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In this issue
- Annual ASA Report on Safe Access Finds States Improving
- Bipartisan Congressional Letter Urges VA to End Medical Cannabis Ban
- Puerto Rico to Implement Limited Medical Cannabis Program
- Voters in Florida Get Another Chance at Initiative
- CBD Found Effective in State Seizure Study
- Georgia Rep Says He Broke State Law to Bring Cannabis to Patients
- California Fixes Error that Triggered Dozens of Local Bans
- Former Chicago NFL Star Speaks Out, Governor Rejects Expansion
- ACTION ALERT: Join Us to Lobby Congress
Annual ASA Report on Safe Access Finds States Improving
Americans for Safe Access has issued its annual report on the status of safe access, “Medical Marijuana Access in the US: A Patient-Focused Analysis of the Patchwork of State Laws.” This year’s report uses a retooled rubric for evaluating state medical cannabis programs from the patients’ perspective and provides policy makers with model legislation and regulations. The new grading criteria put additional emphasis on quality assurance and product safety regulations that protect vulnerable consumers from pesticides and other potential risks.
“Our report provides state lawmakers with timely tools to ensure their medical cannabis programs truly meet the needs of the patients they are meant to serve,” said Mike Liszewski, ASA’s Policy Director. “The range of approaches states have taken has given us substantial evidence of what works and what doesn’t.”
Nineteen states introduced legislation to legalize medical cannabis in 2015. More than a dozen of the 23 states with robust programs passed legislation or created new regulations to expand or improve them, including California, which adopted a comprehensive regulatory approach and added civil protections for patients.
“Too often, patients are denied life-saving treatments solely because they are using medical cannabis,” said California Assembly member Marc Levine, champion of the state’s Medical Cannabis Organ Transplant Act (AB 258), which ended the widespread practice of denying patients transplants on the basis of cannabis use. “It is imperative for state lawmakers to take advantage of vital resources like ASA’s report to improve their state programs.”
The report evaluates each state medical cannabis law on: 1) patients' rights and protection from discrimination, 2) access to medicine, 3) ease of navigation, 4) functionality, and 5) product safety protocols. The report finds that, while many states have important elements helpful to patients, no state has yet established an ideal program.
The most notable state trend in 2015 was the spread of comprehensive product safety rules, many based on the Recommendations to Regulators from the American Herbal Product Association (AHPA). Maryland’s medical marijuana program, for example, which is projected to begin serving patients in 2017, received the highest report grade for product safety by creating stringent safety and quality control measures that incorporate AHPA guidelines in the areas of cultivation, distribution and manufacturing. ASA worked closely with state officials to achieve that, and ASA’s Patient Focused Certification program will be training state auditors responsible for compliance.
“The tools provided by Americans for Safe Access and the Patient Focused Certification program have been tremendously helpful in creating product safety regulations that will ensure Maryland patients are receiving the highest quality products and medicine possible” said Hannah Byron, executive director of the Natalie M. LaPrade Maryland Medical Cannabis Commission.
Maryland is not alone. New Hampshire, New Mexico, and Washington have also adopted regulations that reflect the AHPA standards and score better on ASA’s new report as a result.
"The report highlights how best practice guidance such as the Cannabis Committee's Recommendations to Regulators can assist states in establishing regulations that ensure the quality and safety of cannabis products," says Michael McGuffin, AHPA President.
Letter-grades for all 23 states and the District of Columbia: Alaska (D-), Arizona (B-), California (B+), Colorado (B), Connecticut (C+), Delaware (C), District of Columbia (C), Hawaii (B), Illinois (B+), Maine (B-), Maryland (B), Massachusetts (B), Michigan (D+), Minnesota (C), Montana (D-), Nevada (B), New Hampshire (C), New Jersey (C), New Mexico (B+), New York (C), Oregon (B), Rhode Island (C-), Vermont (D+), and Washington (B).
Bipartisan Congressional Letter Urges VA to End Medical Cannabis Ban
A bipartisan group of 21 members from the House and Senate in January urged the Veterans Administration to revise its medical cannabis policy. Current VA policy prohibits their doctors from providing documentation veterans need to participate in state medical cannabis programs. VA policy even prohibits physicians from discussing potential benefits of medical cannabis with their patients.
