Last December I denied a petition to add Post Traumatic Stress Disorder (PTSD) to the list of debilitating medical conditions that qualify people for an Arizona Medical Marijuana Registration Card. I denied the petition because, at the time, I believed there was a lack of scientific evidence to document whether Cannabis is helpful or not to treat or provide palliative care for PTSD.
The Petitioners appealed my decision to the Arizona Office of Administrative Hearings earlier this year. A few weeks ago the Administrative Law Judge ruled that: “… the Appellant’s appeal is granted and that PTSD is added to the list of debilitating conditions for which marijuana may be dispensed”.
Among the reasons why Judge Shedden issued a recommendation that was different than my decision was that our Rules invite petitioners to submit information other than peer-reviewed data with their petition… and I primarily considered the presence or absence of peer-reviewed data in my December decision. Also, during the March hearing the Petitioners referred to a manuscript (at the time yet to be published) that found an association between Cannabis use and PTSD symptom reduction in some patients. That article was subsequently published in the Journal of Psychoactive Drugs (March 2014). In other words, the information presented by the Petitioners at the hearing and the subsequent published study provided evidence that marijuana may be helpful in the palliative care of PTSD in some patients.
Therefore, today I issued a Director’s Decision that will authorize the use of marijuana (under AMMA) for patients that are currently undergoing conventional treatment for a diagnosis of PTSD. Physician certifications would be valid only for palliative care of PTSD symptoms (not treatment). Certifying physicians will be required to attest that they have reviewed evidence documenting that the patient is currently undergoing conventional treatment for PTSD before signing the medical marijuana certification.
The implementation date of this decision will be January 1, 2015. This allows a few months for certifying physicians, dispensary medical directors, and dispensary agents to develop policies and procedures and educational materials required by our Rules.
JULY 9, 2014
For Further Information, Contact:
Nurse Heather (contact information, above), or
Ken Sobel, Esq., Attorney for AZCNA
C: 619.208.2439 or E-mail: [email protected]
FOR IMMEDIATE RELEASE
NURSES ASSOCIATION CELEBRATES VICTORY FOR VETS IN ARIZONA
A year-long battle waged by the Arizona Cannabis Nurses Association on behalf of PTSD victims – particularly thousands of military service members and veterans returning from Iraq and Afghanistan – ended in victory on Wednesday when Arizona Department of Health Services (“AZ DHS”) Director, Will Humble, announced that he would yield to a Judge’s Decision and allow Post Traumatic Stress Disorder to be listed as a debilitating condition allowing PTSD sufferers to qualify for the right to use medical marijuana to treat the condition.
Nurse Heather Manus, RN, the President of the Arizona Cannabis Nurses Association (“AZCNA”), a nurse’s education and patient support group, hailed the decision on behalf of PTSD patients state-wide. “This is a major step forward for our war heroes and others who suffer from PTSD. Unlike the conventional medications used for PTSD, medical cannabis is a gentle plant therapy which helps in all aspects of the disorder – fear extinction, memory retrieval and stress mediation.” Nurse Heather has been a medical director of a Santa Fe, New Mexico cannabis dispensary since 2010, and as an in-home psych nurse there she frequently helped vets with PTSD to get off other harmful pharmaceutical medications that have serious side effects, and replace those with medical cannabis.
“In New Mexico, PTSD patients have had safe access to cannabis since 2009, and after 4 years and several thousand patients, there has not been one reported adverse effect from its use.” A panel of doctors and scientists in New Mexico unanimously added PTSD in 2009, and unanimously retained it in 2013. Indeed, 13 states now approve medical cannabis for PTSD (including adult-legal Washington and Colorado), and the last 5 states to consider it have added it or retained it. New York – which adopted a medical cannabis program last month – included PTSD as a debilitating condition in its enabling legislation, and therefore became the 12th state to add PTSD. Arizona now becomes the 13th.
In total, 32 states have now approved some form of legal medical cannabis including 9 predominately “red states” whose state legislatures adopted a “Charlotte’s Web” law in 2014 allowing legal access to high CBD Cannabis Oil for the treatment of seizure disorders in children. Two others – Missouri and North Carolina – are set to add such a law this year.
The AZCNA was represented by Ken Sobel, a Tucson native and former student body president of the University of Arizona, and the founder of Spring Fling and the Arizona Student Association. Mr. Sobel applauded the Director’s decision, stating: “This was actually an easy case to prove. Judge Shedden got it right. Politics aside, the science is the same in Arizona as it is in New Mexico, Nevada and California – contiguous states that have listed PTSD in their medical cannabis programs. Hats off to the AZCNA for tirelessly and selflessly pursuing this case on behalf of our returning war heroes.”
