Pubdate: Fri, 17 Jan 2014
Source: Riverhead News-Review (NY)
Copyright: 2014 Times Review Newsgroup
Contact: (631) 298-0410
Website: http://timesreview.com/
Details: http://www.mapinc.org/media/5485
Author: Carrie Miller

MEDICAL MARIJUANA PITCH RAISES CONCERNS, QUESTIONS

Gov. Andrew Cuomo's announcement of plans to launch a pilot medical
marijuana research program came as encouraging news to some but
worried others, with both sides seeing it as New York State inching
closer to the possible legalization of marijuana.

The announcement, made last Wednesday during the governor's State of
the State address, described the pilot program as a way to evaluate
the effectiveness of a statewide medical marijuana system by allowing
eligible participants to legally seek relief from pain and discomfort.

"Research suggests that medical marijuana can help manage the pain and
treatment of cancer and other serious illnesses," Mr. Cuomo said in
his speech. "Twenty states have already started to use it."

Mr. Cuomo said he will use an executive order to revive the Antonio G.
Olivieri controlled substances therapeutic research program, which was
established by law in 1980 and discontinued soon after, and allow up
to 20 hospitals to dispense marijuana to approved patients suffering
from cancer and other serious illnesses.

It is unclear whether any local hospitals, including state-run Stony
Brook University Hospital, would be among those in the program.

While praising Mr. Cuomo's decision to come out in support of medical
marijuana, advocates have concerns about the feasibility of such a
program - many stemming from the limitations of the outdated 1980s law
as well as federal law, under which marijuana remains illegal.

"Back then we didn't have the experience we have now within the other
20 states" that have legalized medical marijuana programs, said Evan
Nison, co-founder and director of the New York Cannabis Alliance,
which works along with Compassionate Care NY and the Drug Policy
Alliance toward the legalization of medical marijuana.

"We're sort of starting from ground zero, from the bottom floor when
there are states around us that have skyscrapers, if you will, that we
can learn from," he said.

Mr. Nison said Cuomo's program relies on the ability of participating
hospitals to dispense the medical marijuana, however "there are very
large concerns that the hospitals cannot participate in these studies
because of the federal regulations."

Most hospitals rely on federal funding, he noted, adding that there
could be issues with insurance as well.

"We've seen in other states that have tried to involve hospitals in
medical marijuana programs that they are just unwilling - and
rightfully so, because they would have a lot to lose under the federal
law," Mr. Nison said.

Advocates feel the governor's proposal is simply a first step rather
than a solution to providing a suitable program and has yet to specify
which patients would be eligible, which hospitals would participate
and where those hospitals would get the marijuana.

According to the 1980 legislation, found in Section 3397 of the
state's public health law, the program must be limited to cancer
patients with cancer, glaucoma and other diseases approved by the
health commissioner. But the legislation also says it "shall be
limited to such patients who are involved in a life-threatening or
sense-threatening situation."

The law suggests that marijuana could be obtained through the federal
government - which is not a possibility since the drug is outlawed -
or from local law enforcement agencies. But Mr. Nilson said using
marijuana confiscated from street crimes "isn't a suitable, or safe
solution for patients, or anyone" - and health experts agree.

Mr. Nison added that under Mr. Cuomo's plan, the drug could not be
obtained from states where it is legally grown.

Since there is an obvious dearth of available, safe marijuana in New
York, plant growers and cultivators are already looking at production
possibilities in the state.

"The New York market is one of the premier markets that we are looking
at," said Derek Peterson, chief operating officer of Terra Tech Corp.,
an all-natural hydroponic food producer that cultivates marijuana for
both medicinal and recreational purposes.

"Our hope would be that we can make a capital investment in New York,
open a new facility in there and get it up and operating to provide
medical cannabis, whether it is through this program or hopefully a
more broadened-out law in the future," Mr. Peterson said.

Terra Tech Corp. uses greenhouses with supplemental lighting to grow
everything from herbs and lettuces to medical-grade marijuana and
employs all-natural processes - even using lady-bugs for pest
management as a substitute for synthetic pesticides.

"The bottom line is you're consuming it and putting it in to your
body," Mr. Peterson said. "So I think consumers are really going to
start paying attention to where their medicine is actually grown. If
you're going to have a program in place, let's make sure it's one that
is not only economically friendly but environmentally friendly as well."

Mr. Peterson said he believes politicians are beginning to understand
the economic impact marijuana production can have, in terms of not
only job creation but tax capture as well.

As an example, Mr. Peterson said, the company paid about a $1.5
million in taxes last year for sales in Oakland, Calif., alone - with
about $500,000 going directly to the city's general fund thanks to a 5
percent special purpose tax that was added to sales of medical
cannabis on top of the state's 10 percent sales tax.

As to interest in a Long Island production facility, Mr. Peterson said
it would be a "no-brainer."

Dr. Brian Durkin, director of the Center for Pain Management at Stony
Brook University Medical Center, said that - if administered in the
right dose using the right varieties - marijuana may be an effective
treatment for patients in some select cases.

