Medical cannabis is replacing prescription drugs for Connecticut’s middle-aged, elderly

July 08--Since the Thames Valley Alternative Relief medical marijuana dispensary opened in Uncasville in 2014, the pharmacists who run it always have seen a diverse bunch coming to the door. The conditions initially approved to qualify people to access medical cannabis products then ranged from cancer to post-traumatic stress disorder, which can affect young and old, rich and poor.

"We've always had a good mix of people," owner Laurie Zrenda said.

As of this week, 26,652 Connecticut residents are registered with the state's medical marijuana program, which allows them access to one of nine licensed dispensaries and possession of up to 2.5 ounces of cannabis at a time. The law that created the program protects any information about participating patients -- including their average age and which diagnoses on the list of approved conditions are most common -- from public information requests.

But doctors, dispensary owners and state officials say medical marijuana is becoming less of a novelty and more a last-ditch effort for older patients with cancer or painful debilitating conditions who are fed up with the side effects of opioids and other prescription medicines.

"They're in pain and they don't know what to do, and it leads them here," Zrenda said.

Joann Church, 68, was prescribed opioid painkillers after non-Hodgkin's lymphoma left her in such extreme pain that she rarely left the armchair in her Montville living room. At one point she was taking multiple narcotic drugs, which caused side effects that required multiple surgeries and left her bloated, still often unable to leave the house and on antidepressant medications.

"I needed to get out of going around this revolving door," she said. "I was just not doing anything. I did not want to live my life that way."

Her oncologist suggested medical marijuana; a physician at his practice, Eastern Connecticut Hematology and Oncology, was registered to certify her for a card. Church said she hesitated at first, worried that the cannabis would make her intoxicated and her friends and family might judge her for using what they saw as an illegal drug.

"I was very skeptical, especially at my age, to let anyone know that this is what I was doing," she said.

Church learned online that she could buy cannabis in an oil form -- she has a chronic inflammatory lung disease, so smoking was out of the question -- and attended a workshop in Massachusetts, where she learned how to infuse the oil into honey that she puts in her tea every morning.

The oil was so effective that Church cut out five different prescription drugs, including the narcotics, from her daily routine. The cannabis treated the pain as well as the opioid drugs but also helped her sleep and eased her anxiety. She even made it into a balm that she said healed a burn on her hand almost overnight.

The cannabis oil is expensive -- she spends almost $100 for a few ounces of oil that she infuses into honey or candy that lasts for weeks, and insurance companies don't cover it -- but she said she spends less than she used to in co-payments on her prescriptions.

Church's friends noticed she looked healthier soon after she replaced the opioid drugs with the cannabis-infused honey.

"They would ask me, 'What are you doing?'" she said. Even then, she worried about telling them.

"The only thing that held me back was the (stigma)," she said. "I didn't want people thinking ... 'Oh gee, is she high?' I wanted them to see me how I was."

Now, she said, she considers herself an advocate. "I can function," she said. "And no one knows unless I tell them."

That kind of word-of-mouth spread of information is how many people come around to medical marijuana despite decades of anti-drug messaging and laws making marijuana an illegal substance.

"So many people will come in saying 'my sister-in-law has a card,'" Zrenda said. As more people realize that using medical cannabis won't make you high, "this whole program is growing," she said.

Most of the people who still are hesitant when they arrive at her door are older.

"I don't get a lot of ... people in their twenties who are nervous about it," she laughs.

James Preston, who lives in Willimantic and has replaced a Vicodin prescription for a back injury with a few puffs of vaporized cannabis oil each day, regularly speaks to fellow veterans in a support group. Some are resistant to trying medical marijuana because of the lingering memory of their fellow service members becoming addicted to illegal drugs during the Vietnam War.

"They still have that feeling (about) what happened over there with the drugs and the heroin," he said. He has been able to persuade several of them to apply for a card.

"I just tell them how it's worked for me," he said.

Dr. John Paggioli, who practices at the Eastern Connecticut Pain Treatment Center in Norwich, said he only recommends his patients try medical marijuana when they already have been prescribed opioid painkillers that they found didn't adequately address their pain.

"All ages have interest in it," Paggioli said. Most are comfortable asking for it, either because they have used marijuana recreationally, or because they are out of options once opioid painkillers stop working, he said.

Paggioli said of about 150 patients to whom he has prescribed opioids, only a handful have replaced those medications with medical cannabis. Most of those patients have psoriatic arthritis or "post-laminectomy syndrome" that affects people who still are in pain after spine surgery. He also occasionally recommends it to people with fibromyalgia, though it hasn't yet officially been added to the list of approved conditions in the program. State Consumer Protection Commissioner Michelle H. Seagull recommended adding fibromyalgia to the list last year but final approval by the state Office of the Attorney General and a General Assembly committee still is pending, so any of Paggioli's patients also must be diagnosed with one of the other conditions on the list before he can refer them for a card.

Because the federal government classifies marijuana as a schedule 1 drug, rigorous research on medical marijuana, including its effects on seniors, is hard to come by.

Anecdotally, Paggioli said, medical marijuana works better for some patients than others. "I've seen a wide range of reactions to using it."

For some of his patients, cannabis can't adequately replace the pain-relieving properties of narcotics. But others entirely have replaced their Oxycodone or Percocet prescriptions with cannabis.

"Some people say it does nothing," Paggioli said. "A lot of people say it helps them sleep. The best response I ever heard was one patient who said that it equated to the effect of his sleeping pill, his muscle relaxer and his antidepressant."

Zrenda said more of her customers -- including an increasing number of people over the age of 80 -- are turning to medical marijuana after they find their prescription medications, especially narcotics, lose effectiveness over time.

"I hear that sentence all the time -- they've tried everything and they don't know what else to do," she said.

After they find the right medical cannabis product for them with the appropriate levels of THC, the chemical component that causes intoxication, and CBD, which doesn't, she starts hearing a different sentence: "'I don't know why I didn't do this three years ago.'"

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