Autism spectrum disorders and sleep apnea have been added to the list of qualifying conditions for Minnesota’s medical cannabis program. Minnesota Commissioner of Health Dr. Ed Ehlinger announced the decision November 30. The news was greeted with enthusiasm by some people with family member with autism spectrum disorder as the treatment has proven helpful in some cases. But it has raised concerns for some medical professionals and law enforcement.
“Any policy decisions about cannabis are difficult due to the relative lack of published scientific evidence,” said Ehlinger. “However, there is increasing evidence for potential benefits of medical cannabis for those with severe autism and obstructive sleep apnea.”
Parents of children on the autism spectrum have sought to have medical cannabis legalized since the Minnesota program began. Concerns about marijuana use have been outweighed by claims that it could help people, especially children and young adults.
The Facebook group Minnesota ASD Parents to Parents Support had many supportive posts after the news was released. “Wow, great news for the autism community,” one parent posted.
Another parent said, “At least for us parents with autistic children we have another option. Not a lot options for the last 15 years with any new medications in the market to help the treatment of aggression or co-existing disorders. Cannabis will change a lot of lives for the better.”
Each year the Minnesota Department of Health uses a formal petitioning process to solicit public input on potential qualifying conditions. Throughout June and July, Minnesotans were invited to submit petitions to add qualifying conditions. The process included public comments, a citizens’ review panel and a set of research summaries for each condition prepared by health department staff.
Petitioners put forward a total of 10 conditions for consideration this year, including anxiety disorders, autism, cortico-basal degeneration, dementia, endogenous cannabinoid deficiency syndrome, liver disease, nausea, obstructive sleep apnea, Parkinson’s disease and peripheral neuropathy. There were also petitions to add cannabis delivery methods including infused edibles and vaporizing or smoking cannabis flowers. These requests were not approved.
In October, the New Condition Review Panel heard from several parents of children with autism. Media accounts indicated that those parents believe medical cannabis would help, especially with children who become aggressive. “He fractured myjaw, dislocated his father’s arm, he’s attacking us on a daily basis,” one woman said of her son. “This is what life was like for us before medical cannabis.”
Another parent said doctors should be able to choose to prescribe medical cannabis. “I think it should be a doctor’s choice,” the parent said. “I think we need some more doctors that learn about medical marijuana, for sure, for children.”
Children who have what is called a dual diagnosis have been able to use medical cannabis, if the second diagnosis is already covered by the state program. The parents who testified in October include parents whose children also have seizures and Tourette’s syndrome, which are already covered by the state program.
“He was punching himself in the head 3,000 times a day, lots of skull fractures, and then we were offered this medication that’s safe and non-addictive,” said one parent. “And not only has it stopped the self-injury completely and the aggression, but he’s now starting to speak.”
Opponents contend that adding autism under the state program is risky, including the Minnesota PsychiatricSociety. “The Minnesota Psychiatric Society is concerned about efforts to add autism as a qualifying condition eligible for medical cannabis in Minnesota,” the group said in a statement. “We believe there is little or no significant scientific evidence that marijuana is beneficial for the treatment of autism spectrum disorder. Of particular concern to our members who treat youth, is the message that marijuana can be beneficial. As doctors, we are concerned about known adverse effects of marijuana on the developing brain.”
The Minnesota Chiefs of Police Association also spoke out in opposition.
Autism spectrum disorder is characterized by sustained social impairments in communication and interactions, and repetitive behaviors, interests or activities. Patients certified for the program because of autism must meet specific requirements. The health department’s autism research brief found a growing body of research indicating that the human body’s endocannabinoid system may play a role in autism symptoms. In support of adding autism, the review panel report noted the lack of effective drug treatments, the potentially severe side effects of current drug treatments and anecdotal evidence of Minnesota children with autism already receiving benefits from medical cannabis taken for other qualifying conditions.
Obstructive sleep apnea is a sleep disorder involving repeated episodes of reduced airflow caused by a complete or partial collapse of the upper airway during sleep. Patients certified for the program because of obstructive sleep apnea must meet published diagnostic criteria for the condition, including interpretation of a formal sleep study. Over time, sleep apnea can result in long-term health effects such as hypertension and cardiovascular problems, reduced cognitive function, decreased mood and quality of life, impaired performance at work and while driving, and even premature death.
The review panel and the health department’s research brief identified some scientific evidence of effectiveness of cannabis treatments. Continuous positive airway pressure is a very effective treatment already in use, but some people with the condition often struggle to stick with that therapy.
Patients certified to have autism or obstructive sleep apnea will be newly eligible to enroll in the program on July 1, 2018 and receive medical cannabis from the state’s two medical cannabis manufacturers beginning August 1, 2018. As with the program’s other qualifying conditions, patients will need advance certification from a Minnesota health care provider. More information on the program’s certification process is available from the Office of Medical Cannabis.
When the 2014 Minnesota Legislature authorized the creation of a medical cannabis program, the law included a set of nine medical conditions that would qualify a person to receive medical cannabis. State rules also direct the commissioner of health to consider the possible addition of other qualifying conditions and delivery methods. The list of current qualifying conditions includes: cancer associated with severe/chronic pain, nausea or severe vomiting, or cachexia or severe wasting; glaucoma; HIV/AIDS; Tourette’s syndrome; amyotrophic lateral sclerosis (ALS); seizures including those characteristic of epilepsy; severe and persistent muscle spasms, including those characteristic of multiple sclerosis; inflammatory bowel disease, including Crohn’s disease; terminal illness, with a probable life expectancy of less than one year; intractable pain and post-traumatic stress disorder.
Information from the Minnesota Department of Health was used for this article. For more information on medical
cannabis in Minnesota, go to www.health.state.mn.us/topics/cannabis/