Pubdate: Mon, 23 May 2016
Source: Daily Local, The (PA)
Copyright: 2016 Daily Local News - a Journal Register Property
Author: Lucas Rodgers
Note: Editor's Note: Second of a two-part series By Lucas Rodgers

Weeding Through the Issues


Medical marijuana has been legalized in Pennsylvania, as well as 23 
other states and the District of Columbia, but there are still many 
questions about how exactly the drug can be used as medicine.

Pennsylvania's Medical Marijuana Act (MMA), or Senate Bill 3, lists 
17 "serious medical conditions" that qualify for treatment with 
medical marijuana. These conditions include cancer, HIV/AIDS, 
amyotrophic lateral sclerosis (ALS), Parkinson's disease, multiple 
sclerosis (MS), epilepsy, inflammatory bowel disease, neuropathies, 
Huntington's disease, Crohn's disease, posttraumatic stress disorder, 
intractable seizures, glaucoma, sickle cell anemia and autism.

"The Pennsylvania Department of Health's Medical Marijuana Program 
vision is to be a high quality, efficient and compliant medical 
program for Pennsylvania residents with serious medical conditions as 
defined by the act," Penny Ickes, deputy director of communications 
at the department, said in an emailed statement. "The department will 
strive to develop and maintain a Medical Marijuana Program that is 
viewed as: a medically focused program benefiting patients; 
consistent, competent, and efficient; leading, innovative, 
researchdriven; and transparent."

Not everyone is in agreement that marijuana, also referred to as 
cannabis, could really be used as an effective medicine to treat the 
listed conditions. Marijuana is still classified as a Schedule I drug 
by the Drug Enforcement Administration, which means it is considered 
to have no currently accepted medical use and a high potential for 
abuse. This classification seems to be in contradiction with the fact 
that almost half the states in America have legalized marijuana for 
medicinal use. Still, not all doctors are ready to recommend 
marijuana as a commonly prescribed medicine.

Dr. Ausim Azizi, who is the chairman of the Department of Neurology 
at the Lewis Katz School of Medicine at Temple University, said there 
is some anecdotal evidence to suggest that marijuana can offer relief 
from symptoms of some of the conditions covered by MMA, but there is 
currently not enough evidence for doctors to prescribe marijuana as a 
common treatment for medical conditions.

However, Azizi said medical marijuana could be used as a tool to 
alleviate chronic pain and it could also potentially be used as a 
substitute for opioids or help people lessen their dependency on 
opioids. There is evidence that medical marijuana treatment for 
chronic pain actually works, but a lot of the evidence is subjective, 
he said. Neuropathic pain is included in the MMA as one of the 
medical conditions eligible for treatment with marijuana.

Ickes said studies have shown that medical marijuana can assist 
patients suffering from serious medical conditions by alleviating 
pain and improving their quality of life.

Azizi said if medical marijuana is another tool to help patients, 
then it's perfectly fine for it to be legal. As far as the medical 
community is concerned, the priority for doctors is "first, do no 
harm" and help patients, he said. "It's a good idea to have it legal 
and be available but not necessarily used in a massive way," he added.

Azizi said he believes the medical community will be happy that 
medical marijuana is legal in Pennsylvania, but it will also be 
skeptical in terms of the efficacy of using marijuana as a 
medication. He said he agrees with the position of the American 
Academy of Neurology (AAN), regarding the need for more research into 
medical marijuana.

According to the AAN's position statement, which is posted on, "the current medical marijuana legislation being passed 
by policymakers across the country, which promotes marijuana-based 
products as treatment options for various neurologic disorders, is 
not supported by high-level medical research."

The statement says there is concern regarding the safety of 
marijuana-based products, especially for long-term use in patients 
with disorders of the nervous system.

"Further research is urgently needed to determine the safety and 
medical benefit of various forms of marijuana in neurologic 
disorders, especially those where anecdotal evidence is available," 
the statement says. "Anecdotal evidence may engender public support 
for the use of these products but such evidence must be substantiated 
by rigorous research, which will in turn inform legislative policy."

