Who is eligible for medical pot? Debate is far from over

Daily Staff Reporter
Published September 7, 2010

Though medical marijuana was legalized in Michigan in 2008, debate is still raging over which patients are eligible to use the treatment.

According to the Michigan Medical Marijuana Act, medical patients in the state of Michigan who want to use marijuana to treat their conditions must first obtain registry identification cards from the Michigan Department of Community Health — a process that has ignited controversy over who should be allowed to use the drug.

And with limited research on the drug that is backed by the federal government, many physicians are hesitant to suggest it as a treatment option, though patients and advocates swear by the drug’s medical efficacy.

Between April 6, 2009 and Oct. 8, 2010, the department received 65,816 new or renewal applications. So far it has approved 35,802 and denied 7,938 of those applications. Most of the denied applications were incomplete, according to the department’s website.

To apply for a card, a patient needs written certification from a licensed physician verifying that he or she has one of the “debilitation medical conditions” specified in the state law. The list includes cancer, glaucoma, HIV/AIDS, Crohn’s disease, Alzheimer’s disease. In addition, the various symptoms of chronic or debilitating conditions are also included, like severe or chronic pain, severe nausea or wasting syndrome — significant weight loss caused by the AIDS virus or chronic fever and diarrhea.

Dr. Daniel Berland, an assistant professor of internal medicine and anesthesiology at the University’s Medical School, treats patients with acute and chronic pain at the University Hospital. He said most of his patients who go to the hospital for chronic pain are either using marijuana or asking for it, which is a “drastic change” from just a year ago.

Dr. James Riddell IV, an associate professor of internal medicine in the Medical School and an infectious disease specialist at the University Hospital who works with HIV/AIDS patients, said some doctors refuse to recognize marijuana as a treatment option, while others not affiliated with the University hand out written certifications for their patients “willy nilly.” He estimated that about 25 percent of doctors, like him, generally support the possibility that marijuana has medical benefits but want to see more scientific evidence.

“You get varying attitudes, and I think in general, physicians are sort of a conservative bunch and in general what we like to see before we endorse any treatment is data,” he said, adding that he has provided written certifications to a “select number” of his patients.

The law only gives a general list of qualifying conditions. To help physicians in the state, Riddell was one of nine doctors at the University who put together a comprehensive guide last March that details how marijuana reportedly affects patients with each qualifying condition.

The guide — based on findings from previous studies on the drug — explains that there are more effective medications for treating each condition. Doctors also agree that until more research is done, marijuana should be used as a last resort and only after other treatments have failed.

Berland, who has never provided a written certification for a patient, said the scientific evidence behind the medical benefits of marijuana is simply not substantial enough to merit the drug as a treatment option. The research that is available, he said, consistently shows that other proven treatments work better and are often cheaper than marijuana. For pain relief, marijuana is about as effective as Tylenol with codeine, he said.

“We all want to have a bias that this drug could be useful, and many of us have a bias that it should be decriminalized,” Berland said. “The long and the short of it is the scientific evidence is limited to non-existent, and so therefore, most (doctors) probably practice by scientific evidence and are not giving it.”

Mike Meno, director of communications for the Marijuana Policy Project — the organization responsible for drafting Michigan’s medical marijuana law — said marijuana is perhaps one of the most studied plants of all time. The “myth” that there is a lack of research on the plant exists because none of the research has been supported by the federal government, he explained.

“While all these studies have been going on in the United States and other countries, the federal government for years has actively blocked much needed (United States Food and Drug Administration) level research that would allow marijuana to move through the FDA approval process,” Meno said.

The reason there hasn’t been research done on the federal level, he added, is because marijuana is held to a “ridiculous standard.”

The Drug Enforcement Agency classifies marijuana, along with GHB, heroin and LSD, as a schedule I drug under the Controlled Substances Act. Schedule I is the most restrictive out of the five drug classifications listed under the act. The category consists of drugs that have a high potential for abuse and no accepted medical use in the United States. In 2001, the DEA denied a petition to make marijuana a less restricted classification, citing its lack of medical use as the primary reason.

Meno disagrees with the DEA’s decision and said several studies confirm marijuana’s safety and medicinal properties.

“It’s a blatant lie for the federal government to say (marijuana) has no medical efficacy,” Meno said. “There are patients who are benefiting from it right now.”

One popular study published in 1999 by the National Academy of Sciences’ Institute of Medicine reported that cannabinoid drugs have a “therapeutic value” for “pain relief, control of nausea and vomiting and appetite stimulation.” The study also highlights the potential value of marijuana’s positive psychological effects on certain patients. Like many scientific studies, the report asserted a need for further research.

Official reports aside, many patients who have turned to marijuana swear by its benefits.

Chuck Ream, a prominent local medical marijuana advocate from Scio Township, Mich., has suffered from a debilitating stomach condition since the 1960s. He said marijuana helped him turn his life around when his condition was at its worst.

“I think (marijuana) saved my life. I would’ve probably killed myself just because I simply couldn’t get control of this,” he said. “I would get up in the morning, driven out of bed by pain, and I would eat baby food out of the can, out of the jar, and I would get down in the fetal position and rock back and forth for most of the day, and it kept getting worse, not better.”

Ream, one of the founders of MedMar Compassionate Healthcare — a non-profit organization on Packard Street in Ann Arbor where registered patients can purchase marijuana products — said there are other medications that work well for him, but he still feels marijuana has a place in his treatment regime.

“Cannabis is just part of my healthy program,” he said, “and I can tell when smoking a joint would really help me a lot, and I can tell other times when it’s not smoking a joint I need.”