Wasilla pain doctor concerned about pot prop’s effect on patients

Editor’s note: The views expressed by the interviewee are his own and do not necessarily reflect the opinions of Algone Interventional Pain Clinic or its employees.

WASILLA — Dr. Matthew Peterson says Valley residents should vote no on the Mat-Su Borough’s Proposition 1 next month if they want local pain patients to have access to quality care.

The proposition in question — for which the borough is currently being sued — asks voters to approve or disapprove an ordinance prohibiting the retail sale of marijuana, as well as cultivation, manufacturing and testing facilities in areas outside of Houston city limits. The prohibition would not apply to industrial hemp, or any part of the cannabis sativa plant with a tetrahydrocannabinol (THC) content less than 0.3 percent, but could apply to medicinal marijuana — which would be a problem, Dr. Peterson said, for several reasons.

A physician since 1998, Peterson said he’s been endorsing marijuana as treatment for pain management to certain patients for the last three years, first in Washington state and for the last year in the Mat-Su Valley. He’s recommended it most often to patients experiencing seizures and severe peripheral neuropathy, or nerve damage that causes the patient to feel as though their feet and sometimes hands “are on fire,” Peterson said. Marijuana can also be used to treat nausea, sleep disorders and chronic pain in cancer patients, he said.

But Peterson wasn’t always in support of marijuana use, medical or otherwise.

“I was a conservative Mormon doctor from Utah and I’d never touched the stuff,” he said.

It wasn’t until five years ago, when a family member was faced with a choice between major brain surgery, potential death, and medical marijuana treatment, that Peterson began to look at the drug in a different light.

The family member was suffering from seizures three or four times an hour, Peterson said — a condition most commonly remedied by removing a portion of the patient’s brain. In this patient’s case, half of the brain would need to be removed to ensure elimination of the seizures, he said, and the family was not willing to take that risk. But the seizures were so bad that the family feared doing nothing was also a death sentence, and medical marijuana treatment seemed to be the only option.

In his research of the drug, Peterson discovered that marijuana is not as cut-and-dry as it appears in the borough’s recent initiative. Both the cannabis sativa and cannabis indica plants are used by pain and seizure patients, and each species contains varying levels of cannabidiol (CBD) and THC. Both of these chemicals can work for pain and seizure management, Peterson said, and different strains affect individual patients differently; so one might find a strain with more than the borough-proposed 0.3 percent THC more effective in meeting their needs.

Peterson also discovered that marijuana seems to be safer, cheaper and more effective, for some patients, than opioid medication, which is being scrutinized across the country.

A 2014 study by the Perelman School of Medicine at the University of Pennsylvania found that, five years after a state legalized marijuana, the rate of opioid-related deaths had decreased by 33.7 percent from the time the law was passed in each of the 13 states studied. In terms of cost, a study published in “Health Affairs” earlier this year found that implementation of medical marijuana laws saved $165.2 million in Medicare costs in 2013 alone, as patients traded prescription drugs for cannabis.

Peterson said the nationwide opioid epidemic — which is largely attributed to prescription drug abuse — is exactly why alternative pain medications like marijuana need to be accessible.

“As a board-certified pain specialist, I’m getting pressure from all fronts (to prescribe) opioids safely. Well, why am I (prescribing) opioids in the first place? Pain. But my argument is, I need access to a potential medication that can work even better than opioids,” he said.

Peterson acknowledged that, as different strains of cannabis affect individual patients differently, so do other kinds of medication, and medical marijuana won’t work for everyone. There are also the health risks associated with smoking or “vaporizing” marijuana — the fastest way to feel the analgesic effects, Peterson said — that the patient would have to weigh against the risks of not taking the drug. Depending on the strain, patients would also have to be mindful of the drug’s potentially psychoactive effects, and determine if such effects would cause them to be more of a danger to themselves than without the drug.

But because of the current lack of legal industry, people don’t always know what they’re getting.

The way things stand, pain patients have to obtain marijuana the same way a recreational user would — grow their own or buy from someone else, the latter of which is not currently legal in the Mat-Borough, since the Assembly enacted a moratorium this spring. But not everyone can afford to grow their own, and without a large-scale manufacturing or cultivation facility, Peterson said, patients don’t have the safe, consistent access to the medical-grade marijuana that pain doctors are recommending.

“You need to know that it’s lab tested, that it’s consistently produced, and … whether you’re using it recreationally or medically, that it is what it’s supposed to be,” he said.

The struggle for Peterson and his family to ensure their own access to medical-grade marijuana has been real, but has clearly yielded results. Not long after Peterson’s afflicted family member started taking marijuana, the frequency of the family member’s seizures decreased from a few times an hour to once or twice a week, he said.

While Alaska may see an increase in recreational users as well as medicinal users with the development of the cannabis industry, Peterson said those in favor of Proposition 1 need to know that their vote won’t make that go away.

“What they need to fear the most is already here, and that’s the black market, which is an unregulated market,” he said. “I don’t want my teenage children using (recreational marijuana) either, but if that’s the choice they truly make for their own lives, I’d rather them walk into a dispensary and know exactly what they’re getting than to go to some black market dealer.”