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A07006 Memo:

submitted in accordance with Assembly Rule III, Sec 1(f)
SPONSOR: Gottfried (MS)
  TITLE OF BILL: An act to amend the public health law, in relation to conditions permitting the use of medical marihuana   PURPOSE OR GENERAL IDEA OF BILL: This bill would make post-traumatic stress disorder (PTSD) an eligible condition under the state medical marijuana law.   SUMMARY OF PROVISIONS: Section 1 of this bill amends section 3360 of the Public Health Law, to add post traumatic stress disorder to the list of conditions for which medical marijuana may be used. Section 2 of this bill provides that this act shall take effect imme- diately.   EXISTING LAW: The Public Health Law specifies ten medical conditions that are eligible for use of medical marijuana and chronic pain has been added by action of the Health Commissioner. PTSD is not among those conditions.   JUSTIFICATION: Post-traumatic stress disorder (PTSD), first defined in 1980, is a seri- ous condition that involves a person developing symptoms - such as anger, flashbacks, nightmares, night sweats, numbing, insomnia, and avoidance - after experiencing a traumatic stressor. Many patients find the available pharmaceutical options dangerous or ineffective, and thou- sands of them have turned to medical marijuana for relief. States are increasingly adding PTSD to their lists of qualifying conditions for medical marijuana. PTSD afflicts numerous patient groups. While the public typically asso- ciates PTSD with military veterans, PTSD is also found among survivors of domestic violence, rape, violent crime, accidents, and among police and fire fighters. Women are twice as likely as men to experience PTSD. PTSD results from an endocannabinoid deficiency. The endocannabinoid system is part of the brain and nervous system involved with appetite, pain-sensation, mood, and memory. With PTSD, the body stops producing enough endocannabinoids to fill receptor sites. This is where the canna- binoids found in marijuana play a therapeutic role. Of the 28 states with medical marijuana programs, 23 cover patients with PTSD. Six of those states collect patient use data. Extrapolating from the relative number of PTSD patients in those six states, approximately 19,000 patients with PTSD in New York could benefit from the use of medical marijuana. Some argue that treatment of PTSD with medical marijuana is not based on double-blind clinical studies proving its efficacy. However, most of the drugs commonly used to treat PTSD also lack clinical proof of their efficacy. Only two drugs have been approved by the FDA for the treatment of PTSD: sertraline (Zoloft), and paroxetine (Paxil). Unlike medical marijuana, both of these drugs have serious side effects, including the risk of suicide, weight gain, and the onset of diabetes. Every other drug used in the treatment of PTSD is prescribed "off label," which means they were not approved by the FDA for the treatment of PTSD. Many of these drugs, which include benzodiazepines, antipsychotics, and mood stabilizers, are even more dangerous and addictive than Zoloft and Paxil. Indeed, the Army Surgeon General issued a warning against the use of antipsychotics for veterans with PTSD in 2012. While available research about medical marijuana for PTSD is limited-be- cause of federal obstacles to conducting such research-the research that does exist supports the use. For example, a Canadian study involving naboline - a prescription drug made of a synthetic cannabinoid (compo- nent of marijuana) reported that, "The majority of patients (72%) receiving naboline experienced either cessation of nightmares or a significant reduction in nightmare intensity. Subjective improvement in sleep time, the quality of sleep, and the reduction of day-time flash- backs and nightsweats were also noted by some patients." In New Mexico, a 2014 study of 80 patients who administered medical marijuana for PTSD, pursuant to state law, found "greater than 75% reduction in CAPS (Clinician Administered Post-traumatic Scale) symptom scores were reported when patients were using cannabis than when they were not... There is extensive evidence that cannabinoids may facilitate extinction of aversive memories." They also found a 77% reduction in suicidal thoughts, and a 50% reduction in the use of medications. The New Mexico study also reported that not a single adverse event occurred among over 3,350 patients with PTSD using medical marijuana that they were tracking.   PRIOR LEGISLATIVE HISTORY: New bill.   FISCAL IMPLICATIONS: The State of New York and certain counties will realize additional tax revenue from the sale of medical marijuana to patients with PTSD.   EFFECTIVE DATE: Immediately
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