State Health Secretary Lynn Gallagher has rejected several recommendations by the New Mexico Medical Cannabis Program’s advisory board, including a proposal to allow marijuana as a treatment for opioid addiction that drew wide bipartisan support in a state that has struggled for decades with a substance abuse epidemic and one of the nation’s highest rates of overdose deaths.
A Republican-sponsored House bill in this year’s legislative session that would have added opioid use disorder as a qualifying condition for the cannabis program passed both chambers of the Legislature, but Gov. Susana Martinez vetoed it. She said she didn’t want to “eliminate an important responsibility” of the Medical Cannabis Advisory Board.
In her five-page decision released Wednesday, Gallagher also shot down allowing Alzheimer’s disease as a condition for enrollment, rejected telemedicine as a means to enroll new patients in the program and declined to increase the number of marijuana plants nonprofit providers may grow.
In the document, dated June 6, Gallagher turned down every recommendation that the advisory board made in November.
Anita Briscoe, an Española native and Albuquerque-based psychiatric nurse practitioner who had proposed adding opioid use disorder to the Medical Cannabis Program, said she was disappointed with Gallagher’s decision.
Briscoe has seen firsthand the effects of the state’s opioid crisis — in her hometown and in her work. She made the proposal, she said, after she and her colleagues collected reports from about 400 patients who said marijuana had eased the effects of their withdrawal symptoms and helped them overcome addictions to heroin and prescription painkillers.
“Opioid dependence can be addressed by cannabis,” Briscoe said Wednesday. “And I feel like [Gallagher] didn’t look deeply enough in the research.”
Along with her proposal in November, Briscoe had submitted articles from the American Medical Association, the American Journal of Public Health and the American Journal of Addiction.
Gallagher wrote in her decision that there have been anecdotal reports of patients with opioid addiction benefiting from cannabis use, but there “appears to be little if any medical literature that actually addresses the effect of cannabis usage on persons with a diagnosed opiate use disorder.”
Animal-based studies show that cannabinoids may help control opioid cravings, Gallagher wrote, but “they are by no means conclusive, and other studies have indicated that cannabis may be detrimental for persons who consume opiates.”
Chronic pain, a condition often treated with opioids, also is a qualifying condition for the Medical Cannabis Program, she added.
Gallagher said she’s concerned about opiate abuse both in New Mexico and across the U.S., but she isn’t certain whether cannabis would be a safe or effective treatment. “Also,” she wrote, “I am concerned that utilizing one addictive substance to treat dependence on another without reliable medical evidence and human research studies is problematic at best considering our current opiate epidemic.”
Briscoe disputed the assertion that marijuana is addictive, saying this is “proven not to be true.” Some people who use marijuana to treat conditions such as depression and anxiety may become psychologically dependent on the substance, she said, because it eases those mood disorders.
Briscoe agreed with Gallagher on one point: There’s not enough research on marijuana’s effect on opiate addiction.
“Research is not allowed with human subjects,” she said.
Gallagher also cited the lack of studies on the effects of cannabis use among people with Alzheimer’s disease or other types of neurodegenerative dementia.
Telemedicine should not be used to enroll patients into the medical marijuana program, Gallagher said, because there is already less oversight of patients’ use of medical cannabis than of prescription medications. Also, she said, evaluations of patients by telemedicine “could further erode the already limited contact that patients have with certifying practitioners.”
And while the request for use of telemedicine asserted there were too few certifying practitioners in rural areas, Gallagher and the Department of Health disagreed. “In fact,” she wrote, the number of certifying practitioners continues to increase as the Medical Cannabis Program grows.”
In her rejection of the advisory board’s recommendation to increase the plant count limit for licensed providers, Gallagher wrote that proposing changes to producer rules does not fall within the board’s responsibilities.
In April, the advisory board recommended additional program changes, proposing the Department of Health add six other conditions to the list of 20 ailments that qualify patients to enroll in the program and that the department increase the amount and potency of cannabis a patient can possess. Gallagher has yet to decide on those recommendations.
The conditions proposed for the program include attention deficit hyperactivity disorder; autism; anxiety; depression; chronic headaches, including migraines; sleep disorder; and dystonia, a neurological condition that causes muscle spasms, tremors and other problems with movement.
For her part, Briscoe said the push to enlist marijuana in the fight against opioid addiction is only beginning. Her proposal has received national and international attention.
“I’ve started going around the country to speak about it,” she said. “So the momentum is not going to stop.”
Contact Justin Horwath at 505-986-3017 or firstname.lastname@example.org.