Unfortunately, Maryland Did NOT Become the 19th Medical Marijuana State
When the Maryland Senate voted earlier today to approve HB 1101 today, it failed to become the 19th medical cannabis (marijuana) state. In spite of the bill's comendable intentions, it remains highly flawed. Some have touted the HB 1101 approach as a "yellow light" on medical cannabis, yet sadly, it can only be seen as a "yellow light" on a "bridge to nowhere."
In spite of the bill's laudable intent, the approach is completely untested, and causing even greater concern, the program is almost certainly unimplementable for legal, financial and practical reasons. In fact, the Maryland Department of Legislative Services found that participation program is "expected to be low (or nonexistent)" and will "not likely to be able to comply with the bill’s requirement to set its fees at a level sufficient to offset program costs...unless it sets its fees at a level that would likely be prohibitively high."
Legal Reasons for Concern
HB 1101 would allow patients to obtain medical cannabis from "Academic Medical Centers" (AMCs), which are essentially teaching-hospitals that have federal approval to conduct trails on human subjects. While this is creative way to reinvent how medical cannabis is distributed to patients, only one potentially eligible AMC (Sinai Hospital in Baltimore) has expressed interest in becoming an AMC. However, by becoming an AMC, the hospital would likely be placing its credentials to conduct research on human subjects in jeopardy. Considering that federal interference is one of the reasons Maryland has been reticent to adopt a proven safe access model, it does not add up why Maryland would be encouraging its facilities to endanger the credentials.
But let's assume for a moment that this legal concern is not in fact an issue...
The DLS analysis points out that HB 1101 must be able to offset the financial costs incurred by the commission that will be set to implement it. While the DLS report mentions that the state might not be able to find any willing and eligible AMCs, it concludes that even if Sinai or another institution stepped forward and applied to be an AMC, the program would still be unable to offset its anticipated costs. Moreover, the state will have to bear the costs of establishing the administrative rules for the program, even if no AMCs ever apply to the state. It's rare feat for an essentially symbolic piece of legislation to come with a price tag, but that's what HB 1101 does, meaning Maryland taxpayers could be forced to pay for a program that may not serve any of the state's patient population.
But let's assume for a moment that the price tag issues are not a factor...
Dubious Practical Value
Absent concerns about the financial and legal viability of HB 1101, the program still contains practical flaws that would make it arguably the least patient-friendly bill in the country. The bill fails to grant physicians to right to recommend cannabis to their patients unless an eligible AMC has been approved by the state to recommend and distribute medical cannabis for certain conditions. In other words, if an AMC did not have foresight to include a patient's particular condition in its application to become an AMC, the patient would be shut out from the program. This would be particularly harmful to patients with rare conditions and conditions for which medical cannabis is an emerging therapeutic option. This also means that the Commission would have to approve conditions, and given the strong resemblance of the work group created by SB 308 (2011) that had difficulty meeting its statutory requirements, it would also require the state's patients to take a serious gamble that the Commission could meet its function.
Geography is another practical concern that should resonate with patients across the state. The most likely AMCs (Sinai, Johns Hopkins Hospital, and the University of Maryland Hospital) are all in Baltimore. Patients who do not live along the I-95 corridor, such as combat veterans living with PTSD in Cumberland, or retirees with cancer living on the Eastern Shore, may have to drive 2-3 hours each way in order to access their AMC to obtain medicine. Even if a patient is fortunate to have a caregiver assist them, the potential 6-hour trip is a completely unnecessary burden to safe access.
So what are Maryland patients left to assume? As someone who lived in Maryland for over 30 years, and has most of my loved ones still residing in the state, there was no state in 2013 that I had more personal hope for than Maryland. I really wanted Maryland to be the next medical marijuana state, but HB 1101 simply falls short, and significantly so.
Maryland's new medical may make lawmakers feel better, but it remains extremely unlikely that it will do the same for the state's patient population.
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