Pot Troubles Article

 

Waterbury Republican – Oct 26, 2014

By LARAINE WESCHLER

POT TROUBLES

Patients denied medical marijuana because of cost, doctors’ attitudes.

A 74 year old woman from Waterbury with Stage 4 lung cancer says her doctor won’t prescribe her the medical marijuana she believes will help alleviate her pain.

A 25 year old man from Watertown with multiple sclerosis has a prescription for medical marijuana from his doctor, but says he can’t afford to buy it.

As medical marijuana makes its debut on the shelves of Connecticut dispensaries, some doctors are saying they won’t be prescribing the newly legalized drug. And if they do, insurance won’t cover the cost, which is more than the product readily available on the black market.

Wellmore Behavioral Health announced last month that it will not prescribe marijuana to treat posttraumatic stress disorder. PTSD is one of 11 debilitating medical conditions that qualify for treatment with marijuana in the state.

“It’s shocking to us that there are any psychiatric conditions that are among the debilitating diseases,” said Gary Steck, chief executive officer of Wellmore. “We don’t believe there’s the science behind it.”

IN CONNECTICUT, ABOUT 100 DOCTORS had certified 2,386 patients for medical marijuana as of Sept. 9, said William Gerrish, spokesman for the Department of Public Health. That’s an average of nearly 24 marijuana patients per doctor, of that group, but still a minority in the state. According to state medical license records, there are 1,700 licensed physicians and surgeons in Connecticut.

The health department won’t release the names of doctors writing the prescriptions.

“So far I’m hitting a brick wall and I’m finding it very frustrating,” said Waterbury resident Rosemary Lemay. “It sounds like I’m going to be in for a pretty rough road. I’m trying to get ahead of this game before things get too bad for me.”

Lemay said her oncologist refused to prescribe her the drug and her internist said he hasn’t yet decided whether he will be prescribing it.

“The word is already out and many local doctors are not even going to entertain that thought. They don’t want nothing to do with it,” Lemay said.

The American Medical Association’s policy calls for controlled studies of the effectiveness of marijuana for patients with serious conditions. The organization has not endorsed the legalization of medical or recreational marijuana, but calls for clinical research.

The Connecticut Medical Society has testified against the state legalization of medical marijuana, saying that any new medicine should be subjected to the rigorous scrutiny of the Federal Food and Drug Administration. Marijuana is still a schedule I controlled substance in the eyes of the federal government.

Mark L. Kraus, chairman of the CSMS Committee on Alcohol and Drug Education, said in 2012 that medical marijuana lacks quality control and standardization, can be contaminated, and does not have reliable dosage. Doctors contacted for comment did not return calls.

Many in the medical community are cautious about certifying patients for marijuana because of potential legal implications and a lack of knowledge about marijuana, said Dr. Andrew Salner, a radiation oncologist and director of the cancer program at Hartford Hospital. Salner has been an advocate for medical marijuana in Connecticut.

“Many people are gun shy about it because of the stigma it carries,” Salner said.

“Physicians want to provide good quality of life and alleviation of symptoms, but they want to use evidence based strategies.”

Physicians also worry about potential abuse by people with addiction issues.

Every year, 1,500 to 1,800 of Wellmore’s clients struggle with substance abuse recovery, including some people who have psychiatric conditions including PTSD.

“We believe it’s inconsistent with our mission,” Steck said.

Lemay said she was given eight months to live when she was diagnosed with Stage 4 lung cancer 16 months ago. Since then, she said, her quality of life has deteriorated to the point where she prays she’ll die in her sleep.

However, she said, she’s continuing to seek treatment because her three sons don’t want to let her go.

“My first granddaughter is getting married in four weeks and I won’t be there. It’s just awful. It’s tough on the family,” Lemay said. “I’m all they have left, so you fight. I try to hide as much as I can from my children, but how much can you hide?”

