MEDICAL MARIJUANA EXPANDS

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 intellect.

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 combativeness.

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
people.”

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 officials.

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 eligibility.

“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.”