Jacob Redmond
Well-Known Member
When Missouri agreed to allow the use of hemp extract to treat severe forms of epilepsy, Marc DeSantis was hopeful his 8-year-old son, Lucas, would benefit.
Lucas has various brain malformations and, at times, has had more than 200 seizures in a day. Having tried more than a dozen other medications to little avail, Marc DeSantis began to look to hemp oil.
"We were super-excited and were probably the first people to go out and print the state registration form," he said.
But that excitement would soon turn to frustration. Under Missouri's law, hemp oil can be obtained only with the approval of a neurologist who must certify that more standard forms of treatment were ineffective at treating seizures.
Both of the neurologists that Lucas sees have refused to authorize the treatment.
"They have been discouraging about the whole thing and really aren't open, it seems, to experimenting with it," Marc DeSantis said.
One of Lucas' doctors practices at Washington University Physicians, which partners with BJC HealthCare. The neurologist declined to be interviewed and referred a reporter to a Washington University School of Medicine spokeswoman.
In an emailed statement, the spokeswoman, Joni Westerhouse, said: "There is little evidence demonstrating hemp oil's effectiveness in reducing frequency or intensity of seizures in children with treatment-resistant epilepsy."
Lucas' other neurologist, who works at Mercy Health, also declined to be interviewed. But the head of child neurology at Mercy Health agreed to speak about hemp oil.
Dr. John Mantovani said legal and safety issues loom over Missouri's process for obtaining the oil, creating a conflict between doctors and their patients.
"My understanding of it today is that I'm not comfortable recommending or prescribing the therapy," he said. He added that "individuals and families are desperate for things to happen quickly, and that has created some tension."
The treatment is controversial. It's not FDA-approved and contains cannabidiol, or CBD, a chemical present in most cannabis, or marijuana, plants. Clinical trials have yet to be performed to evaluate hemp oil's use as a medical product.
But the anecdotal evidence from those who use the treatment has given hope to others around the country.
Darla Templeton, executive director of the Epilepsy Foundation of Missouri and Kansas, said there seems to be a growing body of evidence that hemp oil can help reduce seizures in conjunction with regular medication.
"Each person is different, and it's not an end-all, be-all," she said. "It's an add-on to see if it helps. There's no downside here."
Missouri Joins The Fray
As reports surfaced that some Missouri parents were moving to Colorado so they could use hemp oil to treat epilepsy, state lawmakers moved last year to legalize the treatment.
More than 20 states have approved some form of marijuana, or cannabis, use as medicine. But Colorado has become the focal point, especially for children with severe epilepsy. Fueled by publicity, more-tolerant attitudes toward marijuana and a more-relaxed regulatory environment, families across the country turned toward Colorado to access hemp oil for their kids.
One of those who packed up their lives and set out for Colorado was the Jessee family . They were friends to top Missouri Republicans.
When Missouri lawmakers looked to follow suit on hemp oil, they followed Colorado's model closely, though with more restrictions.
Missouri's Republican-led Legislature made quick work of the hemp oil proposal and it garnered overwhelmingly bipartisan support. It earned Democratic Gov. Jay Nixon's approval last summer.
The law allows licensed nonprofit groups, selected by the state Agriculture Department, to grow and process hemp to be sold as oil for treatment. The oils must be high in CBD, but low in tetrahydrocannabinol, or THC, the chemical that causes the intoxication experienced from marijuana use.
To obtain the oil, parents (on behalf of their children with severe epilepsy) or adults with the condition must submit an application to the state health department.
Part of that application requires certification from the patient's neurologist that clears the way for hemp oil use. The certification requires the neurologist to attest that at least three other epilepsy treatments were unsuccessful and that the patient could benefit from the oil.
If approved, the patient is issued an identification card that is used to pick up and purchase a batch of the oil, which can cost around $300 in some states.
