Central PA doctors prep for medical marijuana
As dispensaries load up on product for the rollout of Pennsylvania's medical marijuana program, midstate doctors and physicians are seeing a flood of phone calls from patients hoping to get ahead of the curve.
“We’ve seen tremendous interest,” said Dr. Jean Santo, a pain management specialist at a UPMC Pinnacle facility in Hampden Township, Cumberland County. “Both in my current practice patients and in the community overall, we’ve received phone calls every day from people who are not our patients asking about it. They’ve already gone online and registered, and they’re all set to go.”
Santo is one of several hundred doctors statewide who have enrolled in the Department of Health’s registry for physicians planning to prescribe medical marijuana. In order to participate, physicians must apply for certification through the Department of Health, maintain an active medical license, and work through a four-hour training course on the risks and benefits of medical marijuana.
Once admitted, physicians can then prescribe medical marijuana in oral, topical and liquid vaporized forms.
First, they have to wait for the medical marijuana program to begin, slated to happen in early 2018.
“There’s no product available yet,” said Santo. “The state hasn’t provided us with any particular certificate they want us to issue, but the patients are certainly ready to go even if the state and dispensaries or growers are not.”
Patients can obtain medical marijuana from one of many dispensaries rushing to open in 2018. The state has approved at least one dispensary each for Cumberland, Dauphin, Lebanon, Lancaster and York counties, as well as Adams and Franklin.
Patients also must register for the program and show a diagnosis of one of 17 approved medical conditions, ranging from glaucoma and post-traumatic stress disorder to cancer.
According to a statement by Gov. Tom Wolf, over 6,000 patients and 300 caregivers enrolled in the first two weeks after the registry went online.
As some specialists are finding out, however, patients’ eagerness to participate in the program may be superseding their awareness of why some doctors are enrolled in the first place.
So said Dr. John Neely, a pediatric oncologist at the Penn State Milton S. Hershey Medical Center.
He only sees pediatric oncology patients. But, Neely said, “The switchboard has been deluged with patients calling and asking for information on how they can get on my program. And they have to be reminded that I’m only seeing children with cancer.”
Dr. David Simons, a pain management specialist with Community Anesthesia Associates in Warwick Township, Lancaster County, also has seen a flood of interest from patients old and new.
“It’s actually been a much greater response than I expected, actually,” said Simons. “My practice would tell you every day there are more and more patients calling. It’s been kind of an onslaught.”
Simons’s office began a waitlist to manage the response, which he estimates is between 60 and 100 patients long.
While marijuana can be used to treat a wide array of medical conditions, including cancer, Simons and others working in pain management have a unique interest in the program’s success.
“The field of chronic pain management is still relatively new,” said Simons. “And we have an incredible amount of technology that’s emerging to help patients manage chronic pain, but we still haven’t seen the ideal medication to help patients.”
According to Simons, medical marijuana could serve as an alternative to habit-forming opioids, which have been blamed for an epidemic of addiction and overdoses around the country.
“In an effort to continue to expand our ability to treat patients with non-opioid medications,” he said, “I feel that medical cannabis is potentially a good option for patients, specifically with chronic pain, but certainly with other medical conditions as well.”
“I do see this as an adjunct to treating [opioid addiction],” added Dr. Theresa Burick, whose Hampden Township practice, the Burick Center for Health and Wellness, provides concierge medical service. “Fortunately, medical marijuana is less toxic and has less long-term negative side effects.”
Burick said she hopes medical marijuana can serve as “an adjunct to hopefully decrease the side-effect profile of these other medications patients are requiring for their comfort and their pain management.”
According to a 2016 analysis published by the National Institute on Drug Abuse, states that opened medical marijuana dispensaries saw a significant decrease in opioid overdose deaths and admission to treatment centers. Some states saw a drop as steep as 31 percent in overdose deaths and a 35 percent drop in admission to treatment centers.
Patients want alternatives.
“I’ve unfortunately had several patients diagnosed with cancer who, interestingly, have gone to other states and had experienced the treatment and then had come back to Pennsylvania and were very interested in resuming that treatment since they already know they had success with it previously,” said Burick.
Still, doctors said, while medical marijuana offers some promising benefits, it is far from a miracle drug and not suitable for every patient.
“Those patients with unrealistic expectations may not qualify,” said Simons. “And those patients with issues of drug abuse, alcohol abuse, medication mismanagement, those patients with a history of that should certainly be very wary of this as a treatment option, particularly if they’re on other medications that may or may not be compatible.”
Simons urged caution. “Patients with severe psychiatric issues — bipolar disease, schizophrenia, etc. — those patients can sometimes be made worse with medical cannabis,” he said.
Doctors prescribing the substance plan to watch patients closely.
“What I think we really don’t know is what’s the best preparation of it and, as we get more experience, will it have any interactions with other medications people are on,” said Neely, the pediatric oncologist at Penn State Hershey.
For him and many other midstate doctors, the rollout of medical marijuana will be a learning experience.
“There’s a lot of unknowns,” he said. “I thought it would be a service to patients, but also an opportunity to learn how to use this in a proper fashion.”