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Doctors debate caution vs. medical need for medical marijuana in Pennsylvania

| Wednesday, Feb. 25, 2015, 3:02 p.m.

To former Pennsylvania Medical Society president Bruce MacLeod, the oath physicians take to “do no harm” means proceeding with caution when it comes to legalizing medical marijuana in Pennsylvania.

“History will judge us harshly for the bad outcomes that may come if we rush too headlong into this,” Dr. MacLeod said at a Senate State Government Committee hearing Wednesday.

To Dr. Jack D'Angelo of Staten Island, the oath means helping a troubled patient with few options find a source of relief.

“We have an obligation as a healer to listen to that desperation and try to help them in a safe manner,” he said.

The Senate committee hearing on a revived proposal to legalize marijuana for medical purposes and establish a state-controlled regulatory structure revealed a spectrum of views among doctors and researchers.

As sponsors push for final passage, they're seeking to address concerns about who should have access, how to track the product as it exchanges hands, and what types of marijuana should be allowed.

Bill co-sponsor and committee chairman Sen. Mike Folmer, R-Lebanon County, said his goal is to allow “safe access to as many patients as possible” while continuing research efforts. Marijuana, he said, cannot cause a fatal overdose and has been used for millennia.

“We're just trying to do the right thing,” he said.

Dr. Steven Shapiro, who is on the board of the Pennsylvania Medical Society, said doctors should be certain cannabis-based medicines, such as those given to children with seizure disorders, aren't going to cause physical or neurological harm as children age. He urged lawmakers to wait until pharmaceutical trials are complete.

“I don't deny there may be medical benefits, but you just cannot walk in and say, ‘We're gonna do this, and it's gonna be fine,' ” Shapiro said. “All you have to do is stand in front of these parents one time and you lose a lot of that bravado.”

Jeffrey Raber, a chemist who runs a cannabis testing lab in California, said the best research can come from a broad law that allows doctors to specialize their treatments. Different strains and doses affect patients in individual ways, he said.

“I think it would be horrifying if it was very restrictive,” Raber said. “Lawmakers aren't doctors, and doctors aren't lawmakers.”

Recent years have seen an avalanche of state-based medical marijuana laws after doctors in Colorado began using cannabidiol, a non-pyschoactive element in marijuana, to treat some cases of epilepsy. Marijuana is illegal at the federal level, but 35 states allow some type for medical purposes, according to the National Organization for the Reform of Marijuana Laws.

This week Alaska became the third state to allow recreational use, after Washington and Colorado. Legalization is set to take effect in Washington, D.C., on Thursday, and Oregon's recreational use law kicks in later this year.

The proposal under consideration in Pennsylvania would allow marijuana to be used by patients with one of 10 conditions: cancer, epilepsy, amyotrophic lateral sclerosis (ALS, also known as Lou Gehrig's disease), cachexia or wasting syndrome, Parkinson's disease, brain injuries, multiple sclerosis, spinocerebellara ataxia (a genetic brain disorder), post-traumatic stress disorder or severe fibromyalgia. It excludes glaucoma and chronic pain, which are commonly included in other states' laws.

No patient would be allowed to smoke medical cannabis, or vaporize it. Growing, processing or selling marijuana without a license would be a criminal offense.

The Senate passed an identical proposal last year, though former Gov. Tom Corbett promised a veto if it made it to his desk. Gov. Tom Wolf has said he supports legalization for medical purposes.

Bill co-sponsor Sen. Daylin Leach, D-Montgomery County, said he hopes to amend the proposal to get rid of the specifications on conditions as conversations continue. He cited the tension between the time it takes to reach consensus, and the thousands of Pennsylvanian patients hoping to try an alternative treatment.

“Every day that goes by that they don't have access to it is really an injustice, in my view,” Leach said.

Melissa Daniels is a staff writer for Trib Total Media. She can be reached at 412-380-8511 or mdaniels@tribweb.com.

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