But few Missouri neurologists have been willing to certify the use of hemp oil for their patients. The state health department says only seven patient applications have been approved. Templeton, of the Epilepsy Foundation, estimates there are 18,000 Missourians with the kind of epilepsy that could qualify for hemp oil treatment.
Supporters of the hemp oil law say the slow start could be caused by a lack of familiarity with the program. The oil hasn't yet been sold in Missouri and won't be available until this fall.
But some of the blame for the slow start has fallen on the medical community.
One of the sponsors of Missouri's law singled out BJC HealthCare, the St. Louis region's largest medical system, for having reservations about the hemp oil treatment.
"I feel like BJC and their lawyers have created an undue burden on parents on seeking this option in the state of Missouri," said Sen. Eric Schmitt, R-Glendale. Schmitt's son has epilepsy.
In a statement to the Post-Dispatch, BJC HealthCare said Missouri's hemp oil law had complex implications that medical providers are in the process of trying to understand.
"Despite anecdotal statements that hemp oil may benefit some individuals with intractable epilepsy, to date there is no medically based evidence to support those statements," it said in a written statement.
BJC HealthCare partners with Washington University Physicians, the workplace of one of the neurologists who declined to sign Lucas DeSantis' application.
Working Out The Kinks
Dr. Mantovani, of Mercy Health, said one of the complex implications of Missouri's law has to do with how doctors are licensed by the federal Drug Enforcement Agency.
Cannabis is classified by the DEA as a "Schedule I" drug, meaning it "has no currently accepted medical use in the United States, a lack of accepted safety for use under medical supervision, and a high potential for abuse."
Doctors are licensed by the DEA and, Mantovani says, approval of a hemp oil treatment could run afoul of the federal government.
"Legal conflict has been a real concern," he said. "I think that's huge."
Removing marijuana as a Schedule I drug could pave the way for more research into using it as medicine. The American Academy of Pediatrics endorsed such a move this year.
Despite the concerns, some neurologists are starting to come to grips with approving hemp oil use in Missouri.
Some neurologists at Cardinal Glennon Children's Medical Center said they would sign the application forms, but for a limited number of patients.
Dr. Sean Goretzke, a SLUCare pediatric neurologist who works at the hospital, said they were going to limit authorizations to "the kids that have incredibly delayed development and intractable epilepsy."
Goretzke said he has the same worries about the treatment as other doctors in the field. But he added that he's willing to support the program for the patients he thinks have a chance of benefiting.
SSM will be monitoring patients who use the oil once it becomes available from the state-approved growers some time this fall. But Goretzke said the state should consider funding and conducting a clinical study on the effectiveness and safety of the treatment. He also said the state should provide additional oversight of the program.
The continued reservation among some neurologists could also put the state's licensed growers in a bind. One of the two growers is Chesterfield-based Noah's Arc Foundation of Missouri.
Dr. Jason Strotheide, president of the foundation, said his center has received complaints from people around the state having trouble getting a neurologist to approve hemp oil use. That has thrown a wrench into production plans.
"Since we don't know how many people are going to have cards, we don't want to overproduce oil," he said. "We don't want things sitting and expiring on the shelf."
Supporters of the program say they expect it to be more popular as doctors become more comfortable with the treatment and patients have used it with more frequency.
But Schmitt, the state senator, said he is frustrated by the concerns of neurologists and the medical systems that won't approve the treatment. He pointed out that the concerns were not raised when the Legislature was considering the bill last year.
And though he applauded SSM for supporting the program, he said patients should be able to get authorization from their own neurologist and not have to doctor-shop to access the oil.
"What I didn't want to have happen is this niche market," he said.
But the niche market may be the only hope now for Lucas and other Missouri children. Marc DeSantis said he's in the process of making appointments with the neurologists at SSM so that Lucas can use the oil when it's available in the fall.
