Pubdate: Fri, 20 Jul 2012
Source: Arizona Republic (Phoenix, AZ)
Copyright: 2012 The Arizona Republic
Author: Yvonne Wingett Sanchez


As director of the Arizona Department of Health Services, Will Humble 
is the man working behind the scenes to run Arizona's fledgling 
medical-marijuana program.

Over the past several months, Humble has been weighing whether to 
expand the program to allow legal use of the drug by those who have 
post-traumatic stress disorder, anxiety, depression or migraines. 
He's heard from patients, their families and physicians who said the 
drug helps manage pain at public hearings. He's listened to opponents 
who say the drug leads to dangerous situations in the home and on the 
road. He's read new University of Arizona studies that concluded 
there is simply not enough evidence to prove whether marijuana is 
medically effective. And back in college, he even tested the drug himself.

The state's program already permits medical marijuana use for 
conditions such as chronic pain, cancer and hepatitis C. As of late 
June, about 30,000 people participated in the state's program, which 
in certain instances, allows them to grow marijuana.

Arizona is one of 17 states nationally that allows medical marijuana. 
It would become the only one in the nation to allow medical marijuana 
for anxiety and depression if those options were approved.

In a Thursday interview with The Arizona Republic, Humble shed light 
on his long-awaited decision, which can be appealed.

Question: Will you put post-traumatic stress disorder on the list of 
qualifying conditions for medical marijuana? Why or why not?

Answer: No. There's just not the scientific evidence out there yet to 
support permanently adding any of the conditions to the qualified 
list, at least right now. I recognize there's a real shortage of 
studies and data that's out there. You base your policy decisions on 
science and research, and not ideology or a predetermined political 
point of view.

Q: You have drawn criticism from some veterans and their advocates 
who accuse of you of being unsympathetic to their stories of how pot 
has changed their lives. How do you respond to that?

A: All I can say is, from the bottom of my heart, I'm not 
unsympathetic. The stories that the veterans told when we had our 
hearing were compelling. But the bottom line is, the science isn't 
there yet. And maybe someday there will be additional research -- and 
there's some research that's ... at least being proposed right now.

Q: Will you put depression on the list of qualifying conditions for 
medical marijuana? Why or why not?

A: No. Same thing for depression. Depression is sort of in the 
category where there is very good treatment these days for depression 
- -- very effective medications that have been through rigorous clinical trials.

Q: Will you put anxiety on the list of qualifying conditions for 
medical marijuana? Why or why not?

A: No. Anxiety was probably the one that had the least amount of research.

Q: Will you put migraines on the list of qualifying conditions for 
medical marijuana? Why or why not?

A: No. On migraines, there were almost no studies out there. 
Migraines is probably already on the list if it causes severe and 
chronic pain, which it does in a lot of patients. Migraine headaches 
are, by their definition, severe. The question is, at what point does 
a clinician think they're chronic as well? A typical clinical 
presentation could easily qualify a patient for a card if a clinician 
really thought that was the best or appropriate treatment.

Q: You have asked for scientific evidence that marijuana is medically 
effective. Some physicians have said that request is unreasonable 
because of restrictions by some agencies on testing the efficacy of 
marijuana. What is your response?

A: I'll concede that the clinical-trial type of research is 
controlled by NIDA (National Institute on Drug Abuse) and they are 
pretty strict when it comes to clinical trials, when it comes to the 
use of testing medical marijuana. But there are all kinds of studies 
that can be conducted that don't need NIDA approval. The barriers 
that exist are really around those clinical types of studies. I've 
never said ... that I would have to have a clinical-trial type of 
design in order to convince me something should be added to the list. 
Observational studies that are not under the control of NIDA can be 
very powerful if they're designed properly and eliminate ... things 
that would confuse the results. The challenge is getting it funded. 
The typical federal funding sources like National Institutes of 
Health and NIDA aren't jumping all over this to fund it. There are 
challenges, but I disagree with people that research can't be done.

Q: You've heard hundreds of personal stories from people attesting 
marijuana has helped them manage pain and stop taking prescription 
pills. Do you believe them?

A: I believe that the folks -- especially the folks that came to the 
hearing --were very sincere in what it's done for them. And a lot of 
the testimony was moving. But this decision is one that I need to 
stay true to the principals of public health with. Using scientific 
literature and research to inform these kinds of policy decisions is 
just the bread and butter of everything we do in public health and 
medicine. I can't make that leap to make decisions based on 
individual testimony -- that's just something I can't do 
professionally, but I am very sympathetic and I do believe the 
testimony the folks had at the hearing.

Q: Has Gov. Jan Brewer, who has opposed medical marijuana, influenced 
your decision?

A: No.

Q: How is the program working overall in Arizona?

A: I honestly believe we have a model program ... We set up the 
regulations, especially regarding the dispensaries and the issuance 
of the cards that give, I think, the best medical character in the 
country. Our regulations, I think, are the best in the country at 
trying to keep this a medical program. Part of the commitment to 
keeping it a medical program means ... making sure we're using 
scientific principals to guide our way. You can see that in the 
decisions to not approve these petitions.

Q: Do you believe people are taking advantage of any particular 
diagnoses to participate in the program?

A: Are there recreational users that have accessed the system for the 
legal protections that it provides? Of course. But I think those 
folks are in the minority, in just looking at the demographics of our 
card users -- the ages, the types of chronic medical conditions ... 
the vast majority are legitimately accessing the system.

Q: Have you ever tried pot either recreationally or medically?

A: Yes. Recreationally. When I was in college at NAU (Northern 
Arizona University). But I didn't particularly like it.

Q: Did you inhale?

A: Yes, I inhaled.
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MAP posted-by: Jay Bergstrom