Still some reservations, but medical marijuana is making a difference for some in Valley

May 14--Maria Belkadi said the medical marijuana she and her husband, Massi, 52, get for their son has helped him.

Marksen, 9, has severe autism and is nonverbal. There have been days when he screamed constantly and was prone to violent outbursts. He has struck and bitten his parents and has even punched himself.

But the plant's medicine has helped calm him, as well as helped him become more verbal, his mother said.

They currently get the medicine in oil form from a dispensary in Washington, D.C., as they go through the process to get his marijuana card for Pennsylvania, then continue to pay the costs for doctor visits and obtain the drugs that health insurance won't cover.

"He gets it usually just once a day," said Belkadi, 39, of Mount Carmel. "I can say, overall, that it's helped. We still haven't found the perfect strain. We've gone through seven or eight different strains. Some of them were terrible, some of them made him worse, some were terrific."

The couple has tried the different strains of medical marijuana from different states. Parents of children eligible for medical marijuana are temporarily allowed to travel to other states to get the drug, if other states allow them access, under the state law.

"I can say, overall, his bad days are a lot better than they were, but he's gotten older and he's gotten stronger," she said. "He's more vocal, he uses sign language a little bit more than what he was. As far as medications go, marijuana has helped him more than any other medications. He's still on other medications."

While the Belkadis and other parents say medical marijuana has helped their children, there still are concerns by some in the medical field about marijuana and whether there just are too many harmful effects.

Dr. John Pagana, a Sunbury family physician who specializes in addiction, said that while the drug seems to work for seizures, he's concerned that there haven't been enough studies that show what all is in the herb.

"There is a medicinal purpose, especially this cannabidiol (CBD) that works for these kids with seizures," Pagana said. "For pain, it's already better than opiates."

He noted, too, there are 25 percent fewer deaths from opiate overdoses in states where marijuana is legal.

But he still has reservations.

"I would like to see more studies done," Pagana said. "We're not sure of the long-term effects."

He said there are more than 300 different chemicals in marijuana.

"We're not sure what they all do. I'm just cautious about it."

What medical conditions are serious enough?

Pennsylvania's medical marijuana program defines a "serious medical condition" as any one of the following:

--Amyotrophic Lateral Sclerosis

--Autism

--Cancer

--Crohn's disease

--Damage to the nervous tissue of the spinal cord with objective neurological indication of intractable spasticity

--Epilepsy

--Glaucoma

--HIV (Human Immunodeficiency Virus) / AIDS (Acquired Immune DeficiencySyndrome)

--Huntington's disease

--Inflammatory bowel disease

--Intractable seizures

--Multiple sclerosis

--Neuropathies

--Parkinson's disease

--Post-traumatic stress disorder

--Severe chronic or intractable pain of neuropathic origin or severe chronic or intractable pain in which conventional therapeutic intervention and opiate therapy is contraindicated or ineffective

--Sickle cell anemia

Pagana's opinion reflects that of Dr. David Casarett, professor of medicine at Duke University and the chief of palliative care at Duke Health in North Carolina, who spoke about medical marijuana when he presented the ninth annual Charles P. Fasano, D.O., Memorial Lecture at Bucknell University on Thursday night.

Casarett investigated the topic of medical marijuana for his 2015 book, "Stoned: A Doctor's Case for Medical Marijuana."

"We don't know a whole lot of what it does," Casarett said.

Pagana does believe that health insurance should cover medical marijuana use where it's proven effective.

"These kids with seizures, it should be covered," he said. "Seizures -- that's a dangerous thing. If that's the only drug that works, they (insurance companies) should pay for it."

Pennsylvania Department of Health spokesman Nate Wardle said, though, "Insurance companies are not required, by the statute, to cover the purchase of medical marijuana, and at this point we are not aware of any that are."

Medicaid and Medicare also do not cover medical marijuana, which has not been approved by the Federal Drug Administration.

Without insurance coverage, that means families such as the Belkadis will end up paying close to $100 or as much as $150 out-of-pocket each month for the drug alone.

Then there are the other costs involved. The Belkadis are in the process of getting Marksen's marijuana card to obtain the drug in Pennsylvania.

"Everything is in the works," Maria Belkadi said. "We likely will be using the dispensary in Scranton."

She said the process to get the card is expensive and time consuming.

"It's a lot more difficult than I thought it was," she said.

Because she obtains the drug as caretaker for her son, she has to undergo a background check and get fingerprinted, then wait for more than a month for the background check to go through.

It's $50 a year for the card.

"You also have to pay for the doctor's visit," Belkadi said. "We were fortunate, we found a doctor in Coal Township who only charged $200. We've seen it quoted as high as $1,000. It's $22 for a background check."

She said just finding a doctor can take months.

Cristy Harding, 52, of Hughesville, and formerly of Turbotville, said the lack of a nearby dispensary is holding her back from registering her son with the program. Her son, Jason, 17, has suffered from a seizure disorder since age 2.

She said there were plans for a dispensary in Williamsport, but that fell through.

"I'm not enrolled," she said. "I don't want to drive to Scranton."

She said it's difficult as a working single mother with a special needs son to drive that far.

"Plus, you have to go every month," Harding said. "I just know there's nothing within an hour of Hughesville."

Meanwhile, two local health systems have not taken a position on medical marijuana.

Geisinger issued this statement:

"Geisinger does not advocate nor renounce the use of medical marijuana. That means we will not encourage physicians to participate in the state's new Medical Marijuana Program, but we will not discourage them, either. We have established a committee that will provide our practitioners with guidelines to inform and assist with the process of certifying patients," said Stephen J. Paolucci, M.D., chairman of Geisinger's Division of Psychiatry. "If Geisinger physicians want to apply to the program so they can help patients obtain medical marijuana, then we want to make sure they understand the program and everything it entails."

Kendra Aucker, president and CEO of Evangelical Community Hospital, issued a statement, saying, "Our medical staff is having ongoing discussions regarding the topic of medical marijuana. While no decision has been made at Evangelical as of yet, we are gathering vital clinical input from our providers before any final decision is made and we will ultimately do what is in the best interest of our patients and community."

Email comments to jsylvester@dailyitem.com. Follow Sylvester on Twitter @JoepSylvester.

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