The Tribune Democrat, Johnstown, PA

February 1, 2014

Pot laws create difficult decisions

John Finnerty
CNHI State Reporter

HARRISBURG — Amy Hagerich didn’t know her son, Jacob, was experimenting with marijuana.

Unlike most stories that start that way, Hagerich said, the drug turned out to be just the thing he needed.

Jacob suffered a variety of health problems, including neurovascular dystrophy, a condition he’d had since he was a toddler. Doctors had prescribed a variety of treatments, with limited success, Hagerich said. His vomiting was so frequent, he had to be home-schooled.

Then, after trying marijuana recreationally at age 14, Jacob discovered that it helped him far more than any other drug, his mother said. He was able to return to school. He graduated. He got a job.

The problem for Jacob, of course, is that marijuana remains illegal. Hagerich, who lives with her son in Greensburg, said that has forced them to make tough choices balancing his health and the law.

Jacob, now 20, has been arrested. While on probation, he’s been plagued by his inability to pass a drug test. A judge is threatening to put him in an in-treatment drug rehabilitation unit to get him to stop using the marijuana that he and his mom insist enables him to function in society.

“He has gone through a nightmare,” Hagerich said. “It’s been horrible.”

One state at a time

Their story typifies the sort of painful decisions advocates say could be alleviated by legalizing marijuana – at least for medical use. Even with mounting support to add Pennsylvania to a list of 20 other states that have done so, significant roadblocks remain. Foremost is Gov. Tom Corbett, who has said he’s unwilling to legalize marijuana, even for medical use, and that such a decision ought to be made in Washington, D.C.

In the meantime, advocates are using the stories of patients such as Jacob Snee to sway lawmakers in hopes of legalizing marijuana one state at a time.

Jacob’s mother said she was terrified of the ramifications of turning to marijuana to treat her son, but she ultimately decided that his quality of life was more important than following the law. The decision paid off in some ways, but also came back to haunt them.

At some point, Hagerich said, it seemed safer to grow marijuana rather than buy the drug from dealers. That was until police one day visited their home looking for a friend of Jacob’s, then discovered his marijuana plants in the process, she said. That led to Jacob’s arrest.

Now he’s faced with a choice. He can give up marijuana to comply with his probation. Or he can continue to flout the law so he can continue to function. He chooses to use marijuana.

Jacob said that the legal fight is interfering with his efforts to try to become a productive member of society. If he doesn’t use marijuana medicinally, within days he feels overcome by nausea.

“I just don’t want other people to have to go through what I’m going through,” Snee said. “It disgusts me.”  

Growing support

Snee’s lot would be better if he lived elsewhere in the United States. The states of Colorado and Washington became beacons of the movement to legalize marijuana when voters approved ballot measures last year allowing adults to use small quantities. Eighteen other states allow restricted use of marijuana for medical purposes. Others still have lessened or removed penalties for possessing small amounts of the drug.

In the mid-Atlantic, Delaware is planning its first “compassion center” to grow medical marijuana by the summer. Patients in New Jersey already have access to medical marijuana. And, earlier this month, New York Gov. Andrew Cuomo proposed that his state should become the 21st to approve the medical use of marijuana.

Polls in Pennsylvania indicate broad support for medical marijuana, as well. A Franklin & Marshall survey released Thursday found support among 81 percent of those who responded.

In November, more than 50 people rallied in the Capitol rotunda in Harrisburg for medical marijuana’s use. They included parents of children suffering from seizure disorders who said legal drugs simply aren’t as effective as marijuana.

The children’s stories helped sway Sen. John Wozniak, D-Westmont.

Once people understand the issue, Wozniak said, they tend to support it. For instance, cannabis used to treat children with seizures isn’t smoked; it’s typically delivered as oil in a dropper.

Children with seizures have become faces of the medical marijuana debate, but they represent only a fraction of the patients who would seek access to the drug.

In Michigan, two-thirds of the 118,368 people who received medical marijuana last year said they used it to treat severe and chronic pain. Another 18 percent cited severe muscle spasms. Epilepsy was cited in just 1 percent of the cases.

