Neighboring States Differ on Marijuana for PTSD

March 24, 2010 – DENVER — A decade ago, Colorado became one of the earliest states to legalize medical marijuana. Its neighbor New Mexico did so more recently. But that does not mean the two Western states agree on all the medicinal merits of cannabis.

Both states allow marijuana to be used to treat the symptoms of a variety of diseases, like AIDS and cancer. When it comes to treating post-traumatic stress disorder, however, New Mexico says yes to medical marijuana, while Colorado’s answer is a resounding no.

Those differences were highlighted this week in the Colorado legislature, when a State House committee on Monday narrowly defeated a proposal that would have directed the Department of Public Health and Environment to consider whether marijuana should be used to help people with post-traumatic stress disorder.

Dr. Ned Calonge, the chief medical officer for the health department, which was against the proposal, said psychiatry departments at the Veterans Affairs hospital in Denver and the University of Colorado School of Medicine in Denver agreed that marijuana should not be recommended for treating the disorder.

“There is no evidence of efficacy of marijuana for treatment of PTSD in the medical literature,” Dr. Calonge said Tuesday in an interview. “In fact, the published literature suggests that such use leads to addiction and abuse of other substances.”

At the same time, he said, some clinical evidence supports the drug’s effectiveness in treating those conditions for which medical marijuana is already approved in Colorado. “I think we’ve set the bar pretty low,” he added.

But supporters of the Colorado proposal cited New Mexico as an example to follow. In that state, the Health Department came to a drastically different conclusion. In January 2009, a medical advisory committee recommended that post-traumatic stress disorder was an eligible condition for medical marijuana treatment.

In its report, the committee acknowledged that were no specific clinical trial data regarding the use of marijuana in treating the disorder. But the committee noted that when smoked, marijuana could help relieve anxiety associated with post-traumatic stress disorder, and cited a number of psychiatric and pharmacological studies.

The secretary of the New Mexico Department of Health, Dr. Alfredo Vigil, signed off on the recommendation a month later.

“There are hints and some indications in the medical literature that there are components of cannabis that might be helpful to some people with PTSD,” Dr. Vigil said Tuesday in an interview, adding, “All of these states are going out on a limb, trying to determine from a medical, clinical point of view, what seems reasonable.”

Currently, more than a quarter of the 1,376 patients approved for medical marijuana in New Mexico have PTSD, more than any other condition including cancer, according to the Health Department. It is unclear how many are veterans.

To qualify, a patient needs a referral from a primary care doctor or a psychiatrist along with documents from the psychiatrist certifying that the patient has the disorder.

The debate over PTSD came as Colorado’s legislature grapples with how to regulate the dispensation of medical marijuana throughout the state. Since the federal Justice Department announced in the fall that it would not prosecute people who use marijuana for medical purposes in states where it is legal, shops have sprung up all over Denver selling medical marijuana, ostensibly to only those who have a doctor’s prescription.

“If there is any legitimate use for any medicine to treat PTSD, we have an obligation to consider it,” said State Representative Sal Pace, a Democrat from Pueblo, who introduced Colorado’s proposal.

Steve Fox, director of state campaigns for the Marijuana Policy Project, which advocates for the legal regulation of the drug, said he was disappointed in the Colorado vote, particularly given New Mexico’s policy. He noted that many antidepressants prescribed to veterans with PTSD have a range of potentially serious side affects, whereas medical marijuana is comparatively benign.

Mr. Pace said he hoped that the Health Department or the legislature would reconsider using marijuana to treat PTSD symptoms.

“I’m not a doctor. I’m not a psychiatrist. I can’t judge myself whether this is legitimate medicine,” Mr. Pace said. “But if we can’t even open the door to that discussion, then we are potentially prohibiting medicine to a needy class of citizens.” By DAN FROSCH Source.

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