Katelyn Baker
Well-Known Member
Hugh Quinn is unequivocal in his opinion about the decision to certify post-traumatic stress disorder as a qualifying condition for medical marijuana in Minnesota.
"I'm 100 percent of support in it," the Itasca County veterans services officer said. "That and chronic pain."
When the Minnesota Legislature in 2014 passed a bill legalizing medical marijuana, it included nine conditions that could be treated with the drug. It also stipulated that the state's health commissioner could add more conditions if he believed the evidence warranted it.
Dr. Edward Ehlinger, the state's health commissioner, added intractable pain (essentially the same thing as chronic pain) late last year, but the addition didn't become effective until Aug. 1. When it did, the number of purchases of medical cannabis instantly doubled, from 1,009 in July to 2,117 in August.
Advocates petitioned Ehlinger to add nine conditions this time around, said Dr. Gary Starr, chief medical officer of LeafLine Labs, one of two companies authorized to grow and sell medical cannabis in Minnesota.
Only PTSD made the cut.
"We've certified two (conditions) where the medical evidence reached a level that I was comfortable that this made sense," Ehlinger said in a telephone interview. "All of the other conditions ... have not reached that level."
CANNABIS AS MEDICINE
Starr contends that more is known about medical cannabis than about some of the medicines many of us use on a daily basis. Anecdotal evidence shows symptoms of sleep difficulties, nightmares or flashbacks being "negated or reduced" with the use of cannabis in some cases, he said.
Ideally, medical marijuana – like any medication for PTSD – is used only in conjunction with visits to a mental health professional, Starr said.
"There is no claim that cannabinoids (the active chemicals in marijuana) are a panacea in this case," he said. "No one is suggesting that by taking cannabis medicine you're fixing PTSD forever. ... This is one tool in the kit."
Medical marijuana, particularly in the carefully regulated form in which it's dispensed in Minnesota, has fewer adverse effects than narcotics, Starr argued.
But here's the rub: Although anyone who goes through a traumatic event can suffer from PTSD, the condition is most associated with military service members and veterans. And the U.S. Department of Veterans Affairs is opposed to marijuana as a treatment for PTSD.
THE VA'S POSITION
"The VA has concluded no convincing research exists to support the use of cannabis for the disorder," Ralph Heussner, spokesman for the VA in Minneapolis, wrote in an email. "The VA does not permit its doctors to certify patients for its use or prescribe it."
The Minnesota Medical Association, which represents the state's doctors, also cited a lack of "well-controlled studies" in a statement responding to the addition of PTSD as a qualifying condition.
In a telephone interview, Dr. David Agerter, the group's president, said many people with PTSD are either already using prescribed pain medications or street drugs. "Adding marijuana – is that the thing to do at that point in time?" Agerter asked.
Past use of street drugs is one thing that has kept John Marshall of Duluth from seeking medical cannabis, he said.
Marshall, who fought in the First Gulf War and is captain of the Duluth Honor Guard, would qualify already because of chronic pain. "I'm on narcotics for pain," he said. "I have excruciating pain 24/7."
He would qualify a second time beginning Aug. 1 because he has been diagnosed with post-traumatic stress.
He's wary of marijuana, Marshall said, because of his use of it in his youth. "I know how the effects of marijuana work. When I used it, it was an escapism."
But he understands, Marshall said, that "There's a huge difference between recreational use for medical reasons" and doesn't think the effects of medical cannabis could be any worse than the opioid pain reliever he already uses.
So he's supportive of veterans who choose medical marijuana, Marshall said.
"If the doctors and scientists are saying it can help reduce ... pain (and) alleviate stress situations, then again, I'm all for it," he said.
EHLINGER'S PERSPECTIVE
Ehlinger said that as a doctor, he wishes there were more solid research available on medical cannabis and PTSD. But he suggested bias in the VA's conclusions because the federal government still outlaws any use of marijuana.
"I suspect that the Veterans Administration, they come with a certain perspective because it's illegal, and they can't support it," Ehlinger said. "I thought that the benefits of cannabis for PTSD far outweigh the potential downsides."
Ehlinger said he realizes VA practitioners won't be able to certify patients as qualifying for medical marijuana. But he said they could turn to other providers for that and still get the rest of their care through the VA.
"I don't see that this would be a reason for them to lose benefits," Ehlinger said.
But that's exactly what could happen for veterans who also suffer from chronic pain, Quinn said. If a veteran is on pain medication through the VA, he or she signs a "pain contract" agreeing not to use any other medication. Under such a contract, the veteran could be screened for drug use at any time. If marijuana were detected "they get kicked off their (VA) pain meds," Quinn said. "It's a conundrum."
