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Crohn's Disease Patient Still Looking For Answers After Amendment 2 Fails

Dr. Ellen Zimmerman, 58, is a gastro neurologist at Shands Hospital at the University of Florida and a professor at the UF College of Medicine. In her opinion, not the opinion of the university, medical marijuana has quite a few risk factors for patients with Crohn’s Disease, giving rise to her vote of “no” on the failed Amendment 2.
Dr. Ellen Zimmerman, 58, is a gastro neurologist at Shands Hospital at the University of Florida and a professor at the UF College of Medicine. In her opinion, not the opinion of the university, medical marijuana has quite a few risk factors for patients with Crohn’s Disease, giving rise to her vote of “no” on the failed Amendment 2.

Nicholas Jammal, 20, was diagnosed with Crohn’s disease in March 2010 during his sophomore year of high school.

“First, it was the weight-loss,” Jammal said.  “When I was a sophomore in high school, I weighed like 95 pounds.”

Jammal said Crohn’s disease stunted his growth until he went into remission with infusions of the drug Remicade.  He called it a “miracle drug" and said he grew 9 inches in a matter of just a couple years.

Though doctors helped his body get back on track in terms of growth, his symptoms, such as the inability to eat without experiencing bowel pain, continued. Jammal was prescribed various medications to help him eat and relieve pain, but nothing worked.

At the end of 2010, Jammal finally turned to self-medication -- smoking marijuana.

“I remember the first time I ate something [while] high," he said. "It was so easy for me to eat. It wasn’t painful.”

But Dr. Ellen Zimmerman isn’t convinced that marijuana is the answer.

As a gastro neurologist at the University of Florida Health Shands Hospital, Zimmerman sees patients daily who suffer from Crohn’s disease. She said studies suggest nearly 20 percent of gastroenterology patients use marijuana to relieve symptoms.  Though there is evidence to suggest marijuana is effective, it does not prevent the formation of fibrous connective tissue (called fibrosis) in the intestine of Crohn's disease patients caused by inflammation.

“What happens is fibrosis in the intestine leads to stricture formation and scar tissue that can narrow off the bowel and can result in the patient requiring surgery,” Zimmerman said.

Zimmerman does not deny marijuana reduces pain in Crohn's disease patients.  "When compared to placebo, it suggests that marijuana will improve symptoms, like diarrhea and abdominal pain," she said.

But she’s more worried about its effects on inflammation.

“There hasn’t been any studies looking at the actual inflammation in the gut to see if that has decreased with marijuana,” Zimmerman said.  “And that is really the bar to which all new medications for Crohn’s disease are held — is that ability to improve inflammation in the gut.”

Robert Porter, 80, is a local retired orthopedic surgeon who practiced medicine in the northeast for about 35 years. He said he is strongly in favor of medical marijuana because he’s done the research, which shows it is safer than some heavily regulated prescription drugs.

Marijuana is categorized as a Schedule 1 drug, the same category as LSD and heroin.

“If you look at the number of deaths since the history of recording side effects that could be attributed to marijuana deaths, it is zero,” Porter said.

In the recent election, there were half of a million more votes cast for Amendment 2 than for the Florida governor’s race. Fifty-eight percent of Floridians voted in favor of the amendment, which fell 2 percent shy of the required 60 percent needed to pass.

Jon Mills, the writer of Amendment 2 , said “[Amendment 2] allows individuals with very debilitating serious medical conditions to consult a Florida physician as to whether they would be better off using medical marijuana than using some other substance."

For example, Mills said oxycodone is a commonly used painkiller that can be more addictive than marijuana.

“One of the amazing statistics is that over the last 10 years, in states where medical marijuana is legal, which there are about 23 (states), the deaths from oxycodone and other of those types of pain killers has gone down by 20 percent,” Mills said.

Denise is a reporter for WUFT News and can be contacted by calling 352-392-6397 or emailing news@wuft.org.