The Congressional letter points out that in November the Senate approved, 93-0, a new policy that would allow veterans and their VA doctors to fully participate in state medical cannabis programs. The policy change was narrowly defeated in a House appropriations vote in April, but the 213-210 tally was an increase of 15 aye votes from last year’s attempt.
Riders such as these to funding bills must be passed each year. The bipartisan CARERS Act, currently pending in both houses of Congress, would permanently solve the issue without the need for annual reauthorization.
Veterans suffer from disproportionate rates of serious medical conditions for which cannabis has proven therapeutic potential, including difficult to treat problems such as neuropathic pain and PTSD. Combining cannabis with opioids in pain treatment can increase the effectiveness of lower doses of opioids and help prevent overdose fatalities. A 75 percent reduction in severity of PTSD symptoms was demonstrated in one study, though more clinical research is needed.
Sen. Kirsten Gillibrand (D, NY), one of the members who signed the letter, also held a news conference to urge a change in VA policy (pictured at right). Other signatories of the letter include Rep. Joe Heck (R, NV), a physician and Army Reserve brigadier general who chairs the House Armed Services personnel panel.
Bi-partisan Congressional letter to the VA
Puerto Rico to Implement Limited Medical Cannabis Program
Following a May 4 executive order from Governor Alejandro Garcia Padilla, Puerto Rico's health department issued regulations in January for the cultivation, manufacturing and distribution of medical cannabis. Health officials are limiting access to topical and edible medical cannabis products. Personal cultivation will remain illegal, as will inhalation as a route of administration.
A seed-to-sale inventory tracking system is planned, with the Puerto Rico Health Department issuing licenses for commercial cultivation of cannabis and manufacture of products for distribution. Independent labs will test products for THC content and contaminants. The program is expected to be operational by the end of the year.
Puerto Rico is not the first U.S. territory to approve a medical cannabis program. Guam passed a voter initiative in 2014 for which draft regulations were issued last summer.
Voters in Florida Get Another Chance at Initiative
Patient advocates in Florida announced at the end of January that they have again qualified a medical cannabis initiative for the state ballot. The measure, again known as Amendment 2, would amend the state constitution to allow patients with a broad range of serious medical conditions to use medical cannabis and obtain it from state-licensed dispensaries.
A similar initiative in 2014, also sponsored by United for Care, received 58% support, but 60% is required for constitutional amendments in Florida. Current state law, passed by the legislature in 2014, allows only high-CBD, low-THC cannabis extracts for a limited number of qualifying conditions. Implementation is underway, with cultivators having been selected, but no medicine is yet available for any patients.
A Quinnipiac University poll last March found 84 percent of Florida voters support legal access to medical cannabis when a physician recommends it. State lawmakers are considering a bill that would allow individuals with terminal conditions to use whole-plant medical cannabis, not just low-THC extracts.
CBD Found Effective in State Seizure Study
Early results of a study in Alabama indicate most patients whose seizures resist other treatments show significant improvement using cannabidiol (CBD) extracts. Researchers report that at least 50% of patients in the study have had a reduction in seizures of more than 50%. Some who were experiencing multiple seizures every day have been seizure-free since starting the CBD extract. 90% of patients enrolled in the study have shown improvement, according to Dr. Jerzy Szaflarski, the lead investigator.
When state legislators passed a narrow medical cannabis bill known as Carly's Law, allowing cannabidiol (CBD) extracts of cannabis with less than 1% THC to be used by people with severe seizure disorders, they also directed the University of Alabama at Birmingham to study the treatment’s effectiveness. UAB researchers plan to present their findings next month at the annual meeting of the American Academy of Neurology.
Theirs is not the only study of CBD and seizures underway in the U.S. Epidiolex, a dose-controlled sublingual CBD extract manufactured by GW Pharmaceuticals, is currently in FDA trials with pediatric seizure patients in a handful of U.S. research hospitals.
Georgia Rep Says He Broke State Law to Bring Cannabis to Patients
Allen Peake, the Republican state representative who authored Georgia’s medical cannabis measure, Haleigh’s Hope Act (HB1), says he broke the law to provide cannabis oil extracts to at least one patient. Rep. Peake admitted to his crime in an interview with to WSB-TV Atlanta, saying, “at some point there is a need for civil disobedience” and that he would do it again if he had to.