The VA does not "administratively prohibit" veterans who participate in state marijuana programs from VA services, Heussner wrote. "However, in some cases, participation in state marijuana programs may be inconsistent with treatment goals; therefore, VA clinicians may modify treatment plans for the health of the patient."
THE NUMBERS
Based on what has occurred in other states, it's not expected medical cannabis use in Minnesota will get the boost from PTSD that it did from intractable pain, Ehlinger said.
Overall, the numbers for the state's program are below original expectations. By this point, the state expected to have around 5,000 enrollees, Ehlinger said. The actual number is about 3,600.
The number of providers – doctors, physician assistants and nurse practitioners – has risen steadily, he said, to 755 currently.
But it's not numbers that his department is concerned about, the health commissioner said.
"My role as commissioner in running this program is to make sure that we have a program that is transparent, is safe and protects individual patients, so they get the right kind of medication in the right dose in the right manner," he said.
Conditions Ehlinger rejected this year included schizophrenia, autism and depression. Starr said he thinks petitioners had a good case for some of those conditions, but that they can't be brought up again unless new evidence surfaces.
Ehlinger believes new research will eventually lead to more conditions he could certify for medical marijuana. But he'd like to see cannabis undergo the same rigorous process of Food and Drug Administration screening as any other drug, Ehlinger said. That would require the Drug Enforcement Agency to reclassify marijuana from a Schedule I drug, a category that also includes heroin and Ecstasy and presupposes there is no medical value.
Both Agerter and Ehlinger said they'd like to see reclassification take place.
"As a physician, I would love to have medical cannabis go through the process the Food and Drug Administration goes through to qualify any medication for distribution through pharmacies," Ehlinger said.
But the federal government has been slow to move in that direction, he added.
"We're not there yet," Ehlinger said. "And we won't be there for a long time."
Medical marijuana in Minnesota
Qualifying conditions for medical cannabis in Minnesota:
News Moderator: Katelyn Baker 420 MAGAZINE ®
Full Article: Medical Marijuana For PTSD Gets Mixed Reviews
Author: John Lundy
Contact: (218) 723-5281
Photo Credit: None Found
Website: Deluth News Tribune
"I'm 100 percent of support in it," the Itasca County veterans services officer said. "That and chronic pain."
When the Minnesota Legislature in 2014 passed a bill legalizing medical marijuana, it included nine conditions that could be treated with the drug. It also stipulated that the state's health commissioner could add more conditions if he believed the evidence warranted it.
Dr. Edward Ehlinger, the state's health commissioner, added intractable pain (essentially the same thing as chronic pain) late last year, but the addition didn't become effective until Aug. 1. When it did, the number of purchases of medical cannabis instantly doubled, from 1,009 in July to 2,117 in August.
Advocates petitioned Ehlinger to add nine conditions this time around, said Dr. Gary Starr, chief medical officer of LeafLine Labs, one of two companies authorized to grow and sell medical cannabis in Minnesota.
Only PTSD made the cut.
"We've certified two (conditions) where the medical evidence reached a level that I was comfortable that this made sense," Ehlinger said in a telephone interview. "All of the other conditions ... have not reached that level."
CANNABIS AS MEDICINE
Starr contends that more is known about medical cannabis than about some of the medicines many of us use on a daily basis. Anecdotal evidence shows symptoms of sleep difficulties, nightmares or flashbacks being "negated or reduced" with the use of cannabis in some cases, he said.
Ideally, medical marijuana – like any medication for PTSD – is used only in conjunction with visits to a mental health professional, Starr said.
"There is no claim that cannabinoids (the active chemicals in marijuana) are a panacea in this case," he said. "No one is suggesting that by taking cannabis medicine you're fixing PTSD forever. ... This is one tool in the kit."
Medical marijuana, particularly in the carefully regulated form in which it's dispensed in Minnesota, has fewer adverse effects than narcotics, Starr argued.
But here's the rub: Although anyone who goes through a traumatic event can suffer from PTSD, the condition is most associated with military service members and veterans. And the U.S. Department of Veterans Affairs is opposed to marijuana as a treatment for PTSD.
THE VA'S POSITION
"The VA has concluded no convincing research exists to support the use of cannabis for the disorder," Ralph Heussner, spokesman for the VA in Minneapolis, wrote in an email. "The VA does not permit its doctors to certify patients for its use or prescribe it."
The Minnesota Medical Association, which represents the state's doctors, also cited a lack of "well-controlled studies" in a statement responding to the addition of PTSD as a qualifying condition.
