolis will cost at least $100.

Add in childcare for Brayden and their four other kids or a night at a hotel, and it’s likely $250 or more _ all before paying for the medicine itself, a bill that could easily surpass $1,000 a month that insurance won’t cover.

“We have no idea how we’re going to come up with it,” Baker said.

Minnesota’s two medical marijuana manufacturers have little role in expanding clinic access as they focus on growing and cultivating the medicine and opening the eight locations the state allows. For the time being, parents are making the drive, Minnesota Medical Solutions CEO Kyle Kingsley said.

The travel expense is a pittance compared to the $1,400 Botker pays each month for Greta’s seizure medication. Still, Botker looks on the bright side: Compared to the split life their family endured when she and Greta lived in Colorado, it’s worth the cost, she said.

“Is it frustrating getting over the growing pains? A little bit,” she said. “But ultimately, I’m so thankful that we’re getting it here in Minnesota.”

Medical pot proposal passes first test in conservative Utah

A panel of Utah lawmakers has given initial approval to a medical marijuana proposal that would allow residents of the conservative state who have chronic and debilitating diseases to use certain edible products containing THC, the chemical responsible for most of the drug’s psychological effects.

After a nearly two-hour debate, a Senate committee voted 3-2 earlier this week to approve the bill and send it to the full Senate for a vote.

Saratoga Springs Republican Sen. Mark Madsen said if the state can push past years of propaganda and misunderstanding surrounding the drug, it would bring compassion and freedom to those who are suffering.

The proposal does not allow the smoking of marijuana, which Madsen, its sponsor, said is unhealthy and an ineffective way to consume the drug.

Under his bill, patients would be issued medical marijuana cards. It also sets up a system of seed-to-sale regulation for licensed growers, producers and dispensers.

It specifies what conditions are eligible, such as AIDS, cancer and post-traumatic stress disorder. Medical specialists — not general practice doctors — would be able to prescribe medical marijuana. For example, Madsen said, someone with cancer would need their oncologist to recommend it.

If Utah passed the bill, it would join 23 states and District of Columbia where medical marijuana programs are in place, according to the National Conference of State Legislatures.

Madsen said this week that he began researching the issue after suffering from persistent back problems. When his doctor recently recommended that he try a pot treatment, Madsen traveled to Colorado to try it through cannabis-infused gummy bears and an electronic-cigarette device.

He said he found the treatment effective, and it lessened his pain. If his doctor agrees that it would let him use fewer or no prescription painkillers, he’d consider taking a cannabis product again.

Madsen said he is confident his bill will pass the GOP-controlled state Senate, and he’s reasonably optimistic about its chances in the Republican-dominated House.

The GOP House speaker and Utah’s Republican governor have said they fear a medical marijuana law would lead to legalized recreational pot or broad recreational use through suspect prescriptions.

Pediatrics group changes pot policy as legalization marches forward

The nation’s most influential pediatricians group updated its policy on marijuana to recommend the drug be removed from the government’s most restrictive category, which includes heroin and other narcotics said to have no accepted medical use.

The American Academy of Pediatrics proposed reclassifying marijuana as a Schedule II controlled substance to allow for greater scientific research and experimentation.

The academy also said marijuana could be a viable treatment option for severely ill children. The new AAP policy, published online in Pediatrics, said pediatric use should only be considered “for children with life-limiting or severely debilitating conditions and for whom current therapies are inadequate.”

The AAP does not advocate legalizing recreational marijuana and it does not deal with marijuana use among adults.

The AAP policy was last updated in 2004. Since then, marijuana laws have changed considerably. Four states — Alaska, Colorado, Oregon and Washington — have legalized recreational marijuana while 19 states have decriminalized pot possession in small amounts. Also, 23 states have legalized medical marijuana.

The Marijuana Policy Project, an organization at the forefront of reforming drug laws, is lobbying to pass a medical marijuana bill in Pennsylvania this year or next year and in Texas in 2015 or 2017. The MPP also is working to expand access under Minnesota’s medical marijuana provision and helping to implement the legislation in Illinois, where the first retail licenses were issued earlier this month.

Illinois lawmakers also could decriminalize marijuana this year and make pot a ticketable offense. Elsewhere, decriminalization is on the legislative agenda in Hawaii, Virginia, Delaware and New Hampshire.

“Criminalizing someone for possessing a small amount of marijuana causes far more harm than marijuana itself,” said Matt Simon, the Goffstown, New Hampshire-based New England political director for the MPP.

Three out of five adults in New Hampshire support removing criminal penalties for marijuana possession, according to a WMUR Granite State Poll released last April. 

In neighboring Vermont, lawmakers could pass recreational marijuana legislation this year or next. But, with bipartisan support for a bill, Rhode Island is in a position to become the first state to legalize recreational marijuana through the legislative process rather than by ballot initiative.

At the federal level, American Indian tribes attending a conference later this month plan to discuss the legalization of pot. Their move follows a Justice Department announcement in December clearing the way for tribes to grow and sell marijuana.

And members of the U.S. House are considering a pair of bills that would end federal marijuana prohibition, as well as a measure sponsored by three Democrats and five Republicans that would allow Veterans Affairs doctors to prescribe medical marijuana.

“Our antiquated drug laws must catch up with the real suffering of so many of our veterans,” said U.S. Rep. Dana Rohrabacher, R-Calif., a co-sponsor of the Veterans Equal Access Act. “This is now a moral cause and a matter of supreme urgency. It is unconscionable that a VA doctor cannot offer a full range of treatments, including medical marijuana … to an American veteran who fought valiantly for our country. Conscience dictates that we not coldly ignore these desperate men and women and that we remove government from its paternalistic stance between patient and doctor.”

More than 20 percent of the 2.8 million U.S. veterans who have served in Iraq and Afghanistan suffer from PTSD and depression. In addition, a recent study found that of the nearly 1 million veterans who receive opioids to treat painful conditions, more than half continue to consume chronically or beyond 90 days. Another study found that the death rate from opiate overdoses among VA patients is about double the national average.

The bill’s sponsors said in states where these patients can legally access medical marijuana, the hands of VA doctors should not be tied.

“We should be allowing these wounded warriors access to the medicine that will help them survive and thrive, including medical marijuana, not treating them like criminals and forcing them into the shadows,” said U.S. Rep. Earl Blumenauer, D-Ore. “It’s shameful.”

On the books… 

In Wisconsin, AB 726 exempts a very limited class of people from criminal penalties for the use and possession of cannabidiol “in a form without a psychoactive effect.” The law, signed by the governor last April, allows people with seizure disorders to get their physician’s approval to possess cannabidiol. However, according to the Marijuana Policy Project, the legislation “doesn’t give patients a realistic way to obtain their medicine in Wisconsin” and “may be unworkable even for the limited population it’s meant to help.”

Medical marijuana bills have repeatedly been offered in Wisconsin, and a bill likely will be introduced this legislative session. Advocates, however, do not expect it to reach a floor vote.