Gaining access to marijuana for overwhelming and painful symptoms of serious afflictions can make a difference for that person’s quality of life and well-being while they fight to get better. Twenty-nine states, the District of Columbia, Guam and Puerto Rico currently allow for public medical marijuana and cannabis programs. Connecticut is one of the states that offers its citizens the option of medical marijuana for certain conditions. For those interested to explore this option, there are many “who, what, how and where” questions to research.
Whether it is utilizing medical marijuana, more readily available CBD oils or whole-plant hemp extracts, an important emotional and mental aspect is best summed up by physician David Casarett in his “A doctor’s case for medical marijuana” TedMed 2016 video: “A lot of the patients I talked with who’ve turned to medical marijuana for help, weren’t turning to medical marijuana because of its benefits or the balance of risks and benefits, or because they thought it was a wonder drug, but because it gave them control over their illness. It let them manage their health in a way that was productive and efficient and effective and comfortable for them.” Relief and a semblance of control is what most patients are seeking.
Tetrahydrocannabinol (THC) is one of over 85 chemical compounds, or cannabinoids, found in the female cannabis flower, and the only one with psychoactive effects. Cannabidiol, or CBD, is another cannabinoid component that is non-psychoactive. The U.S. Department of Agriculture’s 2014 Farm Bill defined cannabis containing less than 0.3 percent THC as “industrial hemp” while cannabis with a THC of more than 0.3 percent was deemed “marijuana”. While a medical marijuana card from Connecticut’s Medical Marijuana Program (MMP) is needed in order to order products with more than 0.3 percent THC, CBD products are more readily available and can be purchased over the counter at some health food stores in the area.
Connecticut’s Medical Marijuana Program
Connecticut’s MMP was first established and signed into law in 2012. It was designed to enable truly sick patients to engage in the palliative use of marijuana while preventing marijuana from being misused or diverted from its medical purpose. The law and program provide immunity from state criminal and civil penalties for physicians, patients, caregivers, dispensaries and producers who act responsibly in accordance with the law. The most current statistics from the program show there are 17,964 registered medical marijuana patients in the state, with 3,673 in Fairfield County, 4,215 in New Haven County, 1,097 in Middlesex County and 1,107 in Litchfield County. There are currently nine dispensary facilities and four medical marijuana producers in Connecticut. Local dispensaries include Compassionate Care Center in Bethel, Bluepoint Wellness of Connecticut in Branford, and Arrow Alternative Care #2, Inc. and Southern CT Wellness & Healing, LLC, both in Milford. As of May 11, 2017, there are 682 registered physicians in the MMP, which means these physicians can legally prescribe MM for specific indications.
The medical conditions currently approved by Connecticut for adults include cancer, glaucoma, positive status for HIV or AIDS, Parkinson’s disease, multiple sclerosis, damage to the nervous tissue of the spinal cord with objective neurological indication of intractable spasticity, epilepsy, cachexia, wasting syndrome, Crohn’s disease, post-traumatic stress disorder (PTSD), sickle cell disease, post laminectomy syndrome with chronic radiculopathy, severe psoriasis and psoriatic arthritis, amyotrophic lateral sclerosis, ulcerative colitis, complex regional pain syndrome, cerebral palsy, cystic fibrosis, irreversible spinal cord injury with objective neurological indication of intractable spasticity, terminal illness requiring end-of-life care and uncontrolled intractable seizure disorder.
For patients less than 18 years of age, the covered debilitating medical conditions include cerebral palsy, cystic fibrosis, irreversible spinal cord injury with objective neurological indication of intractable spasticity, severe epilepsy, terminal illness requiring end-of-life care and uncontrolled intractable seizure disorder.
While the list of conditions is fixed, it has expanded since the MMP first began and the Department of Consumer Protection does consider petitions to add debilitating conditions, treatments or diseases to the current list of 22 conditions for adults and six conditions for youth patients allowed by law.
Medical Cannabis: Part of the Program
Despite the widespread perception of marijuana needing to be inhaled by the patient for them to reap benefits, there are actually a number of ways to use medical cannabis. Dispensaries such as Southern CT Wellness & Healing offer products other forms, including flowers, vape oils, concentrates, edibles, capsules/tablets, oral syringes and sprays, oral strips, tinctures and topicals.
