The use of medical marijuana for the treatment of chronic pain is a controversial subject at best. Marijuana comes from cannabis plant. It is sometimes called “weed”, “pot”, “grass”, “maryjane” or “herb”. The genus Cannabis contains two species which produce the psychoactive cannabinoids: Cannabis indica and Cannabis sativa. Cannabinoids are chemical compounds which bind to receptors in the human brain. The most psychoactive cannabinoid found in the cannabis plant is tetrahydrocannabinol (or delta-9-tetrahydrocannabinol, commonly known as THC) and cannabidiol (CBD).
The Cannabis plant has a long history of medicinal use dating back thousands of years. Cannabis has been used to reduce nausea and vomiting from chemotherapy, to treat chronic pain, and muscle spasticity. It has also been used to treat symptoms related to HIV/AIDS as well as the intractable pain caused by cancers. Cannabis appears to be somewhat effective for the treatment of chronic pain. Chronic pain is defined as ongoing pain for 3-6 months. Cannabis has been used to treat other pains including pain caused by neuropathy and pains possibly due to fibromyalgia and rheumatoid arthritis. Other conditions where cannabis has been used include epilepsy, anxiety, depression, glaucoma and multiple sclerosis.
Medical marijuana can be administered using a variety of delivery methods. The most popular is smoking dried buds. Other methods include inhaling vapors, eating extracts (brownies), taking capsules or using oral sprays. Synthetic cannabinoids are available as prescription drugs in some countries; examples include: dronabinol and nabilone. Recreational use of cannabis is illegal in most parts of the world. In the United States, there are 23 states and the District of Columbia which have legalized the medical use of marijuana and four of those states have legalized its recreational use. These states are Oregon, Washington, Colorado, and Alaska. It should be noted that in the US, federal law outlaws all cannabis use.
Medical marijuana is legal in certain countries, including Austria, Canada, Czech Republic, Finland, Germany, Israel, Italy, the Netherlands, Portugal and Spain.
The U.S. Food and Drug Administration (FDA) has not approved smoked cannabis for any condition or disease. According to the FDA, it issued a 2006 advisory against smoked medical cannabis stating: “marijuana has a high potential for abuse, has no currently accepted medical use in treatment in the United States, and has a lack of accepted safety for use under medical supervision.” In addition, The National Institute on Drug Abuse (NIDA) stated, “Marijuana itself is an unlikely medication candidate for several reasons: (1) it is an unpurified plant containing numerous chemicals with unknown health effects; (2) it is typically consumed by smoking further contributing to potential adverse effects; and (3) its cognitive impairing effects may limit its utility.”
Most recently, the American Academy of Neurology released a position paper in support of “efforts to conduct rigorous research to evaluate the long-term safety and effectiveness of marijuana-based products.” “Further research is needed to determine the benefits and safety of such products,” the authors wrote. “This is of paramount importance when marijuana-based products are used in patients with underlying neurologic disorders, or in children whose developing brains may be more vulnerable to the toxic effects of marijuana.
The psychoactive compounds in Cannabis include THC and CBD. They produce physiological and psychological changes in the human body. Mild euphoria, “high”, and “stoned” are common descriptors. Other side effects include: impairment of short-term memory and long term memory, dry mouth, impaired motor skills and reddening of the eyes, increased heart rate, increased appetite and consumption of food, lowered blood pressure, and impaired concentration.
On July 5, 2014, New York State Gov. Andrew Cuomo signed a limited medical marijuana bill into law. Medical marijuana may not be smoked. It also may not be consumed in a public place. To qualify, a patient must have a written certification from his or her physician. Physicians must first register with the health department and take a two-to-four hour course. A certification must specify the patient is under a physician’s ongoing care for the condition and the patient will likely receive therapeutic or palliative benefits from marijuana, and that he or she has a qualifying condition. The doctor must choose which form of medical marijuana the patient should use. The physician should also state any recommendations or limitations on the certification. The state may also allow nurse practitioners to certify patients.
The following have been certified as qualifying conditions. A patient must have cancer, HIV/AIDS, ALS, Parkinson’s disease, or multiple sclerosis. Other qualifying conditions include: spinal cord damage causing spasticity, epilepsy, inflammatory bowel disease, neuropathies, or Huntington’s disease. Currently, they are trying to decide whether to add Alzheimer’s, muscular dystrophy, dystonia, PTSD, and rheumatoid arthritis within 18 months of the law’s effective date.
The health department will issue registry identification cards to patients and caregivers who submit valid applications, written certifications, and fees of up to $50. Patients will have no legal protection until they have an ID card.
Patients may designate up to two caregivers, who may pick up their medical marijuana for them. Caregivers generally must be at least 21 and they may not serve more than five patients.
Will my insurance pay for my prescription? The answer is no. In the United States, health insurance companies are not able to pay for a medical marijuana prescription. The Food and Drug Administration must approve any substance for medicinal purposes. More research is necessary. In 1970, Congress passed the Controlled Substances Act, which listed marijuana as a Schedule I drug. Since then, it has been illegal to manufacture, distribute or possess marijuana in the United States, according to the federal government. As a result, all expenses incurred filling a medical marijuana prescription will not be reimbursed by the insurance company until it is approved by the FDA and the federal government.
For Further information with regards to the proposed New York State regulations on medical marijuana please follow the following link: ny.gov/medical_marijuana
4 years ago / Comments Off on Medical Marijuana