Pubdate: Mon, 23 May 2016 Source: Daily Local, The (PA) Copyright: 2016 Daily Local News - a Journal Register Property Contact: http://www.dailylocal.com/ Details: http://www.mapinc.org/media/4704 Author: Lucas Rodgers Note: Editor's Note: Second of a two-part series By Lucas Rodgers Weeding Through the Issues MARIJUANA'S ROLE AS MEDICINE REMAINS CONTROVERSIAL 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 www.aan.com, "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. [sidebar] QUALIFYING CONDITIONS FOR MEDICAL MARIJUANA TREATMENT "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. - --- MAP posted-by: Jay Bergstrom