This is especially so in Arizona, the poster child for VA healthcare neglect – where many of our returning vets, including those with symptoms of PTSD, spend 6 months, or more, waiting for even a first visit. Now they can safely access medical cannabis at any of the more than 80 legal dispensaries statewide, once they receive a medical recommendation and AZDHS Patient Card.
The evidence proved that more than 500,000 Arizona residents suffer from PTSD, a serious and debilitating condition involving nightmares, flashbacks, social issues and hyper-vigilance. Although the majority of PTSD sufferers are women – typically as a result of domestic or sexual abuse – it has reached epidemic proportions for our veterans and returning service member community. Government studies show that more than 30% of our returning war heroes suffer from PTSD, and twenty-two veterans commit suicide daily.
On July 25, 2013, the Arizona Cannabis Nurses Association (“AZCNA”) filed a 109 page Petition with AZDHS to Add PTSD as a debilitating condition. The Petition was initially approved for a public hearing which was held at the Department of Health Services in Phoenix on October 29, 2013. Fourteen witnesses, including three doctors and one registered nurse, testified in favor of adding PTSD, and only one anti-smoking advocate against it. However, the AZDHS only allowed each witness about 2 – 3 minutes to testify. In addition, 700 PTSD patients and family members urged the Department to add PTSD through an AZDHS website portal with only two opposed.
However, Director Humble rejected the Petition on January 14, 2014, and the AZCNA appealed.
The Arizona Office of Administrative Hearings (“OAH”) appointed Judge Thomas Shedden to hear the appeal, and between March 26, 2014 and May 15, 2014, more than 24 hours of evidentiary hearings occurred. Three medical doctors – including a doctor who served as the chief medical officer for the US Olympic Track & Field team – and Cannabis Nurse Heather – testified to a “reasonable degree of medical certainty” that medical cannabis was “safe and effective” in the treatment of PTSD.
On June 4, 2014, Judge Shedden announced his decision reversing the Director’s decision, and ordered that PTSD be added as a debilitating condition. Judge Shedden found that AZCNA had presented “substantial evidence” that PTSD sufferers receive a palliative benefit from medical cannabis.
After 35 days, Director Humble finally conceded to the Judge’s decision.
This is a landmark case. This is the first time in the United States where a debilitating condition was added by a Judge’s ruling following a denial by a state agency. Further, this is the first new condition added under Arizona Law in the four year history of the Arizona Medical Marijuana Act. AZDHS had previously denied all 20 petitions seeking to add PTSD and other conditions submitted to it.
As far as the additional conditions imposed by Director Humble – delaying the implementation to January 1, 2015, and limiting patient access to cannabis therapy to only those patients currently undergoing “conventional therapy” – such conditions are not authorized under the law and represent a clear abuse of discretion, discretion that the Department does not have either under the law or the rules, specifically Arizona Administrative Code Rule R9-17-106.
How dare you Mr. Humble refuse to implement the PTSD decision retroactively to the day Thomas Sheddon issued his opinion. Over 50,000 of our veterans alone are suffering from PTSD in Arizona and that does not include victims of rape, trauma and sexual assault (including incest). Victims of priest pedophile (and there are millions of those) are also eligible for cannabis therapy with a doctor’s note.
Please be aware that PTSD (Post Traumatic Stress Disorder) includes everyone that is victim not just veterans of our constant and endless wars. End the war on cannabis and allow all our victims to have access to the medicine TODAY!
You of course will say NO and a court order will overrule you once again you are the prohibitionist’s best friend Humble!
Mr Humble I ask that we stop delaying the need’s of Vets and Civilians with PTSD..I’ve personally dealt with DES regarding basic healthcare insurance I have battled for 8 months to finally have health insurance.As stated before after spending 14 years in healthcare I’m in the process of SSDI
Vets are suffering and Civilians regarding these issues at State and National level..Also I’m battling for SSDI as well thank god I have family support along with my card or I could have not have gotten this far..
As stated before in your previous discussion I have PTSD due to being placed in Arizona State Foster care. Being a victim of abuse,sexual assault reporting it and it being cover up I know will never receive justice.If I’m going thru these issue many other Arizona are as well.Please stop delaying care for PTSD
22 Vets a day commit suicide. That is over 8,000 a year. Approximately 4,000 Vets will have taken their lives by the time Will Humble effective date takes place on January 1st, 2015. Some of those Vets will be from Arizona. Some of those Vets would not die if they understood there was another potential solution for them when all others have failed. Will Humble you have our Veterans’ blood on your hands. Shame on you, shame on the entirety of the State of Arizona who politicians and bureaucrats are failing those who served.
