Huntington’s disease is among a select group of disorders for which eligible patients can be prescribed medical marijuana in New York State. A bill signed this week by N.Y. Gov. Andrew M. Cuomo, passed by both houses of the legislature in June with overwhelming bipartisan support, expands a 2014 state law establishing medical marijuana access by directing the state to set up a program to help critically ill patients obtain “emergency access” as soon as possible. The new law establishes a certification and registry process for physicians to administer the drug, and instructs the state to issue patient cards to those whose life-threatening illness qualifies them, making it clear that they are medical marijuana patients and affording them some protection from law enforcement and child protective services.
Patients must receive a certification from a licensed practitioner who must register with the Department of Health and be qualified to treat the serious condition for which the patient is seeking treatment. Diseases and conditions for which medical marijuana can be prescribed are cancer, HIV/AIDS, ALS (Lou Gehrig’s Disease), Parkinson’s, multiple sclerosis, damage to the nervous tissue of the spinal cord with objective neurological indication on intractable spasticity, epilepsy, inflammatory bowel disease, neuropathies, and Huntington’s, as well as other disorders that in the future may be authorized by the DOH commissioner.
Huntington’s disease (HD) an inherited neurodegenerative genetic defect on chromosome four affects muscle coordination and leads to cognitive decline and behavioral symptoms. In people afflicted with HD, a part of their DNA, known as a CAG repeat, will repeat anywhere from 36 to 120 times, instead of the normal repeat of between 10 and 28 times. Because there is currently no known cure for Huntington’s disease, medical treatment focuses on helping the patient to live as normal a life as possible.
According to MarijuanaDoctors.com, a website founded to be a resource and trusted gateway for patients searching for medical marijuana treatment in legal medical marijuana states, not only does the Huntington’s itself tend to produce a range of psychiatric conditions that include anxiety symptoms, but the simple knowledge that a person has an incurable disease can, understandably, cause stress and anxiety, and medical marijuana has been proven to reduce anxiety in numerous clinical studies.
While antidepressants, anti-anxiety and anti-seizure drugs are often prescribed to Huntington patients, MarijuanaDoctors.com notes that each of these drugs comes with a host of possible negative side effects, and aside from the potential for overdose, many carry a high risk of dependency and addiction. In addition, they may cause nausea, insomnia or gastro-intestinal problems. Worse yet, many of these drugs can actually cause, or contribute, to the worsening of depression or other psychiatric conditions.
MarijuanaDoctors.com maintains that medical marijuana, conversely, does not carry many of these negative effects, (for example, contrary to popular misconception, marijuana actually has relatively low physical addiction potential and no documented risk of mortality from overdose). Yet it may help to reduce tension and anxiety as well as nausea, restlessness or insomnia — the tension-reducing effects of medical marijuana being well known.
Clinical evidence for the efficacy of medical marijuana in treating Huntington’s disease includes numerus studies referred to by MarijuanaDoctors.com that show the possible beneficial use of medical marijuana for patients who suffer from tension or anxiety. Cannabidiol, or CMD, is a chemical component found in marijuana (and which, unlike the better -known cannabinoid Tetrahydrocannabinol (THC), does not cause a high) and is widely believed to be responsible for some of the drug’s beneficial effects.
MarijuanaDoctors.com cites a recent study investigating benefits of medical marijuana for patients suffering from Huntington’s disease that found study participants showed modest improvement of symptoms which increased with the amount of the drug they received. They report even more promising results obtained in an animal study in which a mutant strain of hamsters that exhibited the symptoms of dystonia, a sub-group of disorders that share similar characteristics to Huntington’s disease, were given a synthetic cannabinoid that activates the same cellular receptors as THC. In that study, when under the influence of the synthetic cannabinoid, the hamsters showed marked reduction of rapid jerky movements or slow, repetitive movements, indicating that medical marijuana may be of clinical benefit to persons battling Huntington’s.
Specifically, experimental data published in the Journal of Neuroscience Research in 2011 (“Neuroprotective effects of phytocannabinoid-based medicines in experimental models of Huntington’s disease,” Sagredo et al. 2011 Journal of Neuroscience Research 89: 1509-1518) reported that the combined administration of the plant cannabinoids THC and CBD provide neuroprotection in rat models of Huntington’s disease. The authors reported, “[O]ur data demonstrate that a [one to one] combination of THC and CBD-enriched botanical extracts protected striatal neurons against … toxicity.” By contrast, the administration of individual, selective synthetic cannabinoid agonists did not produce similarly favorable outcomes.
