Medical Cannabis Working Group urges government action

HONOLULU—Last week, The Medical Cannabis Working Group (MCWG) submitted their findings and recommendations to the Legislature to improve Hawaii’s medical cannabis program. The non-government collective of patients, caregivers, physicians, and advocacy organizations was formed after several attempts to create a state-sponsored task force were defeated by Governor Linda Lingle in previous years.

“A review of Hawaii’s 10-year-old medical cannabis program is long overdue,” said Laurie Temple, MCWG Co-Chair and ACLU of Hawaii attorney in a statement. “We hope that the Legislature will learn from our report as well as other states’ experiences and act immediately to rectify the problems.”

It is the goal of MCWG to reform Hawaii’s outdated medical marijuana laws so that patients can receive safe and legal access to their medicine. The group’s findings call for the state to create a distribution system, adjust rules to ensure adequate supply, and transfer oversight of the medical marijuana program from the Department of Public Safety to the Department of Health.

Hawaii first to pass medical marijuana law

In 2000, Hawaii became the first state to permit medicinal use of marijuana with the passage of Act 228. Since then, over 5,700 patients have registered under the law to use medical marijuana. And despite legislation introduced each year at the request of patients who have experienced problems with Hawaii’s medical marijuana program, there have been no changes made to the law since its inception.

MCWG describes a current situation where health care professionals are not adequately trained in the use of cannabis and patients face obstacles and stigma in obtaining medical cannabis safely—if they are even made aware of cannabis treatments by their doctors.

In Hawaii, medical conditions qualifying for medical use of cannabis include cachexia, cancer, chronic pain, epilepsy, seizures, glaucoma, HIV/AIDS, MS, muscle spasticity, nausea, and Crohn’s disease.

A qualifying patient must be diagnosed by a physician as having a “debilitating medical condition” and have a physician’s certification in writing that the potential benefits of medical marijuana outweighs the health risks for the patient.

Although patients are allowed access to medical marijuana, they aren’t supplied with it by their physicians. The only way patients can obtain medical marijuana is by purchasing it off of the streets or using illegally obtained seeds to grow it. If patients choose to grow medical marijuana they must own their own home and can only grow a small quantity—if they grow more they must destroy the excess.

Limits to the amount of medical marijuana a patient and caregiver may have is currently limited to three mature marijuana plants, four immature marijuana plants, and one ounce of usable marijuana per each mature plant.

One patient in MCWG’s report said he was unhappy with the current regulations on growing medical marijuana particularly because many patients do not own their own homes: “There is a unique element of cruelty when patients can grow.” Under the current program, patients aren’t taught how to grow their own plants or even how to destroy their excess. Patients who don’t grow their own plants are forced to buy their medicine off the streets, putting themselves at risk for poor quality marijuana or arrest. Buying from the street is not only risky, but expensive as it’s not covered by health insurance.

“The cost of cannabis prohibits me from having an adequate supply,” another patient said in the report. “Insurance doesn’t cover any of my medical costs associated with cannabis and I just can’t afford to pay the black market price.”

According to the MCWG, the only cannabis medication available to patients for the first five or six months is whatever they can find illegally on the black market where there is no quality control or assurance of purity. Colorado courts have concluded that patients are legally required to break the law in order to acquire their medication. MCWG believes that if a distribution system is established, many of the problems patients currently face in Hawaii would be solved.

State task force not given green light

At the 2008 and 2009 Legislative sessions, bills that would have established a State medical marijuana task force to study Hawaii’s program were vetoed by the governor.

Lingle stated in her objection to 2009’s Senate Bill 1058: “The medical cannabis task force is unnecessary because it would attempt to deal with issues raised by medical marijuana users that can only be addressed by circumventing federal law. The use of marijuana and the distribution of marijuana are still illegal under federal law. Until that law is changed, it is inappropriate for the State of Hawaii to support the production, transportation, and distribution of marijuana. The task force will not be able to resolve these issues.”

The House and Senate met to overturn the governor’s veto. In the Senate, the vote was unanimous. However, the House did not gather sufficient support for the bill.

Sen. Will Espero later proposed that a collective of stakeholders, now known as MCWG, do the work of the task force originally put forward by the Legislature. The original task force called for representatives from several state departments including Public Safety, Health, Transportation, the Attorney General, and the Board of Agriculture. However, MCWG, as an unofficial state entity, could not compel the participation of the state agencies that had been named in the original legislation.

Espero invited representatives from non-governmental groups named in the original bill to participate and asked Pamela Lichty, President of the Drug Policy Forum of Hawaii, and Temple to co-chair MCWG.

“We look forward to increasing awareness among legislators about the many problems faced by Hawaii’s approximately 5,000 medical cannabis patients,” Lichty said in a statement. “As evidenced by the approximately 16 bills addressing various concerns with the medical marijuana program, there are urgent concerns that need to be addressed.”

Members of the group also include R.C. Anderson, director of Honolulu Americans for Safe Access; David J. Barton, M.D., Pain and Palliative Medicine Specialist; Michael A. Glenn, Esq., caregiver ; Marvin Merritt, patient; Joseph Rattner, president of West Oahu Hope for a Cure; and health care providers Anne E. Biedel, M.D., Gary L. Greenly, D.O., and Charles Webb, M.D.

Room for improvement

MCWG recommended four immediate actions to be taken by the Legislature:

1. Create a distribution system so patients are not forced to buy their medicine from illegal sources.

2. Increase the allowable number of plants and the amount of usable cannabis to ensure patients have an adequate supply.

3. Allow caregivers to care for at least five patients to ensure patients have an adequate supply and a competent caregiver.

4. Transfer medical marijuana program oversight from the Department of Public Safety, a law enforcement agancy, to the Department of Health.

Additionally, MCWG recommends that the Legislature take action to ensure that the program addresses patient needs such as enhanced confidentiality, presumptive eligibility, faster certification, and access to forms and other necessary documents on the program website.

MCWG also urges the Legislature to facilitate the development and implementation of policies and procedures to facilitate inter-island transport of medical cannabis, and direct the counties and relevant administrative agencies to educate law enforcement and public safety officers on the medical cannabis law as a whole.

Other recommendations address health care matters such as creating a protocol for adding new covered medical conditions; expediting coverage for hospice patients; and extending the validity of program certification for more than one year for patients with chronic conditions.

Since not all of the problems with the program need to be addressed by legislative action, MCWG recommends that the Medical Cannabis Working Group be permanently convened to identify and help implement strategies, both legislative and administrative, to improve Hawaii’s program.

Medical cannabis patient Teri Heede said: “As a patient, I need safe and legal access to medicine. We don’t make cancer patients make their own chemotherapy treatments or buy them from a stranger in a back alley. This cruel and irrational war on sick and dying people like me must end.”

To view the entire MCWG report, visit http://www.acluhawaii.org/downloads/1002MCWG.pdf.