Smokin Moose
Fallen Cannabis Warrior & Ex Moderator
I've been working as a nurse for 25 years, about half of that in acute care mental health nursing at Good Samaritan Regional Medical Center in Corvallis, Oregon. Eight years ago the Oregon Medical Marijuana Act pass-ed by the initiative process and a state program began registering patients.
It wasn't long before I started meeting patients coming into the regional mental health unit who reported that they were using cannabis to self-medicate for a variety of mental-health symptoms. It wasn't long after that that I started volunteering at the Compassion Center, a volunteer medical facility that helps assist patients with education, support and registration into the medical marijuana program.
Pretty soon I started seeing the same patients who were having psychiatric emergencies coming to the Compassion Center to see me for cannabis recommendations, which I can't provide and which, actually, they couldn't get because there is no allowance in Oregon for psychiatric treatments. All the "debilitating conditions" are physical with the exception of Alzheimer's agitation.
In Corvallis, a very progressive community, there is virtually no doctor who will recommend cannabis for cancer pain or for severe nausea or AIDS. The whole medical system of Corvallis said "No, you're locked out." So then I go down to the Compassion Center and all these people from the medical system that I'm employed in say, "My doctor won't do it, he's afraid he'll lose his license."
So we assist these people by trying to find a physical correlation to their psychiatric symptom. For example, if they're having PTSD symptoms they might be sick and have physical symptoms.
How high a percentage of these people were treating psychiatric symptoms? I put together a very simple survey to find out. I reviewed 172 charts. The average patient age was 43. All the patients were registered in OMMA; 95% were registered for pain. A very large percentage of Oregon registrants are pain patients.
Some 40% had multiple qualifying conditions (not including psychiatric) –physical pain and nausea, for example. Pain and with spasticity –they often go together.
The results: 64% of the patients in the survey showed some kind of significant psychiatric benefit; 39% reported insomnia relief; 5% reported PTSD symptom relief, many of them veterans who go to the VA hospital in Roseburg and are denied. The VA doctors tell them "No, I can't. I'll lose my DEA license." They just don't want to stand up to it –although they're beginning to refer patients to us, which is kind of interesting.
Anxiety, 11%; depressive symptoms, 11%; 15% of the cohort reported that they were using cannabis to decrease the side effects of medications; 56% reported reduced use of medications.
What these patients report to me is that they're sick and tired of Vioxx and they're sick and tired of Flexeril, Vicodin –people are literally sick of these drugs. They can't sleep, they can't function, they're drugged up, they don't have any enjoyment of life.
When they start using cannabis they leave off the Vioxx and they leave off the Vicodin. Vicodin has a place, but for long-term pain management it is really poor.
Appetite stimulation –tremendously important for people who are in pain all the time– was 20%.
I put the survey together as a request to the Oregon Department of Human Services to reconvene the Debilitating Conditions Advisory Panel, which I was a member of in 2000. At that time nine patients had submitted requests to include psychiatric conditions to the list.
The state health officer did a fairly good job of bringing together the panel, but the whole thing was skewed from the outset by political manipulation by the governor's office and by the head of the Department of Health Services. The information that they would allow us to consider had to be filtered through rules stating that if it's not a double-blind, peer-reviewed clinical trial, it doesn't get a lot of evidentiary weight.
We were not allowed to give much weight to patients' reports. And of course there was no relevant double-blind, peer-reviewed clinical trial. So the panel was set up to fail.
A few patients came in and gave very compelling testimonials. And then out of nowhere came a whole bunch of medical experts –psychiatrists from Oregon Health Sciences University and the National Alliance for the Mentally Ill– and they just had fits. "This is quackery," they said.
The only person who even differentiated between affective depressive-type disorders and schizophrenic thought disorders was one of the patients. None of the doctors even made any differentiation between these two completely different sets of medical problems.
After a long, protacted time we all wrote our comments out, and there was a vote, and we voted to add affective disorders –severe agitation and depressive symptoms. Didn't happen. They finally did add Alzheimer's agitation.
So, five years later I brought in the study I'd done with OMMP registrants and asked them to reconvene the Debilitating Conditions Panel based on this new evidence showing that indeed there is some psychiatric effect that people are getting from their cannabis use. And they rejected the request with a "summary denial."
Then Lee Berger, an attorney in Portland, asked if I'd be willing to sue the Department of Human Services' OMMP and I said yes. We filed our petition for judicial review in February –a formal request "to Add Clinical Depression, Depressive Symptoms, Post-Traumatic Stress Disorder (PTSD), Severe Anxiety, Agitation and Insomnia, to Those Diseases and Conditions Which Qualify as 'Debilitating Medical Conditions' under the Oregon Medical Marijuana Act." And it worked! I can't believe it!
We got word last week that, because the OMMP doesn't really want to go to court, they've decided to kind of sue for peace. All we're asking is that they reconvene a panel to evaluate these conditions. So, we're in the process of negotiatng with them to get this thing back on track.
We want to close some of the loopholes that allow them to skew the evidence base. It's pretty clear that there are a lot of patients who are using cannabis for insomnia, for mood stabilizing, and for peace. Just for a a very simple, elemental peace, especially with chronic diseases like severe chronic pain. Cannabis is actually a miracle drug for pain, in my opinion.
