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* All views expressed here are those of Dr. Craig Blinderman and do not reflect the views of New York Presbyterian Hospital. 

Dr. Craig Blinderman, a palliative care specialist at New York Presbyterian Hospital, is one of the New York physicians intrigued by the potential medical marijuana holds for treating pain.

“What we’re trying to do is restore some functioning, whether it’s physical or mental or whatever,” Blinderman said. There’s actually a lot of research that suggests that it has benefits in patients with chronic pain, no appetite, nausea.”

Despite an “exponential increase in research,” however, Blinderman said we’re “just barely scratching the surface of this very complex network” of “cannabinoid receptors” all over our bodies, from our brains to our immune systems.

He insisted that there’s no reason why something so ubiquitous in our bodies shouldn’t be allowed for medical use. 

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  Some of America’s favorite stoners

“The problem is it’s associated with a huge stigma in our society, it’s remarkable just how much stigma is associated with it,” Blinderman said.

He emphasized that THC (tetrahydrocannabinol, the psychoactive component in marijuana), is “not the only cannabinoid that exists.”

“Marijuana, the cannabis plant, contains a number of chemicals [and] can have dozens of different types of cannabinoids,” Blinderman explained. “There are some growers in California that are trying to actually tailor their plants so they can actually have different concentrations, like 20 percent THC or 10 percent cannabinol” (a non-psychoactive component).

These attempts are especially promising for making marijuana a truly effective medication.

“Let’s say the law‘s passed and I prescribe to a patient with severe nausea and pain, and the patient ends up feeling lethargic and spaced out and so forth,” Blinderman said. “I might seek out a different strain that has lower psychoactive qualities.”

Blinderman said there is already evidence suggesting that small doses of cannabis can have an “opioid sparing effect,” meaning one of the possible benefits of medical marijuana could be lessening a person’s need for opioids.

Opioids are very strong pain medications like oxycodone, morphine, and methadone. They are often used for cancer-related pain, and high doses can pose a lot of negative side effects. Cannabis, Blinderman said, may even affect the duration of pain relief and minimize withdrawal symptoms, which would not only decrease how much opioid a patient needs to take, but also how often it needs to be taken.

Blinderman rejects the reasoning that legalizing marijuana is dangerous because some people may use it for reasons other than pain management, pointing out that’s fairly common with prescription drugs already.

“People use ketamine recreationally, for example,” Blinderman explained. “It’s a powerful anesthetic, it’s used all the time, it’s great for pain.”

“Just the fact that people use it and go to dance parties, doesn’t mean I can’t prescribe it to someone with chronic pain, or depression for that matter,” Blinderman added.

Blinderman said he’s heard of studies showing that some elements in cannabis could have the ability to actually stop cancer from growing or spreading, by blocking key enzymes used in angiogenesis: blocking the enzymes prevents tumors from drawing in blood and growing.

“As far as I’m concerned, I don’t think we’ve seen higher incidences of lung cancer” in patients using smokable marijuana to cope with chemotherapy. In fact, a recent study in the Journal of the American Medical Association found no association between smoking marijuana and negative effects on lung functioning.

Ultimately, Blinderman is hopeful about the New York legislation, though expressed dismay at Senator Diane Savino’s rejection of “chronic pain” as a possible use for the substance. Savino said the term is too vague; the legislation instead lists specific illnesses, such as multiple sclerosis, cancer, and epilepsy.

“It should include all types of chronic pain, I think,” Blinderman said. “That’s too bad.”

But he said he understood Savino’s inclination to narrowly restrictive legislation, and called the California legislation “kind of a farce.”

“Anybody can get a prescription for it, for any kind of ailment,” Blinderman said. “It makes a joke out of it being medicinal.”

If medical marijuana were legal in New York state, Blinderman said he would consider recommending it for patients with pain, nausea, appetite problems, and patients having a rough time with chemo.

“Hopefully with more states passing it, there will be more opportunities for research to be done, and clinical testing,” Blinderman said. “Drugs with less evidence have been approved.”

Medical marijuana: the political

Medical marijuana: the personal

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Rob is a Navy veteran who lives in Woodstock, NY. In 1986, he was on a Navy ship off of Libya, pulling watermines out of the Gulf. Rob was one of two men on the ship authorized to carry a loaded firearm.

Sometimes the watermines were on the surface of the water. Other times, Rob recalled, “they put ‘em on anchors, so they’ll be 50 feet below the surface, so you can’t even see ‘em, so they’re very difficult to find.”

“It was a very, very stressful, super high stress time,” Rob said.

Rob is one of the U.S. veterans using marijuana to treat Post-Traumatic Stress Disorder.

It was first suggested to him by a Veterans Affairs doctor at the end of an appointment, who started the illicit conversation by saying, “Now I want to talk to you frankly.”

Cannabis has helped him “tremendously,”Rob said said, with his anger issues, anxiety, sleeping disorder, and ”just generally not being able to concentrate, my mind would often wander back into situations I didn’t necessarily want to always be remembering.”

Rob also did anger management and talk therapy, but was opposed to taking pharmaceutical medications, especially anti-depressants.

“I didn’t like how they made me feel,” he said.

When he started talking anti-depressants, he found himself growing increasingly depressed, reclusive, withdrawn from society, and even suicidal. Before the drugs, depression had never really been a factor in his PTSD.

When he first got out of the Navy, he was supposed to be an air traffic controller, but he “couldn’t handle the job,” he said.

He ended up not working for a while, then took on occasional landscaping and construction odd jobs, but couldn’t keep a regular schedule with his anxiety and sleeping issues.

