Archives for January 2019

The Impact of Legalization of Recreational Marijuana

January 25, 2019 by
Robert Lee, DO, FAAP

Robert Lee, DO, FAAP

(Dr. Robert Lee, DO, MS, FAAP is a pediatrician and Associate Pediatric Residency Program Director at NYU Winthrop Hospital.  He is the Chair for the AAP Section on Osteopathic Pediatricians, Secretary for NYS AAP Chapter 2, and Co-Chair of the NYS AAP Chapter 2 Foster/Kinship Care Committee.)

 “Reefer Madness” is a1936 film revolving around series of tragic events after innocent teenagers became addicted to marijuana.  It was shown to parents as a cautionary tale about the scourge called marijuana.

Today, marijuana for recreational use is legal in 10 states, and more states are considering it.  New York Gov. Andrew Cuomo has stated that the legalization of recreational marijuana is on his agenda for this year. 

What is the position of the American Academy of Pediatrics on the issue of marijuana legalization?

The legalization of marijuana has raised critical questions for pediatricians who care for children and adolescents.  In the 2015 policy statement, “The Impact of Marijuana Policies on Youth: Clinical, Research, and Legal Update,” the American Academy of Pediatrics opposes the legalization of recreational marijuana because of the potential harm to children and adolescents.  Legalization would create an industry to commercialize and market marijuana, which would be harmful for children.  Legalization would also lead to more adult use and likely lead to more adolescent use, despite attempts to restrict sales to underage youth.  It true that we do not have all the data documenting changes to child health from the legalization of marijuana in the states of Washington, Colorado and California.  Remember that it took generations, millions of lives and billions of dollar to establish the harms of combustible tobacco.  We should not consider marijuana “innocent until proven guilty,” given what already know about the harms to adolescents.

Health Effects of Marijuana

Marijuana use in pediatric populations remains an ongoing concern, and marijuana use has known medical, psychological, and cognitive side effects.  Short- and long-term recreational use in adolescents can cause:

  • Impaired memory and decreased concentrations, attention span, and problem solving
  • Alternations in motor control, coordination, judgement, reaction time and tracking ability
  • Negative health effects on lung function
  • Higher rates of psychosis is patients with predisposition to schizophrenia
  • Higher likelihood of drug dependence
  • Lower odds of completing high school or obtaining a degree
  • Increase in use of other illicit drugs
  • Increase in suicide attempts

What is the position statement of NYS American Academy of Pediatrics on New York State’s initiative to legalize marijuana for adult recreational use?

Pediatricians have special expertise in the care of children and adolescents.  Parents and legislators may call on us for expert advice.  NYS American Academy of Pediatrics has issued a position statement that is being shared with legislators, key Executive and State Agency staff and external partners.

NYS American Academy of Pediatrics strongly recommends that legislation include:

  1. Minimum age of sale should be at least 21 years of age
  2. Regulations to prevent underage sale should include at a minimum those protection in place for the sale of alcohol and tobacco to minors. Effective enforcement procedures are critical
  3. Strong regulation of retailers to prevent store locations near areas children frequent, such as parks and schools

NYS AAP recommend protections in place that include:

  1. Regulation by the NYS Department of Health to regulate potency
  2. Child proof packing of all products
  3. Outlawing of any products with appeal to children (i.e. candy)
  4. Labeling of product concerning the health risks to children
  5. Strict restriction on marketing that targets youth (i.e. use of cartoon characters)
  6. Including marijuana smoking in any clean indoor air legislation
  7. Prohibiting combustible marijuana in multi-unit housing
  8. Outlawing use of combustible marijuana in all public spaces where children may be exposed to second hand smoke

New York is likely to join the other 10 states that have legalized recreational marijuana, but as pediatricians, we need to advise legislators about the potential impact on children and adolescents.  More than 18% of NYS high schools currently use marijuana.  This number is going to increase once legalization has occurred.

