Alzheimer's added to medical marijuana treatment list in Minnesota
The decision to allow treatment of Alzheimer's with medical marijuana in Minnesota is getting an unenthusiastic response from an organization representing Alzheimer's patients.
"Much about its use in people with Alzheimer's disease and other dementias is unknown," said Sue Spalding, CEO of the Alzheimer's Association Minnesota-North Dakota chapter. "Marijuana is not approved by the U.S. Food and Drug Administration for the treatment or management of Alzheimer's disease or other dementias. Its potential effectiveness and safety profile have not been thoroughly evaluated."
Minnesota Health Commissioner Jan Malcolm announced on Monday that she has approved Alzheimer's as the 14th condition that can be treated with medical cannabis in the state since the Minnesota Legislature created the program in 2014.
Patients certified to have Alzheimer's disease will become eligible to enroll in the program on July 1 and to receive medical cannabis from the state's two medical marijuana manufacturers beginning Aug. 1.
Experts suggest more than 5.5 million people nationwide may have Alzheimer's, according to the National Institute on Aging.
"Alzheimer's presented the strongest and clearest case for potential benefits," Malcolm said in a telephone news conference.
Malcolm cited two studies that she said suggest an improvement in quality of life and a decrease of symptoms for patients with Alzheimer's. The unknown risks of cannabis use are mitigated in the case of Alzheimer's, she said, because of the advanced age of patients.
Although she lauded the state's "robust and thoughtful and careful program for administering medical cannabis," Malcolm expressed frustration about what she called a shortage of quality research.
Citing available research, a professor who created a popular "drugs of abuse" course at the University of Minnesota College of Pharmacy said medical cannabis has shown little promise as a healing drug.
"A lot of it tends to be: It probably isn't doing harm," said David Ferguson, who teaches in the Department of Medicinal Chemistry. "And it makes patients feel better."
In the case of Alzheimer's patients, Ferguson said, the most practical use for medical marijuana likely would be to reduce aggressive behavior when that occurs.
But the cost of medical marijuana has to be considered, Ferguson said, since it's not covered by health insurance. And patients — or their loved ones — have to find a doctor willing to certify them for treatment with cannabis.
Malcolm touched on that during the news conference.
"This decision does not change the fact that clinicians voluntarily participate in the state's medical cannabis program," she said.
Patients and their families in rural areas of Minnesota have complained about the difficulty of finding participating medical professionals in their regions.
Alzheimer's was one of seven conditions that were brought to the Minnesota Department of Health this year for inclusion in the program, Malcolm said.
The rejected conditions were hepatitis C, juvenile idiopathic arthritis, opioid use disorder, panic disorder, psoriasis and traumatic brain injury.
"I want to acknowledge the difficulty of passing on some of those other conditions," Malcolm said. "The cases made by some of those patients and their families are heart-rending."
Malcolm turned down medical marijuana for opioid use disorder, she said, because other medical treatments are available, and because medical professionals expressed concern about the "mixed signals" of using marijuana to treat opioid abuse.
The current list of qualifying conditions for treatment with medical marijuana in Minnesota:
• Cancer associated with severe/chronic pain, nausea or severe vomiting, or cachexia (severe wasting)
• Tourette's syndrome
• Amyotrophic lateral sclerosis (ALS)
• Seizures, including those characteristic of epilepsy
• Severe and persistent muscle spasms, including those characteristic of multiple sclerosis
• Inflammatory bowel disease, including Crohn's disease
• Terminal illness, with a probable life expectancy of less than one year
• Intractable pain
• Post-traumatic stress disorder
• Autism spectrum disorders
• Obstructive sleep apnea
• Alzheimer's disease (beginning Aug. 1, 2019)
Source: Minnesota Department of Health