Group wants ban on smokable Rx pot
A coalition of medical groups, including several that opposed the ballot question that legalized medical marijuana in Oklahoma, says the law needs at least three fixes to protect public health.
At a joint news conference on Monday afternoon, the group called for three rules on dispensaries: requiring them to have a pharmacist on staff, limiting the number of licenses available to open one and forbidding them to sell smokable forms of marijuana. Patients who grow marijuana for their own medical use would still be permitted to smoke it.
The Oklahoma Health Department is scheduled to vote Tuesday morning on a set of regulations that doesn’t include the medical groups’ three priorities, and it isn’t clear whether the board might consider the proposals in the future. Dr. Jean Hausheer, president of the Oklahoma State Medical Association, said coalition members have met with interim Health Commissioner Tom Bates and members of the board, but the Health Department raised
legal concerns about some of their priorities.
The ban on products that can be smoked is intended to ensure patients get a consistent dose of the active chemicals in marijuana, without the negative health effects of inhaling combusted material, Hausheer said.
“Smoking of any kind is unhealthy,” she said.
Studies have linked marijuana smoking to some, but not all, of the same health effects associated with cigarette smoking. Smoking marijuana increases coughing and causes lung changes that could lead to emphysema over time, and appears to be linked to a higher risk of some cancers, according to a 2014 article in Clinical Reviews in Allergy & Immunology.
Another article, in Current Opinions in Pulmonary Medicine, said low doses of marijuana smoke may not increase lung disease risks, but it’s not clear where that threshold might be.
Two members of a group that had organized support for State Question 788, which legalized medical marijuana, quickly panned the medical coalition’s proposals. Jeremy Dedman, who said he was active with pro-marijuana group Green the Vote, said banning marijuana that can be smoked would reduce patients’ ability to turn it into an inhaled vapor, which he called a healthier option.
“People need to be free to make their own choice in how they take their medicine,” he said.
Little research has been done on the health effects of vaporized marijuana.
Dedman and fellow marijuana activist John Frasure also disagreed with the idea that a pharmacist would have the training to dispense medical marijuana.
While pharmacists may not have had specific training related to marijuana, they have necessary skills for dispensing controlled substances, said Chelsea Church, executive director of the Oklahoma State Board of Pharmacy.
She pointed to experience preventing diversion of medication for illegal purposes and checking for dangerous drug interactions.
Another step the state could take to reduce the risk of diversion to the black market is to limit the number of dispensary licenses that become available initially, said Craig Jones, president of the Oklahoma Hospital Association.
If a market has too many dispensaries, those that aren’t profitable may be tempted to sell some of their product illegally, he said.
Jones pointed to a study from the Marijuana Policy Group that found business failures tended to increase if a market had more than one dispensary per 67,000 people, but said the coalition wasn’t set on that number.
Frasure disagreed, and argued that limiting the number of dispensaries could encourage black market sales, if patients couldn’t easily travel long distances to a dispensary.
Hausheer didn’t rule out pursuing legislative action if the Board of Health doesn’t act on the recommendations. Several groups have called for legislative changes to the law, including New Health Solutions Oklahoma, a trade group for marijuana businesses; the Vote Yes on 788 political action committee; and several free clinics, which hope to receive a portion of the proceeds from taxing medical marijuana.
Gov. Mary Fallin backed down from statements that she would call a special session to deal with medical marijuana, but lawmakers still could make changes when they return next year.
Draft rules
While the Health Department hasn’t acted on the medical coalition’s recommendations, it has made some changes to the original draft rules following the public comment period. The changes to the rules that will be voted on Tuesday include:
• Requiring doctors to screen patients for substance misuse, mental health issues and risk of diverting marijuana to recreational users. A physician would have to review the recommendation for medical marijuana at least once a year.
• Opening the door for doctors to recommend marijuana for pregnant women. The draft rules prohibited medical marijuana for pregnant women in all circumstances. The revised rules would require a physician to balance the risks to the fetus against the benefits to the woman.
• Requiring minors to get a recommendation from a pediatrician or a physician with a board certification in a pediatric specialty.
• Allowing patients to appoint a caregiver if they can’t move well enough to pick it up themselves. The caregiver must get a license, which is valid for two years.
• Requiring dispensaries to have a manager who ensures compliance with all laws and rules.
• Allowing individuals or businesses to own more than one marijuana establishment.
• Limiting marijuana growing to enclosed facilities.
• The rules also included more detailed guidelines for advertising, tracking and processing medical marijuana.
To view the rules, visit omma.ok.gov.