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NC is close to legal medical marijuana, but its leaving an important group behind | Opinion

Charlotte Observer - 3/6/2023

If you live in Pennsylvania, you can use marijuana to treat anxiety disorders, autism, opioid use disorder and Tourette’s. Alabama’s medical marijuana program will cover depression and panic disorder once the medical cannabis industry there is ready to run. Mississippi’s covers Alzheimer’s and dementia. All of these states, along with Florida, cover all diagnoses of Post Traumatic Stress Disorder (PTSD).

None of these conditions, except for PTSD in certain cases, are in the bill that could potentially bring medical marijuana to North Carolina.

On Tuesday, the North Carolina Senate voted 36-10 to push forward with the Compassionate Care Act (a vote, funny enough, that occurred at 4:20 P.M., a number that is often associated with recreational marijuana use). The bill would legalize the use of medical marijuana for 15 conditions, ranging from HIV/AIDs and Crohn’s disease to various versions of end-of-life care.

It’s a significant and welcome expansion from the version of the bill presented last legislative session that would have only approved medicinal use for people who had only a few months to live. Unfortunately, mental illnesses were almost entirely left off the list, despite these conditions being some of the most popular reasons to use marijuana as medicine.

A study from the Journal of Internal Medicine found that of the seven percent of Americans who use marijuana medicinally, nearly half were treating anxiety and/or insomnia. Forty-two percent were using marijuana to treat chronic pain (a symptom that might be covered by the North Carolina bill, but not always), and thirty-nine percent were treating depression symptoms. While women were more likely to use marijuana for PTSD and anxiety, there weren’t notable discrepancies between races.

Other doctors aren’t sold on the benefits of marijuana for mental health patients. In 2019, the American Psychological Association released an official statement opposing marijuana and CBD, saying that there isn’t enough evidence to support their use to treat mental disorders — in fact, APA warned that there is a “strong association of cannabis use with the onset of psychiatric disorders.” The APA called on more research at the federal level to collect data on this.

Dawn Adams is a nurse practitioner, doctor of nursing and a delegate in Virginia’s General Assembly, which legalized medical marijuana in 2020. She’s also the founder of Integrated Health Counseling, LLC, which certifies patients for the commonwealth’s medical marijuana program. Adams says she would recommend North Carolina listen to doctors and practitioners instead of listening to the dispensaries who would profit from sales.

The best thing about Virginia’s medical marijuana law, Adams told me, is the power it gives physicians and patients to decide what works best as treatment. Virginia’s law does not include a list of conditions that qualify for medicinal use. It simply asks that patients who want to use marijuana as medicine, for any reason, talk with their doctor. This, of course, includes mental health provisions.

She noted that the reason so few studies have been performed on the impact of marijuana on mental health is its prohibition at the federal level. This is what makes some doctors, like those at the APA, hesitant to endorse marijuana use for mental health. “What we do have are years of clinical expertise that comes from having a patient base over several years,” Adams told me. “So while that’s anecdotal, from the sense of it doesn’t meet that threshold of true research study outcomes in an objective standpoint, I think we have lots of good information that proves the point.”

The North Carolina bill includes PTSD as a qualifying condition, but it’s the only mental health disorder included in the bill. It also stipulates that “evidence” of PTSD will be required, and that this evidence reduces the patient pool to veterans who were in an active combat zone, former first responders who handled violent crime cases, or the victims of violent crime, including sexual assault. Adams says that this is an instance of legislators assuming they know better than doctors.

“A true clinical diagnosis of PTSD is not dependent on being in a war,” Adams says, “it can be because of many, many variables.”

The bill’s primary sponsor, Republican Bill Rabon, did not respond to my call to ask about the bill excluding mental health. It’s possible, however, that after the bill passes, other conditions may be added to the law down the road. Excluding almost all mental conditions, however, punishes people whose suffering could genuinely benefit from medical marijuana, or who currently use marijuana as medicine illegally in the state. It’s good that medical marijuana is close to becoming legal, but North Carolina shouldn’t leave it’s vulnerable behind.

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