Bill Cummings
Published 8:23 pm, Saturday, August 17, 2013
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Connecticut:Medical marijuana law passed in 2012
94 physicians and 766 patients registered as of July
Average age: 42.8, with a 3-1 ratio of male to female
Does not allow patients to use marijuana for chronic pain; 11 diseases and disorders are eligible for marijuana treatment
California:
Medical marijuana law passed in 1996
62,147 patients and 6,332 doctors registered as of 2013
5,643 medical marijuana identification cards issued between 2012 and 2013
2006 study found that 72 percent of patients are male; 82 percent used marijuana for pain; and 67 percent reported using marijuana daily
Colorado:
Medical marijuana law passed in 2000
105,886 patients issued ID cards as of May 2013
800 doctors registered
220,637 applications received since June 2001.
67 percent of patients are male
Average age: 42
94 percent use marijuana for pain
Source: Connecticut Office of Legislative Research July 15, 2013 report
Doctors are signing up on a daily basis to be certified for prescribing medical marijuana under the state's new law. Patients are signing up too, but they may have to investigate a little to find a doctor because the state is not planning to release its list of marijuana-certified physicians.
As of last month, 94 physicians had registered with the state to issue marijuana eligibility certificates to patients, and 766 patients had filed certifications from doctors, the first step in receiving a medical marijuana identification card to legally purchase and use weed.
"We expect the numbers to rise," said William Rubenstein, commissioner of the state Department of Consumer Protection.
While strong interest was expected following passage of the medical marijuana law last year, some are wondering if Connecticut's new system will become rife with abuse and if questionable patients will troll for doctors willing to schedule an exam and issue eligibility certifications in exchange for a fee.
Websites are already advertising "marijuana doctors" willing to prescribe the weed for eligible ailments and some of those specialize in alternative or holistic approaches to health care. The sites link patients with doctors registered to prescribe marijuana.
"There is always a possibility that a medication can be given liberally and too collectively," said Carolyn Drazinic, a psychiatrist with the University of Connecticut Health Center in Farmington, who also questions whether proof has been established that marijuana offers medical benefits.
"Marijuana is widely used in the general population today," Drazinic said. "This is possibly a slippery slope toward legalization."
Budding business
Medical marijuana is now legal in 20 states -- Illinois recently adopted the law -- and it's become big business, with some national estimates as high as $1.5 billion in revenue annually and projections of $8 billion in four years.
Doctors generally charge a fee to examine patients seeking medical marijuana. Pot growers, those who make marijuana products and those running dispensaries could be in line for a windfall.
Connecticut's marijuana farmers are expected to be in business by early next year and dispensaries should be operating by mid-2014. Licensed pharmacists will run an as yet undetermined number of dispensaries.
So far the number of Connecticut doctors and patients signing up for medical marijuana is a fraction of those registered in California and Colorado -- among the early adopters of medical marijuana laws -- but those states may be a useful predictor of the flood to come.
California has registered 62,147 patients and 6,332 primary caregivers as of 2013, according to figures compiled by the state Office of Legislative Research. Colorado has issued ID cards to 105,886 patients and the program has received 220,637 applications since it began in June 2001.
"The experience in other states is it's a slow growth," said Rubenstein, the state consumer protection commissioner.
In Connecticut, Post Traumatic Stress Disorder is so far the most often cited illness for marijuana treatment, with 212 patients claiming to need weed as of mid- July.
Spinal cord damage is next, with 192 patients registered so far, followed by multiple sclerosis (141 patients); cancer (62); Crohn's disease (29); wasting syndrome (22); epilepsy (21); glaucoma (20); HIV/AIDS (19); cachexia (13) and Parkinson's (4), according a July 15 state research report.
Drazinic said the inclusion of PTSD on the list of treatable disorders is troublesome because a PTSD diagnosis is a subjective determination that's difficult to disprove if abuse is suspected. Crohn's disease, by contrast, is verified by detailed laboratory and imaging results, she said.
Marijuana pipeline
While some doctors registered to prescribe marijuana are members of the mainstream medical community, such as Andrew Salner, chief of radiation oncology at Hartford Hospital, others work in the alternative or holistic health care field.
A national website, marijuanadoctors.com, is already linking patients with doctors and can be searched by state, including Connecticut. With a click of a button, or by filling out a form, patients can find doctors friendly to marijuana treatment close to them or miles away.
