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TRENTON — Diane Riportella is in the final stages of Lou Gehrig’s Disease. She expects to die soon.
The 54-year-old Egg Harbor Township woman says smoking pot "gives me a reprieve from this living nightmare" by suppressing her pain without relying solely on morphine, which leaves her "lifeless."
"When I smoke marijuana, I feel normal. I can express myself and be the person I want," she said at a Senate committee hearing last month.
Poonam Alaigh, the state health commissioner and a doctor, also says she has seen the value of medicinal marijuana. One patient suffering from severe nerve pain recently confided to her he has been using pot in addition to prescription painkillers and feels remarkably better.
"He told me how his life changed so much as a result of this," Alaigh said. "It was an eye-opening experience for me."
But all year long the politics of medical marijuana in New Jersey has trumped any shared belief in its benefits.
Fearing the new law will feed more recreational users than patients, Gov. Chris Christie’s administration proposed unprecedented restrictions limiting the potency level of legal pot far below what can easily be bought on the street, as well as the number of strains sanctioned growers may cultivate.
Christie would also prohibit the sale of cannabis-laced brownies and other edible products popular in other medical marijuana states as an alternative to smoking.
Democratic lawmakers say they never intended such a restrictive program and have advanced a resolution to kill the rules. Christie on Friday sought to end the standoff by announcing a compromise on other parts of his plan, saying he will remove tougher rules on where pot will be distributed and requirements that doctors allow medical marijuana as only a last resort.
But the announcement didn’t quell the controversy over how New Jersey will implement its new medical marijuana law.
In her first interview since the health department unveiled its rules three months ago, Alaigh said New Jersey’s approach to medical marijuana is misunderstood. While concerned about keeping pot from recreational users, she contends New Jersey’s program is better than other states with medical marijuana laws because it is more focused on the patient’s well-being.
"Where other states give patients a license to possess, our physicians will be actively involved ... ensuring the right patients are on the appropriate care plan," she said.
The state also plans to be the first to create a database tracking patients’ progress and side effects from pot, based on reports from doctors and operators of "alternative treatment centers," that will dispense the pot, Alaigh said.
"This is going to be a great observational study over time, and may actually be the foundation for future studies," she said. "This is really exciting."
While medical marijuana advocates strongly oppose many of the adminsitration’s proposals, the debate is hindered because there hasn’t been much research in this country, where pot was declared illegal by the federal government in 1937.
ProCon.org, a nonpartisan, nonprofit research site, identifies 69 studies worldwide: 32 said marijuana is a valid source of pain and symptom relief, 14 concluded it had no medicinal benefit, and 23 had mixed results.
The favorable studies credit marijuana with reducing pain and helping people regain their appetite, including cancer patients undergoing chemotherapy. It’s been shown to reduce muscle spasms seen in mutliple sclerosis patients.
In crafting New Jersey’s medical marijuana program, Alaigh said she was most influenced by the recent studies from McGill University Health Centre in Canada and state-funded research at the University of California at San Diego. At both sites, researchers gave patients marijuana with a potency level at or less than 10 percent THC (tetrahydrocannabinol) and they felt a marked drop in pain, fewer problems with sleep and reduced anxiety, according to the published findings.
Alaigh said this is why the Department of Health and Senior Services would require growers to produce marijuana with a potency level of no more than 10 percent. Patients will have the option to buy low, medium and high doses of pot to see what works best for them, she added.
SIX STRAINS
The department would also restrict the number of plant strains sold in New Jersey to six from the thousands that exist. Known elsewhere by colorful names such as Diesel, AK-47, White Widow, strains reflect varying degrees of chemical compounds cultivators say (but science hasn’t proved) provide an energy boost or a sleeping aid, depending on a patient’s needs.
Alaigh also would prohibit the sale of pot-infused edibles like ice cream and brownies. The alternative treatment centers would sell buds for smoking and vaporizing, as well as lozenges, skin ointments and edible oils. They may also provide patients with recipes for edible goods, Alaigh said.
Alaigh said the edible pot-product market booming in California and Colorado lacks the "integrity" she wants the program to convey, and any benefits of eating pot would be harder to measure. "I don’t want an ATC to become a bakery, This is serious business.’’
