Posts Tagged ‘depression’

Medical Marijuana News

January 17th, 2014

We published our mid-year update of the medical marijuana annual report this week.  It contains different data than our  standard annual report in that we’re reporting aggregate dispensary transaction data.  In the report you’ll see that there were about 422,000 transactions made at dispensaries in ‘13 among the 40,000 patients (about 10 transactions/patient/year).   Dispensaries sold 2,700 Kg of marijuana in ’13 for an estimated gross revenue stream of about $33M.  Transaction data is broken down by age group as well.   Fridays are the busiest day of the week at dispensaries.  

In other news, we completed our review of the latest petitions to add debilitating medical conditions to the official list this week.  As you recall, the AZ Medical Marijuana Act charges us to periodically accept petitions to add new medical conditions to the list that qualifies folks for a card.  Last summer we accepted petitions from the public to add new medical conditions for PTSD, depression and migraines. We also received a lot of informal comments regarding adding PTSD; depression & migraines and heard in person testimony from dozens of folks at our public hearing in October. 

We also contracted with the U of A College of Public Health to do an evidence review of published scientific studies.  You can see the UA’s analyses for depression; migraine headaches and PTSD on our petition website.  Our ADHS Medical Advisory Committee reviewed and analyzed the data, as in past submission periods, and provided me with recommendations earlier this week. 

Our literature review found limited scientific evidence to support permanently adding the petitioned conditions to the statutory list of qualifying debilitating conditions identified in the Act.  I didn’t approve the petitions because of the lack of published data regarding the risks and benefits of using Cannabis to treat or provide relief for the petitioned conditions.  We’ll be accepting petitions again January 27 – 31, 2014.

Chronic Disease Calculator E-tool.

November 25th, 2013

The CDC just developed a great new Cost Calculator that provides state-level annual medical expenditure and absenteeism estimates for 10 chronic conditions.  The tool provides medical expenditures for all of AZ for all payers as well as specific payers Medicaid, Medicare, and commercial insurers.  The 10 chronic conditions are arthritis; asthma; cancer; cardiovascular diseases (congestive heart failure, coronary heart disease, hypertension, stroke, and other heart diseases); depression; and diabetes.  Graphs and charts are provided to visually communicate the cost estimates. 

The Cost Calculator estimates were derived from state- and national- level data from the Medical Expenditure Panel Survey and National Nursing Home Survey so the estimates may differ from estimates generated directly from analysis of claims data.  However, folks can do a customized analysis using other data sources including Medicaid or Medicare claims data. Technical support can be requested at the website or at cdcostcalculator@cdc.gov.

3 Medical Conditions Move to Hearing

August 28th, 2013

Three of the petitions to add debilitating conditions to the medical marijuana program that we received last month will be moving forward to a public hearing, which will be on Tuesday, October 29 from 9 am to noon in our State Lab conference room.  We’ll also broadcast the hearing via Livestream. 

The petitions are for PTSD, Migraines, Depression.  All these conditions have already been through the review process in previous petitions- but we’ve asked the UA College of Public Health to look for any new literature that has been published on these topics since the previous review.  This will be the first set of hearings since the first round back in 2012.

Petitions to Add Debilitating Conditions to the MM List

July 23rd, 2013

The AZ Medical Marijuana Act also requires us to periodically accept petitions to permanently add new medical conditions to the list of conditions that qualify folks for a card.  In Jan 2012, we’ve received petitions to add PTSD 1PTSD 2; Depression; Migraines; and Generalized Anxiety Disorder. In short- I didn’t approve the petitions because of the lack of published data regarding the risks and benefits of using Cannabis to treat or provide relief for the petitioned conditions.  

We’ll begin accepting petitions to add debilitating conditions tomorrow; July24th-July31. Our medical team will meet after that to get me an initial analysis regarding whether any petitions we receive meet the screening criteria.  Assuming we receive qualified petitions, I’ll need to make a final decision by December 2013.  Our website shows folks how, what, where, and when to submit petitions.

Men’s Health Week Time to Think about Our Health

June 13th, 2013

This week is Men’s Health Week – the worldwide event happens every year before Father’s Day calling attention to the issues that affect men’s health. Many groups take the opportunity to talk about men’s health – we should be thinking about our health every week.  The top health issues that impact men’s health are also some of the easiest issues to prevent.  Heart disease and cancer are leading causes of death for men.  The best way to fight heart disease is exercise and sensible eating.  Our Healthy Living website has some interesting ideas on being active and choosing healthy foods. 

If you’re 50 or older or at higher risk, make a pledge to yourself and your family get checked for prostate and colorectal cancer. Men’s Health Week is the perfect opportunity to schedule an appointment.   