Her doctors have prescribed her narcotics including Hydromorphone and Hydrocodone. She said it took over a month to wean herself off addictive drugs and the side effects were bad.

She sees medical marijuana as her chance for some respite without the addiction and side effects.

Because of her lung cancer, Lemay can’t smoke or inhale, but she said she is excited to try marijuana products that can be ingested in other ways.

“I’m right now in limbo. I’m frustrated and I thought it was going to be a heck of a lot easier than what I’m finding so far,” Lemay said. She said she has considered getting the drug illegally from out of state.

“When you’re sick you get desperate,” she said.

IN WATERTOWN, JACOB PERILLO said he had no problem getting a medical marijuana card, but can’t af-ford the price of legal pot.

“Unfortunately, I haven’t tried any products yet since I can’t afford it. I can barely afford food and help pay rent,” Perillo said.

Perillo was diagnosed with multiple sclerosis April 28 after struggling for months to complete simple tasks. He said his legs are shaky, he has bad vision and he has to hold onto a wall to get around his apartment. Because of his condition, he can’t work.

Perillo said a gram of marijuana on the street goes for $20, and an ounce would usually cost about $300. According to priceofweed.com, the average price in Connecticut is $340 an ounce for high quality product.

The price at the state’s six dispensaries varies from $16 a gram to nearly $500 an ounce. At The Healing Corner Inc. in Bristol, where Perillo is registered, the cheapest option is $90 for 5 grams of the raw flower.

Watertown-based producer Theraplant has six different strains on the market and other producers plan to come onboard soon. It’s sold in flower form, pre-rolled cones and MedTabs.

Although he hasn’t spoken with patients about the cost, Salner said he expects it to go down once all four growers are running.

“I’m hopeful that it be-comes affordable for people,” Salner said.

Perillo said he got his medical marijuana card about a month after applying for it, in the middle of May.

“It was pretty straightforward,” Perillo said.

After he made a doctor’s appointment, the doctor looked at his MRIs and filled out the paperwork.

Perillo said he has been a recreational smoker for some time and it helps greatly with his pain, but he would prefer the higher quality and legal medical marijuana. The street grade doesn’t compare to what is available in dispensaries, Perillo said, and he would like to try other forms like edibles and oils. He said he’s tried vaporizers, joints and glass bowls.

IN COLORADO, where medical marijuana has been available for a decade, fewer than 10 percent of doctors have recommended it for their patients. With over 115,000 patients registered for the program as of August, 93 percent reported severe pain as their qualifying condition. In Connecticut, pain in itself is not a qualifying condition for treatment with marijuana.

Dean Holzkamp, spokesman for the Colorado Medical Society, said the organization has had few re-quests from its physicians for information on medical marijuana and hasn’t given its members any guidelines on whether or how to approve it. Although there is a lot of anecdotal information about the medical benefits of marijuana, Steck said the public wouldn’t want a place like Wellmore treating people based on such unscientific information.

Christopher Young, medical director of Wellmore, said marijuana is much more potent than it was 20 years ago when it typically contained 1 to 2 percent THC. Now, it can get it as potent as 20 to 30 percent, Young said.

“There’s really not enough data to support whether conclusions can be drawn on potential harm or benefits,” Young said.

He said studies show that PTSD contributes to cannabis use disorder in adolescents and that it can facilitate the onset of psychotic illnesses like schizophrenia in young people.

“It’s not clear if one causes or aggravates the other,” he said.

For Salner, the anecdotal evidence available is enough to convince him to suggest using marijuana for some patients. He said the drug hasn’t been studied well because the U.S. government has not allowed clinical research.

He said qualifying patients shouldn’t have to be at risk buying unsafe drugs off the street.

He said his patients like the option of buying marijuana in a smokeless form and the ability to buy strains that don’t produce either euphoria or sedation.

Salner recommends that his patients start with the lowest dose possible until they have a better sense of how they tolerate it and the side effects.