A survey conducted by WebMD in 2014 found that 56 percent of doctors 
in America supported legalizing medical marijuana nationwide. WebMD 
surveyed 1,544 doctors from more than 12 specialties in 48 states. Of 
the doctors surveyed, 67 percent said marijuana should be a medical 
option for patients, and 69 percent said medical marijuana can help 
with certain treatments and conditions.

Azizi said it can be difficult to determine how exactly marijuana can 
be used for medical treatments because the cannabis plant has about 
60 different chemicals in it, but it's complicated to analyze how the 
chemicals will affect the patient, and which chemicals will be active 
in the medicine.

He said there are two major active chemicals in cannabis that have 
been studied: cannabidiol (CBD) and tetrahydrocannabinol (THC). CBD 
is considered to be one of the chemicals in cannabis that has medical 
applications, and it has no psychoactive properties. THC, on the 
other hand, is the main psychoactive compound in cannabis, which 
causes the "high" associated with marijuana use.

Azizi said there have been studies on using medical marijuana to 
treat neuropathic pain, but the results tend to be subjective. There 
is some evidence that medical marijuana can help treat muscle spasms 
caused by MS, but it doesn't treat other symptoms of MS, such as 
bladder issues, he said. Clinical trials so far have been small, and 
not really randomized, he said.

Ickes said the department of health is currently researching the 
strains of medical cannabis most effective for medical treatment.

The forms of medical marijuana that are legal in Pennsylvania are: 
pill; oil; topical forms including gel, creams or ointments; 
tincture; liquid; or a form medically appropriate for

administration by vaporization or nebulization, excluding dry leaf or 
plant form. It remains illegal under state and federal law to smoke 
marijuana under any condition.

"Patients with serious medical conditions -- who are residents of the 
commonwealth and have a physician's certification -- will be able to 
obtain medical marijuana at dispensaries in the commonwealth that 
hold valid permits from the department," Ickes said. "A caregiver 
that is designated by the patient and approved by the department will 
be able to obtain medical marijuana at department-approved and 
permitted dispensaries in order to deliver medical marijuana to the patient."

Like any drug, marijuana does have side effects. Azizi said some side 
effects of marijuana include difficulty with attention and 
concentration, loss of balance, drowsiness, dry mouth, nausea, 
impaired judgement, and sometimes even hallucinations. Side effects 
of marijuana may vary, depending on the form consumed, and the strain 
of the plant.

Azizi said marijuana doesn't seem to be very addictive physically, 
but habitual users can develop a psychological addiction to marijuana 
and have cravings for it. He said the psychoactive element of 
marijuana affects synapses in the brain. Azizi said there are some 
concerns about children and teens using marijuana because certain 
chemicals in the drug could potentially interfere with brain development.

US Cannabis Pharmaceutical Research and Development will be hosting 
two one-day seminars in the greater Philadelphia area from 9:30 a.m. 
to 4 p.m. on Saturday, June 4 at the Philadelphia Marriott Downtown, 
1201 Market Street, Philadelphia, PA 19107 and on Sunday, June 5 at 
the Philadelphia Marriott West, 111 Crawford Avenue, West 
Conshohocken, PA 19428. The price of admission is $300 before May 27 
at 12 a.m. and $350 after May 27. The one-day seminars will offer 
concise and comprehensive information on all the areas of medical 
marijuana business: licensure, legal, accounting/taxes, staffing, 
plant production, profitability, liability, etc.



"Serious medical condition."

Any of the following:

Cancer Autism Epilepsy Glaucoma Crohn's disease Neuropathies 
Parkinson's disease Multiple sclerosis Intractable seizures Sickle 
cell anemia Huntington's disease Amyotrophic lateral sclerosis 
Inflammatory bowel disease Severe chronic or intractable pain Damage 
to the nervous tissue of the spinal cord with objective neurological 
indication of intractable spasticity.

Positive status for human immunodeficiency virus or acquired immune 
deficiency syndrome.

Post-traumatic stress disorder of neuropathic origin or severe 
chronic or intractable pain in which conventional therapeutic 
intervention and opiate therapy is contraindicated or ineffective.
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MAP posted-by: Jay Bergstrom