Pubdate: Mon, 22 Aug 2016
Source: Citizens' Voice, The (Wilkes-Barre, PA)
Copyright: 2016 The Citizens' Voice
Author: Kent Jackson


State among several to allow treatment not yet approved by the U.S. 
Food and Drug Administration

Pennsylvania and the federal government disagree about the usefulness 
of marijuana as medicine.

The U.S. Food and Drug Administration hasn't approved marijuana as 
safe and effective for treating any illness, and the U.S. Drug 
Enforcement Administration as recently as Aug. 11 kept marijuana in 
the same drug category as heroin, LSD and ecstasy.

But Pennsylvania enacted a law in April that lists 17 conditions for 
which doctors can prescribe marijuana, including cancer, multiple 
sclerosis, glaucoma, posttraumatic stress disorder, autism, epilepsy 
and Parkinson's, Crohn's and Huntington's diseases.

Pennsylvania doesn't stand alone against the federal government.

Twenty-four other states and the District of Columbia authorized 
medical marijuana programs.

States are reacting as doctors report good outcomes when using 
marijuana to treat conditions such as seizures in children and as 
more Americans turn in favor of medical marijuana.

For now, however, doctors who prescribe marijuana and patients who 
use it are choosing a treatment that lacks the status of medicines 
sold at pharmacies.

Meanwhile, the DEA, which enforces drug laws, and the National 
Institute on Drug Abuse note the dangers of using marijuana, which 
include psychological dependency and loss of points on IQ tests, 
especially in people who began smoking in early adolescence or whose 
mothers took marijuana during pregnancy.

The results from using marijuana as medicine, even when promising, 
haven't been supported yet by the clinical studies that the FDA 
requires of new drugs. Untested drugs have unknown consequences, the 
agency's website says.

Two drugs containing chemicals found in marijuana, however, have 
received the FDA's approval and been available for years.

"The curious thing about this situation is that medical marijuana 
already is available in two products we can dispense. I'm not sure 
this changes the game so much for the patient," said John Keegan, who 
stocks one of the drugs, Marinol, for a customer at his Heights 
Terrace Pharmacy in Hazleton.

Marino lisa synthetic version of tetra hydro can nab io no ls or THC, 
a chemical that causes the euphoria, increased appetite, heightened 
perceptions and - sometimes - panic associated with smoking 
marijuana. The FDA approved Marinol for treating nausea and vomiting 
of people in chemotherapy and loss of appetite for AIDS patients.

A pill such as Marinol contains a specific dose, whereas the levels 
of chemicals such as THC vary in marijuana plants.

"You can't guarantee the potency from crop to crop, similar to wine 
from grapes," Keegan said.

But Elan Nelson of Medicine Man Denver in Colorado, where state 
programs for medical and recreational marijuana are in place, said 
growers can control the levels of THC and other chemicals in the plant.

"If you are growing the same strain of marijuana and you don't vary 
any of your growing methods (temperature, humidity, nutrients, etc.) 
you will get a relatively consistent product," she said in an email.

Colorado requires growers to test plants for levels of THC and 
another chemical, carnabidol or CBD.

CBD, which doesn't cause psycho-effects, is being tested to treat 
seizures in children with epilepsy, but the FDA hasn't approved its use yet.

Karen O'Keefe of the Medical Marijuana Project in Washington, D.C., 
that advocates for legalizing marijuana said the synthesis of 
individual chemicals to produce drugs such as Marinol ignores the 
value of the whole marijuana plant, which has scores of chemicals.

"A lot of doctors and patients believe these compounds work 
synergistically. If you isolate one, you leave behind other compounds 
that people can benefit from," O'Keefe said.

She said Marinol pills contain a set dose that might be too strong 
for some people. Smoking, which isn't legal in Pennsylvania's medical 
marijuana law, and vaping, which is legal in Pennsylvania, produce 
results faster than pills, so patients can stop taking the drug as 
soon as they feel relief, she said.

Pennsylvania law also allows the dispensing of medical marijuana 
processed into oils, creams, ointments, tinctures and liquids, but 
not as dry leaves.

O'Keefe said the optimum levels of THC or CBD vary with patients, and 
that even the same patient might benefit from different levels of 
those chemicals at different times.

Edward Pane, a drug counselor in Hazleton for 40 years, said the 
DEA's decision to continue regarding marijuana as a Schedule I drug 
ignores results such as marijuana's ability to stop seizures in some 
children and ignores the federal government's own practice.

"It goes in the face of the government providing marijuana under 
compassionate use from the 1980s," Pane said.

Through a little-known program, the federal government mails joints 
rolled from marijuana to patients with conditions such as glaucoma. 
Marijuana temporarily reduces the buildup of eye pressure that can 
cause blindness in patients with glaucoma. See page 13

Though the compassionate use program is closed to new applicants, a 
handful of people enrolled in it for decades still receive monthly 
shipments of marijuana grown with federal approval at the University 
of Mississippi.

While the FDA won't certify marijuana as medicine without more 
scientific studies, Pane points out that the federal government's 
decision to remove marijuana from the approved list of medicines in 
1937 was based on racism, not science.

Harry Anslinger, the nation's first commissioner of narcotics, 
pressed to ban the drug following a congressional hearing of only two 
hours because he associated marijuana with Mexican immigrants and 

Eighty years later, the American Civil Liberties Union says 
African-Americans are four times more likely than whites to be 
arrested for marijuana possession. To Pane, that makes the decision 
by the administration of the nation's first African-American 
president to keep the drug in Schedule I more puzzling.

Six years ago, Pane testified in favor of medical marijuana before 
the Health and Human Services Committee of Pennsylvania's House of 

In Pennsylvania, the act provides funding for research about medical marijuana.

After doctors prescribe medical marijuana for 25 or more people with 
the same medical condition, the Pennsylvania Department of Health 
will seek federal approval for a study of marijuana's effects on that 
condition and enlist a health system to do the trials.

Money will come from a 5 percent tax that growers and processors pay 
on gross receipts.

Although Pennsylvania's law is effective now, patients probably won't 
be able to obtain marijuana in the state until 2018.

Meanwhile, John Collins, the new director of Pennsylvania's Office of 
Medical Marijuana and others in the state Department of Health, have 
to authorize doctors to prescribe marijuana, distribute 
identification cards to patients and caregivers, issue permits to 
companies that will grow, process and dispense marijuana and write 
regulations for secure delivery of marijuana.

Patients and caregivers will pay $50 to obtain ID cards that will 
entitle them to buy marijuana at dispensaries after their doctor 
determines that they are likely to receive therapeutic benefit from marijuana.

Patients who receive marijuana through the state's program probably 
won't face arrest even though possession of marijuana remains a federal crime.
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MAP posted-by: Jay Bergstrom