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Pubdate: Sun, 25 Jun 2000
Source: Statesman Journal (OR)
Copyright: 2000 Statesman Journal
Contact: letters@statesmanjournal.com
Address: P.O. Box 13009, Salem, Oregon 97309-1015
Fax: (503) 399-6706
Feedback: http://news.statesmanjournal.com/letter_input.cfm
Website: Statesman Journal: Salem news, sports, entertainment. Serving Salem, Oregon.
Author: Alan Gustafson, Statesman Journal


State officials approve its use for an Alzheimer's disease condition.

State health officials ex-panded Oregon's medical marijuana law Wednesday, making tens of
thousands of residents afflicted with symptoms of Alzheimer's disease eligible to smoke
state-sanctioned marijuana.

The Oregon Health Division added a malady known as Agitation of Alzheimer's disease to the
list of qualifying conditions covered under the state's Medical Marijuana Act. The action took
effect immediately.

More than 60,000 Oregonians have Alzheimer's disease, including 6,850 in Marion and Polk
counties. The disease is marked by a gradual deterioration of a person's mental capacity and

Experts said 70 percent to 80 percent of Alz-heimer's patients develop symptoms of the
agitation syndrome, including verbal outbursts, pacing, restlessness, wandering and

Though a large number of Alzheimer's patients suddenly have become eligible for medical
marijuana, health officials and Alzheimer's experts don't expect many to seek it. They cited
varied reasons, ranging from anti-marijuana attitudes among elderly people to difficulties in
obtaining marijuana.

"We're thinking this is going to affect a very limited number of patients," said Dr. Grant
Higginson, state health officer.

"Remember," Higginson said, "this has to be something where a patient and their family, or
the place where they are living, recognize the need for medical marijuana, then get a
supportive physician (to authorize it). After that, it's a matter of finding the marijuana and a
place to smoke it. That's why I'm saying I think this is going to be a fairly limited number of

Even so, the state's action was significant. It represented the first expansion of the law since
it was passed by voters in 1998.

Measure 67 allowed legal marijuana use for Oregonians suffering from cancer, glaucoma.
HIV or AIDS, weakness and malnutrition caused by disease, severe pain, severe nausea,
seizures and persistent muscle spasms.

The measure also gave the Health Division the authority to allow patients suffering from other
maladies to smoke marijuana.

A recommendation to make Alzheimer's patients with agitation symptoms eligible for medical
marijuana came from a seven-member panel that included physicians, psychiatric nurses, a
medical marijuana patient and a patient advocate.

The advisory panel also favored adding anxiety and bipolar disorder, sometimes called
manic-depressive illness, to the list of covered conditions. The panel did not recommend
adding five of the eight conditions considered: schizophrenia, schizo-affective disorder, post
traumatic stress disorder, insomnia and adult attention deficit disorder.

Higginson said he made the decision to add Alzheimer's disease to the list, and exclude
anxiety and bipolar disorder, after weighing the panel's advice and consulting with state

Though little research has been done into marijuana's effects on Alzheimer's symptoms,
Higginson said he was persuaded by "at least one good study" indicating that marijuana seems
to reduce behavior problems associated with the disease.

Reaction mixed

Reaction was mixed to the state's decision to open the door to medical marijuana for many
Alzheimer's patients.

Shari Ridings, executive director of the Mid-Willamette Alzheimer's Association, cited
concern about the paucity of research into marijuana's affects on Alzheimer's patients and
side-effects from smoking marijuana.

"People who use marijuana often have more forgetfulness and memory loss, so you don't
want to make the symptoms worse," she said. "If someone called me right now and asked
me about it, I would advise them to refrain."

On the other hand, the calming, pain-relieving affects of marijuana could prove to be a
benefit, not only for agitated Alzheimer's' patients but also for their caregivers, said Katherine
Wild, a psychologist with the Oregon Aging and Alzheimer's Disease Center at the Oregon
Health Sciences University in Portland.

"We know from other studies that agitated behavior is a big caregiving headache," she said.
"It's one of the leading causes of nursing home placements or institutionalization. So if
caregivers can get a tool that might help them with behavior problems, maybe they'll go for
it. ... I think it's worth looking at. These people are not getting better, and they're not going
to get better on their own."

Amy Klare, a medical marijuana advocate who served on the advisory panel, said she was
pleased that some Alzheimer's patients would be able to use the law. But she was
disappointed that anxiety and bipolar disorders did not make the list.

"The law is working well and we must continue moving forward to a time when no patient in
this country who could benefit from the use of medical marijuana must fear prosecution or
arrest," she said.

"Denial of the other petitioned conditions doesn't mean that medical marijuana is without
benefit for patients with psychiatric disorders," Klare added. "It means the Oregon Health
Division found a need for more research before these specific conditions could be approved."

Anxiety disorder denied

Higginson said he excluded anxiety from the covered list of maladies because the designation
is too sweeping.

"It would open up the use of medical marijuana to a very large segment of the state's
population," he said. "Forty to 50 percent of the adult population in Oregon could be
classified as having anxiety at one time or another."

Still, Higginson said the Health Division will study the issue further by conducting a physician
survey and by looking into the possibility of supporting clinical trials.

As for denying bipolar disorder a place on the list, Higginson cited possible adverse affects.

"Marijuana has been shown to cause manic attacks in some cases," he said. "The possibility
of initiating such an attack in patients with bipolar disorder is an unacceptable risk, given the
potential consequences and the fact that there is not enough good research to show its benefit
in these cases."

State Rep. Kevin Mannix, R-Salem, applauded the limited expansion of medical marijuana

"I was nervous about this process, but I think the process has succeeded," he said. "It fits in
with the the concept of the original legislation passed by voters."

People whose doctors recommend marijuana have to register with the state Health Division
and get identification cards exempting them from anti-marijuana laws.

Kelly Paige, the state Health Division's Medical Marijuana Program manager said about 700
people have registered to use marijuana for medical purposes since the law took effect May 1,
1999. About 600 registered the first year and about 100 since the anniversary.

Paige said applicants have come from every Oregon county and from all the categories for
which marijuana use is allowed. Most seeking medical marijuana have complained about
chronic and severe pain, she said.

"The new applications are pouring in and people are renewing from last year," Paige said.
"At this point, I need to hire some part-time help because the workload has gotten heavier."
MAP posted-by: Don Beck