Medical marijuana: Autism spectrum disorder, obsessive-compulsive disorder and irritable bowel syndrome to be studied by state panel

COLUMBUS, Ohio – A State Medical Board of Ohio committee voted Wednesday morning to obtain more information on medical marijuana’s potential efficacy with autism spectrum disorder, obsessive-compulsive disorder and irritable bowel syndrome.

The committee, made up of members of the larger Medical Board, will next obtain expert witnesses and seek public comments to help inform a decision on whether to add any of the conditions to the current list of 25 ailments for which a person can legally obtain medical marijuana. Most of the conditions for medial marijuana were established by the legislature when it legalized the drug in 2016.

Late last year, members of the public submitted to the Medical Board 10 petitions of new illnesses for which people can get the drug. The Medical Board undergoes this process every year.

Most years, very few conditions, if any, get approved because the board wants to see the gold standard of medical research showing efficacy: randomized, double-blind, placebo-controlled studies. Very few of those studies exist because marijuana is a Schedule I controlled substance in the U.S., a federal government classification that makes it hard for scientists to legally obtain the drug for research.

During Wednesday’s meeting, the physicians on the medical marijuana conditions committee expressed interest in recent research lead by Dr. Adi Aran, director of pediatric neurology for the Hebrew University of Jerusalem. The double-blind, randomized, placebo-controlled trial used whole-plant extract to assess behavioral problems in 150 youth with autism. The study found that, in one of the groups of children studied, 80% of their parents reported a decrease in problematic behavior, with 62% reporting significant behavior improvements.

“That’s the kind of study that we said we wanted to feel comfortable with this indication,” said Dr. Michael Schottenstein, a Columbus-area psychiatrist.

The Medical Board has considered and rejected autism for its list of conditions for which medical marijuana can be prescribed almost every year since medical marijuana was legalized by the legislature.

Each year when the Medical Board has considered marijuana for autism, physicians from Nationwide Children’s Hospital in Columbus have attended meetings to testify against it. Nationwide ran clinical trials for Epidiolex, a cannabis-based medication for seizures manufactured by GW Research. It received $263,000 for its trials, which led to U.S. Food and Drug Administration approval of the drug.

Schottenstein noted the Nationwide autism researchers “were strident in their opposition to the approval of autism.”

“We wanted to proceed cautiously, and I think that we were right to go down the road because marijuana is potentially a dangerous drug with concerns about addiction, cognitive impairment and increased risk of psychosis,” he said.

But Aran’s study provides arguably better data than exists for some of the other conditions the Medical Board has approved for medical marijuana, Schottenstein said.

“So I asked myself, ‘What am I waiting for now?’… At some point it is just a basic issue of fairness to these patients and their families who are patiently waiting for us to give them another tool to address this condition. And so now that we have this data I feel like now it’s very justifiable for a patient and family to have a conversation with their doctor about the risks and benefits and alternatives regarding medical marijuana,” he said.

Inflammatory bowel disease is currently a “qualifying condition” for medical marijuana in Ohio. The committee on Wednesday decided to further study irritable bowel disease, which is considered a different ailment but it has many of the same symptoms.

And the committee also is going to consider OCD. Minnesota recently added OCD to its list of conditions for medical marijuana, said Dr. Mark Bechtel, a Columbus dermatologist.

People with OCD are often portrayed in popular culture as quirky, Schottenstein said.

“But patients with OCD suffer terribly with this affliction,” he said. “They experience a relentless barrage of unwanted thoughts that people perceive as irrational and distressing, but the thoughts won’t go away.”

The committee rejected some petitions, such as chronic migraines, because they’re already qualified conditions in Ohio’s medical marijuana program.

Other conditions, such as bipolar 2: depression and anxiety, were rejected because the petitioner didn’t include any medical evidence in the petition, which is required for the Medical Board to consider it.

The full board could resurrect study on any of the rejected conditions, but it has never done so.

The committee within the Medical Board will obtain expert testimony and public comment at public meetings in coming months, and send its recommendation — if there is any —to the full board this summer. The full board makes the ultimate decision.

Meantime, the Ohio Senate is considering a bill that would allow medical marijuana to be prescribed for autism and any conditions that a doctor, in their discretion and medical opinion, determine are debilitating to a patient.

Lawmakers are also considering a proposal to legalize recreational marijuana. If they reject it, voters may have the opportunity to decide the issue in November.

Laura Hancock covers state government and politics for and The Plain Dealer. Read more of her work here.

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