Integrative Medicine Blog

Medical Marijuana Comes to the Stram Center for Added Options for Patient Symptom Control

Heidi Puc, MD Wednesday, March 02, 2016

The Stram Center is pleased to be able to prescribe medical marijuana to patients meeting required NYS mandated criteria.We believe that medical marijuana will be a good symptom control option for patients not adequately benefiting from conventional pharmaceutical symptom control options for the qualifying conditions.

Medical marijuana, a controlled substance and classification in the United States as a Schedule I agent with high potential for abuse, is now able to be prescribed in designated forms by registered physicians for specified indications.It is derived from the Cannabis plant (including Cannabis sativa and Cannabis indica species), and this plant has been used in medicine for thousands of years prior to achieving its current status as an illicit substance.

The human body has an endocannabinoid system, comprised of receptors or binding sites for cannabinoid substances which are either made in the body or taken in from outside the body.CB1 receptors are found primarily in the brain, and CB2 receptors function in our immune system and are anti-inflammatory.

Two major components of cannabis include THC (Delta-9-tetrahydrocannabinol) and CBD (cannabidiol). THC is responsible for the therapeutic effects of cannabis use such as decreasing nausea and vomiting, increasing appetite, decreasing pain, and increasing muscle relaxation. It can however cause dizziness, sleepiness, and disorientation and has psychoactive properties. CBD alleviates anxiety, decreases seizures, relaxes blood vessels, causes pain relief, and is anti-inflammatory. The relative ratios of THC and CBD vary in the different allowable medical marijuana products available from NYS dispensaries.

In NYS, in order to receive a prescription for medical marijuana from a registered prescribing NYS physician, a patient must be diagnosed with one of the qualifying conditions listed: cancer, HIV/AIDS, amyotrophic lateral sclerosis (ALS), Parkinson’s disease, multiple sclerosis, spinal cord injury with spasticity, epilepsy, inflammatory bowel disease, Neuropathy or Huntington’s disease. In addition to the qualifying condition, one of the following associated conditions must be present: Cachexia (wasting syndrome), severe or chronic pain, severe nausea, seizures or severe or persistent muscle spasms.

The prescribing NYS physician will need to complete a special medical marijuana prescription through the Health Commerce website, specifying the mode of medical marijuana delivery (vaporized/inhaled, oral/mucosal, oral capsule) as well as ratio of THC :CBD (1:9, 1:1, or 9:1). The patient would need to acquire a registration card through NYS in order to receive the prescribed medical marijuana. The medical marijuana would be obtained from specific NYS dispensaries. The dispensaries give recommended dosing through their pharmacists, and doses are readjusted based on patient response.