Patients must have one of these diagnoses:

A serious condition is defined as: “having one of the following severe debilitating or life-threatening conditions: AND one of these conditions: DIAGNOSES FOR THE FUTURE May additional medical conditions be added to the list of conditions eligible for medical marijuana? Yes, the Commissioner of Health may add other conditions to the list. In fact, the Commissioner recently made a determination to add chronic pain as a serious condition. Effective March 22, 2017, patients with "any severe debilitating pain that a practitioner determines degrades health and functional capability; where the patient has contraindications, has experienced intolerable side effects, or has experienced failure of one or more previously tried therapeutic options;" may qualify for medical marijuana, so long as "there is documented medical evidence of such pain having lasted three months or more beyond onset, or the practitioner reasonably anticipates such pain to last three months or more beyond onset." In addition, scientists and physicians at the Department of Health have analyzed more than 2 dozen scientific studies on Alzheimer's, muscular dystrophy, dystonia, post-traumatic stress disorder, and rheumatoid arthritis. They also sought input from medical professionals and associations. Despite these comprehensive reviews, there is not enough scientific evidence at this time to support the inclusion of these additional conditions to the Medical Marijuana Program. However, the Commissioner has not stopped his review, and will evaluate new scientific evidence as soon as it becomes available. If sufficient scientific evidence becomes available to support the determination that medical marijuana will provide relief to patients suffering from any additional conditions, including these five, the Commissioner will act quickly to add them to the list of covered conditions.

List of conditions covered and their response to medical marijuana:

By far the two most common symptoms experienced by cancer patients undergoing chemotherapy and radiation treatment are profound nausea and vomiting. The next most common difficulty for these patients is pain. These symptoms can lead to dramatic weight loss, fatigue, insomnia and for many patients, anxiety and depression. Patients with these symptoms have poor quality of life and are looking for some relief without adding more negative side effects.

There are a number of conventional medications available for the treatment of nausea and vomiting. There are problems with these medications, such as the inability to swallow the pill due to nausea or inability to keep down a pill down due to vomiting. Also, the high costs of these medications make using them difficult. And, for some patients, these medications just don’t work.

In the 1970s and 1980s, several states, including California, New York, New Mexico and Michigan to name a few, researched the use of natural cannabis to combat nausea and vomiting in cancer patients. In these studies, natural cannabis was found to be effective for both symptoms and was equal to or better than the conventional medications available at that time. In 1988, a study found that out of 56 cancer patients who did not get relief from standard anti-vomiting medications, 78% were symptom-free after use of cannabis. Currently there are a number of new medications that are very effective for nausea and vomiting but there are still some patients who do not respond to them or who cannot tolerate or afford them. For these patients, medical cannabis is a viable alternative.

Many studies have been done using Marinol (dronabinol), which is a synthetic THC pill that is approved by the FDA to treat nausea and vomiting from chemotherapy. Marinol is well known to be inferior to inhaled natural cannabis for a number of reasons. First, Marinol contains only THC; it lacks all of the other therapeutic natural medicines, called cannabinoids, which exist in the cannabis plant. There are about 70 cannabinoids and a number of them have been shown to bolster the effects of THC, meaning one gets a better response when taken together. Also Marinol has more psych activity than natural cannabis, making some patients feel too "high”. This is because the cannabinoids help balance out the high in the natural form but this balance is missing in the synthetic form. Another reason that Marinol is inferior is because it must be taken orally and this can be quite difficult if nausea and vomiting are present. Also, oral administration has a delayed onset and the question of how much actually is absorbed comes into question. Only 5-20% of Marinol is absorbed and because it is metabolized slowly, its therapeutic and psychoactive effects can be very unpredictable. When one inhales natural cannabis, the effects are felt almost immediately and the nausea stops quickly. One can easily regulate the dose and re-dose if needed. Lastly, Marinol is expensive – it costs about $200-$800 per month depending on the dose.

It appears from years of research that cannabis works well as a painkiller without the unwanted side effects of conventional painkillers. For those with severe pain in advanced cancer, cannabis works synergistically in combination with the opioid painkillers to decrease pain without the dangerous side effects of using higher doses of opioids that can cause more nausea, lessen appetite, and can potentially be lethal if too much is used. It is reported that 25% - 40% of cancer patients suffer with neuropathic pain, which is pain that comes from damaged nerves. This type of pain is notoriously resistant to treatment with conventional medications including opioids. There are numerous studies that show that cannabis is particularly effective for this type of pain, with minimal side effects.

Cannabis has also been found to have some anti-tumor effects. The first mention of the anti-tumor properties of cannabis were documented in 1975 when a study showed that three compounds found in the cannabis plant, including THC, retarded the growth of lung cancer cells. Since then, a number of studies have looked at the anti-cancer effects of the cannabinoids. One particular type of aggressive brain tumor, called a glioma, appears to stop growing and even regress in the presence of cannabinoids. This finding was reproduced in multiple studies in the lab and in animals. It has also been noted that THC selectively targeted malignant cells and ignored the healthy cells. In 2006, researchers did the first ever pilot study in humans looking at using THC to shrink recurrent brain tumors. It showed some decrease in tumor growth in some of the patients. In March of 2011, investigators at the British Columbia Children’s Hospital in Vancouver reported the regression (shrinking) of brain tumors in two teenagers who were regularly inhaling cannabis and were not receiving any other conventional treatment.

Additionally, there is active research looking into cannabidiol, a prominent cannabinoid in the natural plant, as a potential treatment for aggressive breast cancer. Researchers at California Pacific Medical Center Research Institute in San Francisco found that cannabidiol (CBD) inhibits a gene that is believed to be responsible for the metastatic process that spreads cells from the original cancer tumor throughout the body. Additionally, separate research studies have shown that the cannabinoids inhibit the growth and spread of various cancer cell lines including breast carcinoma, prostate carcinoma, colorectal carcinoma, gastric adenocarcinoma, skin carcinoma, leukemia cells, neuroblastoma, lung carcinoma and others.

The National Cancer Institute recently posted research on cannabinoids and cannabis on its website. This is progress as the National Cancer Institute is a federal agency and cannabis is still considered by the federal government to be a substance with no medicinal value. The fact that they are posting study results on their website is a sign that the research is sound and the results undeniable. They report, "The potential benefits of medicinal cannabis for people living with cancer include antiemetic effects, appetite stimulation, pain relief, and improved sleep. In the practice of integrative oncology, the health care provider may recommend medicinal cannabis not only for symptom management but also for its possible direct anti-tumor effect". The website also states: "Cannabinoids have a favorable drug safety profile. Unlike opioid receptors, cannabinoid receptors are not located in the brainstem areas controlling respiration; therefore, lethal overdoses due to respiratory suppression do not occur. Although cannabinoids are considered by some to be addictive drugs, their addictive potential is considerably lower than that of other prescribed agents or substances of abuse."

Of course, more research is needed, however, considering the safety profile of cannabis and the promising studies that already have shown remarkable results, most physicians agree that cannabis use by cancer patients is helpful and certainly improves quality of life.

If you or a loved one is suffering with the symptoms caused by cancer and its treatment, medical marijuana may be able to help improve quality of life. Medical marijuana can be taken by vaporizer, tinctures, and edibles so as to avoid smoking. Many patients find tremendous benefit with better sleep, better appetite, relief of anxiety and stress, elimination of nausea and vomiting and less pain.


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