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Medical marijuana versus existing drugs: Local doc talks cannabis, chemicals and lack of research

Medical marijuana will likely be used along with other medications, as there is not yet adequate research on the drug to support using it as a substitute for existing pharmaceuticals, according to a local physician.

In May 2016, medical marijuana became legal in Pennsylvania as a treatment for 17 health conditions, such as chronic pain and epilepsy, and evidence suggests chemical compounds in the cannabis plant could help ease symptoms of those conditions.

Other studies show that medical marijuana, in states where it has become legal, has saved states money on prescription drug costs.

Yet medical marijuana remains illegal under federal law, slowing further research in the U.S. and forcing patients to pay for the drug out of pocket, because its not covered by insurance companies.

Lack of scientific research on cannabis, including exactly what its chemical compounds do and the appropriate dosage for each patient, will likely prevent it from replacing existing medications, according to Dr. Bill Trescher. He heads the division of pediatric neurology at Derry Township-based Penn State Health Milton S. Hershey Medical Center.

The belief that medical marijuana is safer because it isn’t manufactured by pharmaceutical companies is “completely erroneous,” Trescher added, pointing out that the original aim of the pharmaceutical industry was to research compounds in plants and figure out which were beneficial.

There are many chemicals in the cannabis plant, and some could be beneficial to patients while others could be harmful.

“They are still chemicals, and chemicals can have side effects,” Trescher said.

Medical marijuana could reduce demand for opioid pain pills

Medical marijuana might, however, be used alongside other medications when it becomes available here, Trescher said.

He is looking at how medical marijuana could help his patients suffering from seizures.

“There’s 20 or more anti-eplileptic medications, and they all have different roles to play,” Trescher said. “So what I would say is that medical cannabis may be something that would be used with other treatments.”

Another local physician, Dr. Asit P. Upadhyay, is looking at using medical marijuana for pain management.

He has expanded his pain management practice and relocated it from York to Lemoyne, Cumberland County. He also launched a consulting firm to teach physicians how to safely recommend medical marijuana to patients suffering from pain.

His move is based, in part, on studies that show that prescriptions for pain pills dropped in states where medical marijuana has become legal.

A study published in health care policy publication Health Affair, examined Medicare prescription medication costs from 2010 to 2013. It found that the daily doses of pain pills filled per doctor each year fell, on average, by about 1,800.

Pennsylvania is dealing with an opioid pain pill and heroin epidemic that has been attributed, in part, to health care providers overprescribing prescription pain medication.

Chronic pain also happens to be one of the most common conditions found in potential medical marijuana patients here, according to the Pennsylvania Department of Health.

The department surveyed patients online and, out of 5,000 unique responses, found that the two most common qualifying conditions listed are chronic pain and post-traumatic stress disorder.

As a result, patients with chronic pain and PTSD are expected to constitute the two largest markets for medical marijuana in Pennsylvania.

Lenay Ruhl

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