Once he started using marijuana in 1991 or 1992, Rob said, he was able to get a 40-hour-a-week job with a construction firm “and progress my life to where I wanted it to go.”

“My ability to interact with the regular world was back,” he explained. ”It was helping me re-integrate into society after being in the military and being in situations in the military that were clearly uncomfortable.”

Rob said the marijuana helped him be able to talk to a therapist about the overwhelming guilt and anger that was plaguing him.

Back then he used it on a daily basis, but now he said it’s “probably more like once a week, if it’s been a rough week, maybe two or three times a week.”

“Honestly, knowing it’s there as an option makes it less necessary, but it nice to know that it’s there,” he said.

Rob is one of the New Yorkers, and also one of the U.S. veterans, who is hopeful for the legislation being looked at in the NY State Senate that could legalize marijuana for medicinal use in NY State.

“Basically, I’m telling you I do a criminal act to treat myself,” Rob emphasized. “And I will indeed break the law to make sure that I’m a better society member, but if that’s what the government forces me to do, then that’s a shame.”

“It’s a shame that I can serve my country and not get the treatment that even my doctors say I need,” Rob said.

But then he added: “I’m not ashamed, and I’m very proud to have served by country in the US Navy. I just think our government is fearful of something that maybe they should just let physicians take command of instead of a law enforcement aspect.”

Medical marijuana: the political

Medical marijuana: a doctor’s perspective

Follow Danielle Tcholakian on Twitter @danielleiat

The post Medical marijuana: the personal appeared first on Metro.us.

New York State Senator Diane Savino had been a co-sponsor of the New York state medical marijuana bill since she first joined the Senate, and credits her interest in the cause to the “thousands and thousands of New Yorkers who suffer from chronic, debilitating conditions like multiple-sclerosis, epilepsy, diabetes, and cancer.”

“Unfortunately for them, the options that are available to them are high addictive, very deadly narcotics—oxycodone, vicodin, ativan,” she listed. “[These drugs are] a lot more damaging to you than marijuana but because of the laws in New York state, they can’t sit down with their doctor and come up with the best treatment plan for them.”

Savino said the New York bill would be the most regulated marijuana statute in the country.

“California is the worst model, there it’s like the Wild West, literally,” she said. “There’s almost no regulation, there’s almost no discernment on the part of medical professionals [about] who should and shouldn’t have marijuana.”

“It’s exactly the opposite of what we want in New York,” she added.

The way Savino describes it, legalizing marijuana could even be a profitable endeavor for the state.

“We want to license it, we want to tax it, we want to derive a significant amount of revenue from it,” she said.

Savino said there would be a licensing fee imposed upon growers and dispensers, and an excise tax that has yet to be determined.

As for whether medical marijuana will be available to veterans suffering from Post-Traumatic Stress Disorder, a potential use floated by advocacy group the New York Cannabis Alliance, Savino said she’s “not sure.”

“I don’t believe we’re listing that,” she said. “Unfortunately, unlike other drugs, which are regulated by the Food and Drug Administration, marijuana is still going to be considered illegal by the federal government, so we have to list specific conditions.”

Savino said that public opinion is a factor in how restrictive the criteria in the bill is.

“Unfortunately the public is a little leery about what this substance could be used for, so we have to proceed a little bit carefully,” she explained.

But the senator said she knows this legislation is vitally important to many New Yorkers.

Savino said she gets letters and phone calls not just from her own constituents, but from “people all over the state who have been living in pain, and if they just lived across one of the three bridges that connect us to New Jersey, they would have that option [to use medical marijuana].”

“Unfortunately, some people aren’t going to live long enough to avail themselves of this options, but for those people that are, we have to move,” Savino said.

The senator hopes to have a vote on the bill before the end of the legislative session.

Medical marijuana: the personal

Medical marijuana: a doctor’s perspective

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New York State Senator Diane Savino introduced a bill today that would legalize medical marijuana in New York state. 

Under the Compassionate Care Act, doctors will be authorized to give out certifications for marijuana use for patients with serious medical conditions.

Certified patients or designated caregivers will be allowed to possess up to two-and-a-half ounces of marijuana.

People with medical marijuana certifications would be issued registry identification cards by the Department of Health.

The authorizing document is a certification, not a prescription, because “prescription” is a federal Drug Enforcement Agency term, so it legally cannot be prescribed until it is no longer classified as a Schedule 1 drug, according to Evan Nison at the New York Cannabis Alliance.

Nisan said that “advocates feel confident that this might be the year New York finally joins the other 18 states around the country that have medical marijuana laws.”

Adam Scavone, president of the New York Cannabis Alliance, has worked with veterans returning from Iraq and Afghanistan and says that researchers are increasingly having success using marijuana to treat Post Traumatic Stress Disorder.

“In this country, 22 veterans per day are committing suicide, a 20 percent increase from just five years ago,” Scavone said. “We know cannabis is useful in treating PTSD and we can save veterans lives, by passing this law.”

According to Scavone, entrepreneurs and venture capitalists around the country are laying the groundwork for a market that could reach $1.5 billion in legal sales in 2013 alone.

The equivalent Assembly bill was introduced today as well. They Assembly has passed similar legislation previously, so advocates don’t anticipate any problems in that chamber, Nison said.

It will likely be two to three months before there is a vote, however, as the bill makes its way through the committee process.

Governor Andrew Cuomo has previously expressed opposition to legalizing marijuana for medical use.

When asked if the governor would veto the bill if it was passed by the legislature, his office responded, “We will review the bill if it passes the Legislature.”

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