One website offered a friendly chat feature, a computerized operator aptly named "Mary Jane," which pops up to help with appointments and answer questions.
A search of Connecticut marijuana prescribers listed only two clinics. One, the Monroe Alternative Care center, listed office hours and advised of an initial appointment fee of $150. The other, the West Hartford Medical Center, is open three days a week, and "screens and evaluates qualified Connecticut state residents and helps determine if medical marijuana is a viable treatment option for them."
Calls to Dr. Judith Major, who runs the Monroe center, for comment about her practice were not returned. Numerous other doctors also declined to return calls seeking comment about medical marijuana.
Many of the doctors listed on marijuanadoctors.com, whether in Connecticut, New York or New Jersey, displayed an American Medical Association symbol on the information box about their practice.
That's curious considering the AMA is not on board with medical marijuana. In a statement issued in response to questions from Hearst Newspapers, the AMA said it's calling for additional controlled studies and a review of federal prohibitions so clinical research can accelerate.
"This should not be viewed as an endorsement of state-based medical cannabis programs, the legalization of marijuana or that scientific evidence on the therapeutic use of cannabis meets the current standards for a prescription drug product," the AMA said.
When asked for a list of the state's registered doctors, the state consumer protection department, which is in charge of implementing the marijuana law, declined to release names, citing confidentiality provisions within the law passed last year.
Rubenstein said one reason doctors names are not public is physicians could become reluctant to be involved in prescribing marijuana because of the stigma associated with illegal drug.
"I'm sure there are ways doctors want to be identified. If names were made public it could inhibit their judgment if they want to participate," Rubenstein said.
Hearst Newspapers' initial request under state freedom of information law for the names of doctors registered to prescribe medical marijuana was denied. The request allowed for redaction of any patient-related information.
Ken Ferrucci, vice president of public policy and governmental affairs at the Connecticut State Medical Society, which opposed the medical marijuana bill last year, said the society is watching as the law progresses.
"The society is monitoring the development and implementation of the state program and wants to make sure that doctors who certify patients as eligible do it within the confines of the law," Ferrucci said.
Erik Williams, executive director of the Connecticut chapter of the National Organization for the Reform of Marijuana Laws (NORML), said the confidentiality portion of the state law is appropriate.
"I support patient confidentiality," Williams said. "Doctors can advertise if they want. My speculation is doctors think it's not the public's business what they are prescribing."
Williams said there is a "bit of a stigma" surrounding weed even though polls show a majority of Americans support legalizing pot.
"I'm personally offended by doctors who call themselves marijuana doctors," he said. "This is a decision between a doctor and a patient. There are patients with severe deliberating conditions. It's just a tool in their tool box."
Rubenstein insisted Connecticut's law has ample safeguards against abuse, noting physicians must be licensed and both doctors and patients can be penalized and banned from the program for a variety of reasons.
A good high
During testimony last year before a legislative committee considering the medical marijuana bill, patients and doctors generally agreed that weed helps alleviate certain conditions.
Marc Weitzman, an eye surgeon with offices in Fairfield and Stratford, told the committee in written testimony that he has a patient suffering from glaucoma. "If he is able to obtain medical marijuana his glaucoma should improve," Weitzman wrote.
Barry William, who did not reveal his address but said he's a former state government lobbyist, said in written comments that his Parkinson disease was unbearable until his doctor suggested he "smoke some marijuana.
"I tried it. The doctor was right and for the first time in a long time I felt normal," William told the committee.
Drazinic said that while medical marijuana appears to be useful in alleviating some symptoms, such as nausea and vomiting, there have not been enough clinical trials to show pot has a positive impact overall or to determine dosage levels
"There are no controlled trials that looked at marijuana as a possible treatment. Until the results are available for review the jury is still out on whether marijuana is of any benefit," Drazinic said.
She also questioned why a system to grow and dispense marijuana is needed when pills with the same active and potentially beneficial ingredients are now available.
On the other hand, Alan Shackelford, a Colorado doctor, said in written testimony that naysayers overreact to medical marijuana.
"Allowing physicians to add medical marijuana to the treatment options available will improve the quality of life for a great many people for whom current treatments are not adequate," Shackelford said.
Staff writer Ken Dixon contributed to this report.
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