The Wages family get a cannabis card for their daughter, Sydney, who suffers from intractable seizures.

Georgia’s cannabis registry off to fast start; doctors want more info

This was another good day for Sydney, who has autism and suffers from intractable seizures. Just like when the family recently celebrated a new milestone: 10 days seizure-free.

As of Tuesday, more than 130 patients including Sydney had qualified for Georgia’s new medical marijuana registry after its first 50 days of business. Yet the pace — celebrated by families and advocates — comes as some doctors have begun calling for training and information about the oil and how it works.

Those concerns in the medical community are not the only hurdles facing families here — the new law legalizing a limited form of cannabis oil to treat illnesses including cancer, Parkinson’s disease and epilepsy does not address the oil’s manufacture or how to buy or obtain it.

In fact, the sale of any form of marijuana remains a violation of state and federal law. Yet, 23 states, plus the District of Columbia and Guam, offer some form of legalized use of marijuana for medical purposes. And Georgia this year created a way to protect some people from criminal prosecution for having a limited form of the oil in their possession.

‘Treatment is in its infancy’

Now advocates, families and doctors here are trying to figure out how best to practically do that.

“This field of treatment is in its infancy,” said Dr. James L. Smith Jr., an emergency room doctor who called himself “arrogant about what I thought was my fund of knowledge” when he first encountered cannabis oil as a possible treatment — one that has since been successful — for his now 8-year-old daughter, who suffers from a severe form of epilepsy called Doose syndrome.

The concerns, however, do not necessarily mean resistance, he said.

“I think physicians have been hesitant to start because of their lack of knowledge of how to dose it,” said Smith, a board member of the influential Medical Association of Georgia. “As a physician, I understand that. I think the physician community has been genuinely interested and wants to know more.”

FDA-approved pharmaceuticals came with own problems

The Wages family was among the very first to receive permission from the state to use low-dose cannabis oil without fear of prosecution, although it first encountered the oil two years ago after watching a national television news program about the oil’s use. By then, Sydney had spent eight years off any of the seven different federally approved pharmaceutical drugs she had initially been prescribed by doctors — a decision J-Bo and his wife, Lisa, prayed over after seeing a visibly more alert and verbal child off the medicine than on it.

Working initially through a naturopathic doctor, the family found a now-California-based company called Dixie Botanicals: “I contacted the lady that Monday and I said, ‘Ma’am, I’m trying to get the CBD (cannabidiol) oil. I have a daughter with epilepsy.’ She said, OK, they have a 2-ounce bottle and that 2-ounce bottle was $160. And, she said, ‘I suggest using the cinnamon flavor,’ ” J-Bo said of that initial phone call.

When he asked whether it was legal, J-Bo said he was told, “hon, you’re fine.”

“She said by the Farm Act, it’s less than 0.3 percent THC (the high-inducing chemical associated with recreational marijuana use), so it’s legal to ship anywhere, he said.

Feds still don’t approve of marijuana for treatment

It is not clear federal officials would agree with that statement, since the federal farm bill involved limited provisions related to industrial hemp. Marijuana continues to be classified by the U.S. Drug Enforcement Administration as a Schedule I drug, the most dangerous class of drugs with a high potential for abuse and addiction, and no accepted medical uses.

For the Wages family, however, it was a start. That first experience led to several others as they worked — sometimes through trial and error — to figure out what would best help Sydney. They learned to request laboratory reports and researched different and more effective strains of the oil. Knowledge came through word of mouth and, eventually, by connecting with other Georgia families seeking the same.

Sydney now uses “Palmetto Harmony” cannabis oil manufactured through a South Carolina company called Palmetto Synergistic Research — one of three companies currently shipping low-dose oil into Georgia.

They think the oil has helped Sydney. Her seizures are shorter since she started on the oil, they said. On average, she now has a seizure only once or maybe twice a week.

“We have rescue medicines, and it’s sort of the norm,” J-Bo said. “We get — not to say used to it — we sort of get like when you cut your finger. You cut it enough in one place, you get a callus. We sort of get callused to it. I don’t want this to sound any disrespectful way, but I don’t think I would want Sydney any different. She’s taught us so much about unconditional love, faith, patience.”

When Sydney began using the oil, the Wages family returned to a medical doctor who used to treat Sydney. He is monitoring her. She is still not on medicines approved by the Food and Drug Administration, although the family regularly schedules visits for checkups including blood tests.

Doctors seeking more information about cannabis oil

The Medical Association of Georgia has been vocal about getting doctors access to seminars or online webinars as they seek more information about how the oil works. Some physicians worry the oil is, in effect, experimental and not approved by the FDA.

Groups including the Georgia-based Oil for Epilepsy have started to explore how to connect doctors to new and existing research — as well as information about how the oil works and how it’s extracted. There is also talk of forming a new state coalition of people in the medical cannabis industry to help inform doctors and patients about their treatment options and access.

The state Department of Public Health has already partnered with the Georgia Composite Medical Board to develop the process for physicians who may be approached by patients seeking the oil for treatment. Public health officials have so far approved 162 doctors for its new registry, which went live in June.

Georgia has also begun to explore how to develop guidelines related to cultivation and production.

The newly formed state Commission on Medical Cannabis next meets Aug. 26 to talk with manufacturers and growers. Among the topics they are likely to address is the process they use to cultivate plants for the oil. That includes safety, security measures and testing that, among the top manufacturers, is often done by independent UL-listed laboratories.

“I think there’s just a need for additional information in the medical community of what exactly these products are,” said state Rep. Allen Peake, R-Macon, the primary author of the new law, who has been among those willing to bridge the gap as needed. “We’ve made sure families that have wanted the product and properly registered with the state have gotten the product.”

Support real journalism. Support local journalism. Subscribe to The Atlanta Journal-Constitution today. See offers.

Your subscription to the Atlanta Journal-Constitution funds in-depth reporting and investigations that keep you informed. Thank you for supporting real journalism.