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Minnesota doctors’ views differ on medical pot

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ST. PAUL — There’s no one view among doctors about whether the state should legalize medical marijuana.

In one camp, there are physicians like Dr. Jacob Mirman, a primary care doctor in St. Louis Park who says a few patients have told him they use marijuana to cope with medical conditions.

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Mirman hasn’t personally recommended that patients use it, and doesn’t take a position on the specifics of a bill currently advancing at the Capitol. But he supports the idea of making medical marijuana legal — in part because the risks seem small compared to those with some prescription painkillers.

“It’s not fair to put (patients) in a position where they have to break the law to actually get relief from their condition,” Mirman said.

But physicians like Dr. Carrie Borchardt, president of the Minnesota Psychiatric Society, say they’re strongly against the idea. The experience in states that have legalized medical marijuana shows an increased risk of addiction, Borchardt said, plus use by patients with pain and anxiety complaints that can be faked.

“It appears that there is a lot of recreational use under the guise of medical marijuana,” she said.

As debate continues within the medical profession, the state’s leading lobbying group for physicians is quickly trying to develop a position on medical marijuana legislation that’s advancing at the Capitol.

A bill from Rep. Carly Melin, DFL-Hibbing, would allow patients with certain debilitating health conditions access to medical marijuana, as long as a doctor or designated health care professional certified that patients were likely to benefit.

With sponsors from both the Democratic-Farmer-Labor and Republican parties, the bill would make marijuana available to people with conditions such as cancer, glaucoma, AIDS and post-traumatic stress disorder. It also could be an option for people with conditions that result in severe pain, nausea or seizures.

The bill is scheduled for a hearing in a House committee Tuesday. It cleared its first legislative hurdle last week in the House’s health policy committee following emotional testimony from patients and their family members.

Angie Weaver, 32, of Hibbing, said her family wants to stay in Minnesota, but they’re considering moving elsewhere so Weaver’s 7-year-old daughter can obtain medical marijuana. The girl has a rare form of epilepsy that causes 20 to 30 seizures per day.

With a form of medical marijuana that’s available in other states, the girl might have a chance for controlling some seizures as well as recovering cognitive function, Weaver testified.

“It would be the best day of my life if I could hear my daughter say ‘mommy’ again,” Weaver testified.

Maria Botker, 38, of Clinton, said her husband has relocated from the family’s primary home to a house in Colorado, which is one of about 20 states where medical marijuana is legal. The second home lets the couple’s youngest daughter receive a liquid form of medical marijuana for a seizure disorder.

“I miss being a family,” testified Botker, who lives in Minnesota with the couple’s two older daughters.

During last week’s House hearing, Melin said use of medical marijuana for kids with seizure disorders wasn’t part of the medical marijuana debate in 2009 when Minnesota lawmakers passed a bill on the subject.

That bill ultimately was vetoed by former Gov. Tim Pawlenty.

DFL Gov. Mark Dayton has said supporters of the current legislation must work to craft a version that could be accepted by law enforcement officials.

Marijuana is a Schedule I controlled substance along with drugs like heroin and LSD, so doctors under the current bill wouldn’t write prescriptions for it. Instead, a doctor’s certification would allow a patient to obtain an ID card from the state health department, which would regulate a network of new marijuana dispensaries.

Patients could obtain up to 2.5 ounces of marijuana from a dispensary. Patients who live more than 15 miles from a dispensary could be allowed to grow up to six marijuana plants in their homes.

For some doctors, the medical marijuana issue is a difficult dilemma, said Dr. J. Michael Bostwick, a professor of psychiatry at the Mayo Clinic College of Medicine in Rochester. Physicians are frustrated that the debate is moving forward without better research to guide it, Bostwick said.

“The federal government has imposed draconian restrictions on medical marijuana without scientific data to support that,” Bostwick said during a Minnesota Medical Association forum last week in Eagan. “The states have caved to political expediency and have legalized medical marijuana — again, in the absence of scientific data.”

Bostwick stressed in an interview that he’s neutral on the question of whether Minnesota or any state should legalize medical marijuana. He was invited to address physicians last week because he published a 2012 medical journal article on the history and science of medical marijuana, so that doctors can evaluate whether it is “panacea, scourge, or both,” Bostwick wrote.

Marijuana has a long history of being used as a medicine, he wrote, and was prescribed by U.S. physicians from the mid-19th century to the 1930s. That’s when the government started imposing restrictions, leading up to congressional action in 1970 to classify marijuana as “illegal, and without medical value,” Bostwick wrote.

Since then, scientists have learned about how marijuana works in the body, and two legal medications have been developed to mimic some effects. Used to treat cancer pain and nausea, the pills haven’t been popular, Bostwick said, perhaps because it takes too long for patients to feel their effects.

Another drug under development, he said, would come as liquid spray to help with cancer pain and spasticity in patients with multiple sclerosis.

The designation of marijuana as a Schedule I controlled substance has made it difficult for doctors in the United States to do research on the possible utility of medical marijuana, said Dr. Scott Schwantes with Gillette Children’s Specialty Healthcare in St. Paul.

Schwantes said he and Gillette Children’s are neutral on the question of whether Minnesota should pass a medical marijuana law. As for research, he said: “We should be looking at this. And yet, we are unable to fully embrace this as an area of research.”

The prospect of legalized medical marijuana worries many doctors because they don’t know the true risks and benefits, nor do they understand the strength of what patients might be taking, said Dr. Dave Thorson, chairman of the board at the Minnesota Medical Association.

During last week’s forum in Eagan, several doctors said they felt the proposed legislation in Minnesota is too broad, Thorson said. Physicians might prefer a bill that makes medical marijuana available only for patients who are receiving end-of-life or palliative care, he said.

Still, doctors worry about the public safety and public health implications.

Marijuana doesn’t quickly clear from a patient’s blood stream, Thorson said, so there aren’t tests that can show whether someone was under the influence of marijuana at the time of a traffic stop or a workplace accident. Plus, doctors say that smoked marijuana harms the lungs.

Set against all this, physicians recognize the emotional power of stories being told by patients who support legalization, Thorson said. Stories being told by parents of children with seizure disorders and are desperate for medical marijuana help crystallize the dilemma for physicians.

“How do we tell someone with a story like that that they shouldn’t use it?” he asked, referring to testimony at the Capitol last week. “At the same time, we realize the pediatric brain is one of the most susceptible to the side effects from marijuana. It’s just very difficult for us.

“It grips your heart. It’s very powerful, emotional testimony,” Thorson said. “But we are trying to be scientists about it.”

The Pioneer Press is a media partner with Forum News Service.

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