State expands Medical Cannabis Program to patients with anxiety disorders
State health officials have greenlit cannabis as an effective medical treatment for a range of anxiety disorders.
Dispensary managers view the measure, which could expand New Mexico’s Medical Cannabis Program to thousands of new patients, as a positive step forward, but they say dosage and treatment protocols will ultimately remain the responsibility of so-called budtenders until more medical doctors are versed in cannabis products and their effects.
Members of the New Mexico Medical Cannabis Advisory Board in November approved adding anxiety as a qualifying condition of medical cannabis use after citing that up to 25 percent of New Mexico’s adult population — roughly 465,000 people — could be experiencing the effects of such disorders. The ruling is effective Jan. 1.
“Anxiety isn’t always completely alleviated by the medications that we have available now, and being able to utilize cannabis to treat anxiety disorder is something that is in alignment with the Lynn and Erin Compassionate Use Act to relieve symptoms,” said Stephanie Richmond, a physician assistant and advisory board member who petitioned the board in March with fellow board member Dr. Jean-Paul Dedam to add anxiety as a qualifying condition. She was referring to a law enacted in 2007 to legalize and regulate the use of medical cannabis for the treatment of symptoms caused by debilitating conditions.
Richmond said she and Dedam asked if they could submit their own petition when public petitions to add conditions to the program abruptly ceased in 2021 after recreational cannabis was legalized for adults 21 and over. Richmond and Dedam excused themselves from voting on the petition, but four remaining board members voted unanimously to approve it.
According to the meeting report, Dedam spoke about the anxiety experienced by his patients at the New Mexico Cancer Center as well as the efficacy of the plant and CBD, a chemical compound found in cannabis, in treating the symptoms of anxiety disorder. Cancer is already an approved medical cannabis condition.
The petition, the report said, is inclusive of all anxiety diagnoses: generalized anxiety disorder, social anxiety disorder, medicationinduced anxiety disorder, panic disorder and some phobias.
Richmond said she hopes the measure will reduce the need for benzodiazepines, common pharmaceutical drugs prescribed for anxiety disorders with the potential for dependency and negative side effects. She also hopes it will encourage more discussions between patients and doctors about the plant’s use, especially because strong stigmas and misinformation still exist.
“I think patients are worried about being judged, and I think some providers may not be aware of how it can be a helpful treatment alternate,” she said.
Dedam said with open dialogue, doctors can advise patients to avoid products with potentially problematic strains with a high potency of THC, the psychoactive chemical in cannabis, and guide them to strains with more CBD, another ingredient in the plant, which would work better as a treatment for anxiety disorder.
Dr. David Scrase, the acting Cabinet secretary of the state Department of Health who approved the measure, wrote in his decision that because provider oversight was listed as a perceived benefit, the board should “develop informative materials to ensure safe use.”
Scrase cited a 2022 study in which 66 percent of patients identified anxiety or depression as the reason why they use cannabis.
Cannabis dispensary staff say the measure is a strong move in the right direction, but in reality, budtenders are best suited to guide patients through the vast array of strains and products available.
To do that effectively, said Rachael Speegle, CEO of Verdes Cannabis, budtenders need to be exceptionally trained.
“This will never become a pharmaceutically dosed product,” she said. “Physicians should learn more about this product for sure, but it’s never going to be one size fits all.”
Speegle, a former paramedic with a master’s degree in nursing who began working with the legacy company 12 years ago, explained her company focuses on advising clients of the effects products can have on their maladies. The company oversees 150 employees in four dispensaries in Santa Fe, Albuquerque and Rio Rancho. A new dispensary on Coors Boulevard in Albuquerque is due to open next month.
“When somebody comes into the store, and they say they’re feeling anxious, that’s not enough of the story. We have to ask what type of anxiety. Is it anxiety with mental chatter about the next day? Is it PTSD [post-traumatic stress disorder], where you’re reliving an experience? Are you having social anxiety around the holidays? It’s like saying you need help with sleep. Would that be staying asleep or falling asleep? We need more information.
“Once we understand at a deeper level the cause and precipitating factors, it’s much easier to identify the products that are not going to cause additional harm,” she said. “There is a value that comes in going slow when we’re talking about THC integration.”
Speegle said she doesn’t think most dispensaries are prepared to meet the higher demand of patients who could enroll in the Medical Cannabis Program with the inclusion of anxiety disorders.
“I would challenge my fellow competitors to do a better job making recommendations for clients by listening to the client’s stories themselves. Oftentimes, there are clues in those stories and we can partner the right products with the symptoms,” she said, adding her employees must undergo a three-week orientation class with a cannabis curriculum they must complete before starting work.
“They have scenarios, exams, vocabulary lessons and lessons about basic anatomy,” Speegle said.
“Cannabis is not for everybody,” she continued. “This isn’t a magic bullet. It requires people to lean into life as well. We don’t want to intoxicate you, but people have overconsumed and checked out of life instead of using it to lean into life.”
Alex Norwick, general manager of Kure Cannabis Dispensary in Santa Fe, said her company provides medical cannabis services through a nurse practitioner twice a week. The client consults with the practitioner, who files for a medical card on behalf of the patient, she said. Still, clients must rely on the knowledge and experience of budtenders to guide them on usage.
“It’s a win for the cannabis community from a healing perspective,” Norwick said. “It could drive more people to get medical cards.”
Medical cannabis users are exempt from paying a tax on a certain amount of cannabis products.
Speegle said the tax savings can add up significantly over the course of a year, having a positive economic impact on low-income families. Patients with medical cards may also be exempt from positive THC test results with some larger companies that regularly test their employees for illegal drug use.
“Large-scale employers have a zero tolerance for recreational use, but my hope is that people will be able to stay employed longer if they’re able to treat their anxiety disorder with cannabis instead of alcohol or more illicit forms of drugs,” Speegle said.
Dominick Zurlo, the state’s Medical Cannabis Program director, said New Mexico has upgraded its online patient portal to include access to electronic patient identification cards. The improved patient ID cards provide shorter processing times and more immediate access to medical cannabis, he said, adding patients can apply online through medical providers.
“Especially with regard to behavioral health issues or concerns, we really emphasize that patients work and consult with medical providers to ensure that the use of the medication, like any other medication, is beneficial and they’re not experiencing potentially negative side effects,” Zurlo said.
Norwick said she is relieved the state has taken a serious look at the effects of anxiety disorders and the potential for plant medicine to reduce symptoms.
“I personally use cannabis as medicine, so it’s really beautiful that they’re recognizing anxiety and the ability to treat it with plant medicine,” she said. “We believe in a natural, holistic approach to healing. It opens the door for healing to so many people.”