Patients suffering from nausea and anxiety benefit from the
tetrahydrocannabinol (THC) found in marijuana, while those suffering
from pain benefit from the cannabinoid in the plant, Dr. Durkin said,
adding that "not all marijuana is the same."

"The way it's grown depends on how much cannabinoid effect it has
verses THC effect," he said. Usually the amounts of each are inversely
proportional, meaning the lower the THC the higher the cannabinoid
level in the plant.

"They have shown that mild doses of marijuana with a strong
cannabinoid effect can be effective for mild to moderate pain, but
higher doses tend to make pain worse," Dr. Durkin said, referring to a
research study completed by University of California's Center for
Medicinal Cannabis Research.

Dr. Durkin said he believes more work needs to be done in the interest
of supplying patients with a safe, quality-controlled form of marijuana.

"There's a place for this, I'm sure, in medicine and I think the
proper way to do that is just like all other medications that are
available for use - they should go through clinical trials and be
tested in a controlled environment to see if it is effective or not.
If it is effective it should be marketed just like all other
medications in the United States," he said.

Currently, cancer patients must rely on opioids for pain relief, which
Dr. Durkin says bring with them significant side effects.

"The problem with opioids is that we get tolerant of them, making them
less effective over time," he said, adding that opioids also have
cognitive effects and that overuse can cause patients to stop breathing.

According to Dr. Durkin, 50 percent of U.S. patients who die of cancer
do so with moderate to severe pain.

"The stuff we have available now, it is not optimal," he
said.

Cancer patients suffering from nausea and loss of appetite can benefit
from one of two U.S. Food and Drug Administration approved medications
that use synthetic equivalents to mirror the medicinal benefits of
marijuana, according to the manufacturers' websites.

Physicians caring for cancer patients suffering from nausea and
vomiting associated with chemotherapy treatment can prescribe Cesamet
(nabilone), which offers a man-made substitute for THC.

AIDS patients suffering from poor appetite and weight loss can be
prescribed Marinol (dronabinol), which also contains a man-made THC
substitute.

No approved marijuana-related options are currently available for
patients seeking pain relief, Dr. Durbin said, though he noted that
one may be on its way.

The oral spray Sativex, which is derived from extracts of the
marijuana plant itself (rather than a synthetic version), is currently
in Phase 3 of clinical trials, testing its effectiveness in treating
pain in cancer patients. It is also marketed to treat spasticity in
multiple sclerosis patients, according to its developer, GW Pharma.
Sativex would be the first FDA-approved drug using extracts taken from
the plant itself.

The Republican-controlled state Senate has thus far blocked
legislation authorizing a state medical marijuana program in New York.
And the North Fork's two elected state leaders have concerns about Mr.
Cuomo's proposed program, saying it needed to be thoughtfully planned
out before taking effect.

"I want to see the language and I want to see how restrictive it will
be," said Senator Kenneth LaValle (R-Port Jefferson). "These things
begin to create a slippery slope, and there are already people out
there, to use a Christmas analogy, that have sugar plums dancing in
their heads, as to where this could go."

Mr. LaValle said he had visited California, where medicinal marijuana
is legal, and took time to see a marijuana industry in high-gear.

When asked whether New York should model its laws on California's, he
said, "Don't count me in on that. No, no, no. I would say that the
vast majority of people are OK with compassionate care in a very
restrictive environment, in a very restrictive way, but beyond that it
is not something that I would support."

Assemblyman Anthony Palumbo (R-New Suffolk) said, "If there is a
medical benefit I think it needs to be very particularly and
specifically described, prescribed and proven before we even consider
such a measure in New York State."

A former prosecutor, Mr. Palumbo also spoke of the effects drug abuse
and drug use can have on a society and said more research needed to be
done.

Riverhead Police Chief David Hegermiller said he had some questions
about Mr. Cuomo's proposed research program.

"If there is a legitimate reason to use marijuana medically, who is
overseeing usage to see that it's used appropriately and not abused?
All those [kinds of] questions needs to be answered," he said.

But Chief Hegermiller said he didn't see any such program affecting
police work at the street level. As far as policing the use of medical
marijuana, the chief said he imagined it would be enforced the same
way other prescription medications are.

North Fork residents voiced varied opinions on the possibility that
New York State could join Colorado and Washington in the marijuana
movement. Several who were interviewed by a reporter - most of whom
did not give a name - offered comments ranging from "those states are
disgraceful" to "it is a naturally occurring plant that comes from the
earth that is a healthy if not a healthier alternative to pain
management options."

Mr. Nison, the medical marijuana advocate, said, "If the governor or
the state Legislature makes [Mr. Cuomo's proposal] out to be the
solution, or treats this as the solution, we will not have a suitable
program in New York.

"Patients will not have access to anywhere near the quality of
medicine that they need," Mr. Nison said, "and patients will probably
continue to move out of state, to places like Colorado."
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