Pubdate: Thu, 28 Aug 2014
Source: Tucson Weekly (AZ)
Copyright: 2014 Tucson Weekly
Contact:  http://www.tucsonweekly.com/
Details: http://www.mapinc.org/media/462
Author: Mari Herreras

ARIZONA CANNABIS NURSES ASSOCIATION VS. HUMBLE

The Legal Wrangling Over PTSD And Medical Marijuana Continues With 
New Complaint Filed Against Department Of Health Services

Back in July, folks with the Arizona Cannabis Nurses Association were
undeniably happy with an administrative judge's recommendation that
the state allow post-traumatic stress disorder on the list of
qualifying conditions for those who apply for a medical marijuana
patient card.

Well, that was July. Last week, the AZCNA filed an appeal in Maricopa
County Superior Court against the Arizona Department of Health
Services and its director Will Humble to challenge the language used
in how patients can claim PTSD status. They also want cards issued
sooner than Jan. 1, 2015.

"When a cancer patient applies for a patient card, no one asks them if
they are in chemotherapy as treatment in order to qualify," said Kenny
Sobel, AZCNA attorney.

What's different for those with PTSD unlike cancer patients, is that
Humble is asking that they show they are undergoing some form of
treatment beyond using medical marijuana for relief of their symptoms.

Sobel said that Humble's decision to treat PTSD patients differently
than other medical marijuana qualifying patients violates their
constitutional rights. The other issue for AZCNA is that those who
supported their petition more than a year ago, such as veterans, as
well as sexual abuse and domestic violence victims, have to wait more
than five months before they can apply for their patient cards.

"There's a crisis going on right now," Sobel said. "Veterans are
committing suicide at an alarming rate and those, particularly using
the Phoenix VA, aren't able to get the care they need."

When Humble responded to the administrative judge's decision, he
explained that when he first denied the AZCNA petition on Jan. 14,
2014, he did so because he felt there was a lack of scientific
evidence backing medical marijuana's use for PTSD, but that during the
hearing, AZCNA provided evidence that had just been published-namely a
March 2014 article published by the Journal of Psychoactive Drugs that
showed a connection between marijuana and palliative care for PTSD
patients.

Humble's decision to go with the admin judge's recommendation included
a requirement that certifying docs attest that the patient is
undergoing "conventional treatment for PTSD," before signing the
patient card certification.

According to AZCNA's latest appeal, nothing in the state statutes on
medical marijuana "suggest or implied that the Director has any
authority to treat a newly added debilitating disease or medical
condition any different from the debilitating conditions listed in the
original Act."

Humble told the Tucson Weekly that he feels unfairly attacked by Sobel
at the moment and wonders if AZCNA recognizes three outcomes can
happen from their appeal. First, the judge will look at evidence and
case law and rule that Humble made his decision within the boundaries
of the state statute and his discretion as ADHS director.

"I think that's what will happen," Humble said.

"But theoretically the judge could override and say that I must make
it for both palliative care and treatment ... but the other that could
likely happen is that the judge could send it back to the agency, to
me, and say that my statutory authority allows me to give a thumbs up
or down on the administrative judge's decision."

Which means, according to Humble, that PTSD as a qualifying condition
could just go away and AZCNA or another organization would have to
start their petition process all over again.

Humble said he made the decision that marijuana be used for PTSD
patients as a palliative care, not treatment, because there is no
evidence that it cures PTSD, but relieves symptoms. The medical
marijuana law states palliative or treatment, but not both, "not or/and."

"When it came time for making a final decision, I had to make one I
could live with professionally," Humble said. The rule that a patient
be undergoing treatment isn't how AZCNA is interpreting it to the
media, he said. Conventional treatment doesn't have to be prescription
drugs or psychiatric care, but a range of treatments, from counseling,
group therapy, simple directions from a physician to do medication or
take walks or learning coping skills. "Something beyond smoking pot."

The petition process that began last year also included petitions for
generalized anxiety disorder, depression, skin cancer and migraine
headaches. Humble rejected those, too, and PTSD was the only
conditioned championed in the appeal process.

"Sobel has made it sound like I advocate for shoving pills down
people's throats. That's not true," Humble said. "I honestly believe I
did what was responsible using my own professional judgment public
health wise and it stays true to the statute."

Humble said that with or without the PTSD designation, he understands
that since the state began issuing patient cards physicians have been
signing certifications for those with PTSD under chronic pain-that
PTSD can cause chronic pain. "We've approved those cards," he said.

Depending on what happens with Sobel's appeal, Humble said his staff
is moving forward, designing the new patient card form that will be
available to upload by Jan. 1, and sending information to certifying
physicians on PTSD.

"A period of time is needed to help dispensaries and physicians get up
to speed and give IT time get new forms ready. Those were the reasons
for the Jan. 1 start. That's the kind of thing I've done my whole time
as director with other areas. Time allows us to do things
responsibly," he said.

Of course, Sobel disagrees. His clients, he said, believe there is no
logical and rational reason to delay PTSD suffers from applying for
patient cards now that is it listed as a qualifying condition.

"Cancer is not curable. Cannabis provides a palliative benefit since
there's no real cure," Sobel said, adding that Humble needs to treat
PTSD patients the same. If conventional therapy has a wide
interpretation, "then perhaps the director should have put it in writing."  
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MAP posted-by: Jo-D