Waiting on Washington

Not everyone is as convinced of marijuana’s effectiveness. Among the biggest doubters in the state is the Pennsylvania Medical Society, which remains opposed to medical marijuana until more research is done – an official stance that belies varied opinions among doctors.

During a panel discussion sponsored by the society, Dr. Lee Harris, a neurologist, noted evidence that shows the success of cannabis treatments for children with epilepsy, as well as patients with chronic pain and nausea. Research to confirm those findings has not taken place, Harris said.

“It’s reasonable to consider it as a treatment,” Harris said. “The benefits outweigh the risks.”

Others in Pennsylvania – Corbett among them – say it’s up to the Food and Drug Administration to do that research and make that determination. A decision doesn’t appear imminent, however.

As more states approve the medical use of marijuana, federal regulators warn they don’t “serve the interests of public health because they might expose patients to unsafe and ineffective drug products,” said Morgan Liscinsky, an FDA spokeswoman.

Varieties and nuance

In the meantime, the FDA’s own review of the drug is complicated because regulators typically seek to judge the effectiveness of a drug’s various components, said Mark Rosenfeld, a Utah researcher who conducts most of his studies on cannabis in China and Israel to avoid U.S. restrictions.

For patients using marijuana, combinations of the drug tend to work together to create the worthwhile effects, said Rosenfeld. That flummoxes regulators who want to understand exactly how it works.

Marijuana’s varieties also complicate the debate – at least on the state level – because some are less potent than others.

Rosenfeld noted that some variations, such as those used by epileptic children, include such low levels of THC, the drug found in the cannabis plant, that they are less psychoactive than Benadryl.

Advocates of medical marijuana worry about the nuances. Patrick Nightingale, an attorney with the Pittsburgh branch of NORML, who also represents Snee, said he’s concerned about potential compromise in Harrisburg to legalize only the use of cannabis with low levels of THC.

That would be fine for epileptic children, he said, but does nothing to help those with conditions including post-traumatic stress disorder and cancer.

Some doctors argue that Congress should reclassify the drug – based on its already proven benefits – to make it easier for researchers to conduct the studies needed to convince the FDA.

Reclassify or declassify?

Marijuana’s current classification under the Controlled Substances Act is on Schedule 1, among the drugs considered to be the most dangerous. Liscinsky said that’s based on the premise that it has “a high potential for abuse, no accepted medical use in treatment in the United States, and lacks accepted safety for use under medical supervision.”

A bill to reschedule marijuana is mired in committee, despite having 22 co-sponsors, none of whom are from Pennsylvania.

U.S. Rep. Tom Marino, R-Lycoming, is skeptical of the effort, said spokeswoman Sarah Wolf.

“As a former U.S. attorney, Tom saw first-hand the detrimental effects this drug had on countless lives, and he opposes any efforts to weaken the drug’s current status as a Schedule I controlled substance,” Wolf said in an email.

Josh Stanley, co-founder of the Realm of Caring, a Colorado nonprofit that developed a cannabis treatment for children with epilepsy, said he would like to see cannabis products labeled as herbal supplements. That would put some restrictions on marketers, he said, but the products would be available to those who need them.

“We don’t need reclassification, we need declassification,” said Stanley, whose group was featured in a CNN segment that helped catapult the issue of medical marijuana into the national spotlight.

Frustrating wait

Waiting for a decision – or a review by federal regulators – frustrates advocates such as Stanley.

He predicts an FDA review would cost $300 million to $500 million for research, last seven to 12 years, and yield a drug that will cost patients $10,000 a month to use.

“We have a profit-care system, not a health care system,” Stanley said.

Parents of epileptic children say that’s too long and costly.

Three mothers testified before a state Senate committee Tuesday to describe the human costs of delay.

Deena Kenny, of Lehigh County, said the legal drugs given to her son turned the boy so homicidal that he repeatedly tried to kill her.

“This was due to an FDA-approved medication,” she said.