Transcript X - cdrewu.edu

Understanding Medical Marijuana Laws:
What is and is not considered in
past and current state policies
Rosalie Liccardo Pacula, Ph.D.
Anne Boustead, JD, MPhil
and
Katherine Pfrommer, MA
Research presented here was supported by grants from
NIDA (R01DA032693; 3R01DA032693-03S1)
What do we mean by medical marijuana?
How is it different from other medications?
Typical Pharmaceutical
Specified Medical
Conditions
X
Clinically established
dosage necessary for
relieving symptoms
X
Standardized doses for
purchase
X
Clinically established
guidelines regarding
frequency of dosage
X
Clinical limits on duration
X
Labelling of active (and
inactive) ingredients
X
Clinically preferred
mechanisms for delivering
X
Pacula 2 September 2014
What do we mean by medical marijuana?
How is it different from other medications?
Typical Pharmaceutical
MM Today
Specified Medical
Conditions
X
X
Clinically established
dosage necessary for
relieving symptoms
X
Standardized doses for
purchase
X
Clinically established
guidelines regarding
frequency of dosage
X
Clinical limits on duration
X
Labelling of active (and
inactive) ingredients
X
X
Clinically preferred
mechanisms for delivering
X
X
X
Pacula 3 September 2014
Today’s presentation
• Discuss how state laws have evolved, with an emphasis
on the types of dimensions that are reflected in the
laws
• Draw parallels with other types of medicines, so as to
predict how medical marijuana laws may change in the
future
Pacula 4 September 2014
Five Distinct Periods of Recent
Medical Marijuana State Laws
Modern Period of MM
laws
Period Characterization
1972-1996
Exploration of medicinal value
1996-2000
Protection of patient rights
2000-2009
Protection of patient’s access to supply
2009-2013
Regulation of access to MJ
2014- present
Regulation of MJ as only medicine
Pacula 5 September 2014
1972-1996: Exploration of Marijuana as Medicine
Pacula 6 September 2014
1996-2000: Ballot Era
• CA was the first state to pass what is commonly
recognized as a medical marijuana law in 1996
• Early state ballot laws protected patients who used
medical marijuana and caregivers who assisted in
that use
– “Medical use” was generally defined broadly to include
consumption in addition to cultivation, production,
transportation and acquisition
• These laws generally did not:
– Explicitly protect entities that produced or distributed
marijuana
– Regulate licenses for use or provision of marijuana
– Regulate production
Pacula 7 September 2014
1996-2000: Ballot Era States
Pacula 8 September 2014
Model MM Law in these Early Years
Marijuana Policy Project Model Law 2000
Defined activities
included in medical use
Registry provisions
Legal protections for
patients and caregivers
Cancer, glaucoma, HIV/AIDS,
disease that causes “pain”,
nausea or seizures
States *may* include registry
provisions
Full legal protections available
with written certification
Amount limitations
“Adequate supply”; states may
elect to define adequate supply
Source of medical
marijuana
States may opt to include
protections for cultivators and
production agencies
Pacula 9 September 2014
2000-2009: Early Legislative Era
• Most laws during this period included registry
provisions and allowances for home cultivation
• Few laws at this time included explicit provisions for
dispensaries
– Colorado 2001 law did not explicitly sanction cooperatives
but were implicitly allowed
– California SB 420 explicitly allowed for cooperative
cultivation of marijuana but did not regulate them – left this
up to local governments
• Regulation was inhibited by uncertainty about federal
enforcement of the Controlled Substances Act
Pacula 10 September 2014
The Early Legislative Era 2000-2009
Pacula 11 September 2014
The 2009 Ogden Memo Clarified the
Federal Government’s Position
• In October 19, 2009, Deputy Attorney General David
Ogden released a memo stating that federal
prosecutors “should not focus federal resources …
on individuals who are in clear and unambiguous
compliance with existing state laws providing for the
medical use of marijuana.”
Pacula 12 September 2014
2009-2013: Late Legislative Era
• States began enacting more comprehensive (and
tightly controlled) distribution mechanisms
• State regulatory authorities become more prominent:
– Regulate hours /licensing of dispensaries
– Regulate growers / producers
– Labeling requirements on products
• Still missing from the laws:
– Explicit regulations on potency (THC) and other
cannabinoids.
– Regulations on medical products that can be sold (testing,
forms)
– Regulations on how it should be consumed (Exception:
New York)
Pacula 13 September 2014
The Late Legislative Era 2010-2013
Pacula 14 September 2014
2014-Present: CBD-only laws
• Cannabidiol, or “CBD” is a naturally occurring
compound in cannbis that has medical effects but
does not make people feel “stoned” and can actually
counter the psychoactive effects of delta-9 THC
• Some CBD-only laws have stricter requirements on
who can give permission to use CBD
– For example, Utah and Iowa both require that CBD use be
recommended by a neurologist
• CBD-oil is generally only allowed for a narrow range
of medical conditions
– Generally for epilepsy or a seizure condition
Pacula 15 September 2014
2014 to the Present: Cannabis as only medicine
Pacula 16 September 2014
Model Medical Marijuana Laws Today
• ASA and MPP model policies include requirements for
patients and caregivers to register with the state
– Caregiver more carefully defined; sometimes limits on how
many people they can care for and relationship to patient
• Both model policies recognize – and protect – a variety of
entities involved in producing and distributing medical
marijuana
– Not only dispensaries and cultivation centers, but also testing
and manufacturing facilities
• ASA model law includes provisions for testing and
labeling medical marijuana
– requires the adoption of “product safety standards for the
cultivation, processing, manufacturing, labeling, testing, and
distribution” of medical marijuana
Pacula 17 September 2014
Summary of the Evolution of State
Medical Marijuana Laws
Modern Period of MM
laws
Period Characterization
1972-1996
Exploration of medicinal value
1996-2000
Protection of patient rights
2000-2009
Protection of patient’s access to supply
2010-2013
Regulation of access to MJ
2014- present
Regulation of MJ as only medicine
Pacula 18 September 2014
Likely Next Directions for Medical Marijuana
Policies
• Medical marijuana regulation may begin to more closely
resemble regulation of pharmaceuticals
– Dosage limits
– Labeling and testing requirements
– Product restrictions
Pacula 19 September 2014
Youth-targeted products sold today
in dispensaries – hard to consider this “medicine”
Pacula 20 September 2014
Likely Next Directions for Medical Marijuana
Policies
• Medical marijuana regulation may begin to more closely
resemble regulation of pharmaceuticals
– Dosage limits
– Labeling and testing requirements
– Product restrictions
• States may enhance legal protections as different types
of entities become involved in producing medical
marijuana.
• Likely to see more of a difference in medical marijuana
laws and legalization policies
Pacula 21 September 2014
Thank you!!
Pacula 22 September 2014