Kansas S.366 – Genester Wilson-King MD FACOG (October 2019)

Special Committee on Federal and State Affairs Kansas Legislative Research Department

Attn : Joanna Dolan

23 October 2019 ; Room 346-S-Statehouse

RE : 5366

Chairman Barker and Committee members

Thank you for the opportunity to provide the Committee with my testimony supporting medical cannabis for Kansas.

I am Genester Wilson-King, MD FACOG, a Board Certified Obstetrician and Gynecologist, and Fellow of the American College Obstetrics and Gyne cology. I have practiced in the state of Florida for more than 25 years.

I am on the Board of Directors and Co-Vice President of the Society of Cannabis Clinicians (SCC), an organization whose mission is to expand knowledge on the medical use of cannabis, facilitate best practice standards for cannabis consultations, to study, discuss and make recommendations relating to research, practice and policy in the medical use of canna bis, to further the recruitment of medical graduates and healthcare professionals willing to recommend cannabis to pat ients . SCC is dedicated to maintaining and advancing the highest possible ideals and service standards in the education, practice and research in the medical use of cannabis. We have a 13-hour CME program that enables physicians to implement cannabis into their practices upon completion.

I am also a member of the Board of Directors and Treasurer for the Doctors for Cannabis Regulation (DFCR). This organization serves as a voice for physicians who believe that cannabis prohibition has failed and that the misuse of cannabis should be treated as a health issue rather than a criminal one. DFCR’s physician members strive neither to minimize nor to exaggerate scientific literature about the risks and benefits of cannabis use. DFCR promotes evidence-based strategies to prevent recreational marijuana use by minors and misuse by adults. Through education of physicians and the public, DFCR supports the legalization and effective regulation of cannabis in the United States and around the world.

I have experience in many facets of the industry. I worked as Medical Director for a cannabis company in a vertically integrated cannabis program. I was involved in cultivation, manufacturing, product packaging and dispensing of many different cannabis products. I utilize that knowledge to empower my patients in selecting their cannabis products. As mentioned previously, I am an experienced clinician, who utilizes cannabis use as another treatment modality when it is appropriate. I am an authorized physician that recommends medical cannabis products to qualified patients in accordance with Florida’s strict regulatory  system.  This field of medicine is near and dear to me, and I have witnessed its profound medical benefits.

Cannabis has been used as a medicine for thousands of years. In fact, in the mid 1800s, cannabis was the most widely prescribed medicine in this country. It was used for a myriad of conditions including seizure disorders, gastrointestinal disorders, nausea and vomiting, loss of appetite, Parkinson’s, Multiple Sclerosis, cancer, mental illness, glaucoma and many others.

Research on the effects of cannabis in the late 1980s led to the discovery of a previously unknown biochemical communication system in the human body called the ECS, which plays a critical role in regulating our physiology. This system modulates our stress, pain response, sleep, appetite, behavior, energy metabolism, immunity and many other important bodily functions.  A major part of this system uses a “lock-and-key” mechanism, with natural endocannabinoid compounds (endo means made within our body) as the keys and the cannabinoid receptors as the locks.

Recent scientific investigations prove that dysfunction of the ECS (specifically a deficiency of the endocannabinoid locks and keys) can result in illnesses such as anxiety, depression, autism, seizures, migraines, irritable bowel syndrome and dozens of other serious medical conditions. This mechanism is the basis of the use of cannabis as medicine: augmenting the naturally occurring ECS by using the “phytocannabinoid keys” from the cannabis plant to boost the deficient endocannabinoid system (ECS). This assist serves to restore physiologic function in the body to homeostasis (a stable, balanced state) .

In January 2017, the National Academy of Sciences, Engineering and Medicine released a report entitled The health effects of cannabis and cannabinoids: The current state of evidence and recommendations for research. The panel of researchers reviewed over 10,000 articles to draw the following conclusions :

  1. There is conclusive or substantial evidence that cannabis or cannabinoids are effective
    • For the treatment for chronic pain in adults (cannabis)
    • Antiemetics in the treatment of chemotherapy-induced nausea and vomiting (oral cannabinoids)
    • For improving patient-reported multiple sclerosis spasticity symptoms (oral cannabinoids)
  2. There is moderate evidence that cannabis or cannabinoids are effective for:
    • Improving short-term sleep outcomes in individuals with sleep disturbance associated with obstructive sleep apnea syndrome, fibromyalgia, chronic pain, and multiple sclerosis (cannabinoids, primarily nabiximols)

Increasing but  limited clinical data demonstrates that cannabinoids are safe and effective in the treatment  of seizure disorders, Tourette Syndrome,  and several geriatric conditions.  And, clinical studies involving the therapeutic use of cannabis demonstrate improvements in anxiety, depression and neurocognition (Abi-Jaoude, Eli a, et al, Abuhasira, Ra n, et al, Sulak et al, Walsh et al-complete reference below).

There is a list of conditions for which one can qualify to be a patient in the state of Florida. I have seen firsthand the incredible medical benefits of cannabis . If you ever have the opportunity to talk to patients, you will be humbled by their stories and their years of unnecessary suffering prior to the passage of Florida’s cannabis laws.

