In the year since medical marijuana has been available to Georgians, patient advocates say it has become a useful tool to treat chronic pain. But they also say significant barriers to access remain, particularly for lower-income individuals who lack the means to pay out of pocket.
“It has given people another option other than prescription drugs and surgical procedures,” Frank Eady of the Pancreatic Cancer Support Group at Winship Cancer Institute at Emory, told The Atlanta Journal-Constitution.
Eady and other experts said the availability in Georgia of medical marijuana has allowed some patients in the Peach State to scale back, or completely end, use of opioids for chronic pain.
Patients must apply for a state-issued registry card to buy the products, which contain low levels of THC, the chemical in marijuana that produces a high. As of March 27, there are 17,022 active patients in the registry, an increase of 44% since Aug. 31, 2023, according to the Georgia Department of Public Health.
The data based on that registry appears to support anecdotal accounts of how products are being used. DPH reports that 70% of cardholders in the state have been using marijuana to deal with intractable pain and post-traumatic stress disorder (PTSD). Cancer, peripheral neuropathy, multiple sclerosis, and seizure disorder make up the rest, according to health officials.
But despite the potential benefits, lower-income populations in Georgia are struggling to access it.
Credit: Natrice Miller / Natrice.Miller@ajc.com
Credit: Natrice Miller / Natrice.Miller@ajc.com
“It’s sad that a year has passed and access has been so restricted,” Deon L. Sanders, a licensed therapist and CEO of Seek Wise Counsel, a therapy practice specializing in African American psychology, told the AJC. “It’s a problem that people can get opioid prescriptions at a doctor —often with refills — but not medical marijuana.”
Sanders said he has worked with patients for whom marijuana was more helpful than a cocktail of prescription drugs.
“There are clients who might be on several different medications, one for anxiety, one for depression, one for sleep,” he said. “When people switch to medical marijuana, their depression might improve, which reduces sleep disorder, which reduces anxiety. It can remove the need to be on many drugs at once.”
Medical marijuana, in the form of low-THC oil, is legal in Georgia for patients who have doctor-approved cards issued by the state. State law allows these approved patients to legally possess up to 20 fluid ounces of “low-THC oil,” which was approved by the Legislature to treat a limited list of medical conditions in children and adults.
Though recreational marijuana use remains illegal in Georgia, eligible patients may buy low-THC medical marijuana products with up to 5% THC, the compound that gives users a high. Street marijuana has a far higher level of THC.
The use indications on THC cards align with data collected by the Georgia Center for Oncology Research and Education, which found that 45% of Georgia cancer survivors say they need help overcoming issues with sleep, while 43% say they need help managing pain.
Eady said some patients are turning to medical marijuana because it helps them avoid side effects from opioid pain medications.
“One opioid side effect is constipation,” Eady said. “With pancreatic cancer often comes issues with digestion, chemotherapy, nausea, and loss of appetite. When you add constipation to that mix, it gets frustrating. For some patients, medical marijuana has helped avoid these side effects.” It has also given cancer patients an alternative to nerve-blocking surgery, he added.
The side effects of cannabis are generally very mild, particularly when compared with opioids, Angela Bryan, Professor of Psychology and Neuroscience at the University of Colorado Boulder, told the AJC. “That’s why many people say that they want to use cannabis instead of opioids for pain relief in cancer and other conditions associated with chronic pain.”
Eady also said that medical marijuana has helped patients “either completely avoid opioids or be able to take fewer than they had in the past.” A study by the University of Georgia confirmed as much when it found that opioid use is lower in states that eased marijuana laws.
The use of THC to ameliorate symptoms of Parkinson’s Disease has been less common, said Barbara Gadson, Information and Referral Coordinator at the Morehouse School of Medicine.
“I haven’t found many movement specialists who have the desire to prescribe it because it relaxes the patients more, and they want the patients to be more active,” Gadson told the AJC.
Gadson said her clients would like additional education and research around how medical marijuana could help Parkinson’s patients. “Without research, people are not willing to jump into this — especially when these people have never taken drugs in their lives.”
The two companies currently operating in Georgia — Trulieve and Botanical Sciences — are licensed to cultivate medical marijuana on 100,000 square feet of indoor growing space.
In November, a Georgia panel that oversees medical marijuana awarded another four production licenses to Fine Fettle, TheraTrue Georgia, Natures Georgia and Treevana Remedy, the AJC reported. Each can operate greenhouses with 50,000 square feet of growing room.
Despite the increased availability of medical marijuana in the state, lack of insurance reimbursement remains a barrier to access, especially for those who had been taking dronabinol and were hoping to switch to medical marijuana. The synthetic THC obtained FDA approval in 1985 for the treatment of HIV/AIDs-induced anorexia and chemotherapy-induced nausea and vomiting. Though covered by insurance, it’s in short supply, as the AJC reported in March.
Lisa Pinkney, president of Trulieve Georgia, says her company is lobbying the U.S. Drug Enforcement Administration (DEA) to remove marijuana from DEA’s banned drugs list so that insurance companies could potentially provide reimbursement. The U.S. Drug Enforcement Agency ranks drugs on a schedule, with Schedule One drugs considered to have the highest risk of abuse, with no recognized medical use in the U.S., while Schedule Five drugs have the lowest potential for abuse.
“Medical cannabis is still a Schedule One drug on the DEA’s Schedule of Narcotics,” Pinkney told the AJC. “As a result, traditional insurance does not cover the cost. It’s a barrier, but we hope to see marijuana descheduled. It’s currently on the list with opioids. We would like to see it lowered to Schedule Three. We believe it’s coming soon.”
In March, State Rep. Shelly Hutchinson (D-Snellville) urged officials to legalize marijuana completely as a means of collecting tax revenue lost to illicit cannabis, and avoiding mixed messaging to kids on marijuana.
Sanders, for his part, says Georgia should find a way to cover the cost of marijuana in long-term treatment programs, as programs in Florida and California have sought to do.
“It can take 18-24 months for the brain to heal from trauma, incarceration, and homelessness,” he said. “Quick-fix hospital programs discharge patients with a variety of prescriptions that aren’t working. It would be nice to have medical marijuana as a longer-term treatment option.”
What’s the difference between marijuana and medical marijuana? Marijuana refers to cannabis plants that contain a wide range of compounds, including the psychoactive component THC that produces a high. Georgia has legalized only low-THC medical cannabis oil and only for patients who are registered with the state as having one of 17 qualifying health conditions. The oil can contain only up to 5% THC – far lower than levels in recreational/street marijuana.
How many Georgians are using it? As of March 27, Georgia Department of Public Health reports there are 17,022 active patients registered with the state’s Low THC Oil Registry. The number is up 44% since Aug. 31, 2023, when 11,805 active patients were registered.
