Racine Couple's Story Illustrates Debate Around Medical Marijuana

Christine Green

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Racine, Mo. - The land where Tom and Darlene Poor live has been handed down in Tom's family since before the Civil War. Family members, who live like a community, maintain cabins together and grow vegetables in a shared garden.

Their place is quiet, the lone exception this day being the Poors' dog, Alex, splashing in and out of the creek behind their home.

The couple do not want to leave "their little bit of paradise," but last week said they will if medical marijuana is not legalized in Missouri soon.

That could happen as early as this fall.

New Approach Missouri – the campaign to make Missouri the 25th state to legalize medical marijuana – has submitted more than the requisite number of signatures needed for their initiative petition to be on the November ballot. The Missouri secretary of state's office, with the help of local election authorities, is currently verifying those signatures. Voters will know if the petition made the cut on Aug. 9.

Both of the Poors signed the petition.

Tom, 73, suffers from Parkinson's disease, which is progressive and eventually will become debilitating. Darlene, 54, also said she suffers from seizures. On the patio table outside of their home, a journal sits next to an iPad full of Darlene's notes, detailing marijuana's effect on people who suffer from Parkinson's disease.

Tom served in the U.S. Air Force and the U.S. Army during the Vietnam War and Darlene believes he may have been exposed to toxins such as Agent Orange, possibly causing his health problems.

Currently, Tom's hands shake if he doesn't concentrate and his foot drags a bit when he walks. At times, drool runs down the side of his mouth and his speech slurs. He thrashes in his sleep and can be lethargic, Darlene said.

"It makes him not himself," she said of the disease affecting her husband of 33 years. "He's usually happy go lucky."

Parkinson's is incurable, and the couple say none of the legal medicines Tom takes will stop the progression of the disease.

"The first neurologist that I saw, I asked, 'What about medication for this?'" Tom said. "He said whenever you shake enough that you are too embarrassed in public, come see me."

Though he takes medication for his tremors, Tom said he hates it and that it's damaging his liver and kidneys. He also said that he has tried marijuana, has seen it work and believes it can slow the progression of his disease.

Benefits and risk?

Despite being legal in nearly half the states, a question hangs over medical marijuana.

"Whether smoking or otherwise consuming marijuana has therapeutic benefits that outweigh its health risks is still an open question that science has not resolved," Nora Volkow, director of the federal National Institute of Drug Abuse, wrote in an open letter on its website.

The U.S. Food and Drug Administration has not recognized or approved the marijuana plant as medicine, but two pill forms extracting chemicals in marijuana called cannabinoids have been FDA-approved.

According to the National Institute of Drug Abuse, research suggests that THC and other cannabinoids may have potential in the treatment of pain, nausea, epilepsy, obesity, wasting diseases such as AIDS, addiction, autoimmune disorders and other conditions.

The Center for Medicinal Cannabis Research, run out of the University of California-San Diego, concluded cannabis reduces spasticity, or extreme muscle stiffness, for patients with multiple sclerosis. Another one of its clinical studies concluded cannabis "has analgesic effects in pain conditions secondary to injury or disease of the nervous system," including in cases where other therapies didn't work for the patients.

"This suggests that cannabis may provide a treatment option for those individuals who do not respond or respond inadequately to currently available therapies," the study said.

The national medical director of the National Parkinson Foundation, Dr. Michael S. Okun, noted in 2014 that there is some preliminary evidence that marijuana may help Parkinson's patients with symptoms, including studies that showed mild to substantial alleviation of general symptoms, improvement of rest tremors, alleviation of muscle rigidity and more, but noted that most of the scientific papers produced so far suffer from methodological shortcomings that raise questions about the result.

The National Parkinson Foundation also has received countless calls via its hotline from patients detailing their positive experiences with medical marijuana, but the personal reports "lack scientific rigor," he wrote.

At the same time, Okun also noted the concerns of the NIDA.

Health risks include negatively affecting brain development in teenagers and young adults. There is evidence marijuana use can reduce thinking, memory and learning functions and affect how the brain builds connections between the areas necessary for these functions. They can also lose IQ points. Those who started smoking marijuana as adults did not show notable IQ declines, according to NIDA.

Marijuana also may worsen symptoms for those who have schizophrenia. Study findings have been mixed as to whether marijuana can be linked to depression or anxiety.

