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Alzheimer's added to Minnesota's medical marijuana list

Star Tribune - 12/3/2018

Dec. 03--Alzheimer's disease will be eligible for treatment with medical marijuana in Minnesota starting next year, becoming the 14th health condition certified by the state since the program began in 2015.

The Minnesota Department of Health announced Monday that it was adding the degenerative neurological disorder to its cannabis program, which already includes cancer pain, epileptic seizures, post-traumatic stress disorder and autism.

While research on cannabis and Alzheimer's is limited, some studies have found that marijuana inhibits the formation of tau proteins that accelerate dementia and memory loss related to the disease.

"Any policy decisions about cannabis are difficult due to the relative lack of published scientific evidence," said state Health Commissioner Jan Malcolm. "However, there is some evidence for potential benefits of medical cannabis to improve the mood, sleep and behavior of patients suffering from Alzheimer's disease."

Seven conditions had been submitted this summer by advocacy groups to a state medical marijuana advisory panel, but Malcolm added only Alzheimer's. The others were hepatitis C, Juvenile Rheumatoid Arthritis, Opioid Use Disorders, Panic Disorder, Psoriasis and Traumatic Brain Injury.

Minnesota will now be among 15 states in which medical marijuana can be used to treat Alzheimer's, according to the petition filed this summer to add the condition as a qualifying condition.

Dr. William Orr, a Minneapolis-based geriatric psychiatrist, supported the petition and argued that advanced Alzheimer's can lead to patients becoming confused, aggressive and combative. Benzodiazepines and narcotics can calm these patients, he wrote, but those drugs aren't federally approved for the purpose and can cause severe, mood-altering side effects.

"I believe that advanced dementia patients with tremendous anxiety, restlessness, and pain will benefit" from medical marijuana, he wrote. "Such patients are episodically distraught and become quickly angered and paranoid of staff trying to help them due to their confusion and inability to understand their circumstances."

The Minnesota Association of Geriatrics took a neutral position, saying that cannabis to treat Alzheimer's was not well-studied, but that it supported further research.

Minnesota's medical marijuana program started three years ago, with two companies approved to distribute cannabis in liquid or pill form. Patients seeking cannabis must obtain certification that they have qualifying conditions. The state lists 1,391 doctors or other practitioners in the state who are authorized to grant certification.

The state also uses the program to launch research, because of the limited evidence about the medical benefits of a drug that is otherwise considered an illegal controlled substance that can impair judgment and cause addiction. A state survey-based study earlier this year found 60 percent of patients with chronic pain believed cannabis was helping, and that 43 percent of their doctors agreed.

The state listed 12,207 patients in its active medical marijuana registry this September, up from 7,007 a year earlier. The addition last December of autism and sleep apnea to the list of qualifying conditions did not fuel the increase. Only 396 people with either of those conditions were registered this September.

Most registered people reported intractable pain, a condition added in 2016. The 7,917 people with that condition made up 65 percent of the registry. PTSD and muscle spasms were the next most common conditions.

How much the addition of Alzheimer's will increase the registry is unclear. The Alzheimer's Association estimates that 94,000 people in Minnesota have the disease. Alzheimer's was the principal cause of 2,220 deaths in the state in 2016.

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