From The Medical Cannabis Coalition of Hawaii
Aloha MCCHI Supporters: September 19, 2017
At 10am on Wednesday, September 20, the Department of Health (DOH) is having the first public hearing for its new petition process to add new conditions for the use of medical cannabis.
The following two conditions are being considered:
a) Amyotrophic Lateral Sclerosis (ALS) / Lou Gehrig's Disease;
b) General Anxiety Disorder (GAD)
The hearing will be held on Wednesday, September 20, 2017 from 10 am to 11 am at the Kalanimoku Building, 1151 Punchbowl Street, Video Conference Center, Room B10 in the basement.
If you would like to submit testimony but are not able to attend the hearing, please submit it by email at medicalcannabis@doh.hawaii.gov. Please be sure to type “Testimony for 2017 Petition Process” in the email subject line. All testimony must be received no later than September 20, 2017, at 4:30 pm.
Our partners at the Drug Policy Forum of Hawai'i (DPFHI) have submitted testimony in support of both conditions. For your convenience, excerpts are copied below.
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ALS
It is our belief that this petition process is a complement to the statutory route of adding conditions – either making up for an omission or oversight, or by paving the way for common but overlooked conditions. The absence of Amyotrophic Lateral Sclerosis (ALS), also known as Lou Gehrig’s Syndrome, is an example of the former, an omission. This fatal and incurable disease is explicitly recognized as a qualifying condition in at least 18 states (AZ, AR, CT, DE, FL, IL, ME, MA, MI, MN, NH, NJ, NM, NY, ND, OH, PA and WV ) and falls under broader categories in at least three states (CA, MD, OR) and the District of Columbia. It is also recognized in Georgia if it is “severe or end-stage”. The latter case, however, points to a problem: why should a patient have to wait to that stage, or until it meets some of the general symptoms such as “severe pain” or “wasting” under Hawaii’s current law? In addition to relieving the painful symptoms of ALS, increasing evidence, including preclinical data, shows that a patient’s life may be prolonged by medical cannabis.[1] It would function as an alternative therapy rather than a panacea.[2]
Ultimately, growing the list of qualifying conditions will help more patients by allowing the physicians or advance practice registered nurses (APRN) to certify a patient for either a very specific condition whose symptoms have yet to entirely manifest themselves or for a broader condition that would capture many who currently suffer in silence, excluded by the current list. ALS patients and their loved ones deserve to have medical cannabis officially recognized as a qualifying condition.
[1] “Cannabis and amyotrophic lateral sclerosis: hypothetical and practical applications, and a call for clinical trials”; American Journal of Hospice and Palliative Care, May 2010; https://www.ncbi.nlm.nih.gov/pubmed/20439484
[2] “Complementary and Alternative Therapies in Amyotrophic Lateral Sclerosis”, Neurologic Clinics, November 2015, http://www.sciencedirect.com/science/article/pii/S0733861915000651?via%3Dihub
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GAD
It is our belief that this petition process is a complement to the statutory route of adding conditions – either making up for an omission or oversight, or by paving the way for lesser known or common but overlooked conditions. The absence of General Anxiety Disorder (GAD) from the list of qualifying conditions is an example of the latter. Currently, in addition to therapy and other treatments, GAD patients can be prescribed antidepressants, anti-anxiety drugs, and beta-blockers. According to the National Institute of Mental Health, antidepressants take weeks to take effect and can have numerous side-effects such as headaches, nausea, or difficulty sleeping.[1]The most common anti-anxiety drugs are benzodiazepines, which are particularly harmful in combination with commonly used opioid painkillers.[2] Likewise, beta-blockers have numerous potential side effects that could be avoided if a patient takes medical cannabis. Further, there is research showing that the cannabadiol component of cannabis can reduce anxiety in the related condition, Social Anxiety Disorder (SAD).[3]
Ultimately, growing the list of qualifying conditions will help more patients by allowing the physicians or advance practice registered nurses (APRN) to certify a patient for either a very specific condition whose symptoms have yet to entirely manifest themselves or for a broader condition that would capture many who currently suffer in silence, excluded by the current list. GAD patients and their loved ones deserve to have medical cannabis officially recognized as a qualifying condition. Medical cannabis would simply function as an alternative rather than a panacea.
Hawai’i would be the first state to recognize GAD, and this would help send a signal across the country and beyond. A signal that we will not let residents suffering from anxiety denied a medication that might help them just because of the absurdity of the federal classification of cannabis as a Schedule 1 drug “with no currently accepted medical use”. Since 2000, Hawai’i has officially exposed that fallacy, and we need to continue doing so.
[1] “Anxiety Disorders”, https://www.nimh.nih.gov/health/topics/anxiety-disorders/index.shtml
[2] In 2017, the Hawai’i State Legislature passed, and Governor Ige enacted, legislation to limit concurrent prescriptions of opioids and benzodiazepines, see
[3] “Neural basis of anxiolytic effects of cannabidiol (CBD) in generalized social anxiety disorder: a preliminary report”, Journal of Psychopharmacology, September 2010, http://journals.sagepub.com/doi/abs/10.1177/0269881110379283