Marijuana smokers have a higher risk of lung infections, though researchers have yet to determine if they have a higher risk of lung cancer, according to NIDA. Marijuana can also be used through vaporization, as edibles and in teas, oils and waxes.

About 30 percent of users may have some degree of addiction or "marijuana use disorder," meaning a person can't stop using marijuana even though its use is affecting their daily life, according to NIDA. There are no cases of death caused by marijuana overuse.

Okun concluded, "Scientifically it is not crazy to think that marijuana may play some positive role in the alleviation of Parkinson's disease symptoms. There are cannabinoid (THC) receptors all over the brain, and these receptors seem to be concentrated in a region important to Parkinson's disease, commonly referred to as the basal ganglia."

But marijuana is not a substitute for prescribed medical therapies, he said, and concluded, "Much more research will be needed to understand which patients, which symptoms and how best to safely administer medical marijuana in Parkinson's disease, especially over the long term."

Tom Poor said he is frustrated by the fact that he currently can't even have a conversation with a physician about the pros and cons of using medical marijuana for his condition.

"Their reply was until it's approved by the FDA, they are not going to prescribe it, end of story," Tom said.

One reason medical research has lagged behind on marijuana is because it was classified as a Schedule I drug temporarily in 1972, so that a commission could review its effects. It recommended marijuana be reclassified and not criminalized, but then-president Richard Nixon declined. Under federal law, Schedule I drugs are those that have a high potential for abuse, and those for which there was no currently accepted medical use in treatment in the United States. Marijuana was lumped together with heroin, LSD and others.

Because of marijuana's classification, researchers must get approval from the Drug Enforcement Administration and the FDA. Once a researcher has received clearance, NIDA said it can release to the researcher marijuana grown in a highly monitored compound.

Between 2008 and 2014, about $1.1 billion of the $1.4 billion the NIH has granted on marijuana research through all of its 27 branches went to study abuse and addiction, according to analysis by a student reporting project based at the Arizona State University Walter Cronkite School of Journalism. The analysis concluded that only $297 million was spent on marijuana's effects on the brain and potential medical benefits.

Missouri's turn?

November could be the first time Missourians would be able to vote to legalize medical marijuana. Though the legislature considered legalizing medical marijuana this session, the bill failed in the House, 66-67, making the petition its best route. The initiative petition, if passed, would allow Missouri residents ages 18 and older to access medical marijuana if a doctor recommends them for a card, which would have to be renewed annually.

In order to be recommended, the resident must suffer from one of the illnesses listed in the petition, including cancer, epilepsy, glaucoma, post-traumatic stress disorder as well as others. Parkinson's is listed as well.

Each patient would also be able to cultivate six marijuana plants in an enclosed, locked area.

The Missouri Department of Health and Senior Services would oversee almost all aspects of the law, from distribution of cards to licensing of dispensaries to cultivation of plants.

A 4 percent sales tax on medical marijuana would go toward veterans' programs.

Public and recreational use of marijuana would still be prohibited.

"We want to put conversations about medical decisions back in the hands of doctors and their patients," said Jack Cardetti, New Approach Missouri's spokesman.

A specialist in sports medicine in St. Louis, orthopedic surgeon Rick Lehman testified during a House hearing earlier this year that he supports the passage of medical marijuana. Lehman said medical marijuana could fix a problem that doctors helped create: opioid addiction, which often leads to heroin addiction and overdose deaths. He added that no one has ever died by consuming too much marijuana.

On the other hand, Kansas City ophthalmologist John Hagan said "rushing into" legalizing medical marijuana would be a mistake.

"I just think this is going to be a public health catastrophe," Hagan said. "I don't think it has been adequately presented to the public."

Hagan said that patients don't need medical marijuana because there are adequate legal medicines available that treat patients. As a physician who treats glaucoma patients who ask about medical marijuana, Hagan said he warns them against it, saying that marijuana isn't made consistently, isn't FDA-approved and has several toxins.

"It's like if you would put 35 different types of medication in a brew and then not measure them out and then hand them out," Hagan said.

Hagan said one scientific article concluded that patients who took marijuana to treat glaucoma end up doing worse than their counterparts. This is because the patients stopped using their eye drops and relied solely on marijuana.

He likened the publicity and acceptance around medical marijuana to tobacco in the 1940s, before scientists definitely knew it negatively affected health.

