Pubdate: Tue, 23 Jul 2013
Source: Telegraph, The (Nashua, NH)
Copyright: 2013 Telegraph Publishing Company
Author: Danielle Curtis

Cannabis Care


If you have glaucoma, cancer, or multiple sclerosis, don't go running 
to the medical marijuana dispensary just yet.

New Hampshire's medicinal marijuana legislation is one of the 
strictest in the nation, and a diagnosis of one of the qualifying 
conditions may not be enough. The law also stipulates that patients 
who suffer from debilitating symptoms as a result of their condition 
may only use marijuana after they have not responded to other, more 
traditional, forms of treatment.

That requirement makes New Hampshire's law different from many other 
states that provide legal medical marijuana. And the legislation's 
key sponsor, Donna Schlachman, said the difference really comes down 
to one word: and.

"The New Hampshire Medical Society worked with the House subcommittee 
very closely on the definitions and eligibility requirements," she 
said. "They are one of the strong reasons the law said 'and' instead 
of 'or'. They were concerned with it being too wide open."

Originally, Schlachman said, the eligibility requirements outlined in 
the legislation required that a patient suffer from a qualifying 
condition, or from a debilitating illness that has produced one of 
several symptoms, from wasting syndrome to severe pain, that has not 
responded to other treatments.

Turning the "or" into "and," Schlachman said, makes the law much stricter.

Dr. Travis Harker, president of the New Hampshire Medical Society, 
said it was a change that the medical community was pushing for.

"We tried to help limit the scope to what we thought would be a safe 
and appropriate group, and limit the number of diagnoses eligible," he said.

In Oregon, he said, where the system runs like that proposed in New 
Hampshire's law, with fewer restrictions, 55,000 patients are 
currently using medical marijuana.

While he could not estimate how many people may become eligible for 
the therapeutic treatment in New Hampshire, he said it would be far fewer.

The medical society also played a role in one of the most 
controversial changes to the marijuana legislation: removing PTSD 
from the list of qualifying medical conditions.

While veterans groups in the state were angered by the decision to 
leave it out of the law, Harker said treatment for the condition 
relies heavily on cognitive behavioral therapy, which could be 
interrupted if a patient is using medical marijuana to dampen their anxiety.

Still, while the state's law may be narrower than others in the 
nation, the conditions that qualify a patient for medical marijuana 
do not differ greatly from those allowed in other states, 
particularly in New England.

Every other New England state already has a medical marijuana law on 
the books, in varying stages of implementation.

Each law lists specific illnesses eligible for medical marijuana 
treatment: cancer, multiple sclerosis, ALS, hepatitis C and Crohn's 
disease, among others.

Massachusetts makes Parkinson's disease patients eligible  an illness 
not included in New Hampshire's law  while Maine recently added PTSD 
to its list of qualifying illnesses.

It's New Hampshire's requirement that these patients also see severe 
symptoms not managed with other medications that sets it apart.

In the other states, an illness presenting such symptoms is listed 
simply as another qualifying condition.

If Schlachman had her way, the Granite State legislation wouldn't 
have been quite so strict.

The illnesses eligible for therapeutic marijuana have changed over 
the past several years of trying to pass the bill, she said.

While spinal cord and traumatic brain injuries were added in, PTSD 
and a chronic pain condition called RSD were not included.

But the law does give doctors and patients some leeway. Under the 
legislation, the Department of Health and Human Services may make a 
patient eligible, on a case by case basis, for a condition not 
listed, based on the written request of a medical provider.

And Schlachman said she's confident that as the law is put into 
practice, and doctors and policymakers become more familiar with it, 
additional diagnoses will be added over time.

"It's baby steps," she said. "We're getting something going, making 
sure it works. I expect we'll go back and tweak things over time."
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