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Medical cannabis TOM ARNESON, MD, MPH, research manager at the Minnesota

Department of Health’s Office of Medical Cannabis, provides a clinical and research perspective to implementation of the state’s medical cannabis program. Board-certified in public health and general preventive medicine, he also oversees research on the program’s impact.

What does your work as the research manager of the Office of Medical Cannabis (OMC) entail? A distinctive part of Minnesota’s program is tracking what happens with enrollees, including what they purchase and what they and their certifying provider report as benefits and harms. I helped design how information is collected during program participation and my staff and I are now organizing and analyzing data from the first year of the program. I also summarize existing research literature and spend significant time doing presentations and communicating with clinicians.

Only certain conditions qualify for use of medical cannabis. Please tell us about those conditions. The law that set up the program defined nine qualifying medical conditions and gave the health commissioner authority to add more. The nine original conditions were cancer, glaucoma, HIV/AIDS, Tourette syndrome, amyotrophic lateral sclerosis (Lou Gehrig’s disease), seizures, severe and persistent muscle spasms, Crohn’s disease, and terminal illness. In late 2015 the commissioner added intractable pain, effective August 2016, and on December 1, 2016, he announced addition of posttraumatic stress disorder, effective August 2017. Each June and July citizens can submit petitions to add additional conditions.

Please discuss the process by which a patient can obtain medical cannabis. Patients should first talk to their health care providers, because the first step in enrollment is being certified by a physician, advanced practice registered nurse, or physician assistant as having a qualifying medical condition. After getting certified, the Office of Medical Cannabis contacts the patient, letting them know how to complete their application and pay the enrollment fee needed prior to approval. The patient needs to be approved for the program by the Office of Medical Cannabis before they can purchase medical cannabis.

Please share some success stories that you have seen in the brief time that your office has been open. Both patients and their certifying health care practitioners describe a high level of benefit for many. Survey findings for



patients enrolled during the first three months are in a report now on the OMC web site. Much more detailed descriptions of the patients and their experiences will become available over the next six months. The impact has been dramatic—even life changing for some. I have heard some of these stories directly from patients and some have been featured in the press. Though these are sometimes derided as “anecdotes,” it is important to remember that for the patient and their family, the life improvement can have profound significance.

What are some of the common consumer misperceptions you have heard about the medical cannabis program? We continue to hear from people who have the incorrect belief the program allows them to grow their own cannabis plants, smoke cannabis, and purchase cannabis at a retail pharmacy. The program does not allow any of these three things. Patients sometimes contact the Office of Medical Cannabis hoping or expecting to get a list of health care practitioners willing to certify patients for the program. The privacy policies under which the program operates do not allow the Office to share such a list.

A growing number of states have legalized recreational use of marijuana. How could this impact medical cannabis programs? The four states that first had medical cannabis programs and then legalized recreational marijuana prior to November 2016 are finding it challenging to regulate both programs simultaneously. Both of the cannabis programs in these four states focus on similar smokeable and edible whole plant materials, but with different levels of taxation and different rules. Minnesota’s medical cannabis products are oils and liquids, not whole plant, and there is no state sales tax or other state taxes charged when these products are purchased. If Minnesota were to legalize recreational marijuana, the impact on the medical cannabis program would depend on the details of recreational marijuana taxation and rules.

What advice can you give to people who might benefit from medical cannabis but, for whatever reason, are afraid to try it? Given the current state of knowledge, use of medical cannabis products is admittedly something of an experiment for any individual person. An important consideration is how well existing treatments are managing symptoms and how disturbing the side effects of current treatments are. The case for trying medical cannabis is stronger if patients are dissatisfied with their current symptom control and side effects. photo credit: Greg Christensen

MN Healthcare News March 2017  
MN Healthcare News March 2017  

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