Medical marijuana is currently legal in 30 different states, and Missouri has three measures on the ballot Nov. 6 for the legalization of medical marijuana. Yet some advocates and healthcare professionals disagree on what is best for Missouri patients.
One of those advocating for legalization is Lonnie Kessler. He lives in Moberly and has epilepsy. He has a service dog, Orthros, who has been helping with Lonnie’s seizures for four years.
But Lonnie says he needs more than a service dog these days.
“The most imminent threat to my life right now is epilepsy, which no longer responds to traditional medications and treatments,” Kessler said, “which led me to reach out to several neurologists in an attempt to obtain a recommendation for the CBD program in Missouri.”
CBD, or cannabidiol, is more commonly known as hemp extract and is currently legal in Missouri. However, the program is very limited and Kessler was unable to get a CBD card for the side effects of his epilepsy like nausea, weight loss, irritability and depression.
He added that legalization is about more than people just wanting to get high.
“It’s because people want to live a quality life. That's something that medical marijuana can do,” Kessler said.
Missourians have three different medical marijuana measures to vote on next week.
Amendment 2, which is sponsored by New Approach Missouri, places a four percent tax on the drug. The money would go to the Missouri Veterans Health and Care fund, and the Department of Health and Senior Services would be in charge of administering, licensing, and regulating the program. Kessler advocates for Amendment 2 through his work with the Epilepsy Foundation and New Approach Missouri.
Amendment 3 proposes a 15 percent tax on medical marijuana, which is about two times higher than the highest currently existing medical marijuana tax. Amendment 3 is almost entirely funded by Brad Bradshaw, a Springfield physician who wants to create a board to research “presently incurable diseases.”
Then there’s Proposition C, which proposes only a two percent tax on medical marijuana. Proposition C changes state laws, but not the state constitution, as the amendments would.
Jack Cardetti is the spokesperson for New Approach Missouri.
“What Amendment 2 does is really puts the power when it comes to healthcare decision-making back in the hands of doctors and patients, where we believe it should be,” he said.
Cardetti said that New Approach believes Amendment 2 would benefit those with illnesses like cancer, epilepsy, PTSD, and other qualifying conditions, and for patients like Kessler who were given opioids to treat pain, legalization would open doors to alternative treatment options.
“In my advocacy and talking to my doctors, they agree that medical cannabis can be beneficial. Just no one is willing to write the recommendation because of hospital affiliation. They're scared of losing their licenses, losing their jobs, and I can't blame them,” Kessler said.
And some healthcare professionals have voiced concerns about medical marijuana. Dr. Van Stoecker is a dermatologist in Rolla. He’s researched and written several articles for the Missouri State Medical Association’s journal, including one on the risks of medical marijuana.
Stoecker said one of his concerns about the medical marijuana ballot measures is the lack of THC level regulation. He says that some research has shown that THC can shrink parts of the brain with chronic use.
“A number of states regulate the THC content, however, the three medical marijuana measures in 2018 for Missouri have no such regulation,” Stoecker said. “So yes, that could be regulated, but these laws do not do that.”
Another concern raised by some physicians, like Stoecker, is a lack of evidence for all but three uses of medical marijuana. A 2017 National Academy of Science study cites strong medical evidence for using marijuana to relieve chronic pain, chemotherapy-induced nausea and vomiting, and insomnia, but Stoecker said there are still better treatment options for those symptoms.
“For all these things that marijuana is indicated for, there are better therapies,” he said. “And then, of course, with the doctor's point of view is that you're throwing the THC in with the CBD, which is the effective part.”
The Missouri State Medical Association is a group of about 4,000 physicians, residents and medical students from all specialties across the state. For context, there are about 16,000 active physicians in Missouri according to the Association of American Medical Colleges.
Jeff Howell is the general counsel and director of government relations for the Missouri State Medical Association. He says the association opposes all three measures because of marijuana’s federal classification as a Schedule One drug.
“Because it's a schedule one drug, it hasn't been subject to rigorous testing that the FDA does on other pharmaceuticals. And so until they remove that from schedule one and allow some more scientific testing, we're going to be opposed to medical marijuana,” Howell said.
If any of the measures pass in November, physicians still have to decide if and how they will prescribe medical marijuana. Stoecker said you can think of physician’s views of medical marijuana similarly to opioids.
“We have a wide range of physician on narcotic prescribing behavior, and we're going to have a wide range of physician marijuana prescribing behavior after those one or more of those laws pass,” he says.
And for Lonnie Kessler, he said that if Amendment 2 doesn’t pass, he says he has three options: to undergo surgery to remove a portion of his brain, to obtain cannabis illegally and possibly face criminal penalties, or move to a state that has legalized marijuana and leave his family behind.