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Considering cannabis

Updated: 
October 24, 2017 - 10:40am

KAILUA-KONA — Anecdotal evidence supports the notion that certain properties of cannabis offer medical utility in the fight against epilepsy, at least for some patients.

The measure of that utility remains a relative mystery, however, due to federal roadblocks around the popular application of cannabis as a treatment for all qualifying medical conditions, as well as the study of those applications.

Regulatory issues in Hawaii, particularly on the Big Island, have also proven to be impediments as the medical marijuana industry tries to get off the ground across the state.

Dr. Stacey Kerr, medical director for Hawaiian Ethos, said a greater urgency is developing around cannabis as a treatment for epilepsy — a condition that affects roughly 15,000 people in Hawaii.

Hawaiian Ethos is one of the two medical marijuana license holders in Hawaii County and plans to open dispensaries in Kona and Hilo.

“It’s not just for patients to benefit, but it’s for us to start learning what’s working,” she said. “Once we can provide patients with known, pure, clean medicine, we can start asking them, ‘What’s your problem? How’s it working?’ Then we aggregate that data and we all get smarter. We just need patients to be taking it and communicating.”

Kerr spoke at a gathering Thursday night at Kona Coffee and Tea sponsored by the Epilepsy Foundation of Hawaii.

Naomi Manuel, executive director of the foundation, said her Oahu-based organization doesn’t often visit neighbor islands, but the interest the foundation received at a talk story on Oahu examining medical marijuana as an alternative to traditional methods inspired the trip.

Around 25 people showed up Thursday and a second meeting was held in Hilo Friday evening.

Manuel explained her foundation’s support of the burgeoning medical marijuana industry and the value of cultivating cannabis as the newest treatment option for epileptics, despite the existence of a multitude of treatments for the condition.

“There is urgency for those with epilepsy who have seizures that are intractable, (meaning) they can’t control them with regular medications,” Manuel said. “For those types of epilepsy, those seizures unable to be controlled by (regular) medications, cannabis is another option.”

Medical marijuana is legal in Hawaii. License holders like Hawaiian Ethos received legal clearance to begin operations in July of last year but aren’t yet distributing on the Big Island as dispensaries have yet to open.

Zachary Taffany, COO of Hawaiian Ethos, said his company has the green light from the state but is waiting on the county to sign off. He’s tentatively hoping the operation will be up and running by February.

“The Big Island especially has a very strict compliance, and we’re doing our best to work closely with them. We hope the Big Island dispensaries won’t be last to open,” he said. “It’s just deep scrutiny and a lot of time. We have 10 of the 11 signatures we need for our permit, but we’re not going to disclose the agency that’s holding us up.”

Even when dispensaries finally do open their doors, prescription of cannabis for a particular ailment like epilepsy isn’t how Hawaii physicians will operate.

Some may not operate at all where cannabis is concerned, as Taffany said there is a time-consuming barrier requiring doctors to register with the state. However, Hawaiian Ethos will attempt to help physicians through that process.

Those physicians who do register will simply assign medical marijuana cards based on whether a patient has a qualifying condition. At that point, patients will have to self-medicate.

Cannabis counselors can provide information as informal guides, but can’t tell patients seeking a particular outcome what type of cannabis to consume, how to consume it or in what quantities.

Kerr said this could pose a problem, as each individual is unique and may require more or less of a certain type administered in a specific way. In some cases, cannabis may not help an epileptic patient. It could even worsen their condition.

“Prescribing won’t happen until science opens up and there are more clinical trials done,” Taffany said. “Dosing accuracy and consistency of effect are going to need to be dialed before physicians feel confident actually prescribing it.”

The Drug Enforcement Agency continues to regard marijuana as a Schedule 1 substance without any medical value. Because of that, usable data on cannabis as a treatment for epilepsy is severely limited as the DEA refuses to issue licenses for clinical trials.

However, Kerr said that three physicians in Maine, Washington and California have collaborated to aggregate data on 272 epileptic patients treated with cannabis at their practices. Those doctors have since published the results.

Of the 272 patients, 14 percent treated showed no improvement at all, while 15 percent had a 1-25 percent reduction in seizures.

However, 28 percent of patients had a 76-99 percent reduction in seizures and 10 percent were relieved of their seizures entirely.

Kerr noted these results are promising, and more clinical research is likely all that’s standing between patients with a host of conditions and relief by way of medicinal marijuana.

She mentioned cannabis has medical properties useful in treating a variety of ailments, including general issues of pain, HIV and AIDS, lupus, glaucoma, cancer, multiple sclerosis, rheumatoid arthritis and opioid abuse, among several others.

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