There's no question the last thing the pharmacy industry wants is millions and millions of Americans growing and using their own medicine that covers such a wide array of diseases.
By Ed Glick
It wasn't long before I started meeting patients coming into the regional mental health unit who reported that they were using cannabis to self-medicate for a variety of mental-health symptoms. It wasn't long after that that I started volunteering at the Compassion Center, a volunteer medical facility that helps assist patients with education, support and registration into the medical marijuana program.
Pretty soon I started seeing the same patients who were having psychiatric emergencies coming to the Compassion Center to see me for cannabis recommendations, which I can't provide and which, actually, they couldn't get because there is no allowance in Oregon for psychiatric treatments. All the "debilitating conditions" are physical with the exception of Alzheimer's agitation.
In Corvallis, a very progressive community, there is virtually no doctor who will recommend cannabis for cancer pain or for severe nausea or AIDS. The whole medical system of Corvallis said "No, you're locked out." So then I go down to the Compassion Center and all these people from the medical system that I'm employed in say, "My doctor won't do it, he's afraid he'll lose his license."
So we assist these people by trying to find a physical correlation to their psychiatric symptom. For example, if they're having PTSD symptoms they might be sick and have physical symptoms.
How high a percentage of these people were treating psychiatric symptoms? I put together a very simple survey to find out. I reviewed 172 charts. The average patient age was 43. All the patients were registered in OMMA; 95% were registered for pain. A very large percentage of Oregon registrants are pain patients.
Some 40% had multiple qualifying conditions (not including psychiatric) –physical pain and nausea, for example. Pain and with spasticity –they often go together.
The results: 64% of the patients in the survey showed some kind of significant psychiatric benefit; 39% reported insomnia relief; 5% reported PTSD symptom relief, many of them veterans who go to the VA hospital in Roseburg and are denied. The VA doctors tell them "No, I can't. I'll lose my DEA license." They just don't want to stand up to it –although they're beginning to refer patients to us, which is kind of interesting.
Anxiety, 11%; depressive symptoms, 11%; 15% of the cohort reported that they were using cannabis to decrease the side effects of medications; 56% reported reduced use of medications.
What these patients report to me is that they're sick and tired of Vioxx and they're sick and tired of Flexeril, Vicodin –people are literally sick of these drugs. They can't sleep, they can't function, they're drugged up, they don't have any enjoyment of life.
When they start using cannabis they leave off the Vioxx and they leave off the Vicodin. Vicodin has a place, but for long-term pain management it is really poor.
Appetite stimulation –tremendously important for people who are in pain all the time– was 20%.
I put the survey together as a request to the Oregon Department of Human Services to reconvene the Debilitating Conditions Advisory Panel, which I was a member of in 2000. At that time nine patients had submitted requests to include psychiatric conditions to the list.
The state health officer did a fairly good job of bringing together the panel, but the whole thing was skewed from the outset by political manipulation by the governor's office and by the head of the Department of Health Services. The information that they would allow us to consider had to be filtered through rules stating that if it's not a double-blind, peer-reviewed clinical trial, it doesn't get a lot of evidentiary weight.
We were not allowed to give much weight to patients' reports. And of course there was no relevant double-blind, peer-reviewed clinical trial. So the panel was set up to fail.
A few patients came in and gave very compelling testimonials. And then out of nowhere came a whole bunch of medical experts –psychiatrists from Oregon Health Sciences University and the National Alliance for the Mentally Ill– and they just had fits. "This is quackery," they said.
The only person who even differentiated between affective depressive-type disorders and schizophrenic thought disorders was one of the patients. None of the doctors even made any differentiation between these two completely different sets of medical problems.
After a long, protacted time we all wrote our comments out, and there was a vote, and we voted to add affective disorders –severe agitation and depressive symptoms. Didn't happen. They finally did add Alzheimer's agitation.
So, five years later I brought in the study I'd done with OMMP registrants and asked them to reconvene the Debilitating Conditions Panel based on this new evidence showing that indeed there is some psychiatric effect that people are getting from their cannabis use. And they rejected the request with a "summary denial."
Then Lee Berger, an attorney in Portland, asked if I'd be willing to sue the Department of Human Services' OMMP and I said yes. We filed our petition for judicial review in February –a formal request "to Add Clinical Depression, Depressive Symptoms, Post-Traumatic Stress Disorder (PTSD), Severe Anxiety, Agitation and Insomnia, to Those Diseases and Conditions Which Qualify as 'Debilitating Medical Conditions' under the Oregon Medical Marijuana Act." And it worked! I can't believe it!
We got word last week that, because the OMMP doesn't really want to go to court, they've decided to kind of sue for peace. All we're asking is that they reconvene a panel to evaluate these conditions. So, we're in the process of negotiatng with them to get this thing back on track.
We want to close some of the loopholes that allow them to skew the evidence base. It's pretty clear that there are a lot of patients who are using cannabis for insomnia, for mood stabilizing, and for peace. Just for a a very simple, elemental peace, especially with chronic diseases like severe chronic pain. Cannabis is actually a miracle drug for pain, in my opinion.
There's no question the last thing the pharmacy industry wants is millions and millions of Americans growing and using their own medicine that covers such a wide array of diseases.
By Ed Glick
