Pubdate: Thu, 16 Jul 2015
Source: Denver Post (CO)
Copyright: 2015 The Denver Post Corp
Author: Electa Draper


The Colorado Board of Health voted 6-2 - amid shouts, hisses and boos 
from a packed house - not to add post-traumatic stress disorder to 
the medical conditions that can be treated under the state's medical 
marijuana program.

The board voted Wednesday against the recommendation of the state's 
chief medical officer.

A dozen of the veterans who testified said cannabis has saved their 
lives. Many said drugs legally prescribed to them for PTSD at 
veterans clinics or by other doctors - antidepressants, 
antipsychotics, opioids and others - nearly killed them or robbed 
them of quality of life.

"It is our brothers and sisters who are committing suicide every day. 
We know cannabis can help. We're not going to go away," said John 
Evans, director of Veterans 4 Freedoms.

"We've legalized it," Evans said. "We'll take the tax dollars from 
our tourists (for recreational marijuana) before we'll help our vets."

The president of the nine-member board, Tony Cappello, an 
epidemiologist, said he could not vote to approve pot's use for PTSD 
because scientific evidence does not support it. Most board members 
agreed that mountains of anecdotal evidence aren't enough. One board 
member was absent.

"I'm struggling with the science piece," board member Dr. Christopher 
Stanley said.

The American and Colorado psychiatric associations do not support it, 
said board member Dr. Ray Estacio, an internist at Denver Health and 
associate professor in medicine at the University of Colorado Denver.

But board member Joan Sowinski, an environmental and occupational 
health consultant, said the testimony from veterans and other PTSD 
sufferers was so persuasive - as was recent research about symptoms 
reduction - that she could support it. Jill Hunsaker-Ryan, an Eagle 
County commissioner, was the only other yes vote.

"Blood is on your hands," one audience member shouted after the board 
voted not to make Colorado the 10th state to allow medicinal 
marijuana use for PTSD.

The state's chief medical officer, Dr. Larry Wolk, director of the 
Colorado Department of Public Health and Environment, recommended the 
state add the condition. He suggested a provision that would cause 
the issue to be re-examined in four years, after two state-funded 
studies produced results.

Wolk said listing PTSD as a treatable condition would increase 
transparency and reveal actual usage, shedding light on its 
effectiveness and reinforcing a physician-patient relationship for many users.

Many veterans are self-medicating with recreational marijuana or 
using medical marijuana ostensibly as pain treatment, although it is 
really for PTSD, he said.

Currently allowed uses of marijuana include pain (93 percent of 
recommendations), cancer, epilepsy, glaucoma, muscles spasms, 
multiple sclerosis, severe nausea and wasting disease (cachexia).

Dr. Doris Gundersen, a psychiatrist who spoke at the meeting, said 
only 4 percent to 5 percent of the state's physicians recommend 
medical marijuana to patients. About 15 physicians make 75 percent of 
the recommendations, she said. The state has roughly 14,000 licensed doctors.

"Why are so few getting on board? (Because) there is a lack of 
quality evidence that it is safe and effective ... and does no harm," 
Gundersen said.

One of the state-funded medical marijuana investigators, Sue Sisley, 
who is looking at effects on veterans' PTSD, said federal policy on 
marijuana is a prime reason research is scant. It will take at least 
four years for her study, she said, because the team has been delayed 
in getting the study drug, still illegal under federal law, from the 
authorized supplier - the U.S. government.

A few of the roughly 30 public speakers noted that what patients want 
- - not hard science - is driving demand for expanded medicinal uses of 
marijuana. That's not a bad thing, advocates said.

"It is very important patients become part of this discussion," said 
Teri Robnett, director of the Cannabis Patients Alliance and member 
of the state's advisory council. "Patients are getting enormous relief."
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MAP posted-by: Jay Bergstrom