South Carolina looking at supply in demand for marijuana derivative

Two months ago, you couldn’t be sure what Harmony Ralph of Horry County saw when she opened her eyes.

They remained immobile, seeming to stare into some middle distance, and it was hard to tell if she saw anything at all.

But since then, she has regained the ability to hold her head up, sit without draping onto the arm of her wheelchair, cross her legs, kiss her mother and laugh and cry.

Now when her brown eyes are open, they explore her environment, moving from the cartoon on the television to the drinking straw in her mother’s hand to the faces of those around her.

And when her eyes turn to you, you know that a 5-year-old has you in her sights.

Harmony Ralph is the face of medical marijuana in South Carolina.

She had her first epileptic seizure when she was 6 months old, her mother Janel Ralph said. She was rushed to the Medical University of South Carolina where she was diagnosed with lissencephaly, a rare disorder in which the brain fails to develop the numerous folds that give it the room to store and process information normally.

In that first visit to MUSC, Harmony was given a round drugs and was seizure free for a year. Then came another attack, another round of drugs and again a period when she had no seizures. But then a brutal seizure nearly took her life and the pharmaceutical drugs to prevent them became a constant part of her diet, with dosages increasing to keep pace with the increasing frequency and violence of the seizures.

At one time, Janel Ralph said, she could expect her daughter to have clusters of seizures three to five times a day, and that was on the good days. Even with the drugs, though, Harmony had nearly constant seizures, ranging from nonstop blinking of her eyes to uncontrolled jerking of her arms and legs.

The change came after Janel Ralph got her first supply of CBD oil, a derivative of marijuana, and began giving it to Harmony.

Within two weeks, the seizures could be counted on a per week, rather than per day basis. Seizures over the next two months were tallied on the fingers of one hand.

A big fan

“I’m a big fan of CBD oil,” said S.C. Sen. Tom Davis, R-Beaufort, the author of the bill that made it legal for Janel Ralph to possess a derivative of marijuana to control Harmony’s seizures.

Davis said this week that he first heard about CBD oil from a constituent whose granddaughter in Charleston was having 80 to 90 seizures an hour.

He researched it and discovered that CBD oil had helped people in other states and introduced a bill, which Gov. Nikki Haley signed into law last summer, that made possession of the oil legal to treat children with uncontrollable epileptic seizures as long as it was prescribed by a physician.

The bill details the amount of cannabidiol and tetrahydrocannabinol, or THC, that can be in the oil. THC, marijuana’s psychoactive ingredient, is limited by the bill to just 0.9 percent, far below what is needed to produce a high.

Within two weeks of his constituent’s granddaughter getting the drug, Davis said, the seizures went down by 80 percent.

Now, he said he plans to introduce a bill on the first day of the upcoming session Jan. 13 that will allow a low-THC marijuana to be grown in South Carolina so that it’s produced legally in South Carolina for people like Janel Ralph and his constituent’s family.

Under Davis’ bill, the S.C. Department of Agriculture would supervise growers and the Department of Health and Environmental Control would make sure what’s grown is the low-THC variety.

Growers would be audited, as well.

“What happens now is like the black market,” Davis said of how parents currently get CBD oil.

Janel Ralph didn’t say exactly where she gets CBD, but it’s a matter of knowing someone who knows someone.

She talked about other South Carolina families, whom she called medical refugees, where a child and one parent have moved to states such as Colorado or California where the oil has been used medicinally for at least several years and is readily available.

“It’s incumbent on us to take the next logical step,” Davis said.

Later in the session, he plans to introduce a separate bill to expand CBD oil’s medicinal uses to include treatment of post traumatic stress disorder, autism, glaucoma and chronic pain.

Davis said he doesn’t think there will be much opposition to legislation that would allow people to grow the low-THC marijuana to supply the need for CBD oil.

As for expanding the illnesses that can be treated with it, Davis said, “That’s going to cause some consternation.”

Opposition

Already, four of the state’s top law enforcement officers have written the legislature’s Medical Marijuana Study Committee that Davis chairs to object to any expansion of the state’s medical marijuana law until the U.S. government addresses “marijuana’s status as an illegal substance.”

“We want to do everything in our power to bring relief and comfort to those who suffer,” they wrote, “but as law enforcement officers, and individuals who are entrusted to live by and enforce the laws of this state, we must stop short of condoning relief that comes through an illegal manner.”

The letter was signed by Chief Mack Keel of the State Law Enforcement Division, Sheriff Chuck Wright, president of the S.C. Sheriff’s Association, Chief Dan Reynolds, president of the S.C. Police Chiefs Association, and Colonel Mike Oliver, president of the S.C. Law Enforcement Officers Association.

Davis rejected their argument, noting that the state has decided not to wait on federal action in the passage of the bill allowing people to possess CBD oil.

He knows that expanding the medical conditions it can be used to treat will cause some people to say the system will be abused, which he acknowledges it could be.

But he points to alcohol abuse and abuse of prescription medications as not leading to calls for alcohol or prescription drug prohibition. And, he repeated, the marijuana the state would allow grown would have only a trace amount of a psychoactive ingredient.

“You’re always going to have the potential for abuse,” Davis said, “but you have to weigh that against the tremendous good it can do.”

Dr. Jonathan Halford of MUSC also doesn’t favor Davis’ bill to allow low-CBD marijuana to be cultivated and sold through prescriptions in South Carolina.

He believes that CBD oil likely has medicinal use, but he said that a British company produces a CBD oil that is made from plants cloned to have the desired qualities. That, he suggested, is a ready-enough supplier for the need.

Halford said there have been studies that indicate medicinal value in CBD oil, but they were not the carefully controlled clinical trials that MUSC and two other universities will undertake for the federal government. In the initial study, patients with Gervais syndrome will be divided into groups, with one group getting CBD oil and the other a placebo.

Gervais syndrome, like lissencephaly, is a neurological disorder that causes epileptic seizures.

If that goes well, a second type of epileptic seizure disease will be studied.

Halford said the trial could last for years, if patients are responding. If they don’t, it could end in six months.

He acknowledged that some patients can, like Harmony, become nearly comatose from pharmaceutical drugs to combat the seizures. But he said that’s because some physicians add medication after medication to fight the problem. They over prescribe.

The right medication with the proper dose, he said, should control the seizures while leaving patients mentally alert.

“You never know,” he said of what to expect from a clinical trial.

Not in the trials

Harmony Ralph doesn’t have the type of epilepsy that either of MUSC’s trials will study. But at this point, her mother doesn’t need an academic stamp to tell her that what she sees with her own eyes is true.

Janel Ralph has become part of a nationwide network of parents whose children respond better to one level of the derivative while others thrive on a different level altogether. She also doesn’t believe that a pharmaceutically-produced CBD oil will address those nuances.

She talked further about non-academic trials with derivatives synthesized from the whole marijuana plant and the advances seen from that. Again, she doesn’t believe such research would be part of a pharmaceutically-produced derivative.

She said, further, that CBD oil has been associated with seemingly-miraculous cures of cancer, including stage four lung cancer. Accounts of such cures can be found on the Internet.

But, mostly, Janel Ralph talks about hearing Harmony laugh and cry for the first time in 2 1/2 years and about Harmony drinking through a straw for the first time in her life, something her parents and therapists have tried to teach her for four years.

She talks about other new things Harmony can do since the last time you saw her.

“It’s crazy,” she said. “Amazing.”