July 16, 2010 -- Last Friday, the Washington State Medical Quality Assurance Commission approved a petition to add "chronic renal failure with hemodialysis" to the list of conditions for which marijuana may be recommended in our state. The commission rejected a petition to add Alzheimer's and a petition to add neuropathic pain.

The Commission noted that medical marijuana use is currently grounds for kidney transplant denial in our state. One commission member suggested our state's medical marijuana transplant denial policy could change in the future. Until then, the commission suggests that nefrologists and kidney patients be fully informed about this potential to "affect future treatment options,"

The petition submitted by the Cannabis Defense Coalition for neuropathic pain was denied. The reason for denials seems to be one or more of the following:

1. The term "neuropathic pain" is broad and somewhat ambiguous

2. Many neuropathic pain patients are already covered by the "intractable pain unrelieved by standard treatments or medications" clause.

3. The commission doesn't support the use of medical marijuana as a "first line" treatment for neuropathic pain patients.

If we wish to appeal the decision, we must file suit in in superior court. We believe in the veracity of our petition, that cannabis is effective in the treatment of neuropathic pain, and that scientific studies back this up. We intend to appeal the decision, and are working to find an administrative appeals lawyer to take the case. We expect this to cost many thousands of dollars. Financial support for this project is most appreciated.

Petition submitted to add neuropathic pain to medical marijuana law

March 5, 2010 -- The Cannabis Defense Coalition is petitioning the Washington State Medical Quality Assurance Commission to add neuropathic pain to the list of conditions qualifying to use medical marijuana under RCW 69.51A.

Credible research indicates that use of medicinal cannabis is an effective treatment for neuropathic pain. We submit this petition because there is sufficient evidence to support this indication for medicinal cannabis use. Adding it will help neuropathic pain patients receive this treatment, especially those who are presently excluded by the "intractable pain" requirement that a patient has tried and failed all other standard treatments or medications before being allowed the therapeutic benefits of this cannabinoid-based medicine and the legal protections of our medical marijuana law.

We recognize that intractable pain is already covered by RCW 69.51A, and that many neuropathic pain patients qualify under the intractable pain clause. We are specifically applying for neuropathic pain without the requirement that a patient have exhausted all other standard treatments or medications. Multiple sclerosis and epilepsy are two neurological conditions that do not require patients to have exhausted the complete realm of standard medical treatments before they can qualify to use medicinal cannabis. We petition for neuropathic pain to be treated in the same way.

With our petition, we included three positive double blind, randomized, placebo-controlled clinical trials of cannabis in the treatment of neuropathic pain, and a review article for the treatment of neuropathic pain with cannabinoids. We also included a report from the University of California Center for Medical Cannabis Research of their most recent legislatively mandated research, which includes discussion of the evidence supporting the treatment of neuropathic pain with cannabis, to support our petition.

Petition documents

• Neuropathic pain petition (PDF, 80k) - March 5, 2010
• Attachment 1 (PDF, 237k) - Neurology, 2007
  Cannabis in painful HIV-associated sensory neuropathy: A randomized placebo-controlled trial
• Attachment 2 (PDF, 150k) - Neuropsychopharmacology, 2008
  Smoked Medicinal Cannabis for Neuropathic Pain in HIV: A Randomized, Crossover Clinical Trial
• Attachment 3 (PDF, 746k) - Journal of Pain, Vol. 9
  A Randomized, Placebo-Controlled, Crossover Trial of Cannabis Cigarettes in Neuropathic Pain
• Attachment 4 (PDF, 801k) - Neurotherapeutics, 2009
  Cannabinoids as Pharmacotherapies for Neuropathic Pain: From the Bench to the Bedside
• Attachment 5 (PDF, 337k) - February 11, 2010
  Report to the Legislature and Governor of the State of California presenting findings pursuant to SB847 which created the CMCR and provided state funding

Other recent petitions

• July 20, 2009 petition (PDF, 121k) to add bipolar disorder, severe depression, and anxiety related disorders, specifically social phobia - Denied.
• January 28, 2009 petition (PDF, 19k) to add Barrett's esophagus and Celiac disease - Withdrawn by petitioner.