Stress also leads to health problems in men, including depression.  If you’re suffering from depression, it’s harder to be physically active and eat well. Sometimes a chat with a professional can put you back on track or a doctor may prescribe medication to help put your life back in balance. Most employers offer an Employee Assistance Program that will offer free or low cost access to a mental health professional.  The parity law also makes your regular health insurance provide access to mental health care. 

If you’re still smoking, stop.  Every puff of a cigarette or cigar takes time off your life. Nicotine is a highly addictive substance – quitting isn’t easy, but it’s not impossible. If you need help, call the ASHLine at 1-800-556-6222. 

Finally, consider getting a physical this year to identify hidden health conditions.  If you don’t do it for yourself, do it for your family.

Be Part of the Mental Health Solution

March 29th, 2013

Students can’t be academically successful when they’re battling anxiety, depression, substance abuse and other common conditions.  Nearly 50% of lifetime mental disorders begin by the mid-teens.  That’s why we’ve launched a partnership with Kognito Interactive to educate middle and high-school teachers how to recognize signs of depression and other mental health disorders that have the potential to lead to low academic achievement, violence or even suicide. At Risk for Middle School Educators and At Risk for High School Teachers are hour-long, avatar-based online training programs where teachers, administrators and staff learn to recognize and help when a student’s behavior and appearance may be a sign of psychological distress, such as depression, anxiety or substance abuse. 

When equipped with the appropriate knowledge on how to handle sensitive situations, teachers and staff have a better chance of success in connecting the student with help.  At-Risk simulations are the first online trainings available to provide realistic and risk-free role-play exercises in identifying, speaking with, and referring troubled youth.  Developed with input from teachers and some of the country’s leading authorities on youth suicide prevention, At-Risk helps connect students to treatment early on- which is critical to improving mental health outcomes. 

This professional development opportunity is free and available to high schools and middle schools in Arizona.  It only takes an hour to complete, doesn’t need to take away from class time, and comes with a certificate of completion.  It can also be paused and restarted without having to start from the beginning.  To take the training…  sign in at the following links for Middle School and High School.

 

New M2 Petitions on Horizon Again

January 23rd, 2013

Last January we accepted petitions from the public to add PTSD 1PTSD 2; Depression; Migraines; and Generalized Anxiety Disorder to the list of conditions that qualify patients to receive a Medical Marijuana Registration Card.  Because my guiding principle for making the decision was to use science and research to make the decision, we contracted with the U of A College of Public Health to do an evidence review of published scientific studies to help us to make a more informed decision.  You can see the UA’s analyses for Depression; Generalized Anxiety Disorder; Migraine Headaches; and Post Traumatic Stress Disorder (PTSD) on our petition website.   Our literature review found limited scientific evidence to document whether Cannabis is helpful or not for the petitioned conditions or that support permanently adding the petitioned conditions to the statutory list of qualifying debilitating conditions identified in the Act.  In short- I didn’t approve the petitions last year because of the lack of published data regarding the risks and benefits of using Cannabis to treat or provide relief for the petitioned conditions. 

The AZ Medical Marijuana Act requires us to periodically accept petitions to add new medical conditions- and we are once again accepting petitions to add new debilitating medical conditions this week (January 25 – 31) on our petition website. Our medical team will meet after January 31st and will be providing me with an initial analysis regarding whether any petitions we receive meet the screening criteria…  and we’ll be using the UA College of Public Health to review the scientific literature for any that pass the screening test.  Assuming we receive qualified petitions, I’ll need to make a final decision by July 2013.  Our website shows folks how, what, where, and when to submit petitions.

M2 Petition Decision

July 19th, 2012

The voter approved list of conditions that already qualify patients for an AZ Medical Marijuana Registration Card (with a doctor’s certification) includes any of the following: any chronic or debilitating disease or medical condition (or its treatment) that causes severe and chronic pain, severe nausea, severe and persistent muscle spasms, wasting, or seizures, cancer, glaucoma, HIV, Hepatitis C, ALS, Crohn’s disease, agitation of Alzheimer’s disease.  The AZ Medical Marijuana Act also requires us to periodically accept petitions to permanently add new medical conditions to the list of conditions that qualify folks for a card.  

We accepted petitions from the public to add new medical conditions back in January.  Folks submitted numerous articles as a part their petitions for PTSD 1PTSD 2; Depression; Migraines; and Generalized Anxiety Disorder.  We also received lots of informal comments regarding adding PTSD; Depression; Migraines; Generalized Anxiety Disorder and General comments.  We also heard in person testimony from dozens of folks at our public hearing in May.

