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For the first time since creating the District Medical Marijuana Program more than three years ago, the D.C. Council Committee on Health convened an oversight hearing on Monday to examine the program's successes and areas for improvement. When the program was created with the passage of B18-0622 on May 4, 2010 in the wake of Congress lifting a decade-old ban, many in the Council said they realized the rules would eventually need to be revisited, but they wanted to give the program a chance to work before modifying it. In the words of Councilmember and Committee Chair Yvette Alexander, the time has come for the Council to "examine if the program is working."

Over a dozen District medical cannabis advocates offered public testimony, ranging from a patient for whom access to cannabis means she no longer needs her pharmaceutical pain medication to several potential patients with debilitating conditions and the parent of a young person living with epilepsy, as well as cultivators, dispensary operators and other advocates. Almost every public witness echoed one point: revise the  language on qualifying conditions to allow physicians to recommend medical cannabis whenever they deem it appropriate in their professional medical opinion. Even the lone executive (government) witness, Dr. Fesha Woldu, stated physicians should be in charge of treatment decisions, noting that their conduct is already professionally monitored, so they do not need additional oversight.

ASA staff in their testimony urged the Council to allow the Department of Health (DOH) to begin adding new conditions  through the rule-making process without waiting for the Advisory Committee to be formed. ASA Executive Director Steph Sherer was one of the prospective patients who testified at the hearing, urging the Council to let physicians use their professional judgment for which conditions cannabis may benefit their patients. While DOH seems to prefer using the Advisory Committee as the method to add new conditions, Councilmember Alexander asked Dr. Woldu to reconsider this approach.

Throughout the hearing, Councilmember Alexander expressed concern over how few patients have been enrolled in the program. There are an estimated 15,000 people living with HIV/AIDS in the District who are eligible, but a scant 59 patients have registered in the program. That's less than half a percent of the District's HIV+ population, and some of those 59 are enrolled for one or more of the other 3 conditions: cancer, glaucoma and severe muscle spasms such as associated with MS.

This points to a problem with District physicians being unwilling or unprepared to write recommendations for patients, something confirmed by numerous patient stories relayed to ASA. One reason for the absurdly low number of patients receiving the care they qualify for is that DO) has yet to produce the Training Program for Recommending Physicians mandated by the program regulations.

Section 805 of the regulations directs DOH to make available a training program to physicians about the medical uses of cannabis and the District's program. This is important because no medical schools currently offer any training in cannabis therapeutics. While DOH has made some efforts to promote the program and encourage training for D.C. physicians (including support of ASA's CME course at our National Medical Cannabis Unity Conference last February), the Department is still working to create the program. Councilmember Alexander echoed ASA's desire to see the training program offered on an on-going basis.

One of the other barriers to enrolling in the program was demonstrated dramatically by ASA's Steph Sherer during her testimony as she unfurled the nine full pages of the District's medical marijuana application form, with 23 lines to initial, alongside the District's firearm application and registration forms, which is only five pages with a handful of lines to initial, despite D.C. having arguably the strictest gun laws in the nation. When it takes that much more effort to enroll in a medical program than it does to purchase a deadly weapon, the current application may be too burdensome for many patients.

As the hearing closed, the advocates in the room appeared to be reinvigorated and optimistic about seeing meaningful reforms to the District's medical cannabis program. Improvements seem more possible than ever, but patient advocates in the District must continue their efforts. In addition to joining Safe Access DC, patient advocates can still submit written testimony to the Committee on Health until close of business on November 4, 2013.

Written statements should be submitted either to Mr. Ronald King, Senior Policy Advisor at the Committee on Health via e-mail at [email protected] or to Ms. Nyasha Smith, Secretary to the Council, Room 5 of the John A. Wilson Building, 1350 Pennsylvania Avenue, N.W. Washington, D.C. 20004.