News Moderator: Jacob Redmond 420 MAGAZINE ®
Full Article: Missouri hemp oil program slow to take off : Business
Author: Jordan Shapiro
Contact: jshapiro@post-dispatch.com
Photo Credit: AP Photo/Carla K. Johnson
Website: St. Louis Sports, News, Jobs, Classifieds, Entertainment & Weather
Lucas has various brain malformations and, at times, has had more than 200 seizures in a day. Having tried more than a dozen other medications to little avail, Marc DeSantis began to look to hemp oil.
"We were super-excited and were probably the first people to go out and print the state registration form," he said.
But that excitement would soon turn to frustration. Under Missouri's law, hemp oil can be obtained only with the approval of a neurologist who must certify that more standard forms of treatment were ineffective at treating seizures.
Both of the neurologists that Lucas sees have refused to authorize the treatment.
"They have been discouraging about the whole thing and really aren't open, it seems, to experimenting with it," Marc DeSantis said.
One of Lucas' doctors practices at Washington University Physicians, which partners with BJC HealthCare. The neurologist declined to be interviewed and referred a reporter to a Washington University School of Medicine spokeswoman.
In an emailed statement, the spokeswoman, Joni Westerhouse, said: "There is little evidence demonstrating hemp oil's effectiveness in reducing frequency or intensity of seizures in children with treatment-resistant epilepsy."
Lucas' other neurologist, who works at Mercy Health, also declined to be interviewed. But the head of child neurology at Mercy Health agreed to speak about hemp oil.
Dr. John Mantovani said legal and safety issues loom over Missouri's process for obtaining the oil, creating a conflict between doctors and their patients.
"My understanding of it today is that I'm not comfortable recommending or prescribing the therapy," he said. He added that "individuals and families are desperate for things to happen quickly, and that has created some tension."
The treatment is controversial. It's not FDA-approved and contains cannabidiol, or CBD, a chemical present in most cannabis, or marijuana, plants. Clinical trials have yet to be performed to evaluate hemp oil's use as a medical product.
But the anecdotal evidence from those who use the treatment has given hope to others around the country.
Darla Templeton, executive director of the Epilepsy Foundation of Missouri and Kansas, said there seems to be a growing body of evidence that hemp oil can help reduce seizures in conjunction with regular medication.
"Each person is different, and it's not an end-all, be-all," she said. "It's an add-on to see if it helps. There's no downside here."
Missouri Joins The Fray
As reports surfaced that some Missouri parents were moving to Colorado so they could use hemp oil to treat epilepsy, state lawmakers moved last year to legalize the treatment.
More than 20 states have approved some form of marijuana, or cannabis, use as medicine. But Colorado has become the focal point, especially for children with severe epilepsy. Fueled by publicity, more-tolerant attitudes toward marijuana and a more-relaxed regulatory environment, families across the country turned toward Colorado to access hemp oil for their kids.
One of those who packed up their lives and set out for Colorado was the Jessee family . They were friends to top Missouri Republicans.
When Missouri lawmakers looked to follow suit on hemp oil, they followed Colorado's model closely, though with more restrictions.
Missouri's Republican-led Legislature made quick work of the hemp oil proposal and it garnered overwhelmingly bipartisan support. It earned Democratic Gov. Jay Nixon's approval last summer.
The law allows licensed nonprofit groups, selected by the state Agriculture Department, to grow and process hemp to be sold as oil for treatment. The oils must be high in CBD, but low in tetrahydrocannabinol, or THC, the chemical that causes the intoxication experienced from marijuana use.
To obtain the oil, parents (on behalf of their children with severe epilepsy) or adults with the condition must submit an application to the state health department.
Part of that application requires certification from the patient's neurologist that clears the way for hemp oil use. The certification requires the neurologist to attest that at least three other epilepsy treatments were unsuccessful and that the patient could benefit from the oil.
If approved, the patient is issued an identification card that is used to pick up and purchase a batch of the oil, which can cost around $300 in some states.
But few Missouri neurologists have been willing to certify the use of hemp oil for their patients. The state health department says only seven patient applications have been approved. Templeton, of the Epilepsy Foundation, estimates there are 18,000 Missourians with the kind of epilepsy that could qualify for hemp oil treatment.