The two studies cited by Alaigh showed less-potent pot relieved pain, but their leaders say more research is needed to determine the effects of higher levels.
Igor Grant, director of the Center for Cannabis Research at the University of California-San Diego, said in seven clinical trials, his team relied on marijuana with a maximum potency of 8 percent because that’s what is produced at the only legal place the center could obtain it, a federally sanctioned lab.
Grant said patients felt the most pain relief at the 4 percent to 6 percent potency, with fewer benefits and more side effects at the higher range. "I don’t think anyone has done enough research yet but our data show for neuropathic pain, THC doses of 4 percent were fine and did ameliorate the pain, and the side effects were very tolerable," he said.
Grant noted his studies were short-term, and did not take into account how the body grows accustomed to the drug and its side effects if the patient is a frequent user.
The clinical director of McGill’s Pain Clinic, Mark Ware, gave patients with severe nerve pain marijuana with potencies of 2.5 percent, 6 percent and 9.4 percent. Patients who received the highest dose felt the least pain and slept better, according to a McGill statement on the research released in August.
Although Ware did not use pot with a THC level in excess of 10 percent, he said future studies should examine the impact on patients who consume higher potency levels.
QUESTIONS REMAIN
"So would we get better results if we had slightly higher THC levels, would we get better results if the patients could use it for longer periods, or if they could use it more frequently during the day?" Ware said. "I think these are questions that we can’t answer."
The San Diego and McGill studies did not look at pot in edible forms. Grant said in general, inhaling the drug is faster and more reliable than any edible product. Those who support medical marijuana, however, say patients, not the government, should decide what form of the plant is best for them, whether it’s in a pipe or baked into a cookie.
"This is very important to chronic pain sufferers, plus it offers an alternative for throat and lung cancer patients, who have difficulty smoking the medicine," said Cindy Kleiner, 47, of Wantage. She takes Marinol, an FDA-approved synthetic form of THC that doesn’t do enough to control the chronic pain she suffers from two car accidents. She said she researched medical marijuana in anticipation of the law passing.
"When cannabis is smoked, it only lasts for approximately two hours and you are not even getting close to the 10 percent THC. When it is eaten, the dosage can be measured and it can last up to 12 hours," Kleiner said.
Kleiner and other patients also object to limiting strains and potency because some who already use pot illegally are exposed to THC levels at 15 percent or 20 percent.
"Patients are not going to buy from legal dispensaries. They are going to be forced to purchase this medicine on the streets because of the better quality there," said Kleiner.
Patients and medical marijuana advocacy groups say they are frustrated by the administration’s reluctance to give more credence to the experience in other countries.
"Many of the new restrictions created by the Department of Health and Senior Services are based in politics, not in science," said Chris Goldstein, a board member for the Coalition for Medical Marijuana New Jersey.
Philippe Lucas from the Vancouver Island Compassion Society, a nonprofit marijuana club operating outside Canada’s sanctioned program, said government-supplied marijuana is typically 12 percent THC potency, compared with the 15 percent to 25 percent he sells.
"The main thing to remind regulators is that if the product legally available to patients is not as good (or as potent) as that available on the black market, patients will keep having to risk arrest to get effective medicine, and that benefits no one," Lucas said in an e-mail. "That’s exactly the situation we currently face in Canada."
Dale Gieringer, state coordinator for the California National Organization for the Reform of Marijuana Laws, noted that cannabis products sold in the Netherlands have potency levels ranging from 6 percent to 18 percent, and are "rigorously tested according to established pharmaceutical standards" in that country.
Alaigh said she has reviewed European studies and practices, and does not give them as much weight.
"There is no drug that gets approved here based on studies outside the U.S.,’’ Alaigh said, "This is not an FDA approved drug, but I cannot relax our standards."
NewsHawk: MedicalNeed: 420 MAGAZINE
Source: nj.com
Author: Susan K. Livio
Contact: Contact Us - NJ.com
Copyright:2009 New Jersey On-Line LLC.
