Arizona's top health officer want to limit marijuana prescriptions

PHOENIX -- Arizona's chief health officer is proposing to make it more difficult to add new conditions to the list for which doctors can recommend the drug.

The change would require "clear and convincing evidence' published in peer-reviewed scientific journals, that there is some benefit from the use of marijuana to humans for the specified medical condition. State Health Director Will Humble said that probably means multiple articles.

That's a big change from the current regulations which allow consideration of "a summary of the evidence' that marijuana will either help treat the condition or at least provide some relief from symptoms. And while the current rules also ask for articles in scientific journals, there is no mandate that the research be "evidence based' -- or that the conclusions be clear and convincing.

Humble's proposal comes months after he effectively was required, against his own judgment, to allow doctors to make medical marijuana available for post-traumatic stress disorder.

He originally had rejected the application as being based largely on anecdotal evidence. But Humble reversed himself when a state hearing officer pointed out that his agency's own rules specifically require him to consider such evidence.

And Humble said had his proposed rules been in effect at the time, he never would have made marijuana available for PTSD.

The move drew opposition from Jeffrey Kaufman, an attorney whose practice includes representing marijuana dispensaries.

"The governments have constructed a complex and impossible program and maze for anyone to get medical marijuana studies funding,' he said. "So, obviously, it's going to be impossible for anybody to have any type of peer-reviewed literature or studies.'

That's also the assessment of attorney Ken Sobel who brought the legal challenge that resulted in Humble adding PTSD to the list. And he said a lawsuit is likely if Humble goes ahead with the change.

"It would be really in violation of the voters' intent,' Sobel said, saying wanted an easy method of adding conditions because of the legal roadblocks to scientific research.

But Humble is defending the new restriction.

"I want everything we do to be based on evidence and data,' he said.

The 2010 The voter-approved law allows the use of the drug by patients suffering from a list of specific medical conditions, ranging from glaucoma and AIDS to any chronic or debilitating condition that leads to severe and chronic plan. At last count, close to 53,000 people have qualified under that existing list, allowing them to purchase up to 2 1/2 ounces of marijuana every two weeks.

That 2010 law, however, also requires Humble to consider requests to expand the list of conditions for which marijuana can be legally recommended by a doctor.

Humble had rejected repeated efforts to add PTSD to the list, saying there was a lack of scientific studies.

But in June, a hearing officer said the agency's own rules require Humble to consider the anecdotal testimony of doctors and nurses who said the drug has helped their patients. And Humble backed down after proponents, in what he called "a stroke of luck,' also came up with a study out of New Mexico that found what he said was "an association between cannabis used and PTSD symptoms in some patients.'

Still, Humble said all that probably would not meet the new standards.

"The rules that we're proposing today make it really clear that it needs to be not just published data but published data that's convincing,' he said. "And not just one, unless it's a really, really good study.'

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