State leads U.S. in medical marijuana testing

Questions remain as attitudes toward the medicine evolve
April 27, 2018

Eight years into its medical marijuana program, Delaware can lay claim to having the top medical marijuana testing program in the country, the program's administrator says.

Paul Hyland, administrator for the Delaware Office of Medical Marijuana, said the state is testing every batch of medicine through an independent contractor, which makes Delaware a pioneer in that area.

Delaware lawmakers legalized medical marijuana in 2011, and the state's first dispensary, First State Compassion Center, opened June 2015 in Wilmington. Nearly two years later, in May 2017, First State opened the state's second compassion center in The Vineyards off Route 9, a few miles outside Lewes.

To ensure quality and compliance statewide, in November 2016 the Delaware Division of Public Health named Harrington-based AgroLab Organic to test medical marijuana for dispensaries statewide.

Hyland said he originally looked to other states for examples of established medical marijuana testing protocols, but, he said, there really are no established processes. There was a vision to test every plant in Delaware, but that wasn't feasible, he said.

Hyland said batches of marijuana are tested for molds, funguses, critters, debris and bacteria. A batch is defined as any plants with the same genetics, grown in the same room at the same time, he said.

Hyland said 4,424 patients, 260 caregivers and 12 pediatric patients are enrolled in the program as of March 12.

Hyland said when the program first started, he thought the number of patients would top out at 5,000, but he expects to reach that number by the end of the year. He said he now expects the number of patients to top out at 9,000, and he attributes the rise to broader acceptance of marijuana as medicine and successful petitionning by patients to allow more conditions to qualify.

Hyland said two more compassion centers are scheduled to open in 2018 – Columbia Care in Kent County and Compassionate Care Research Institute in New Castle County.

He said it's frustrating that only one company is currently producing medical marijuana for the entire state, but both new companies are actively growing medicine, and he said he expects both to open to patients in early summer.

Hyland said the state has consolidated the medicine tracking system with BioTrackTHC, which will allow compassion centers to know the up-to-the-minute amount of medicine a patient has purchased.

Pediatric patients challenged

If there's a stigma associated with adults who use medical marijuana, it's 10-fold for adults who are interested in their child using it.

Dawn Wells' daughter Kenedy Welch is a 15-year-old student in the Indian River School District. She said Kenedy has a number of neurological conditions affecting her brain function.

"She's a rare bug. Complex," said Wells affectionately. "The thing is, looking at her, you wouldn't realize it, until she begins to talk."

Wells said Kenedy has had problems from an early age. Kenedy's first brain surgery was at the age of 1, and she also had stomach surgery.

"Her body looks like she's been in a knife fight," she said.

Wells said she's interested in having Kenedy try medical marijuana because she's exhausted every other avenue of medication. The problem in Delaware, she said, is that very few pediatricians are willing to sign off on a pediatric marijuana use.

"I'm not sure what else to do," she said.

Wells said Kenedy takes 28 pills a day, which doesn't include previously prescribed seizure medicine she's allergic to. Wells, who lists medications and procedures like a well-trained physician, said Kenedy has tried other seizure-related medicines, but has had adverse reactions.

"They make her just crazy," she said.

Under the state's medical marijuana law, pediatric patients suffering from seizures can be prescribed oils derived from the plant, but those patients need caregiver and doctor approval.

Wells said she's been trying to get Kenedy's doctors to approve her for the oils, but it's been a difficult road. She said doctors have no problem giving children medications that are more harmful to them than medical marijuana.

"It's ridiculous," she said.

Wells said she thinks doctors don't want to deal with the stigma associated with prescribing medical marijuana for pediatric patients.

Specifically related to Kenedy's case, Wells asks, what is there to lose?

"She's allergic to everything else. If it doesn't work, then OK," she said. "She's taken so many pills, and there's been no relief. Any kind of normalcy would be great."

Wells said she wants to see if medical marijuana can help unlock what's inside Kenedy.

"My daughter is in there, peering through the windows. We see glimpses, but she's stuck inside her own brain," she said.

Filling the doctor/patient void

In Delaware, before obtaining a medical marijuana card, a patient must get written certification from a Delaware-licensed physician who has a bona fide relationship with the patient. Even if a patient has a qualifying condition, the physician is not required to certify patients.

Some doctors, who may not have been trained on marijuana-based protocols, remain hesitant to prescribe marijuana, which means that, although marijuana is becoming more acceptable in medical circles, some patients have not been able to try it.

This void in the patient-physician relationship has created an opportunity for some physicians who do accept that marijuana has medicinal purposes.

One of those physicians is Lisa Deberardinis, an anesthesiologist, who has partnered with businesswoman Carrie Fischer to open Disjointed on Route 1 in Lewes, in the Key West-colored development near Baker's Exxon.

This is Fischer's second attempt at opening a doctor's office in the Cape Region with a focus on medical marijuana.

In early March 2017, she and Dr. Matthew Roman opened Nature's Way Medicine in Nassau Commons, but the office quickly closed.

Fischer, who has a background in pharmaceutical sales, said there's a need for establishing a safe alternative to the opioids many patients are prescribed. She said she's back in business because there's an opportunity to help patients, and then described Disjointed as a non-narcotic pain management office.

Deberardinis, an anesthesiologist for 15 years, said she is willing to work with patients who think medical marijuana may be a viable option or with doctors who still have qualms about filling out the paperwork.

"I look at chemicals, and their ability to work, on a scientific basis," she said. "This seems necessary. There's a lot of patients who can't get off prescribed painkillers."

Fischer said big pharma may not be happy, but there are plenty of patients who need medical marijuana.

Deberardinis said her job is to screen patients to see if they fit the criteria associated with the qualifying conditions – which include cancer, terminal illness, AIDS, HIV, decompensated cirrhosis, amyotrophic lateral sclerosis (Lou Gehrig's Disease), agitation of Alzheimer's disease, autism with aggressive behavior and a list of conditions that are associated with chronic or debilitating diseases.

Deberardinis said she doesn't see medical marijuana as a cure-all, but it should be an option for patients who haven't had success with other medicines.

Fischer said there's a large population of people who are convinced medical marijuana helps, and they don't want to take pills.

"They want a safe alternative," she said.

Deberardinis said she wants a patient's primary care physician to refer them to her; she said she's not OK with going against the advice of the primary care physician.

"We're going to be thorough," Deberardinis said. "This isn't going to just be a place where someone can come in and get a card. I wouldn't hesitate to call a primary care physician if there were any questions."


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