Pubdate: Sun, 04 May 2014
Source: Philadelphia Inquirer, The (PA)
Copyright: 2014 Philadelphia Newspapers Inc
Contact:  http://www.philly.com/inquirer/
Details: http://www.mapinc.org/media/340
Author: Jan Hefler

MEDICAL MARIJUANA SEEN TO HAVE DRAMATIC EFFECT ON SYMPTOM RELIEF

EGG HARBOR TOWNSHIP, N.J. - Before buying cannabis at South Jersey's
only medical-marijuana dispensary, patients must circle one of six
animated faces that stare out from a clipboard.

The row of smiling, wincing, frowning, and sobbing cartoon faces is
being used to rank the degree of pain that patients experience due to
cancer, multiple sclerosis, epilepsy, and several other conditions the
state deems treatable by cannabis.

When the patients return to the Compassionate Care Foundation
dispensary in Egg Harbor Township for a refill, they again are handed
the Wong-Baker FACES Pain Rating Scale so that the effect of the
marijuana can be assessed.

The results so far are "absolutely dramatic," said Suzanne Miller, a
researcher with a Ph.D. who sits on the dispensary's board of
trustees. Miller is also a professor and the director of behavioral
medicine at Fox Chase Cancer Center/Temple Health in Philadelphia.
About 80 percent of the 145 CCF patients who completed the rankings at
least twice over the last two months have charted significant
improvement, she said.

Still being collected and analyzed, the data show that on average,
most patients are reporting their pain levels decreased by 30 to 50
percent, Miller said. "You usually see smaller results, about 10
percent, or 20 percent," she said.

An author of four books and a contributor to more than 100 academic
articles, Miller will be the lead researcher on a report she plans to
submit to medical journals for publication possibly this fall. The
dispensary has 600 registered patients and expects to have more data
by that time.

On a gloomy, wet morning last week, several patients walked into the
dispensary to purchase cannabis, which is packaged in plastic bottles
and sold at $428 an ounce. Two patients who agreed to be interviewed
afterward said the marijuana they bought had changed their lives.
Three other patients who were reached by phone said it markedly eased
their pain.

'Zero' pain

"I was addicted to Vicodin," said Gary Carnevale Sr., a multiple
sclerosis patient from Bayville, Ocean County, shortly after he picked
up an ounce of "Red Cherry Berry" marijuana from an employee behind a
glass window at the dispensary. Carnevale, 57, a former licensed
practical nurse, said increasing amounts of prescribed Vicodin,
OxyContin, Percocet, and other narcotics did not relieve the throbbing
pain shooting up his back and legs, and he then had to be hospitalized
for two weeks early last year.

Carnevale was among the first patients to come to CCF, which opened
six months ago inside a cavernous warehouse just outside Atlantic
City. Marijuana plants are also grown at that location under special
purple, red, blue, and yellow lights.

"I took three or four hits. I laid in bed, and I could not believe the
pain slipping away," Carnevale said, recalling the first day he smoked
it using a vaporizer. "My pain was like ten. . . . But when I smoke
marijuana, I swear it's zero," he said. While he previously spent most
of his days in bed, he said he now is able to function and even took a
recent vacation with his family, including his two
grandchildren.

Jacqueline Angotti, a nurse-practitioner from Robbinsville, began
sobbing when asked the effect the marijuana had on her 9-year-old son,
Miles, who had suffered multiple, daily seizures since he was 2. "He's
been seizure-free; he's had none for the past 31 days and has had no
side effects," she said. "And he's better cognitively."

In the past, Miles was forced to wear a mask to protect his face and
teeth from frequent falls caused by the violent seizures, she said.
And, for the same reason, he had to eat meals from a tray while
sitting on the floor. Angotti turned the marijuana buds into a
tincture, which she gives to Miles in tiny doses three times a day,
and he no longer needs his mask, she said. "He eats dinner at the
table now," she added.

Bill Thomas, the dispensary CEO, said the frequent hugs that grateful
patients bestow on staff and the tears he has witnessed in the waiting
room convince him of marijuana's medical worth. "To us, this is
medicine. To everyone else, it's something else. It's pot. . . . But
this is not Colorado," he said. His staff wear white medical jackets,
and only patients who have a doctor's approval may buy the drug.

Those afflicted with seizures, multiple sclerosis, Crohn's disease,
irritable bowel syndrome, and glaucoma are reporting the greatest
benefit, Thomas said. One patient who had Crohn's disease experienced
a "total reversal" and was able to return to work, he said.

Because there is a dearth of scientific studies, anecdotal evidence is
practically the only proof available at this time, Thomas said.
Marijuana's status as a federally prohibited Schedule I drug, ranking
it more dangerous than opium, has blocked studies on its medicinal
value, he said.

Though the federal government still considers marijuana illegal, the
Obama administration recently announced it will not enforce the ban in
states that have legalized it for medical and for recreational use
except in egregious trafficking cases and when it is being marketed to
minors.

New Jersey is one of 22 states that have legalized medical marijuana,
and many others are weighing it. Its strictly regulated program calls
for doctors to write "recommendations" - not prescriptions -
authorizing patients to obtain cannabis. But they are not required to
provide dosing information, leaving patients to use marijuana on a
trial-and-error basis.

Thomas said he looks forward to having an analysis of the patient
surveys completed and having a more detailed questionnaire for
patients developed so that CCF can determine what doses and strains
are most helpful for its patients. "This is the drug that needs to be
studied," he said.

Adjusting doses

One in five patients initially told staff that they did not get relief
by taking the cannabis they had purchased, Thomas said. But when the
strain and dose were modified, he said, half of those patients
reported their pain had lessened. Marijuana contains 60 chemicals, he
said, and the various strains have different ratios of the
ingredients. CCF currently sells six strains and is planning an
expansion next month.

Back in the dispensary waiting room, a 60-year-old Brigantine woman
who suffers from multiple sclerosis was busy gathering up her
one-quarter ounce of marijuana and her umbrella as she prepared to
head home. "I had pain every day in my feet and occasionally in my
face," she said, declining to be named. "It's debilitating, and when
it's in my face it's like lightning."

After baking marijuana brownies with the cannabis, she said, her pain
improved 80 percent. "It's a valid medicine," she said. "And it is
time it's seen that way."
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MAP posted-by: Matt