Pubdate: Thu, 29 May 2014
Source: Minneapolis Star-Tribune (MN)
Copyright: 2014 Star Tribune
Contact: http://www.startribunecompany.com/143
Website: http://www.startribune.com
Details: http://www.mapinc.org/media/266
Author: Patrick Condon
Page: B1

SOME MEDICAL MARIJUANA BACKERS BACK OUT OF TRIAL

Patients Who Lobbied for the New Law Won't Participate in Test 
Because of Plant Marijuana Prohibition.

Cassie Traun, a 24-year-old IT worker from St. Paul, went to the 
Capitol about a dozen times in April and May to lobby for medical marijuana.

She sat before committees of lawmakers, and even confessed to buying 
and using the drug illegally because she's convinced it effectively 
treats her Crohn's disease.

This week Gov. Mark Dayton is expected to sign a bill legalizing 
marijuana for about 5,000 Minnesotans, including sufferers of 
Crohn's, an inflammatory bowel disease.

But Minnesota's new law will not allow patients to possess or smoke 
marijuana in its plant form. For that reason, Traun and some of the 
medical users who fought hardest for the laws passage, have decided 
they won't participate in the new state program.

"They're asking me to remain a criminal if I want to continue the 
treatment plan that I like, and that my doctor approves of," Traun said.

Her plan for now is to keep buying marijuana from a black market dealer.

Under Minnesota's new law, eligible patients will be able to use 
marijuana only in oil or liquid forms. Some patients like Traun worry 
that marijuana-based oils are more potent and likely to intoxicate 
than are the plant's leaves and buds - a concern backed up by experts.

By denying patients access to plants, and prohibiting smoking of the 
drug, Minnesota will be unique as it becomes the 22nd U.S. state to 
legalize marijuana as a treatment for some afflictions. While the 
wider medical community remains split over the benefits of medical 
marijuana, several prominent doctors who have made the medicinal 
qualities of the cannabis plant a focus of their work are skeptical 
about the details of Minnesota's program.

State program 'different'

"All the other medical cannabis programs in the country are going to 
be watching what happens in Minnesota very carefully, because it's so 
different and unique," said Dr. Steven Jenison, a physician who was 
the first medical director of New Mexico's seven-year-old program and 
later chaired its medical advisory board. "There are aspects that are 
intriguing, but also aspects that a lot of us consider to be a bit mystifying."

Cannabis-based liquids are common for treating children with severe 
epileptic seizures; certain compounds of the plant are mixed with 
olive oil and administered orally. Parents of some of those children 
were among the most visible lobbyists for Minnesota's law.

But adult patients with conditions including Crohn's and other 
diseases also lobbied hard for the bill. Many wanted access to the 
medicinal qualities of the whole plant. When the active ingredient is 
extracted and condensed, it becomes a substance known on the black 
market as "hash oil." That oil can then be loaded into a vaporizer, 
where it is heated to a point short of combustion, then inhaled.

"A lot of patients dose the plant in minimal amounts. They're not 
trying to get high, they're trying to achieve symptom control," said 
Dr. Sue Sisley, a psychiatrist who has been conducting research at 
the University of Arizona into marijuana's possible benefits for 
post-traumatic stress disorder sufferers. "Why would they subject 
themselves to something far more toxic, something much more likely to 
make them intoxicated?"

Oil issues

Sisley said that anecdotal reports from users of the oil have found 
"reports of altered mental states, feeling emotionally blunted, 
zombielike." Lack of formal research has also meant little reliable 
information on what constitutes a safe, effective dose.

Traun was diagnosed with Crohn's when she was 16. The disease causes 
inflammation of the intestinal lining, which frequently leads to 
abdominal pain, bouts of nausea, severe diarrhea, weight loss and malnutrition.

For several years after diagnosis, Traun tried a series of 
pharmaceuticals that included steroids, a drug called Imuran used to 
help prevent transplant patients from rejecting new kidneys, and 
finally Remicade, an antibody partly produced from mouse DNA. None 
delivered long-lasting benefits and some had brutal side effects.

During her freshman year in college, Traun's symptoms worsened. For 
several months, she couldn't keep food down and survived on a liquid 
diet. She lost 30 pounds.

"That's when I tried cannabis," Traun said. "I actually started as a 
recreational user, but I quickly found that after I used it I was 
actually able to eat a little bit. A few months later I was in 
remission, and that's how it's been for five years now."

