State Health Director Will Humble acted illegally in denying access to medical marijuana to people — many of them former soldiers — suffering from post-traumatic stress disorder, an administrative law judge has ruled.
Judge Thomas Shedden said Humble relied solely on the lack of scientific “peer-reviewed” studies in determining that PTSD should not be added to the list of conditions for which marijuana could be made available. But the judge said the health chief should also have considered the testimony of doctors and nurses who said the drug has helped their patients.
Humble said Friday he is studying the ruling but has not decided whether he will follow it. Under state law, Shedden's decision is merely a recommendation and Humble has until July 9 to decide whether to reject it.
Attorney Kenneth Sobel, representing the Arizona Cannabis Nurses Association, which brought the claim, said Friday if that happens he will ask a superior judge to intercede and overrule Humble.
“Veterans desperately need this medicine,” he said, citing figures showing 22 former soldiers kill themselves every day, many of them suffering from PTSD.
The 2010 voter-approved Arizona Medical Marijuana Act allows the use of the drug by patients suffering from a list of several specified medical conditions. These range from glaucoma and AIDS to any chronic or debilitating condition that leads to severe and chronic plan.
So far close to 50,000 people have qualified under the existing list of conditions to purchase up to 2 1/2 ounces of marijuana every two weeks.
But the law also requires Humble to consider requests for expanding the list of conditions for which marijuana can be recommended.
Proponents of adding PTSD to that list tried in 2012 and again last year. That led Humble to contract with the College of Public Health at the University of Arizona to review peer-reviewed studies to determine whether there is any basis for that addition. That report found “observational studies of varying quality,” with the conclusion that “the totality of this evidence should be considered very low quality with a high degree of uncertainty.” Based on that, Humble decided he could not make marijuana available for PTSD.
Shedden said he reads the health department's own rules to say that decision should not be based solely on scientific studies.
He said the rules also require consideration of other evidence that marijuana will treat a medical condition or at least its symptoms. And Shedden said there was “substantial evidence” that the drug alleviates the symptoms of PTSD — even if that evidence came from doctors and patients citing their own experiences.
For example, he cited testimony by Dr. Richard Strand who said his own review of medical literature shows that traditional drugs are not effective for everyone suffering from PTSD. Strand said there are side effects.
Shedden also considered the testimony of Ricardo Pereyda who said the medical marijuana he is able to get for his chronic pain has helped him deal with PTSD following his Army service in Iraq as a military policeman.
“There's plenty of anecdotal evidence,” Humble said Friday. “At the hearings that we had, one family after the next came up and personally testified that they believed that marijuana provided relief for their PTSD.”
Humble said he considered that.
“But throughout my entire career I've really focused on using scientific evidence really as the cornerstone of good, effective decision making when it comes to public policy,” he said. And that evidence is not there.
Sobel, however, said relying solely on scientific studies to expand who gets medical marijuana is unreasonable simply because there are none — at least in part because the federal government has thrown roadblocks in the path of researchers. In fact, he doubted that anyone could find the kind of study that Humble wants now for PTSD for any of the other conditions for which marijuana already can be recommended by doctors.
Beyond that, Sobel said the rules themselves make clear that marijuana can be considered appropriate if it provides a “palliative benefit.” And that's where anecdotal evidence comes in.
“Good doctors will tell you that probably the best way to find out if it makes you feel better is to ask the patient,” he said.
Anyway, Sobel said, even if there are no scientific studies on marijuana being beneficial, he said there also are no studies showing it is harmful.