Treatment of Epilepsy with Medical Marijuana

Epilepsy In 2015, 3.4 million people in the nation had active epilepsy (CDC, 2015). It is essential to have proper treatment of epilepsy, as a high frequency of seizure activity can result in damage to the brain and developmental delays (Porter & Jacobson, 2013). Self-treatment of epilepsy with marijuana has gained a large amount of attention through social media (Wilson, Shuman, & Filloux, 2018). Many parents who have children with treatment-resistant epilepsy have found relief by providing cannabis to their children (Wilson et al., 2018). The FDA has approved cannabidiol as a form of treatment for intractable seizures (Patel & Kiriakopoulo, 2018).

Health Problem:

Treatment of Epilepsy with Medical Marijuana There are many barriers that complicate the treatment of intractable epilepsy with medical marijuana, as it is illegal federally, laws vary across states, costs, and there is a lack of access to medical forms of marijuana. Cannabidiol (CBD oil) became legal in Utah in 2014. However, the use of it requires a medical card which costs $200 annually (Wilson et al., 2018). Insurance companies do not cover the fees associated with a medical card or the costs of cannabidiol (Wilson et al., 2018). There is also a lack of effective concentrations of CBD oil in Utah. Many parents travel away from Utah to access effective forms of medical marijuana in neighboring states at dispensaries (Wilson et al., 2018).

Treatment of epilepsy with marijuana has gained momentum, with social media presenting positive results (Wilson et al., 2018). This exposure to positive outcomes has shaped perceptions of parents’ decisions to medicate their children with this drug (Wilson et al., 2018). However, problems arise when parents are responsible for determining the dosages, as the majority of the time, it is not being managed by a provider (Wilson et al., 2018). The state of Colorado, which has legalized both recreational and medical marijuana, has observed multiple hospital admissions of children with THC toxicity (Wilson et al., 2018). Many providers are reluctant to advise patients on how to use cannabis for treatment-resistant epilepsy, as there have not been specific recommendations outlined for providers to follow. Parents are left to experimentally determine the dosages based on trial/error of what they observe with seizure activity (Wilson et al., 2018).

Health Inequities Social Ecological Model

This problem exists at the government level as the legal status of medical marijuana is currently being determined in the state of Utah. Proposition 2 won on the ballot for the use of medical marijuana with certain qualifying conditions, including epilepsy (Utah Proposition 2, 2018). However, a special session with the legislature will be held in December to create a compromise bill. The legislature could alter and revise Proposition 2 in a way that will limit access for patients. On the federal government level, the use of marijuana is illegal. The Controlled Substance Act, created in 1970, listed marijuana as a Schedule I drug, which limits research capabilities (Martin, 2016).

As Utah is predominantly of LDS religion, the problem also exists on the community level. The many patterns, values, and cultural norms of the community reflect a society that is not supportive of marijuana use. The majority of the legislature representing Utah is of the Republican party and tends not to endorse the use of medical marijuana. The social stigma, beliefs, and values in Utah add to the difficulties in bringing society to accept and implement laws to use it. The problem also exists on an interpersonal level, as many parents are left with the responsibility to manage dosages they deem fit for their child’s epilepsy. Most parents have the best intentions to improve their child’s well-being. However, at times, the type of marijuana used and dosages may vary widely, which can ultimately cause harm to the child.

Health Intervention I would target patients with treatment-resistant epilepsy and set up a community clinic with providers who are trained and educated on current knowledge and practices with medical marijuana. With the passing of Proposition 2 in Utah, medical marijuana will likely be supplied through pharmacies that can regulate its dosages and forms of it. The program would involve establishing regular appointments with a trained provider who is currently researching medical cannabis and seizure management. Appointments would be once weekly with patients and would require parents to record the frequency and duration of seizures. It would also involve a provider who is familiar with treatment-resistant epilepsy and can monitor the progression of the disease, and can give appropriate recommendations.

The clinic would also provide a place for parents and children to develop a community of social support. The overall goal would be to improve seizures in patients and remove the responsibility of parents managing the disease and determining dosages of the drug. Health Policy Proposition 2 in Utah won on the ballot. However, there will be a special session for a compromise bill in December held at the state level of the legislature in Utah. The proposition outlines qualifying conditions for using this drug and includes epilepsy (Utah Proposition 2, 2018). It also includes regulating medical marijuana through pharmacies (Utah Proposition 2, 2018). The bill is on the right track to addressing the health problem and improving the lives of patients and lifting the responsibility of parents to determine dosages. It will also provide easy access to quality concentrations and forms of medical marijuana.

To approach policy change in Utah, I would contact Senator Jani Iwamoto in a letter to provide insight into the problem from a health professional standpoint. I could also get involved with public hearings and provide testimony. It would also be helpful to join the non-profit organization, The Marijuana Policy Project, which lobbies congress with goals for Federal and State policy changes regarding medical marijuana (“Marijuana Policy Project,” 2018). One goal of this organization includes the renewal of the Rohrabacher Amendment by congress to protect states’ use of medical marijuana from federal intervention (“Marijuana Policy Project,” 2018). Another goal is to remove federal laws that prohibit the use and remove marijuana from the schedule I category (“Marijuana Policy Project,” 2018).

Conclusion

Medical marijuana has potential benefits to help patients with debilitating conditions. However, more research is needed to establish the best management for these conditions. National policies need to change, remove marijuana from the schedule I category and allow states to determine legal status.

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