Reg­u­la­tions must align to sup­port use of med­i­cal pot

Honolulu Star-Advertiser - - INSIGHT - By Clifton Otto, M.D. Clifton Otto, M.D., is a retina spe­cial­ist in Hawaii and a cer­ti­fy­ing physi­cian for Hawaii’s Med­i­cal Use of Mar­i­juana Pro­gram.

It’s en­cour­ag­ing to see agree­ment on im­prove­ments to Hawaii’s Med­i­cal Use of Mar­i­juana Pro­gram this past leg­isla­tive ses­sion, like adding new de­bil­i­tat­ing con­di­tions and in­creas­ing the ar­bi­trary num­ber of plants a pa­tient can pos­sess. Thank you for the re­cent ed­i­to­rial on the tweaks to the pro­gram (“Med­i­cal pot law aided by tweaks,” Our View, May 11).

How­ever, our Leg­is­la­ture may have missed its last chance to stand up for the state-ac­cepted med­i­cal use of mar­i­juana in Hawaii and to pro­tect our pro­gram from fed­eral in­ter­fer­ence be­fore Hawaii’s dis­pen­saries start sell­ing a Sched­ule I con­trolled sub­stance to pa­tients. Com­mit­tee chair­per­sons ei­ther de­ferred or com­pletely de­nied public hear­ings to sev­eral bills that could have made a dif­fer­ence, in­clud­ing: Se­nate Bill 120 and House Bill 170, both of which would have re­quired that the Depart­ment of Public Safety (PSD) pro­vide a sched­ul­ing rec­om­men­da­tion to the Leg­is­la­ture rec­og­niz­ing that mar­i­juana can­not be in a state sched­ule that re­quires the “high­est de­gree of dan­ger”; and SB 1093, which would have pro­vided statu­tory sup­port for the fact that the state-ac­cepted med­i­cal use of mar­i­juana here is “cur­rently ac­cepted med­i­cal use in treat­ment in the United States.”

Even the an­nual Uni­form Con­trolled Sub­stances Act up­date bills, SB 997 and HB 1131, which have pro­vided PSD with the op­por­tu­nity for the past 17 years to ful­fill its ad­min­is­tra­tive duty to fix the cur­rent state clas­si­fi­ca­tion of mar­i­juana, were used once again to merely rub­ber stamp sched­ul­ing changes at the fed­eral level rather than to sup­port state law. Add to this the pre­vail­ing false be­lief that fed­eral pre­emp­tion some­how means that our state can­not stand up for its author­ity to ac­cept the med­i­cal use of mar­i­juana, along with the com­monly held as­sump­tion that Hawaii’s Med­i­cal Use of Mar­i­juana Pro­gram vi­o­lates fed­eral law, and you have a per­fect storm for sup­press­ing a recog­ni­tion of the im­pact that state-ac­cepted med­i­cal use has upon fed­eral sched­ul­ing.

Such chilling only serves to per­pet­u­ate the suf­fer­ing of our pa­tients and puts Hawaii’s dis­pen­saries at risk of be­ing con­sid­ered “con­tin­u­ing crim­i­nal en­ter­prises” in the eyes of a po­ten­tially hos­tile fed­eral ad­min­is­tra­tion.

The way to fix this sit­u­a­tion is to first rec­og­nize col­lec­tively that mar­i­juana al­ready has med­i­cal use in Hawaii, some­thing that would prob­a­bly be very dif­fi­cult for many of our law en­force­ment of­fi­cers and med­i­cal pro­fes­sion­als to ad­mit at this time. States have the author­ity to ac­cept the med­i­cal use of con­trolled sub­stances, which is how Hawaii ac­cepted the med­i­cal use of mar­i­juana in 2000 and cre­ated its own state-reg­u­lated med­i­cal use of mar­i­juana pro­gram. If Hawaii’s pro­gram violated fed­eral law, we would see the U.S. Depart­ment of Jus­tice shut­ting it down, not is­su­ing pol­icy guide­lines de­signed to help states that have ac­cepted the med­i­cal use of mar­i­juana keep such med­i­cal use well reg­u­lated and strictly in­tra-state.

The prob­lem lies with the ob­so­lete fed­eral reg­u­la­tion that still has mar­i­juana on the fed­eral Sched­ule I list, and the Drug En­force­ment Agengy’s own out­dated in­ter­pre­ta­tive rule, which was adopted be­fore any state had ac­cepted the med­i­cal use of mar­i­juana and which per­pet­u­ates the myth that FDA ap­proval is the only way that a con­trolled sub­stance can have ac­cepted med­i­cal use.

It’s well past time for our state law­mak­ers, our state ex­ec­u­tive of­fice and our con­gres­sional rep­re­sen­ta­tives to step up to the plate and sup­port the state-ac­cepted med­i­cal use of mar­i­juana in Hawaii, for the sake of our pa­tients, be­cause it’s the right thing to do.

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