July 26, 2018


Medicinal Cannabis - Lessons from NY

Best Practices in the U.S

Families 4 Access were delighted to host a working seminar “Lessons from New York” with Rosemary Mazanet MD/PhD, Chief Scientific Officer of Columbia Care, on 23 July 2018.

The working seminar was attended by medical professionals, regulators, charities with patients who would benefit from access to medicinal cannabis, researchers, and others. Below is a short summary of what was discussed at the seminar.

Medicinal cannabis can now be legally bought and used in 32 US states and territories. In 2017, the US Institute of Medicine (now known as the National Academy for Science, Engineering and Medicine) determined that cannabis components are conclusively effective in 3 clinical settings, the treatment for chronic pain in adults, to treat chemotherapy induced nausea and vomiting, and to improve patient-reported multiple sclerosis spasticity symptoms.

However, in the 32 legal US states and territories, medicinal cannabis can be recommended by doctors to treat a broad range of indications that are slightly different in every state. The common qualifying conditions are appetite loss, cancer, Crohn's disease, eating disorders such as anorexia, mental health conditions like post-traumatic stress disorder (PTSD), multiple sclerosis, sleep, muscle spasms, nausea, pain, and seizure disorders.

A very important fact about the US cannabis market is that all medicinal cannabis in the US is purchased by the patient customer, there is no health insurance payments that offset the price.

The legalised US states have varying strict conditions:

  1. Restrictions in allowable product types.
  2. Requirements for testing of product - GMP like manufacturing.
  3. Requirements for physician certification and training.
  4. Requirement for dispensing pharmacist.
  5. Amount of product dispensed in 30 days/refills.
  6. Requirements for qualifying condition description.

New York State implemented its medicinal cannabis program in January, 2016 and was initially criticised for being one of the most restrictive in the country, however, these restrictions have given the program medical legitimacy.  The program has evolved over time, and remains restrictive enough to avoid systemic abuse, yet expanded to include additional medical indications including PTSD, chronic pain, and most recently opioid abuse, once the state determined that there was enough data to support these indications. Of interest, the “average” Columbia Care patient in the New York market is a 58-year-old female.

The opportunity that lies now before legislators in the UK and other countries that are seeking to begin a medicinal cannabis program is to implement a unified, strictly enforced, and patient and public health focused medicinal cannabis effort that ensures high quality products where a dose is precisely and easily administered.  

Only by taking a restricted, organised, and systematic approach will legislators be able to make informed decisions on how to guide the programme in future years, and perhaps teach the rest of the world the best way to use these medicines.

You can read a more detailed version of this summary here.