Because my guiding principle for making the decision was to use science and research, we contracted with the U of A College of Public Health to do an evidence review of published scientific studies to help us to make a more informed decision.  You can see the UA’s analyses for Depression; Generalized Anxiety Disorder; Migraine Headaches; and Post Traumatic Stress Disorder (PTSD) on our petition website.   The UA used the GRADE methodology to evaluate the quality of the studies looking at the benefits and harms of using Cannabis to treat or provide relief for the conditions that were petitioned to add to the list of qualifying conditions for a Medical Marijuana Registration card.  Also, our ADHS Medical Advisory Committee reviewed and analyzed the data and provided me with recommendations earlier this week.

We heard and received a host of moving stories from the public both on-line and during our a public hearing in May.  Many of the commenters and folks that testified self-reported that they believe Cannabis provided relief for the petitioned conditions.  However, our literature review found limited scientific evidence to document whether Cannabis is helpful or not for the petitioned conditions or that support permanently adding the petitioned conditions to the statutory list of qualifying debilitating conditions identified in the Act.  In short- I didn’t approve the petitions because of the lack of published data regarding the risks and benefits of using Cannabis to treat or provide relief for the petitioned conditions. 

However, some of the petitioned conditions (such as migraine headaches) already qualify patients for a medical marijuana registration card if they cause severe and chronic pain, severe nausea, severe and persistent muscle spasms, wasting, or seizures.

Whatever you think of the decision, just know that our team and I really took an objective and close look at the scientific evidence before making this decision.  And remember, the Act provides for a judicial review of this decision and a continuing petition process.  In fact, we’ll be accepting petitions again next week.

The Scientific Literature Gradient

July 18th, 2012

Medicine and public health have relied on peer-reviewed published scientific literature to help guide progress in patient treatment and public health interventions for decades- even centuries. For example, when we did the fact-finding to inform our decision about whether to add the petitioned conditions to the list of disorders that qualify for AZ medical marijuana cards- we (and the UA) turned to the scientific literature. Within the scientific literature- there are different categories of research designs that each have their strengths and weaknesses. 

Studies to assess the effectiveness of an intervention (like whether Cannabis is an effective treatment for depression) can have an Experimental or Observational design. For example, a randomized and controlled experimental study selects participants at random and places them in the intervention or control group and then follows up on the subjects over time to assess any differences in outcomes. Experimental studies generally provide the highest quality and most reliable results. 

An Observational study isn’t really experimental- rather, it’s a study that looks at natural variation regarding an intervention (or exposure) and looks at differences in outcomes among people or populations. Controlled observational studies can look at before and after conditions. For example, a cohort observational study can look at populations prospectively, retrospectively, or as part of a time series. Observational studies can also be of case-control or cross-sectional design. Observational studies can also simply look at a series of cases and look at interventions and outcomes without a control group. 

In general, the highest quality studies use the experimental approach and include a randomized design. Studies in the category can be very high quality if there is little bias and confounders are identified and controlled for… and if the study is large. Observational studies are generally of lower quality- although they can be quite useful if they limit bias, are consistent, direct, and control for confounding factors. The lowest quality study is what’s called a case series with no controls. Often, case series studies are simply observations made by clinicians- but without control groups… and they usually don’t control for confounders or bias.

 Anyway- you get the idea… scientific studies are absolutely critical to helping the public health system design interventions, make policy decisions, and measure results. Published scientific literature allows us to use science to inform our policy decisions and interventions in an objective way- increasing the likelihood that the public health system makes a positive impact in people’s lives.  Understanding what makes a published scientific study strong and compelling is critical to sorting through the published scientific literature for the types of strong studies that make for solid foundations for policy and intervention decisions. 

My post tomorrow will summarize ways to evaluate the quality and reliability of various kinds of studies.

Medical Condition Petition Status

July 6th, 2012

The AZ Medical Marijuana Act requires us to periodically accept petitions to add new medical conditions to the list of conditions that qualify folks for an AZ Medical Marijuana Registration Card.  In January, we accepted petitions from the public and had a public hearing in May.  Folks submitted numerous articles as a part their petitions for PTSD 1PTSD 2; Depression; Migraines; and Generalized Anxiety Disorder.   We also received lots of informal comments regarding adding PTSD; Depression; Migraines; Generalized Anxiety Disorder and General comments.

We also contracted with the U of A to review published scientific studies related to marijuana use and the petitioned conditions.  You can see the UA analyses for Depression; Generalized Anxiety Disorder; Migraine Headaches; and Post Traumatic Stress Disorder (PTSD) on our petition website.  Our ADHS medical team will be meeting within the next week or so and will be providing me with their analysis and recommendations.  The ultimate decision rests with me,  the Director, and I have a decision deadline in late July.