Some examples of patient stories that reaffirm my commitment to cannabis as a treatment modality include:

  1. A 54y/o with Multiple Sclerosis who suffered from severe and debilitating spasms, such that she was unable to function in her daily life. She also had chronic pain, muscle weakness, fatigue, insomnia, and was taking 12-14 medications per day for her symptoms. Her cannabis regimen decreased her medication intake to 0-2 pills per day, has allowed her to sleep, 90-100% pain relief on most days and she has become a productive contributing member of society.
  2. A 35y/o with a disease called Stiff Person Syndrome. She experienced severe muscle spasms such that she was confined to a wheelchair intermittently the past 5+ years. At times she was bedridden, unable to move or speak. Stiff Person Syndrome is a chronic disease with frequent exacerbations. Conventional pharmaceuticals were essentially ineffective, and this young patient endured immobility for extended periods of time missing her young children’s school plays, soccer games, and many family activities. She decided to try cannabis during one of her exacerbations. When she used cannabis, she was able to talk after 10-15 minutes, out of bed, out of her wheelchair and walking in less than 3 hours.
  3. A child with 50+ seizures per day. After being on more than 5 drugs a day (for years) to manage the seizures, cannabis decreased them to 0-2 per week and sometimes going for 30 days without a single seizure.
  4. 44y/o undergoing cancer chemotherapy was unable to  sleep, eat, had anxiety to  the point of not being able to function and experienced pain. After titration to the lowest effective dose of cannabis needed, the patient was able to alleviate all symptoms. Using conventional medicines, this patient would have been prescribed at least 4 different medications!

These severe conditions take a toll on not only the patient but the family and caregivers. Cannabis has been a blessing and a miracle to many. Using cannabis can help many patients in the state of Kansas return to being productive contributing citizens of society. I urge your support of the use of medical cannabis in the state of Kansas

Respectfully submitted,

Genester Wilson-King, MD FACOG

References:

Abi-Jaoude, Elia, et al. “Preliminary evidence on cannabis effectiveness and tolerability for adults with Tourette syndrome.” The Journal of neuropsychiatry and clinical neurosciences 29.4 (2017): 391- 400Abrams, Donald I., and M. Guzman. “Cannabis in cancer care.” Clinical Pharmacology & Therapeutics 97.6 (2015): 575-586.

Abuhasira, Ran, et al. “Epidemiological characteristics, safety and efficacy of medical cannabis in the elderly.” European journal of internal medicine (2018): 44-50.

Hickman, et al. If cannabis caused schizophrenia-how many cannabis users may need to be prevented in order to prevent one case of schizophrenia? England and Wales calculations. Addiction, 104, 1856- 1861. 2009

Koppel, Barbara S., et al. “Systematic review: Efficacy and safety of medical marijuana in selected neurologic disorders Report of the Guideline Development Subcommittee of the American Academy of Neurology.” Neurology 82.17 (2014): 1556-1563.

Lee, Martin. Smoke Signals: A Social History of Marijuana- Medical, Recreational and Scientific. Publisher Simon and Schuster 2012.

Lynch, M. E., and Mark A. Ware. “Cannabinoids for the treatment of chronic non-cancer pain: an updated systematic review of randomized controlled trials.” Journal of neuroimmune pharmacology 10.2 (2015): 293-301.

McPartland, John M . “The endocannabinoid system: an osteopathic perspective.” The Journal of the American Osteopathic Association 108.10 (2008): 586-600.

Mechoulam, Raphael, David Panikashvili, and Esther Shohami. Cannabinoids and brain injury: therapeutic im plications.” Trends in molecular medicine 8.2 (2002): 58-61.

National Academies of Sciences, Engineering, and Medicine. The health effects of cannabis and cannabinoids: The current state of evidence and recommendations for research. National Academies Press, 2017.

Portenoy, Russell K., et al. “Nabiximols for opioidtreated cancer patients with poorly-controlled chronic pain: a randomized , placebo controlled, graded-dose trial.” The Journal of Pain 13.5 (2012): 438-449.

Russo, Ethan B. “Clinical endocannabinoid deficiency reconsidered: current research supports the theory in migraine, fibromyalgia, irritable bowel, and other treatment-resistant syndromes.” Cannabis and cannabinoid research 1.1 (2016): 154-165.

Russo, E., M ead, A., & Sula k, D. Cu rrent and Future Status of Cannabis Research.” Clinical Researcher

29.2 (2015): 58-63 .

Sulak, Dustin, Russell Sa net o, and Bonni Goldstei n. “The current status of artisanal cannabis for the treatment of epilepsy in the United States .” Epilepsy & Behavior 70 (2017): 328-333.

Walsh, Zach, et al. “Medical cannabis and mental health: A guided systematic review.” Clinical psychology review 51 (2017): 15-29.

Whiting, Penny F., et al. Cannabinoids for Medical U se: A Systematic Review and Meta-analysis.” JAMA 313.24 (2015): 2456-2473.

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