Website:Medical marijuana issue in N.J. pits pain-relief proof against politics | NJ.com
The 54-year-old Egg Harbor Township woman says smoking pot "gives me a reprieve from this living nightmare" by suppressing her pain without relying solely on morphine, which leaves her "lifeless."
"When I smoke marijuana, I feel normal. I can express myself and be the person I want," she said at a Senate committee hearing last month.
Poonam Alaigh, the state health commissioner and a doctor, also says she has seen the value of medicinal marijuana. One patient suffering from severe nerve pain recently confided to her he has been using pot in addition to prescription painkillers and feels remarkably better.
"He told me how his life changed so much as a result of this," Alaigh said. "It was an eye-opening experience for me."
But all year long the politics of medical marijuana in New Jersey has trumped any shared belief in its benefits.
Fearing the new law will feed more recreational users than patients, Gov. Chris Christie’s administration proposed unprecedented restrictions limiting the potency level of legal pot far below what can easily be bought on the street, as well as the number of strains sanctioned growers may cultivate.
Christie would also prohibit the sale of cannabis-laced brownies and other edible products popular in other medical marijuana states as an alternative to smoking.
Democratic lawmakers say they never intended such a restrictive program and have advanced a resolution to kill the rules. Christie on Friday sought to end the standoff by announcing a compromise on other parts of his plan, saying he will remove tougher rules on where pot will be distributed and requirements that doctors allow medical marijuana as only a last resort.
But the announcement didn’t quell the controversy over how New Jersey will implement its new medical marijuana law.
In her first interview since the health department unveiled its rules three months ago, Alaigh said New Jersey’s approach to medical marijuana is misunderstood. While concerned about keeping pot from recreational users, she contends New Jersey’s program is better than other states with medical marijuana laws because it is more focused on the patient’s well-being.
"Where other states give patients a license to possess, our physicians will be actively involved ... ensuring the right patients are on the appropriate care plan," she said.
The state also plans to be the first to create a database tracking patients’ progress and side effects from pot, based on reports from doctors and operators of "alternative treatment centers," that will dispense the pot, Alaigh said.
"This is going to be a great observational study over time, and may actually be the foundation for future studies," she said. "This is really exciting."
While medical marijuana advocates strongly oppose many of the adminsitration’s proposals, the debate is hindered because there hasn’t been much research in this country, where pot was declared illegal by the federal government in 1937.
ProCon.org, a nonpartisan, nonprofit research site, identifies 69 studies worldwide: 32 said marijuana is a valid source of pain and symptom relief, 14 concluded it had no medicinal benefit, and 23 had mixed results.
The favorable studies credit marijuana with reducing pain and helping people regain their appetite, including cancer patients undergoing chemotherapy. It’s been shown to reduce muscle spasms seen in mutliple sclerosis patients.
In crafting New Jersey’s medical marijuana program, Alaigh said she was most influenced by the recent studies from McGill University Health Centre in Canada and state-funded research at the University of California at San Diego. At both sites, researchers gave patients marijuana with a potency level at or less than 10 percent THC (tetrahydrocannabinol) and they felt a marked drop in pain, fewer problems with sleep and reduced anxiety, according to the published findings.
Alaigh said this is why the Department of Health and Senior Services would require growers to produce marijuana with a potency level of no more than 10 percent. Patients will have the option to buy low, medium and high doses of pot to see what works best for them, she added.
SIX STRAINS
The department would also restrict the number of plant strains sold in New Jersey to six from the thousands that exist. Known elsewhere by colorful names such as Diesel, AK-47, White Widow, strains reflect varying degrees of chemical compounds cultivators say (but science hasn’t proved) provide an energy boost or a sleeping aid, depending on a patient’s needs.
Alaigh also would prohibit the sale of pot-infused edibles like ice cream and brownies. The alternative treatment centers would sell buds for smoking and vaporizing, as well as lozenges, skin ointments and edible oils. They may also provide patients with recipes for edible goods, Alaigh said.
Alaigh said the edible pot-product market booming in California and Colorado lacks the "integrity" she wants the program to convey, and any benefits of eating pot would be harder to measure. "I don’t want an ATC to become a bakery, This is serious business.’’
