Monday, July 16, 2012

PTSD Petitioners Will Attract Sympathy

Post traumatic stress disorder (PTSD) is by far the most sympathetic of the pending petitions to add to the list of debilitating medical conditions for which medical cannabis can be prescribed under the Arizona Medical Marijuana Act (AMMA).  Arizoneout discussed the petition procedures in a July 5 post.

The Arizona Department of Health Services (ADHS) has not posted the actual petitions on its website.  The written public comments ADHS has received, however, are overwhelmingly in support of adding PTSD.  Many of the supportive comments come from military veterans. 

One of the scientific articles in support of allowing medical cannabis to treat PTSD is authored by Dr. Sue Sisley, a Scottsdale physician in private practice who also is on the clinical faculty at St. Joseph’s Hospital and Medical Center and is an assistant professor in the telemedicine program at the University of Arizona (UA) College of Medicine.  Her paper summarizes a number of research studies, and one that she relies on the most was conducted on rat subjects. 

ADHS partnered with the College of Public Health at UA to have faculty researchers conduct evidence reviews of available peer-reviewed scientific research on each of the four conditions under review for inclusion as AMMA debilitating medical conditions.  The structure of the UA evidence review basically excluded from the starting point of its analysis the types of articles that Dr. Sisley relies on.  The UA reviewers considered only English language articles and human studies, and rejected considering animal studies, case reports or case series, editorials or opinions, and experiments on biochemical or pathophysiological pathways.

As a result, the UA faculty evidence review concluded that there were no studies that directly addressed the benefits and harms of marijuana use for treatment of PTSD, and that no conclusions could be drawn about those benefits and harms from the available scientific evidence.

Because ADHS Director Will Humble, the final decision maker (at least until we get into litigation and a judge will have to decide), has insisted that he will make his decisions on science.  Thus, the UA evidence review gives him the justification he needs to deny the petition to add PTSD as a debilitating medical condition under the AMMA. 

A lot of veterans will be disappointed if Humble decides to reject the PTSD petition. 

The U.S. Department of Veterans Affairs began to allow patients treated at its medical facilities to use medical marijuana in states where it is legal back in 2010.  Because the drug remains illegal under federal law, however, VA doctors themselves cannot recommend it.

Federal law also makes it very hard to conduct solid scientific research on the effectiveness of medical pot in treating PTSD.  Dr. Sisley herself is trying to conduct a research study, and gained approval from the Food and Drug Administration in April 2011.  She is still waiting for the Department of Health and Human Services’ scientific review panel to approve the study; that is the agency that has to supply the marijuana Dr. Sisley must use in her research.  The AMMA itself does not allow for the use of marijuana for research purposes.

One thing the public comments make clear is that a number of Arizonans already are using medical marijuana to treat PTSD.  Several of the public comments in support of  the PTSD petition were from people who already are Qualified Patients authorized to use medical pot for other conditions. 

The comments are similar to these from a military veteran allowed to use cannabis for chronic pain: “ My job evaluations have improved, people at work comment how much better I am to get along with, and did I mention that I have actually started sleeping nearly all night.  Before being on this program, I would be awake every 3-4 hours either with a nightmare or jolting awake to get up and check around the house (hyper-vigilant).”

That veteran says he started using medical marijuana because of its ability to moderate the pain he had from a severe back injury.  “[B]ut the benefits to my PTSD makes me wonder why no one is jumping up and down and shouting from the rooftops at the VA that ‘This Works’ and a whole lot better than Trazadone, Zoloft and other . . . medications.  I am more productive at work, more pleasant to be around and feel immensely better than I have in nearly twenty years.”

Whether ADHS Director Humble can turn all these passionate veterans down  remains to be seen.  Nevertheless, it is clear that veterans out there are using marijuana legally while also working a variety of jobs here in Arizona.

1 comment:

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