In a telephone interview, Dr. David Agerter, the group's president, said many people with PTSD are either already using prescribed pain medications or street drugs. "Adding marijuana – is that the thing to do at that point in time?" Agerter asked.
Past use of street drugs is one thing that has kept John Marshall of Duluth from seeking medical cannabis, he said.
Marshall, who fought in the First Gulf War and is captain of the Duluth Honor Guard, would qualify already because of chronic pain. "I'm on narcotics for pain," he said. "I have excruciating pain 24/7."
He would qualify a second time beginning Aug. 1 because he has been diagnosed with post-traumatic stress.
He's wary of marijuana, Marshall said, because of his use of it in his youth. "I know how the effects of marijuana work. When I used it, it was an escapism."
But he understands, Marshall said, that "There's a huge difference between recreational use for medical reasons" and doesn't think the effects of medical cannabis could be any worse than the opioid pain reliever he already uses.
So he's supportive of veterans who choose medical marijuana, Marshall said.
"If the doctors and scientists are saying it can help reduce ... pain (and) alleviate stress situations, then again, I'm all for it," he said.
EHLINGER'S PERSPECTIVE
Ehlinger said that as a doctor, he wishes there were more solid research available on medical cannabis and PTSD. But he suggested bias in the VA's conclusions because the federal government still outlaws any use of marijuana.
"I suspect that the Veterans Administration, they come with a certain perspective because it's illegal, and they can't support it," Ehlinger said. "I thought that the benefits of cannabis for PTSD far outweigh the potential downsides."
Ehlinger said he realizes VA practitioners won't be able to certify patients as qualifying for medical marijuana. But he said they could turn to other providers for that and still get the rest of their care through the VA.
"I don't see that this would be a reason for them to lose benefits," Ehlinger said.
But that's exactly what could happen for veterans who also suffer from chronic pain, Quinn said. If a veteran is on pain medication through the VA, he or she signs a "pain contract" agreeing not to use any other medication. Under such a contract, the veteran could be screened for drug use at any time. If marijuana were detected "they get kicked off their (VA) pain meds," Quinn said. "It's a conundrum."
The VA does not "administratively prohibit" veterans who participate in state marijuana programs from VA services, Heussner wrote. "However, in some cases, participation in state marijuana programs may be inconsistent with treatment goals; therefore, VA clinicians may modify treatment plans for the health of the patient."
THE NUMBERS
Based on what has occurred in other states, it's not expected medical cannabis use in Minnesota will get the boost from PTSD that it did from intractable pain, Ehlinger said.
Overall, the numbers for the state's program are below original expectations. By this point, the state expected to have around 5,000 enrollees, Ehlinger said. The actual number is about 3,600.
The number of providers – doctors, physician assistants and nurse practitioners – has risen steadily, he said, to 755 currently.
But it's not numbers that his department is concerned about, the health commissioner said.
"My role as commissioner in running this program is to make sure that we have a program that is transparent, is safe and protects individual patients, so they get the right kind of medication in the right dose in the right manner," he said.
Conditions Ehlinger rejected this year included schizophrenia, autism and depression. Starr said he thinks petitioners had a good case for some of those conditions, but that they can't be brought up again unless new evidence surfaces.
Ehlinger believes new research will eventually lead to more conditions he could certify for medical marijuana. But he'd like to see cannabis undergo the same rigorous process of Food and Drug Administration screening as any other drug, Ehlinger said. That would require the Drug Enforcement Agency to reclassify marijuana from a Schedule I drug, a category that also includes heroin and Ecstasy and presupposes there is no medical value.
Both Agerter and Ehlinger said they'd like to see reclassification take place.
"As a physician, I would love to have medical cannabis go through the process the Food and Drug Administration goes through to qualify any medication for distribution through pharmacies," Ehlinger said.
But the federal government has been slow to move in that direction, he added.
"We're not there yet," Ehlinger said. "And we won't be there for a long time."
Medical marijuana in Minnesota
Qualifying conditions for medical cannabis in Minnesota:
- Glaucoma
- HIV/AIDS
- Tourette syndrome
- ALS
- Seizures
- Muscle spasms
- Inflammatory bowel disease, including Crohn's disease
- Cancer
- Terminal illness
- Intractable pain (began Aug. 1, 2016)
- Post-traumatic stress disorder (beginning Aug. 1, 2017)
News Moderator: Katelyn Baker 420 MAGAZINE ®
Full Article: Medical Marijuana For PTSD Gets Mixed Reviews
Author: John Lundy
Contact: (218) 723-5281
Photo Credit: None Found
Website: Deluth News Tribune
