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How Pa. law compares to other states’ medical marijuana programs

Wesley Venteicher

Pennsylvania's new medical marijuana law lets patients use the drug to treat a broader set of conditions — including post-traumatic stress disorder and autism — than many other states with medical marijuana programs, while at the same time restricting the drug's use more tightly than some other states.

Gov. Tom Wolf signed legislation Sunday making Pennsylvania the 24th state, plus Washington, D.C., to legalize the drug for medical use. The law allows use of marijuana pills, oils, tinctures, liquids and other forms to treat 17 conditions but forbids smoking it, which only two other states with medical programs have done.

Advocates have praised the law's broad scope, while other groups are more cautious, noting the limited amount of high-quality evidence to support many of the approved uses.

“Pennsylvania has a pretty comprehensive conditions list,” said Becky Dansky, a legislative analyst with Medical Marijuana Project, a Washington, D.C.-based group that advocates for ending marijuana prohibition.

Pennsylvania is the first state to allow medical marijuana as a treatment for all types of autism, and only the 11th state to explicitly authorize the drug to treat PTSD, Dansky said. Like 17 other states, Pennsylvania allows patients to use marijuana to treat chronic pain, though the law says marijuana should be used when “conventional therapeutic intervention and opiate therapy is contraindicated or ineffective.”

The state joins five others that authorize medical marijuana for Parkinson's disease. Pennsylvania doesn't include Hepatitis C, which nine states include.

Regulations vary, with some states — such as Maryland, Massachusetts and California — giving doctors authority to recommend marijuana for unlisted conditions when doctors determine it would be beneficial or other treatments have proven ineffective. Pennsylvania does not provide that authority. The new state law does not allow recreational use, which is legal in Colorado, Washington and Oregon.

Delaware allows cannabis for people with autism who are prone to injure themselves or behave aggressively, Dansky said.

No clinical trials have evaluated cannabis as a treatment for PTSD or autism, said Marcel Bonn-Miller, an adjunct assistant professor at the University of Pennsylvania Perleman School of Medicine who studies the drug.

Bonn-Miller has launched what he said will be the first randomized controlled trial of cannabis as a PTSD treatment.

“The science just isn't there yet,” Bonn-Miller said. “It's a little scary; you don't want to have people that have bad reactions.”

Marijuana remains illegal under federal law. Partly because the government has restricted access to it, few high-quality medical studies have assessed its value for treating disease.

Studies have shown marijuana's value for treating chronic pain, multiple sclerosis and the nausea that results from cancer treatment, said Bonn-Miller. But the studies lack certainty because of the high variability of chemicals in marijuana plants, Bonn-Miller said. The drug contains about 120 types of chemical compounds known as cannabinoids, including the most common, Tetrahydrocannabinol, known as THC.

Along with its medical benefits, marijuana — particularly THC — has been shown to increase anxiety in some who smoke it, and in some people, the drug is addictive, he said.

The chronic pain findings are especially important in states battling opioid epidemics, Dansky said. While opioids can kill people, marijuana is not fatal, experts said. Dansky cited one study that showed opioid overdose deaths decreased by a quarter in the first year in states that legalized medical marijuana. While acknowledging the study's promise, Bonn-Miller noted it did not prove medical marijuana laws caused the decreased deaths.

Bonn-Miller praised Pennsylvania's law for allocating a portion of new taxes to medical marijuana research, which he said only Colorado and California have done so far. The law imposes a 5 percent tax on the sale of marijuana from growers to distributors but does not tax sales to patients.

More states could soon follow Pennsylvania's lead in legalizing medical marijuana, Dansky said. Louisiana's law, which is dysfunctional because of a technicality, could be fixed as early as June, she said. Ballot initiatives could appear in November in Ohio, Florida, Missouri, Arkansas and Nebraska, she said.

“Every state has its own problems and its own strengths,” Dansky said.

Wes Venteicher is a Tribune-Review staff writer. Reach him at 412-380-5676 or [email protected].


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