Medical marijuana for kids still faces big hurdles

TRENTON, N.J.; Aug. 19, 2013

On Friday, Gov. Chris Christie agreed to give chronically ill children easier access, if lawmakers accept his conditions for changes to Senate Bill 2482.

While he agreed with provisions that would allow production of edible forms of pot, and allow state dispensaries to grow more than 3 strains of the drug.

But he struck a part of the bill that would have decreased the number of physicians required to sign off before children can get the pot. Young patients must have the OK of both a pediatrician and a psychiatrist.

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Sen. Nick Scutari, one of the sponsors of the bill, said he's pleased that children would be given access to edible marijuana in strains appropriate for their medical needs, but concerned that psychiatric review is an unnecessary hurdle for parents. He said he will review the conditional veto before discussing with fellow lawmakers how to proceed.

Experts say there could be several issues with the psychiatric requirement. First, there are very few pediatric psychiatrists. The average wait time for an appointment with a specialized pediatric psychiatrist is at least a few months, which will cause a significant delay in treatment.

There are even fewer registered with the state medical marijuana program.

Unlike pediatricians, they may not have an existing relationship with the ailing child,mand therefore, might be reluctant to approve the medical marijuana.

Governor Christie wants the edible options, including an oil form, limited to minors only. Adults would have to smoke the marijuana or take hard lozenges.

Months ago, he expressed concern that easing restrictions on medical marijuana would lead us "down a slippery slope," making it easier for the drug to fall into the wrong hands.

Doctors say, however, that there are many patients of all ages who may not be able to smoke mairjuana or use the lozenges, due to severe lung conditions or weakness of respiratory muscles. That includes patients with advanced Amyotrophic Lateral Sclerosis (ALS or Lou Gehrig's disease). For them, lozenges can be as much of a choling hazard as in children.

Right now, New Jersey's medical marijuana law limits dispensaries to 3 strains the of the plant, none of which are the type which provide medical benefits for children. The new bill would lift those limitations.

Doctors say concerns that minors using medical marijuana will be "stoned" are unfounded.

The strains that will be used by minors are low in THC, the compound of marijuana which makes users feel "high."

It is high in another compound called cannabidiol (CBD). CBD does not have psychoactive properties, but has been touted for its many medical benefits, including anti-seizure, antioxidant, anti-psychotic, and neuroprotective properties.

This is the type of strain that is currently of interest to the families of young children who have a severe seizure disorder called Dravet Syndrome, including 2 year old Vivian Wilson of New Jersey and 5 year old Charlotte Figi of Colorado.

Charlotte's family reports that medical marijuana has reduced her seizure load from 300 a day down to just a few per month. There are over 40 other patients in Colorado using this strain of medical marijuana for debilitating conditions, with promising results.

Last week, Brian Wilson, Vivian's father confronted the governor during a campaign stop in a diner. In a moment captured on video that made news shows and websites, Wilson told the governor, "Please don't let my daughter die."

Christie, who has raised concerns that adults might use pot recommended for their children, told him, "I know you think it's simple, but it's not," during their brief exchange.

Wilson and his wife, Meghan, said in a statement they are disappointed Christie "decided to make it so difficult for parents, who are already enduring tremendous pain and heartache, to get approval for such a safe and simple medication."

They said it's not fair that other drugs can be prescribed for children without additional doctors signing off, and that any changed will take months to a year to go into effect.

"We can't wait a year before we start treating her," Wilson told the North Jersey Record.

This report prepared with the assistance of Amy Ondeyka, M.D., a senior resident in emergency medicine at Cooper University Hospital.

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