The two studies cited by Alaigh showed less-potent pot relieved pain, but their leaders say more research is needed to determine the effects of higher levels.
Igor Grant, director of the Center for Cannabis Research at the University of California-San Diego, said in seven clinical trials, his team relied on marijuana with a maximum potency of 8 percent because that’s what is produced at the only legal place the center could obtain it, a federally sanctioned lab.
Grant said patients felt the most pain relief at the 4 percent to 6 percent potency, with fewer benefits and more side effects at the higher range. "I don’t think anyone has done enough research yet but our data show for neuropathic pain, THC doses of 4 percent were fine and did ameliorate the pain, and the side effects were very tolerable," he said.
Grant noted his studies were short-term, and did not take into account how the body grows accustomed to the drug and its side effects if the patient is a frequent user.
The clinical director of McGill’s Pain Clinic, Mark Ware, gave patients with severe nerve pain marijuana with potencies of 2.5 percent, 6 percent and 9.4 percent. Patients who received the highest dose felt the least pain and slept better, according to a McGill statement on the research released in August.
Although Ware did not use pot with a THC level in excess of 10 percent, he said future studies should examine the impact on patients who consume higher potency levels.
QUESTIONS REMAIN
"So would we get better results if we had slightly higher THC levels, would we get better results if the patients could use it for longer periods, or if they could use it more frequently during the day?" Ware said. "I think these are questions that we can’t answer."
The San Diego and McGill studies did not look at pot in edible forms. Grant said in general, inhaling the drug is faster and more reliable than any edible product. Those who support medical marijuana, however, say patients, not the government, should decide what form of the plant is best for them, whether it’s in a pipe or baked into a cookie.
"This is very important to chronic pain sufferers, plus it offers an alternative for throat and lung cancer patients, who have difficulty smoking the medicine," said Cindy Kleiner, 47, of Wantage. She takes Marinol, an FDA-approved synthetic form of THC that doesn’t do enough to control the chronic pain she suffers from two car accidents. She said she researched medical marijuana in anticipation of the law passing.
"When cannabis is smoked, it only lasts for approximately two hours and you are not even getting close to the 10 percent THC. When it is eaten, the dosage can be measured and it can last up to 12 hours," Kleiner said.
Kleiner and other patients also object to limiting strains and potency because some who already use pot illegally are exposed to THC levels at 15 percent or 20 percent.
"Patients are not going to buy from legal dispensaries. They are going to be forced to purchase this medicine on the streets because of the better quality there," said Kleiner.
Patients and medical marijuana advocacy groups say they are frustrated by the administration’s reluctance to give more credence to the experience in other countries.
"Many of the new restrictions created by the Department of Health and Senior Services are based in politics, not in science," said Chris Goldstein, a board member for the Coalition for Medical Marijuana New Jersey.
Philippe Lucas from the Vancouver Island Compassion Society, a nonprofit marijuana club operating outside Canada’s sanctioned program, said government-supplied marijuana is typically 12 percent THC potency, compared with the 15 percent to 25 percent he sells.
"The main thing to remind regulators is that if the product legally available to patients is not as good (or as potent) as that available on the black market, patients will keep having to risk arrest to get effective medicine, and that benefits no one," Lucas said in an e-mail. "That’s exactly the situation we currently face in Canada."
Dale Gieringer, state coordinator for the California National Organization for the Reform of Marijuana Laws, noted that cannabis products sold in the Netherlands have potency levels ranging from 6 percent to 18 percent, and are "rigorously tested according to established pharmaceutical standards" in that country.
Alaigh said she has reviewed European studies and practices, and does not give them as much weight.
"There is no drug that gets approved here based on studies outside the U.S.,’’ Alaigh said, "This is not an FDA approved drug, but I cannot relax our standards."
NewsHawk: MedicalNeed: 420 MAGAZINE
Source: nj.com
Author: Susan K. Livio
Contact: Contact Us - NJ.com
Copyright:2009 New Jersey On-Line LLC.
Website:Medical marijuana issue in N.J. pits pain-relief proof against politics | NJ.com
