Medical Marijuana for Kids Could Pit Parents Against Pediatricians

Andrew Kitchenman | June 21, 2013 | Health Care
Bill would ease restraints that require three doctors to sign off on prescriptions for children

According to current state law, any doctor who wants to prescribe medical marijuana to a child must have a pediatrician and a psychiatrist vet his decision. That’s a particularly daunting challenge in New Jersey, where few pediatricians have been willing to agree to patients registering with the state’s nascent medical marijuana program.

That challenge could be eased significantly by a bill now advancing in the Legislature: (S-2842/A-4241 would require that children be treated the same as adults when being considered for medical marijuana.

As might be expected, the bill has sparked off considerable controversy in New Jersey’s medical community. What’s more, Gov. Chris Christie has indicated his skepticism toward allowing children to receive the substance in general and has asked state health officials to review the current regulations.

But for at least one parent, medical marijuana could ease the pain and suffering of her son.

Hope resident Jennie Stormes advocated for the change in the law on behalf of Jackson Stormes, a 14 year old who has used marijuana to reduce the symptoms of Dravet Syndrome, a severe form of epilepsy.

She said the substance has reduced the intensity and duration of her son’s seizures, after years of unsuccessful approaches such as brain surgery.

“The additional doctor appointments for a child who has failed so many medications, brain surgery, and other treatments are cruel and the cost is burdensome for a single mother who is working more than one job without any child support,” said Stormes, a pediatric nurse.

“This requirement,” she added, “should be the same as all citizens of New Jersey who meet the medical criteria.”

The measure is opposed by the American Academy of Pediatrics’ New Jersey chapter, whose members believe their specialized knowledge is essential to making sure that marijuana is appropriate in individual cases. They emphasize that current medical knowledge hasn’t reached a consensus on what is the appropriate dosage for children.

“There’s very little data on the use of medical marijuana in children,” said Fran Gallagher, the state chapter’s executive director. “Therefore, you want to have the very best pediatric expertise.”

Gallagher continued, “There needs to be outreach and education about the fact that the law exists and what the regulations are,” adding that the academy “is behind children having any type of pain medication that’s beneficial.”

Stormes noted that clinical work is being done in San Francisco to establish the appropriate doses for children. She also said that allowing New Jersey children to use the substance will increase this knowledge.

According to Stormes, her son has been prescribed other medications for which appropriate doses for children haven’t been established.

She’s worked to have a primary care doctor and a psychiatrist approve her son’s treatment, along with the prescribing doctor. She added that it appears the state will approve her son for the substance, despite the fact that he no longer sees a pediatrician.

Dr. Anthony Anzalone, an advocate of the medical marijuana program, said reducing the requirement to consult with a pediatrician and a psychiatrist for each child “would save a lot of headaches. I think it would be very good.”

If any specialist should be consulted, it should neurologists, Anzalone said. That’s because they have the greatest expertise in how the nervous system interacts with cannabinoids, the chemical compounds in marijuana that trigger various effects.

Advocates for children having easier access to medical marijuana said there are other restrictions in the state regulations that should be removed. These include limiting the medical use of the plant to three strains.

Doing so makes it possible to select marijuana that is rich in cannabidiol, or CBD, but has little THC, the compound most strongly associated with “getting stoned.”

Stormes said it’s important that her son receive the medication without becoming high.

Dr. Sunil Aggarwal, a physical medicine and rehabilitation specialist in New York City, has studied the use of medical marijuana, including cases where it was prescribed to children. He said there are studies over the past decades that have found that CBD can help children with seizure disorders.

“There’s a lot of benefits that CBD is able to show,” Aggarwal said, including working as an antipsychotic and providing pain relief without apparent toxic side effects. He said the substance should be studied more, including being used in further clinical trials.

The Senate passed its version of the bill yesterday through a 25-13 vote. The Assembly Budget Committee approved it on a 9-1 vote with two abstentions. While all Democrats on the Assembly committee supported the measure, the Republicans were split, with one in favor, one opposed and two abstaining.

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