Sunday, November 19, 2017

NJ panel OKs marijuana for more conditions

The Medicinal Marijuana Program Review Panel--five physicians, two pharmacists and one RN, who were appointed by the New Jersey Department of Health—gave their final approval on October 25th for the use of marijuana for a number of additional medical conditions.

Dr. Alex Bekker, MD, PhD, a professor and department chairman at Rutgers New Jersey Medical School, led the panel of medical experts that approved marijuana therapy for chronic pain, anxiety, migraines, and Tourette's syndrome.

About one third of all Americans suffer from chronic pain at sometime in their lives. Indeed, 32 of the 45 petitions that the panel reviewed were related to chronic pain. In approving marijuana therapy for pain, the panel relied on over 400 peer-reviewed journal articles to make their evidence-based decision. The National Academy of Sciences also endorsed medical marijuana for chronic pain when “conventional therapies fail.” The panel noted the many side effects, and possible severe adverse effects, of both prescription opiates and over-the-counter pain relievers. The panel acknowledged that there were significantly fewer opiate overdose deaths in states with robust medical marijuana programs.
The panel said that opiate addiction is a “public health emergency” in America, the day before President Trump formally declared this emergency. Marijuana has been shown to be an effective substitute for pharmaceutical pain relievers and can also help ease the withdrawal from opiate addiction.

One of the chronic pain petitions that the panel approved was MMP-063, “Opioid Use Disorder.” This petition was submitted by Vanessa Waltz, a Board Member of the Coalition for Medical Marijuana--New Jersey. In approving this condition to qualify for marijuana therapy in the state's program, the panel recognized that marijuana, far from being a “gateway” to harder drug use, is actually an “exit drug.” In 1999, the Institute of Medicine thoroughly repudiated the Gateway Theory saying, “There is no conclusive evidence that the drug effects of marijuana are causally linked to the subsequent abuse of other illicit drugs.” Even the Drug Enforcement Administration (DEA) acknowledged in the July 8, 2011 Federal Register that there was no “direct causal relationship between regular marijuana and other illicit drug use.” The reality is that marijuana can be an exit drug from addicting and dangerous prescription drugs, from street drugs like heroin, and even from alcohol addiction and overuse.

The panel also approved anxiety, both primary and secondary anxiety (related to Autism and Alzheimer’s disease). The panel noted that anxiety can be debilitating. When anxiety does require pharmaceutical intervention, most conventional treatment is unacceptable. The benzodiazepams, or minor tranquilizers, for example, are widely abused and withdrawal from them can be life-threatening. Anti-depressants are often prescribed for anxiety, but they are not effective for two to six weeks, and anxiety is not a depressive illness. The panel felt that there was a significant place for marijuana in fighting anxiety.

Also given final approval by the panel were migraine headaches and Tourette’s syndrome. The panel cited articles and research by Dr. Ethan Russo in support of marijuana for migraines. Dr. Russo is one of the leading authorities in medical marijuana in the United States. In approving marijuana for Tourette’s, the panel noted that there currently is no accepted nor effective pharmacologic treatment for the syndrome. Only major tranquilizers (anti-psychotic or neuroleptics drugs) are prescribed, but Tourette’s is not a psychotic disorder.

The panel only rejected two petitions, MMP-020 Asthma, and MMP-055 Chronic fatigue syndrome. The panel was not convinced that there was sufficient evidence presented in the petitions to support including these two conditions in New Jersey’s Medicinal Marijuana Program.

The panel should be congratulated for its research, its thoroughness and its courageous adherence to evidence-based criteria in its decision making. When the science is objectively pursued, the therapeutic potential of medical marijuana is found to be enormous.

Now the commissioner of the Department of Health has 180 days to decide what, if any, of the panel’s final recommendations to accept. In recognition of the now formally declared public health emergency that is the opiate epidemic in America, the commissioner must act speedily in adopting the final recommendations of the panel. Lives are at stake.

Indeed, the entire country should follow the final recommendations of the experts in New Jersey’s Medicinal Marijuana Program Review Panel.

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