Traun said blood tests since showed year-over-year lessening of her 
intestinal inflammation, although she still suffers occasional 
nausea. She used to smoke marijuana, but more recently switched to a 
vaporizer. Traun said she also keeps a supply of hash oil on hand 
because it helps allay particularly severe instances of nausea, but 
she doesn't want to have to use it regularly.

"People say marijuana treats the symptoms but not the disease," Traun 
said. "But I believe it's treating my disease itself. I believe I 
have to vaporize daily to stay in remission."

Traun is not the only person who lobbied for the medical marijuana 
law and is eligible to join but leaning against it. Under the law, 
patients who enroll in a registry administered by the Department of 
Health will have their usage and outcomes monitored in what's being 
described as "observational research." The goal is to get patients 
access to the drug starting July 1, 2015.

Access at a price

But there's one big catch for those who already partake.

Patients who enroll in the program face greater legal jeopardy if 
they supplement with illegal plant marijuana.

Possession of small amounts of marijuana is a petty misdemeanor, but 
participants in the new program caught with the plant form can be 
jailed for up to 90 days, fined $1,000 and expelled from the program.

"I think I'm going to have to stick with my current arrangement," 
said Patrick McClellan, a 47-year-old Bloomington resident who treats 
severe pain from muscular dystrophy by vaporizing plant marijuana 
that he buys illegally.

He was a fixture at the Capitol while lawmakers debated medical 
marijuana earlier this year, and was among a group of advocates who 
met privately with Dayton in March.

"If I were to get into this program, and I get the oil and it's way 
too powerful and then I decide to go back to leaf, I could be 
prosecuted," McClellan said.

When McClellan feels symptoms starting, he puts a small amount of 
leaf marijuana in his vaporizer and takes one or two light puffs.

He's worried if he were forced to vaporize oil, "I would get stoned 
out of my mind. Patients don't want to be high. We just want to treat 
our symptoms."

Kendra Miller, a 26-year-old registered nurse and Crohn's sufferer 
from St. Louis Park, also lobbied at the Capitol multiple times.

She said that if the new law McClellan uses the marijuana to get 
relief from the severe pain of powerful muscle spasms.

Kendra Miller, nurse and medical marijuana supporter offered access 
to plant marijuana, she'd probably surrender her nurse's license and 
enroll. Miller does not believe the state would allow her to keep her 
nurse's license and be in the program.

"I don't believe this plan has enough of a likelihood of working, 
that doing that would be worth it for me," she said.

According to the Washington-based Marijuana Policy Project, which 
lobbies for legalization of marijuana for both medical and 
recreational purposes, the other 21 states with medical marijuana 
laws all allow patients to possess and smoke plant material. Fifteen 
of those states allow patients to grow their own plants. Strict controls

Minnesota will feature one of the tightest distribution systems 
nationwide, allowing only two manufacturers and eight dispensaries 
statewide. Arizona, which approved medical marijuana by voter 
initiative in 2010, had 71 dispensaries by late 2013. The Illinois 
General Assembly last summer passed a law authorizing 60 
dispensaries. Nevada's Legislature approved up to 66 dispensaries 
last year and New Mexico has 23 distribution sites.

Minnesota will also allow fewer eligible conditions than most other 
states: Cancer with certain symptoms; glaucoma; HIV/AIDS; Tourette's 
syndrome; Amyotrophic Lateral Sclerosis (Lou Gehrig's disease); 
seizure-inducing epilepsy; severe and persistent muscle spasms 
including those brought on by multiple sclerosis or muscular 
dystrophy; Crohn's disease, and terminal illness with a life 
expectancy of less than a year or which causes severe pain, nausea, 
severe vomiting or wasting.

Advocates had pushed for a more expansive Minnesota law that would 
have permitted plant marijuana, a wider distribution system and more 
eligible conditions. But Dayton insisted on a bill that was not 
opposed by law enforcement and the medical community. Law enforcement 
in particular opposed legal plant possession and smoking.

Sisley, the marijuana researcher at the University of Arizona, said 
she hopes Minnesota's program works. She said she would advise state 
health officials, as they build the program, to involve top 
researchers from around the country.

Miller said that while she doesn't intend to enroll initially, she 
will be watching closely as Minnesota's program rolls out.

"I do want there to be a workable law here," Miller said. "I think 
it's a matter of waiting and watching to see if people who do enroll 
will get access and find relief."
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MAP posted-by: Jay Bergstrom