Keeping Missouri Kids Safe, a coalition of health professionals, law enforcement groups and drug abuse advocates, has also joined the list of vocal opponents of medical marijuana in Missouri. Spokesperson Joy Sweeney said medical marijuana could open a backdoor for recreational use, especially by teens.

"Any access equals use," Sweeney said.

She also said that she fears legalizing marijuana sends a message to kids that it isn't harmful or addictive because it will be perceived as medicine.

"We don't vote on medicine," Sweeney said. "It will hurt more people than it helps, I truly believe that."

But Darlene Poor doesn't believe that is a good argument, saying that a prohibition on medical marijuana won't work to prevent misuse. If teens want marijuana, they will get it anyway illegally, she added.

"They don't know what strand, or how strong or what's safe," Darlene said. "(Illegal) marijuana's not safe. It should be controlled."

But by legalizing marijuana and regulating standards and packaging, Darlene said Missourians will be better off.

"We might have felt the same way a long time ago," Darlene said. "But now we see it works."

'Look at my hands'

After doing their own research on the affects of medical marijuana and Parkinson's disease, the Poors wanted to see for themselves if it would help Tom. They packed their car and headed to Colorado, where recreational use as well as the medical use of marijuana is legal and where a friend lives who owns a dispensary.

They arrived at night. Their friend primed a vaporizer for Tom, who said he took three puffs. Within minutes, his hands stopped shaking.

"It really works," Tom said he remembers saying to Darlene. "Look at my hands! Look at my hands!"

The effects wore off three hours later, which is when Tom repeated the process. Tom's tremors disappeared again, he said. The next morning, Darlene said they got back into the car and drove back to Racine. They only went for those few puffs.

Social stigma

The social stigma around marijuana use also has changed rapidly in the last decade. A Gallup study published in October of 2013 found that for the first time, a clear majority of Americans – 58 percent – believed marijuana should be legalized. Earlier that year, Washington and Colorado had legalized the recreational use of marijuana.

Twenty-four states and Washington, D.C., also have legalized medical marijuana, with Pennsylvania being the latest state by enacting laws in April. Though legalized, not all states have operational dispensaries and systems, yet.

The only state bordering Missouri that has legalized marijuana for any kind of use is Illinois. It passed its law in 2014 to legalize medical cannabis for a four-year pilot program.

The Illinois Department of Public Health has issued about 6,000 medical marijuana cards to residents, said Tom Anderson, the Illinois State Medical Society president. Card holders have been able to purchase limited amounts of marijuana every two weeks from Illinois dispensaries since last November.

Anderson said there isn't a uniform opinion among doctors in Illinois about medical marijuana.

"Cautious acceptance and implementation of law is a fair statement of where we are on this," Anderson said.

He also said that although his organization, like most state medical societies, didn't take a position on medical marijuana, it is helping educate physicians in the intricacies of the program if they choose to participate.

Anderson said physicians haven't been feeling pressure from patients to increase access.

"There are not great electoral-sized meetings with signage to change the law and make it easier," Anderson said.

Though Darlene Poor noted that the stigma surrounding marijuana has been changing, the Poors are reluctant advocates. As two people who don't have criminal records, who don't drink alcohol, they don't like the implications that might come with asking for medical marijuana, which is the perception that they are growing marijuana, smoking it illegally or want it just to get high.

Darlene said they see medical marijuana as a life-or-death decision, especially in Tom's case.

Even though Darlene said they might move to Toronto, Canada, where her son lives and where medical marijuana is legalized, she said they would be leaving family and neighbors behind, and leaving their home in Racine, which they don't want to do. During her most recent seizure three weeks ago, her neighbor stayed with her and kept her safe until Tom returned and took her to the hospital.

"We will end up dying in a place we don't know," Darlene said.

But for the couple, Racine will always be home, even if they have to move to get medical marijuana. When they die, the Poors plan to cremate their bodies, mix their ashes and spread them under a sugar maple in their little Racine family cemetery.

What are cannabinoids?
"Cannabinoids are chemicals related to delta-9-tetrahydrocannabinol (THC), marijuana's main mind-altering ingredient. Other than THC, the marijuana plant contains more than 100 other cannabinoids. Scientists as well as illegal manufacturers have produced many cannabinoids in the lab. Some of these cannabinoids are extremely powerful and have led to serious health effects when abused."
- National Institute on Drug Abuse

Racine couple's story illustrates debate around medical marijuana.


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