Information for Parents

Marijuana: What Parents Need to Know

Legalizing Marijuana Not Good for Kids: AAP Policy Explained

Filed Under: Blog, Blog Archives

January 2019

January 16, 2019 by

NYS AAP – Chapter 2
President’s Message – January 2019

Dear NYS AAP – Chapter 2 Member,
     Happy New Year!
     Our best wishes for the New Year to each of our members and readers. 2018 was a successful year for the Chapter and we hope that your continued support and engagement in 2019 will help us to accomplish more to advance the health of the children in our care and support the practice of Pediatrics.
     Please see below for information about recent and upcoming events, and other updates.
Steven J. Goldstein, MD, FAAP
President, NYS AAP – Chapter 2
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December Chapter Executive Committee Meeting

On December 13th we held our quarterly Chapter business meeting at NYU Winthrop Hospital. In addition to regular business, a representative from the American Dairy Association spoke about the role of dairy in pediatric nutrition, the director of NYC Early Intervention educated us about accessing EI, and the NYS AAP Director of Policy, Advocacy & External Relations, Elie Ward, discussed the NY State Patient Centered Medical Home.  Important information about the NY State PCMH will be posted soon, so please visit our website for updates.  Value Based Payment is coming and all practices need to know about new payment paradigms and requirements.  If you would like to attend an upcoming Chapter meeting, please email our Executive Director, Jessica Geslani, at jgeslani@aap.org.
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E-Cigarettes in Suffolk County

Earlier in the day on December 13th Chapter Legislative Committee members, Dr. Eve Krief and Chapter V.P. Dr. Shetal Shah, and I had the opportunity to speak before the Suffolk County Legislature Health Committee to advocate for a ban on flavored e-cigarettes.  Flavored e-cigarettes are very appealing to young people and there is little awareness that the products contain nicotine and are addicting. There was a huge turnout from every vaping establishment in the county and the measure was tabled by the committee.  A week later the county unanimously passed a resolution to raise the fines for selling e-cigarettes to those under 21.  Work on this important issue also offered the Chapter a unique opportunity to partner with other community-minded organizations, such as the Suffolk County Principals Association and the Campaign for Tobacco Free Kids.
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Healthy People 2020 Grant Program

The topic of the 2019 Healthy People 2020 Grant Program for Chapters is School Success: Health and Safety.  Five chapters will be selected by May 31st and awarded $20,000 each, supported by the AAP Friends of Children Fund, to develop and implement innovative programs.  View the Request for Proposals and Application via the link above.  Applications are due March 29th.  If you have an idea for a Grant Program, please contact Jessica Geslani at jgeslani@aap.org.  The Chapter may only support one grant application each year.
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AAP Election Results and Changes in Bylaws

Dr. Kyle Yasuda is our new AAP President and Dr. Sally Goza is President-Elect.  Immediate Past President Dr. Colleen Kraft was a great role model for us all as she advocated with great energy and conviction for kids at the border (and everywhere else) during her tenure.  We look forward to hearing more from our new AAP leadership. (Follow them on Twitter! Kyle: @kyleyasuda and Sally: @sallygoza.)
The AAP National Bylaws were amended to change the structure of the National Board to include Members-at-Large.  More information is available on the AAP website and in Pediatric News.
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Call for Mentors!

We are pleased to announce that the NYS AAP – Chapter 2 is launching a new Mentoring Program!  If you are a pediatrician who completed training 10+ years ago and are interested in mentoring early career physicians in the Chapter 2 area, please consider signing up.
  • The time commitment is approximately 1 hour per month, (this can be in person or via phone, facetime, skype, etc.)
  • We are seeking a diverse group of individuals who want to make a difference in the careers of our early career pediatricians.
Any questions? Contact:
Dr. David Fagan, Mentoring Committee Chair, at dfagan@northwell.edu or Jessica Geslani at jgeslani@aap.org
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NYS AAP – Chapter 2 & 3 Gun Violence Prevention Committee

The NYS AAP – Chapter 2 & 3 Gun Violence Prevention (GVP) Committee, co-chaired by Drs. Jeff Oestreicher and Nina Agrawal, will focus on two goals for the first six months of 2019, their “30 & 30.” GVP Committee members will hold 30 in-district meetings with state and federal legislators to push for policies including Extreme Risk Protection Orders, Safe Storage and state and federal research funding.  During this time the committee will also host 30 educational forums across the state (noon conferences and ground rounds, for example) in order to galvanize the health care community in sounding the alarm on the need for evidence-based solutions to the epidemic of pediatric gun violence.
Join the monthly meetings (Jan 28, Feb 25, March 25, April 29, May 20, and June 24) to learn more, with locations to be announced soon!  The first half of each meeting will also include a wide variety of experts (writers, policy makers, public health professionals) who will teach and provide us with tools to become better, more effective advocates.  For more information about the committee, or to join, contact Jessica Geslani at jgeslani@aap.org.
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NYS AAP – Chapter 2 & 3 Opioid Crisis Committee