Supporters of the hemp oil law say the slow start could be caused by a lack of familiarity with the program. The oil hasn't yet been sold in Missouri and won't be available until this fall.
But some of the blame for the slow start has fallen on the medical community.
One of the sponsors of Missouri's law singled out BJC HealthCare, the St. Louis region's largest medical system, for having reservations about the hemp oil treatment.
"I feel like BJC and their lawyers have created an undue burden on parents on seeking this option in the state of Missouri," said Sen. Eric Schmitt, R-Glendale. Schmitt's son has epilepsy.
In a statement to the Post-Dispatch, BJC HealthCare said Missouri's hemp oil law had complex implications that medical providers are in the process of trying to understand.
"Despite anecdotal statements that hemp oil may benefit some individuals with intractable epilepsy, to date there is no medically based evidence to support those statements," it said in a written statement.
BJC HealthCare partners with Washington University Physicians, the workplace of one of the neurologists who declined to sign Lucas DeSantis' application.
Working Out The Kinks
Dr. Mantovani, of Mercy Health, said one of the complex implications of Missouri's law has to do with how doctors are licensed by the federal Drug Enforcement Agency.
Cannabis is classified by the DEA as a "Schedule I" drug, meaning it "has no currently accepted medical use in the United States, a lack of accepted safety for use under medical supervision, and a high potential for abuse."
Doctors are licensed by the DEA and, Mantovani says, approval of a hemp oil treatment could run afoul of the federal government.
"Legal conflict has been a real concern," he said. "I think that's huge."
Removing marijuana as a Schedule I drug could pave the way for more research into using it as medicine. The American Academy of Pediatrics endorsed such a move this year.
Despite the concerns, some neurologists are starting to come to grips with approving hemp oil use in Missouri.
Some neurologists at Cardinal Glennon Children's Medical Center said they would sign the application forms, but for a limited number of patients.
Dr. Sean Goretzke, a SLUCare pediatric neurologist who works at the hospital, said they were going to limit authorizations to "the kids that have incredibly delayed development and intractable epilepsy."
Goretzke said he has the same worries about the treatment as other doctors in the field. But he added that he's willing to support the program for the patients he thinks have a chance of benefiting.
SSM will be monitoring patients who use the oil once it becomes available from the state-approved growers some time this fall. But Goretzke said the state should consider funding and conducting a clinical study on the effectiveness and safety of the treatment. He also said the state should provide additional oversight of the program.
The continued reservation among some neurologists could also put the state's licensed growers in a bind. One of the two growers is Chesterfield-based Noah's Arc Foundation of Missouri.
Dr. Jason Strotheide, president of the foundation, said his center has received complaints from people around the state having trouble getting a neurologist to approve hemp oil use. That has thrown a wrench into production plans.
"Since we don't know how many people are going to have cards, we don't want to overproduce oil," he said. "We don't want things sitting and expiring on the shelf."
Supporters of the program say they expect it to be more popular as doctors become more comfortable with the treatment and patients have used it with more frequency.
But Schmitt, the state senator, said he is frustrated by the concerns of neurologists and the medical systems that won't approve the treatment. He pointed out that the concerns were not raised when the Legislature was considering the bill last year.
And though he applauded SSM for supporting the program, he said patients should be able to get authorization from their own neurologist and not have to doctor-shop to access the oil.
"What I didn't want to have happen is this niche market," he said.
But the niche market may be the only hope now for Lucas and other Missouri children. Marc DeSantis said he's in the process of making appointments with the neurologists at SSM so that Lucas can use the oil when it's available in the fall.
News Moderator: Jacob Redmond 420 MAGAZINE ®
Full Article: Missouri hemp oil program slow to take off : Business
Author: Jordan Shapiro
Contact: jshapiro@post-dispatch.com
Photo Credit: AP Photo/Carla K. Johnson
Website: St. Louis Sports, News, Jobs, Classifieds, Entertainment & Weather
