Transcript 2010_Smith_Maine - Maine Association of Psychiatric Physicians

Maine’s New Medicinal
Marijuana Law
Maine Association of Psychiatric Physicians
April 30, 2010
Gordon H. Smith, Esq.
Executive Vice President
Maine Medical Association
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Background
1999
Original law passes via public initiative, use
permitted for medicinal purposes, but no legal
means to acquire the product
Nov. 2009 Maine Medical Marijuana Act approved by voters
(I.B.2009, Chapter 1)
Dec. 2009 Governor Baldacci establishes a Task Force, by
Executive Order
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Maine Medical Marijuana Task Force
Formed to:
• Review the implementation of similar laws in other states
• Make recommendations on the implementation of the law
in Maine to ensure effective implementation and ongoing
monitoring and to protect public health and safety
• Advise HHS on rules and fees
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Debilitating Medical Conditions
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Cancer
Glaucoma
HIV/AIDS
Hepatitis C
ALS
Crohn’s Disease
Agitation of Alzheimer’s disease
Nail-patella syndrome
OR
the treatment of any of these conditions
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More Conditions
• A chronic or debilitating disease or medical
condition or its treatment that produces intractable
pain, which is pain that has not responded to
ordinary medical or surgical measurers for more
than 6 months
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More Conditions
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A chronic or debilitating disease or medical condition or its
treatment that produces:
1. Cachexia or wasting syndrome
2. Severe nausea
3. Seizures
4. Severe and persistent muscle spasms
(including M.S.)
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More Conditions
• Any other medical condition or its treatment approved by HHS
to be recommended by Advisory Board consisting of at least 11
health care practitioners, including:
neurology
addictionology
gastroenterology
gynecology
pain management
medical oncology
psychiatry
infectious disease
hospice medicine
family medicine
pediatrics
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Advisory Board
• Members must be board certified in their specialty
and knowledgeable about the medical use of
marijuana.
• Board also includes two public members, one of
whom is a registered patient.
• Practitioners must be chosen from list submitted by
MMA and MOA.
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Other functions of Advisory Board
• Conduct, at least yearly, public hearings adding
additional medical conditions, medical treatments or
diseases to the list
• Make recommendations on adding medical conditions
• Recommend quantities of marijuana necessary to
constitute an adequate supply
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Role of Physician
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Medical Certification
Document signed by a physician and stating
that in the physician’s professional opinion a
patient is likely to receive therapeutic or
palliative benefit from the medical use of
marijuana to treat or alleviate the patient’s
debilitating medical condition or symptoms
associated with the debilitating medical
condition.
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Physician
• Must have DEA license
• Certification must be made “only” in the course of
a bonafide physician-relationship after the
physician has completed a full assessment of the
qualifying patient’s medical history
• BOLIM and Osteopathic Board will expect
compliance with Rule Chapter 11.
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Physician
• Licensing boards can not discipline a
physician for simply participating with the
new law, but can discipline a licensee for
failing to properly evaluate or treat a
patient’s medical condition or otherwise
violating the applicable standard of care
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Protections for Physician
• State law provides that a physician can not be
arrested, prosecuted or disciplined in any way
“solely for providing written certifications or for
otherwise stating that a patient is likely to receive
therapeutic benefit from the medicinal use of
marijuana”.
• Attorney General Eric Holder’s statement on behalf
of the Obama administration.
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Risks for Physicians
• Standard malpractice risks if meaningful informed consent is
not achieved
• Failure to review potential side effects, interaction with other
medication, etc.
• Can’t ensure appropriate dosage or purity of product
• Reversal of federal position
• Becoming “the pot doc”
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Options for Physicians
• Participate in the program, preparing
medical certificates for those patients who
may qualify
• Just say no
• Role of MMA
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Additional Aspects of the Law
• Special provisions for minors
• Establishment of licensed dispensaries
• Registry and identification cards for
registered patients, registered caregivers,
and officers, board members and employees
of dispensaries
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Issues Unresolved by L.D. 1811
• Deleting any medical conditions from the
list
• Centralized growing facility
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Proposed Rules (HHS)
Proposed rules follow the initiated law and
amendment and fill in any gaps.
• Thirty-seven terms defined
• Section 4.5 amplifies requirements of physician’s
written certification
• Specifies regulatory requirements of dispensaries
and registry identification cards
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Issues
• Will the number of physicians willing to
participate be sufficient to meet patient
demand?
• How many dispensaries (limit of 8) will be
licensed, given the proposed $15,000 annual
fee?
• How many eligible patients will seek a
medical certificate at $100 per certificate?
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Questions?
Gordon H. Smith, Esq.
Executive Vice President
Maine Medical Association
[email protected]
www.mainemed.com
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