Mr. Humble you saw this coming when you were smoking pot in college and we were treating our Vietnam Veterans for “Shell Shock” or PTSD with natural marijuana not Marinol. This is not new to you. You are an Epidemiologist with a billion dollar budget. You have “drug” this medical marijuana inevitability out to the bitter end while you invested heavily in synthetic behavioral health medications that compete with pot. You were with Arizona Health Services in 1996 when we approved medical marijuana with a 65% margin. Don’t pretend like ya didn’t see it coming or that you are not aware of the unnecessary pain, suffering and death caused with this unforgivable recalcitrance.
The head cops cut the ribbon in Washington today and buried a painful and deadly hatchet that has split this nation down the middle. Get on the right side of history and your responsibility to serve the citizens of Arizona.
Good thing when goodness is recognized.
Please tell them why you have to put this off to January 1, 2015 Mr. Humble.
Good thing when goodness is recognized.
It is unfortunate that you have to be taken to court just to lose so often. I would think at some point you might start to see the other side and become more receptive of the changing landscape with regard to medical marijuana. Fortunate the community persists to challenge your shortsightedness that is keeping help out of reach of patients / veterans. It is painful to think of the relief you have denied so many for too long.
Mr Humble Please stop delaying care to Vets and Civilians and help pioneer research in this state.So we can help vet’s and civilians.Another vet lost there life today from a police officer our community.
Vet’s are losing there life’s to not only suicide but DUI,police officers and Alcoholism list can go on some people don’t have 6 months or health insurance to wait for care to manage symptoms.Thank you Mr Humble for your time.
At least you are not considering these medicine as the last resort. Most of the doctors are maybe tired taking care PTSD patients and want to do “shortcut” so that $$$ will roll out fast. Less work but Lots of cash.
I ask that you take the necessary time to implement the law into effect.I also ask that you help hospitals with providing necessary care with civilians and vet’s with PTSD acute stress disorder.
Not turn PTSD patient’s away when they are having symptoms related to PTSD. Provide the patient with additional treatment resources for help.We should not have patient’s to the point where they are a threat to self or other before they recieve help.
I have gone thru the process of trying for 9months to get necessary help that I need for complex treatment resistant PTSD.I have had PTSD for 20 years also working in healthcare field for 15year’s in hospitals I have seen first hand.The failure of Arizona healthcare system.
Mr Humble I ask that you implemented law Asap with great thinking to help those we care for with PTSD not just with alternative medicine but also providing additional knowledge to hospitals and treatment facility’s and Dr’s.
Mr Humble majority of State Licensed Dispensary owner’s are not going to put patient’s first they will put profits before patient’s.Please the take time you need to implement law so we have a solid system the helps patient’s at the same time help’s the patient’s seek treatment and care.
Majority of the loud mouth’s Mr Humble that are getting laws passed are profiting HUGE financially.I ask that you put patient’s first before dispensary’s putting political pressure on you.
If I knew the people I was working with people were profiting off patients I would have never sat in the court room when (name removed by editor) testified waiting and being up every night until the next hearing.Open my life up again to this misery of PTSD. Mr Humble I asked these same people in front of camera’s for help I was thrown under bus.
Mr Humble thank you for your time
Hello Mr Humble,
I would like to help you improve the healthcare system also regarding PTSD as well Mr Humble.If you could please implement law Asap with additional info stated below will help people immediately.
Majority of local city’s in Maricopa County have there own channel.Could we please some how team up with local city’s and provide resident’s help regarding suicide prevention and such.I see on my local channel Domestic violence prevention and number’s.
It would help out the west valley a ton with Luke Air-force base.Also if we could provide additional literature to State Licensed Dispensary’s regarding different treatment option and help number’s.
Some Civilians and Veterans do not have internet if they are struggling financially for additional help as well.If they feel vulnerable the can reach out for help as well.
If a patient shows up to a local hospital and has a diagnosis of PTSD or another mental illness.We automatically provide additional literature on DC order’s.Much like educational literature that is provided with a common cold or cluster headache.It would help a ton for a patient that is not at the point of hurting self or other’s.If they are they could call a help line.
I hope you take these ideas and other’s to help with PTSD and implementing asap Mr Humble thank you for your time
Mr Humble I’ve stated many times before why I have PTSD I would like to call on you and other political leader’s.To outlaw the use of Blanket wrap’s as restraint’s in the Arizona State Foster Care System and Juvenile Correction system.
So another child does not lose there life there are many article’s on this topic.As well the media attention it brought to Phoenix in Feb 1995 when a child lost in Arizona Foster Group Home.I have witnessed this first hand Mr Humble I know from exp .Please look into this so another child does not lose there life.I will sleep a lot better at night and have peace.
I thank you Mr Humble for listening to me.I appreciate you adding PTSD to list.Thank’s again for you time