Just Say Yes?

Just Say Yes?

Legalizing marijuana treatments may improve care and life of sick

By Eve Becker

Marijuana, pot, dope, grass, mary jane or any other synonym you know, remains illegal under federal law. However, 16 states and the District of Columbia have approved the use of medical marijuana to ease cancer pain and muscle spasms associated with multiple sclerosis among other conditions. Currently illegal in Illinois, the discussion to change that continues.

A medical marijuana bill was shot down last April in the Illinois House, but House supporters have vowed to reintroduce the measure, promising to win over critics by making it the most restrictive medical marijuana law in the nation.

Rep. Lou Lang, D-Skokie, says that under his plan, a doctor would need to confirm that a patient has one of 19 specific diseases listed—like cancer, Crohn’s disease, lupus and multiple sclerosis, to name a few. The doctor would write a letter to the Illinois Department of Public Health (IDPH) making a case for the patient to use a cannabinoid drug. The IDPH would have a determined set of rules for the patient to meet. This may include the IDPH requesting the patient’s files from the doctor. The patient would then have to waive all rights associated with the Health Insurance Portability and Accountability Act of 1996 to let a third party view private records.

If all the standards are met, the IDPH will issue a license to the patient allowing him or her to get the required medication from a Managed Care Organization or appropriate dispensary.

“Under this highly regulated bill, we want people to live a higher quality of life and feel better,” says Lang, who argues that marijuana is a less dangerous alternative to heavily addictive narcotics such as Vicodin, morphine or Oxycontin. “For many it resolves their pain, resolves their nausea… gives them [a better] quality of life.”

But its use garners mixed responses. Some patients who have used a cannabinoid product report that it has been minimally effective in easing cancer pain, though some say it has helped reduce anxiety and counter appetite loss due to chemotherapy, says registered nurse Judith Paice, PhD and director of the cancer pain program at Northwestern University Feinberg School of Medicine in the Division of Hematology and Oncology.

“I’ve never seen much efficacy with pain control,” Paice says. Patients who have had previous exposure to marijuana can generally tolerate the drug, she says. But those who have not previously used marijuana often report confusion, impaired thinking and increased anxiety.

“Sometimes the family members of patients, with very good intentions, will purchase marijuana and make brownies with it for their 80-year-old mother, who then becomes very confused. People with prior exposure to marijuana seem to have few adverse reactions or negative emotional responses. But people who have not had prior exposure to it often have complex reactions, and it may make them highly anxious.”

Plus, Paice says, the particulates that are inhaled while smoking marijuana can be irritating to patients who are already ill. She does see promise in a new cannabinoid medication, Sativex, which comes in spray form and is already approved in Canada, the United Kingdom and several European countries.

Since Sativex is a spray, it eliminates the problem of inhaling particulates when smoking. In addition to containing THC, the main psychoactive ingredient in cannabis, Sativex also contains cannabidiol, which counteracts the euphoric effect of THC. Sativex has been shown to alleviate complex neuropathic pain associated with multiple sclerosis with fewer changes in cognitive function, she says.

One of the drawbacks to using a cannabinoid-based medication is the cost. For example, Marinol, a cannibanoid, is a pill used to treat the nausea and vomiting that comes with chemotherapy. A bottle of 90 five-milligram tablets prescribed to be taken three times a day costs $1,364. Paice says non-cannabinoid drugs such as Compazine and Zofran are cheaper and can be more effective.

Still, there are instances where medical marijuana would be the ideal treatment. “If my doctor tells me to get a product, I want that product,” says Lang. “If we had all 50 states in the federal government approving and encouraging the use of this drug, the cost would come down.”

Lang argues today, and did in April on the House floor, that if there were a product your brother, sister, parent or child had to have to feel better, you’d walk through a wall to get it for them.

“Somehow, we think we’re on some high ground protecting people from a product they sometimes need,” Lang says. “It’s immoral not to let someone get a product that would help them feel better. Especially when that product is not dangerous or addictive.”

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