The NYS AAP – Chapter 2 & 3 Opioid Crisis Committee is devoted to finding solutions and implementing standardized measures to help pediatricians navigate this crisis.  It is essential to identify substance abuse in adolescents early and to implement prevention strategies immediately.  The Substance Abuse and Mental Health Services Administration (SAMHSA) recommends using the Universal Screening for Substance Use, Brief Intervention, and/or Referral to Treatment (SBIRT) as a part of routine health care.  The AAP recommends screening all adolescents for tobacco, alcohol and other substance use using a validated tool such as the CRAFFT.
Opioids should only be prescribed when the benefit is seriously considered and outweighs the risks. If there is no alternative, short acting opioids, rather than long acting or extended release opioids, should be used for treating acute pain in opioid naïve patients.  Patients and families must be educated about opioid use, adverse effects, and disposal.
The Joint Commission, the CDC, and the FDA have recommended/mandated that non-pharmacologic modalities be offered to patients for pain.  We need to dramatically rethink opioid use in the world of Pediatrics.  If you would like to be part of this mission, please contact Dr. Richard Ancona at 1084e5@optonline.nett or Dr. Mirna Giordano at mg2267@columbia.edu.
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NYS AAP Policy Statement on Marijuana

The mid-term elections changed the balance of political power not only nationally, but in New York State as well.  With a new legislature, many new initiatives will be considered by Albany.  In anticipation of the possibility of new marijuana laws in NY, a state-wide committee (NYS AAP – Chapters 1, 2, and 3) created a position paper that may be found here:
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National AAP Committee Members – Call for Nominations

The AAP Board of Directors is soliciting nominations to fill the following vacancies for Member positions on AAP National Committees for terms beginning July 1, 2019:
  • Committee on Adolescence (COA): 1 position
  • Committee on Child Health Financing: 2 positions
  • Committee on Coding and Nomenclature (COCN): 1 position
  • Committee on Drugs: 1 position
  • Committee on Fetus and Newborn (COFN): 2 positions
  • Committee on Medical Liability and Risk Management: 2 positions
  • Committee on Native American Child Health: 2 positions
  • Committee on Pediatric AIDS (COPA): 3 positions
  • Committee on Pediatric Research: 2 positions
  • Committee on Practice & Ambulatory Medicine (COPAM): 3 positions
  • Committee on Psychosocial Aspects of Child and Family Health (COPACFH): 2 positions
You can find the requirements, the statements of needs for each position, and the application materials on AAP.org. To be considered complete, an application must include the following: (1) factsheet, (2) biographical summary, (3) letter of nomination, and (4) letter of support.  Upon receipt, a request for Conflict of Interest Disclosure will be sent to the candidate which will finalize the application process.
The deadline for nominations is Friday, February 22, 2019.  Nominees must submit the completed application materials to their Chapter President and the AAP Nominations Team (nominations@aap.org). If you are interested in obtaining a letter of support from the NYS AAP – Chapter 2 President, please email Jessica Geslani at jgeslani@aap.org as soon as possible. We can support one applicant per committee.
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NYS AAP Annual Advocacy Day – March 19th

Mark your calendars because our Annual Advocacy Day in Albany is scheduled for Tuesday, March 19th at The University Club. This day highlights our pediatric advocacy agenda with a full day in Albany hearing from legislators, government officials, and NYS AAP leaders, and is followed by visits to the offices of members of the State Assembly and Senate. More details will be available soon. We look forward to welcoming all Chapter members, including medical students and pediatric trainees, to this event.
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     The Officers of Chapter 2 welcome your feedback, thoughts, suggestions, and constructive criticism.  Please see our email addresses below to contact us.
Follow us on Twitter: @NYSAAPCh2
Follow Steve Goldstein on Twitter: @SteveGoldstei10
     With our best wishes for a healthy and productive autumn!
My best,
Steve Goldstein, Chapter President SJG34@Cornell.edu | Twitter: @SteveGoldstei10
and the Officers:
Shetal Shah, Vice President shetaldoc@hotmail.com | Twitter @NICUBatman
Robert Lee, Secretary rlee@aap.net
Sanjivan Patel, Treasurer sapatel@wyckoffhospital.org
Filed Under: Newsletters