Pubdate: Sat, 22 Mar 2014
Source: Honolulu Star-Advertiser (HI)
Copyright: 2014 Star Advertiser
Contact: 
http://www.staradvertiser.com/info/Star-Advertiser_Letter_to_the_Editor.html
Website: http://www.staradvertiser.com/
Details: http://www.mapinc.org/media/5154
Author: Ira Zunin
Page: B6

BILL MAKES PROGRESS TOWARD BETTER ACCESS TO MEDICAL POT

Hawaii has yet to craft a functional law that addresses medical
marijuana for chronic disease. Progress to date has been incremental
but in the right direction. Last year the platform for medical
marijuana moved from the Department of Public Safety to the Department
of Health, establishing it as a mainstream medical program.

SB 2574 SD 1, relating to medical marijuana, permits board-certified
pain specialist physicians, oncologists, ophthalmologists and
board-certified palliative care physicians to prescribe medical
marijuana beginning Jan. 2. Currently, only primary care physicians
are authorized to prescribe.

"We are committed to increasing access to medical marijuana for
patients who require it for chronic disease," says Sen. Josh Green,
chairman of the Senate Committee on Health.

Hawaii is in the middle of the pack. Approximately 20 states have
approved legislation for medical marijuana. Several more are on the
verge of doing so. Federal law is still at tension with state laws
across the country, and federal law enforcement has been inconsistent
in its interface with the states. Recent legislation approving
recreational use of marijuana in Colorado and Washington has raised
many questions about the evolving federal response and how this may
affect other states that legally condone the use of medical marijuana.

With few exceptions such as glaucoma, marijuana does not affect the
physiology of the chronic diseases it has been approved to treat.
Rather, it works primarily by shifting one's relationship to an
illness. The experience of chronic pain, for example, is a combination
of the physical inputs from the nervous system and how we react to
those inputs plus the personal impact of related disability. It does
not block the sensation of pain like opiate analgesics.

For several reasons, however, marijuana is safer than opiates and many
other pharmaceuticals. While it can be habit-forming, marijuana does
not result in a frank physiological addiction. It is also far safer
than virtually any illicit drug and does not come even close to the
damaging physical effects wrought by alcohol abuse.

Marijuana use still carries health risks. While it has not been
implicated in lung cancer (like tobacco), it can cause asthma, chronic
bronchitis and emphysema. Vaporizers do mitigate adverse effects of
smoke inhalation and are becoming more widely used.

It also clouds the mind, can be fatiguing and, in the long run, may
diminish motivation. As with alcohol, the earlier in the day one
starts, the more challenging the drug can be to maintaining a healthy
lifestyle. After-work or after-dinner use is better tolerated. In
contrast, those who start using in the morning typically need to
re-dose several times during the day. When smoking, the primary effect
lasts roughly three hours and results in changing blood sugar levels,
leaving one prone to mood swings. Among those most devastated are our
youth who start to use regularly in their early teens and then suffer
permanent social deficits.

All considered, decriminalizing the use of medical marijuana is wise.
In addition to the relative safety and efficacy of medical marijuana,
law enforcement and Hawaii's courts have far more compelling
priorities such as diversion of pharmaceuticals, crystal
methamphetamine labs and violent crime.

SB 2574 SD 1, which enables selected specialists, in addition to
primary care physicians, to prescribe medical marijuana, is a positive
step. But the laws on the books for medical marijuana in Hawaii still
leave a lot to be desired. With a prescription, patients can possess,
smoke and grow marijuana, but there is no way to legally purchase it.

"The Senate Committee on Health intends to continue expanding access
to medical marijuana to Hawaii's patients, including proposals for a
pilot dispensary program that will provide safe, quality medicine that
meets the standard of medical care," Green says.

To have a functional law for medical marijuana, Hawaii needs to create
responsible access via dispensaries.

Note: None of the providers at Manakai o Malama Integrative
Healthcare Group and Rehabilitation Center prescribe medical marijuana.

Ira Zunin, M.D., M.P.H., M.B.A., is medical director of Manakai
o Malama Integrative Healthcare Group and Rehabilitation Center and
CEO of Global Advisory Services Inc.
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MAP posted-by: Matt