For those with qualifying conditions, the process is streamlined. Only a physician can begin the MMP application process as they need to certify for the state that the patient has a medical condition that qualifies for a medical marijuana registration certificate. Similar to getting a passport, proof of identity, proof of Connecticut residency, a passport-size photograph and a $100 registration fee are required elements. For those that need a primary caregiver to fill the medical marijuana prescription, that person must register as a qualified caregiver before the department will issue the patient a registration certificate.
The patient then turns to the approved medical marijuana dispensary to begin the prescription process. “When a patient is diagnosed with one of the conditions, we need to know which symptoms they need help with. With PTSD, for instance, we would investigate whether they have anxiety during the day, night terrors or other specific symptoms. Based on the need, we would adjust what THC:CBD ratio was needed and what type of delivery system was best for that patient,” explains Deepa Desai, PharmD, one of four pharmacists who own Southern CT Wellness & Healing.
Dosing depends on the patient’s symptoms, their history, the side effects of their current medications, and the patient’s familiarity with using marijuana and how it affects their body, says Desai. As an example, she explains, they may start with a lower dose for patients that have not tried cannabis before in order to gauge how they react.
Crohn’s disease is another example. Medical marijuana has the potential to alleviate nausea, vomiting and headache symptoms in order to help the patient eat more food. Since there usually are issues with ingestion, delivery might be suggested via syringes under the tongue, tinctures or dissolvable strips.
Cannabinoid Products: Outside the MMP
What happens if someone does not have one of the conditions currently approved for medical marijuana prescriptions but would like to try medical marijuana to relieve pain from arthritis or another condition? Companies with CBD products operate outside of the state medical marijuana program so a medical marijuana card is not needed to obtain products. It is important to note that CBD-labeled dietary supplements with the single CBD cannabinoid can currently only be legally sold in states with medical marijuana laws. However, a whole-plant, hemp extract CBD product that contains all cannabinoids—such as the Stanley Brothers’ proprietary Charlotte’s Web grown in Colorado—can be sold in all 50 states.
“We have been filling in the gaps with people who are not interested in the psychoactive high and also those who cannot qualify for a medical card but still need and are seeking relief,” says Lisa Macre of Orange-based MedTech Healthcare Solutions. The company was created by owner Thomas Macre to offer clients a variety of hemp oils, gel pens and supplements made from the proprietary Charlotte’s Web whole-plant hemp extract. “The reason we are legal across the U.S. is because we can guarantee that there is 0.3 percent THC or less in our products; they are grown, manufactured and bottled in one plant,” explains Allison Ondy, MedTech’s director of operations. “Growers can have similar strains but the percentage of THC can vary.”
Ondy mentions that their accounts with naturopaths, integrated health offices and apothecaries continue to grow as the products can also be used as a supplement for general well-being. “We are even working with a neurologist in Manhattan since the product is a great neuro-protectant,” Lisa Macre adds. In regard to child dosing, Ondy says, they refer clients to the Realm of Caring nonprofit, which focuses on dosing and recommended variations, especially for children.
“I have been in pain for over 20 years due to fibromyalgia, arthritis and spinal stenosis. I’ve tried everything to alleviate my symptoms, including pain meds, shots, acupuncture, trigger point injections, patches. Nothing works as well as this oil. After one month of use, my pain is 80 percent improved. My ‘brain fog’ has been replaced with clarity and focus. I am less anxious and experience a sense of well-being without the ‘high’ that THC causes,” says Louise Barillaro of her experience with the Charlotte’s Web oil.
State Researching Expansion of MMP
The door was opened for research into prospective new uses for medical marijuana in our state during Connecticut’s 2016 legislative session. Department of Public Health-licensed medical facilities, higher education institutions and medical marijuana dispensary facilities and producers licensed in Connecticut were given the greenlight at that time to start applying for research program licenses.
The first Connecticut medical marijuana research program was approved in December 2016. The Connecticut Department of Consumer Protection gave the go-ahead to Saint Francis Hospital and Medical Center’s Medical Marijuana research program to study the effectiveness of medical marijuana versus oxycodone in patients experiencing pain after suffering multiple rib fractures. Branford’s The Connecticut Hospice Inc. has also been approved for their study on the use of cannabis for pain management and opioid usage reductions in palliative care.