Investigators concluded, “In our opinion, these data provide sufficient preclinical evidence to justify a clinical evaluation of [one to one THC to CBD] cannabis-based medicine … as a neuroprotective agent capable of delaying disease progression in patients affected by HD, a disorder that is currently poorly managed in the clinic, prompting an urgent need for clinical trials with agents showing positive results in preclinical studies.”
The Open Source Cannabis Research website lists and links to more than 50 clinical studies dating from 1981 to present investigating marijuana as a treatment for Huntington’s disease.
New York’s medical marijuana program is projected to become fully operational in January 2016, although the Drug Policy Alliance (DPA) — a public advocacy organization supported by individuals who believe the ‘war on drugs’ is doing more harm than good, and promotes drug policies grounded in science, compassion, health and human rights — reports that some are expressing skepticism that program will come on line as scheduled, noting that the state has yet to launch a system for patients to register, and just unveiled the mandatory doctor training in mid-October.
In July 2014, Governor Cuomo signed a bill to establish a medical marijuana program for New York State, commenting at the time that the new law represented an important step toward bringing relief to patients living with extraordinary pain and illness.
In his remarks, Governor Cuomo observed: “[T]he legislation I am signing today strikes the right balance between our desire to give those suffering from serious diseases access to treatment, and our obligation to guard against threats to public health and safety. I applaud the lawmakers and advocates whose efforts over the past years were crucial in making medical marijuana a reality in New York State.”
Organizations seeking to manufacture or distribute medical marijuana must be registered with DOH and conform to a specific list of requirements. Registration will be valid for two years at a time, renewable, and subject to revocation. Registered organizations will be required to comply with strict security and record keeping requirements. The law allows for five registered organizations that can each operate up to four dispensaries statewide.
However, the DPA cites recent media reports suggesting that several planned medical marijuana dispensaries are experiencing difficulty finalizing sites, and that with only 20 dispensaries statewide for almost 20 million people across 54,000 square miles, failure of even one dispensary to open is problematic, especially for critically ill persons. Moreover, health insurers will not be required to provide coverage for medical marijuana.
Under the new regulatory regime, any form of medical marijuana not approved by the Department of Health is prohibited, and under no circumstances will smoking be allowed. The DOH will issue guidelines regulating the allowed dosage amounts, and patients will not be allowed to possess an amount in excess of a 30-day supply. The medical marijuana will be dispensed in a sealed and properly labeled package with a safety insert included, and the patient will be required to keep the medical marijuana in the packaging in which it was dispensed. All manufacturing and dispensing of medical marijuana by registered organizations will take place in New York and registered organizations will contract with an independent laboratory to test the drug.
The new law makes it a Class E felony for a practitioner to certify an individual as eligible to facilitate the possession of medical marijuana if he or she knows or reasonably should know the person who is asking for it has no need for it. The law also makes it a misdemeanor for recipients to sell or trade the medical marijuana, or retain beyond what is needed for treatment for their own use or the use of others.
“We’re heartened that Governor Cuomo did the right thing and signed this emergency bill,” says Julie Netherland, New York deputy state director at the Drug Policy Alliance in a release. “Patients in New York are suffering, and some patients lives are at risk every day they are forced to wait. There’s no real victory until critically ill patients get their medicine.”
The DPA is actively involved in the legislative process and seeks to roll back excesses of the drug war, block new harmful initiatives, and promote sensible drug policy reforms. As a result of the organization’s work they claim that hundreds of thousands of people have been diverted from incarceration to drug treatment programs, and hundreds of thousands of sick and dying patients can safely access medicine without being considered criminals. The DPA Honorary Board includes prominent figures from both the political left and the right renowned for leadership in the fields of business, law, medicine, media and politics, ranging from Sting, Russell Simmons, and Arianna Huffington, to a former U.S. secretary of state, secretary of defense, surgeon general, attorney general, and chairman of the Federal Reserve. A full list of DPA Board and Honorary Board members can be found at:
Drug Policy Alliance (DPA)
Office of New York State Governor Andrew M. Cuomo
Images Courtesy Office of New York State Governor Andrew M. Cuomo