REGIONAL- Medical cannabis use in Minnesota could increase significantly next year if a petition to approve its use by people with diagnosed anxiety disorders is approved by state Health Commissioner …
REGIONAL- Medical cannabis use in Minnesota could increase significantly next year if a petition to approve its use by people with diagnosed anxiety disorders is approved by state Health Commissioner Jan Malcolm.
Petitions to add anxiety disorder as a qualifying medical condition for medical cannabis have been submitted and denied every year since 2016, but after an in-depth review of the issue by the Office of Medical Cannabis, Malcolm asked that a petition be resubmitted for 2021.
Past petitions have failed largely because of a dearth of research specifically related to the effects of medical cannabis and its derivatives on anxiety disorder. Such was the reasoning of Malcolm in 2020 when she denied the petition, with a desire to avoid unintended consequences.
Of the 36 states with medical cannabis programs, only four – Nevada, New Jersey, North Dakota, and Pennsylvania – have added anxiety disorder to their approved use lists.
The largest change in the mix of medical cannabis users after approving anxiety disorder occurred in New Jersey, where 58 percent of approved conditions in 2020 were for anxiety disorder.
In North Dakota, anxiety disorder quickly became the number one condition among patients enrolled in the medical cannabis program after being approved in 2019. Forty percent of program patients had anxiety disorder as a primary diagnosis.
While the research base is still small, the petition suggests multiple possible benefits for anxiety disorder patients from using medicinal cannabis.
The primary class of drugs used to treat anxiety disorder, benzodiazepines, can be addictive and lead to overdoses and fatalities, issues that could be avoided if a patient used medical cannabis instead.
Drawing evidence from those with post-traumatic stress disorder who are part of the Minnesota program already, this group has demonstrated decreased anxiety symptom relief from medicinal cannabis.
It may also be a viable legal alternative for high-risk medication and illegal drugs among historically disadvantaged communities, the petition suggests.
Among those who have already filed public comments, almost all are in favor of approving the petition. A sample of the comments include;
“I am a retired RN/ nursing educator. I have been prescribed anti-anxiety oral meds in the past but found them not helpful, so I discontinued. CBD has helped a little, so I am interested in trying oral cannabis as an anti-anxiety agent.”
“Marijuana helps me to feel actual balance my life, and not feel like a hazy cloud that other medications I have been prescribed do, such as Xanax. Giving people another option to help alleviate their issue, especially a more natural option, only seems like a good idea.”
The petition asking for approval does not contain a section detailing possible disadvantages arising due to approving this particular use, but a comment from someone claiming to be a Minnesota psychiatrist registered this detailed objection based on his/her clinical experience:
“As an acute care psychiatrist, I saw many people who were psychotic or manic as either the direct effect of cannabis or because it exacerbated an underlying major psychiatric disorder,” the individual wrote. “In the outpatients that I have treated cannabis was associated with chronic depression and cognitive symptoms that were often seen by the patient as evidence that they needed treatment for attention-deficit/hyperactivity disorder. In both scenarios, cannabis use was more than a psychiatric diagnosis - it led to these patients having significant impairment in their relationships, vocational achievement, and general ability to function. Some tried to stop and developed cannabis hyperemesis syndrome or other symptoms of withdrawal. There are better and safer treatments for anxiety disorders. There are better and safer treatments for anxiety disorders that do not respond to first line treatments. I recommend against an anxiety or panic attack indication for medical cannabis because in the vast majority of people I have seen it caused significant anxiety and panic.”
The limited research available and reviewed by the department leans in the other direction, saying that little evidence exists to suggest that medical cannabis use would routinely lead to such outcomes as those described by the psychiatrist.
A second petition being considered would add another delivery option for administering medical cannabis and its derivatives.
Formally called gastrointestinal uptake infused edibles, in simple terms these are food products that are infused with cannabis extracts that are eaten and swallowed and processed in the stomach or intestines, then processed in the liver.
GI uptake reportedly allows cannabinoids to spread more evenly throughout the body, something particularly of benefit for patients who require constant treatment, according to the petition. Patients who have sensory processing disorders or who find other methods objectionable may find edibles to be more acceptable.
Allowing manufactured edibles also lessens the possibility of contamination or improper dosages that can result from “home made” edibles, and is therefore considered a safety benefit, the petition says.
Extensive informational materials for both petitions can be found on the Office of Medical Cannabis website at https://www.health.state.mn.us/people/cannabis/petitions/index.html. The deadline for providing written comments in support or opposition to these petitions is Friday, Oct. 1, and submission information is posted on the same webpage.
The petition for use for anxiety disorder and submitted comments will then go to a Medical Cannabis Review Panel to develop a report identifying potential benefits and harms. The panel does not review the edibles petition. Commissioner Malcolm will approve or deny the petitions by Dec. 1.