Georgia law makes no provision for obtaining any medical cannabis products but allows registered patients with certain medical conditions to legally use low-THC extracts containing primarily cannabidiol (CBD) and tetrahydrocannabinolic acid (THCa). As a result, qualified patients and their caregivers may only access medical cannabis in one of the few states that recognize out-of-state registry cards and then bring it back to Georgia in violation of federal law.
Rep. Peake introduced HB 722 this year to allow production and distribution of the extracts in Georgia. If enacted, the bill would also expand the list of qualifying conditions to include HIV/AIDS, Alzheimer’s disease, intractable pain, and 14 other conditions.
A November 2015 poll found that more than 84% percent of likely 2016 Georgia primary voters support such a measure. Governor Nathan Deal opposes it.
California Fixes Error that Triggered Dozens of Local Bans
AB21 removes the March 1 deadline for local governments to regulate medical cannabis operations under the comprehensive regulations the legislature passed in September. That trio of bills, passed in the waning hours of the legislative session, inadvertently included language giving the state sole authority over medical cannabis operations in cities and counties that did not have regulations as of March 1. As a result, dozens of California cities took action in January to ban all cultivation and dispensaries.
The bill to fix that was introduced by Assembly member Jim Wood (D, Healdsburg), the author of the original legislation. He said the date was a drafting error. AB21 cleared the Assembly on a vote of 66-0 at the end of January. It took effect upon being signed by the governor.
“I am not advocating for or against a particular position on medical cannabis,” said Assembly member Wood (pictured at right with Gov. Brown signing the bill). “I am advocating for local elected officials to take the time to engage in a process that results good public policy, not knee jerk reactions.”
ASA is also calling on California lawmakers to remove licensing requirements from the new medical cannabis law that apply to some personal non-commercial cultivation of medical cannabis. The new law will require a state and local license for individual patients who cultivate more than 100 square feet of medical cannabis or for primary caregivers who cultivate medical cannabis in more than 500 square feet (for up to five patients). Those restrictions were not vetted or approved by any of the legislature's policy committees that reviewed the bills and may burden individuals with expensive and complicated licensing.
“Many patients grow their own medicine for economic reasons or to maintain access to a specific strain they need that is not available in the commercial marketplace,” said ASA California Director Don Duncan. “We cannot know how many personal medical cultivators will be affected, but it is unfair to require them to obtain licenses if they are not part of the commercial market. And possibly illegal.”
In 2010, the California Supreme Court ruled in People v. Kelly that the limits the legislature established in 2003 on how much cannabis patients can cultivate and possess were unconstitutional changes to a voter initiative.
Former Chicago NFL Star Speaks Out, Governor Rejects Expansion
Another professional football player is speaking out on the effectiveness of medical cannabis. NFL great Jim McMahon, 56, went public last month about how it has helped him manage the painful legacy of his 15-year football career.
The former Chicago Bears quarterback says he has been able to substitute medical cannabis for prescription narcotics he took for years. Before getting his medical cannabis card in Arizona, where he now lives, he was taking 100 Percocet pills a month.
"They were doing more harm than good," he told the media. "This medical marijuana has been a godsend. It relieves me of the pain."
McMahon returned to Illinois last month to celebrate the 30th anniversary of his team’s Super Bowl championship. The timing happened to coincide with Governor Bruce Rauner considering an expansion of the state’s qualifying conditions list. The state advisory board recommended adding eight new conditions, including intractable pain, and patient advocates had submitted a petition with 25,000 signatures urging the governor to expand the program. Nonetheless, the governor rejected the recommendation of those experts late last month.
The head of the advisory board, Dr. Leslie Mendoza Temple, told reporters she was “deeply disappointed" by the decision but will try again this spring. Only about 4,000 patients have registered with the Illinois pilot program, far below projections.
ACTION ALERT: Join Us to Lobby Congress
Register today to join us in Washington, D.C. to lobby Congress on the most comprehensive federal legislation on medical cannabis ever introduced.
On Tuesday, March 22, following our 2016 National Medical Cannabis Unity Conference, ASA staff and hundreds of patient advocates will hit Capitol Hill to urge our elected representatives to bring the CARERS Act to a vote. The CARERS Act would lift the threat of federal prosecution for anyone in compliance with state medical cannabis laws, remove barriers to research, and fix a host of other problems that are preventing the full implementation of state programs.
The Lobby Day follows three days of informative panels on best practices and other developments in the medical cannabis industry, as well as fun networking events with other patients, providers, activists, and medical and legal professionals from around the country. Register Now!
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