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F I S C A L I M P A C T R E P O R T





SPONSOR: SPAC DATE TYPED: 3/8/01 HB
SHORT TITLE: Compassionate Use Medical Marijuana Act SB CS 319/aSJC/aSFL
ANALYST: Esquibel


APPROPRIATION



Appropriation Contained
Estimated Additional Impact
Recurring

or Non-Rec

Fund

Affected

FY01 FY02 FY01 FY02
N/A



(Parenthesis ( ) Indicate Expenditure Decreases)



Duplicates HB431; Relates to HB355, SB315, SB317, SB2; Conflicts with HB412



SOURCES OF INFORMATION



Department of Public Safety (DPS)

Department of Health (DOH)

State Department of Education (SDE)

NM Commission on Higher Education (CHE)

Children, Youth and Families Department (CYFD)

Economic Development Department (EDD)

Attorney General's Office (AG)

Developmental Disabilities Planning Council (DDPC)

Tourism Department (TD)

State Agency on Aging (SAOA)

Board of Nursing

NM Health Policy Commission (HPC)



SUMMARY



Synopsis of Senate Floor Amendments



The Senate Floor four times amended the Senate Public Affairs Committee substitute for Senate Bill 319 as amended by Senate Judiciary Committee to do the following:





Synopsis of SJC Amendments



The Senate Judiciary Committee amendments to the Senate Public Affairs Committee substitute for Senate Bill 319 define "cannabis" to mean any derivative of the marijuana plant; change all references in the bill from marijuana to cannabis; and change the advisory board's composition to nine practitioners nominated by the NM Medical Society and submitted to the Secretary of Health for approval by the NM Senate.



Synopsis of SPAC Substitute



The Senate Public Affairs Committee substitute for SB319 includes the following changes to the original bill:



1. Section 3, Definitions, revises the definition of "debilitating medical condition" to mean:

2. Section 4, Rule Making by Secretary for Establishing Program



Among the various responsibilities of the Secretary of Health under this act is the empowerment to make recommendations for requirements and procedures for program qualification.



3. Section 6, Lawful Activities



In addition to participants and their care givers, persons approved by the program to produce, possess, distribute, dispense or sell marijuana for purposes of the program will also be relieved from arrest or prosecution.



4. Section 8 Prohibitions, Restrictions, and Limitations on the Medical Use of Marijuana



Includes prohibitions, restrictions and limitations on the medical use of marijuana that do not relieve the certified patient, or primary caregiver from liability or criminal prosecution for activities not authorized in Subsection A of Section 6 of the Compassionate Use Medical Marijuana Act.



6. Section 14, Effective Date, has been included.

Synopsis of Bill



Senate Bill 319 proposes to enact the Compassionate Use Medical Marijuana Act, and amends and repeals certain provisions of the Controlled Substances Act. Key provisions of the bill include:







Significant Issues



Arguments for the medical use of marijuana include:



Arguments against the medical use of marijuana include:

3. Marijuana causes cancer of the lungs, mouth, lip and tongue.

4. The National Institute of Allergy and Infectious Disease reports that the many carcinogens in marijuana smoke would be a health hazard for patients with compromised immune systems.

5. Marijuana is a Schedule I controlled substance determined by the FDA to be highly addictive with no medicinal value.

6. Studies have shown that HIV positive smokers progress to full blown AIDS twice as fast as nonsmokers. (AIDS Weekly)

7. According to the American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders (DSM IV), marijuana causes mental disorders such as schizophrenia and other psychoses, depression, panic attacks, hallucinations, paranoia, hostility, depersonalization, flashbacks, decreased cognitive performance, disconnected thought delusions and impaired memory.

8. The main psychoactive ingredient in marijuana (THC) is already legally available as a Schedule II controlled substance.

9. The quality control of marijuana is difficult to standardize and regulate.



FISCAL IMPLICATIONS



The Department of Public Safety anticipates that there would be an administrative and fiscal impact on all law enforcement and the criminal justice system because a new crime involving false reporting of participation in the Act would have been created. Creation of new crimes creates a fiscal impact on all aspects of the criminal justice system. Additionally, the legislation as proposed exempts certain people from prosecution which could entail training law enforcement officers and prosecutors as to how to apply the provisions of the Act in making decisions as to whether individuals should be arrested and/or prosecuted.



The Board of Nursing indicates that the bill could increase the cost of care if all practitioners who have prescriptive authority are not included in the provisions of the bill. This would include not just physicians are currently prescribed in the bill, but also doctors of oriental medicine, dentists, physician assistants, certified nurse practitioners, clinical nurse specialists and certified nurse midwives.



ADMINISTRATIVE IMPLICATIONS



The bill includes no appropriation to DOH to allow it to implement the medical use of marijuana program.



Repealing the state laws criminalizing marijuana places the enforcement burden entirely on the federal government.



It may be necessary to amend certain sections of the Medical Practice Act in order to fully offer physicians or other providers prescribing marijuana for therapeutic use the protections offered under the Act.



CONFLICT/DUPLICATION/COMPANIONSHIP/RELATIONSHIP



Senate Bill 319:

Duplicates HB431, Compassion Use of Medical Marijuana Act

Relates to HB355, providing for the control of methanphetamine

Relates to SB315, decriminalizing possession of one ounce or less of marijuana

Relates to SB317, amending penalties for possession of a controlled substance

Relates to SB2, amending sections of the Pain Relief Act

Conflicts with HB412, increasing penalties for controlled substances



TECHNICAL ISSUES





1. Legal sources of marijuana for research purposes include:

2. Using marijuana confiscated by state police for the purposes of a medicinal use of marijuana program requires that the marijuana must be tested to meet federal requirements on impurity, which is cost prohibitive.



OTHER SUBSTANTIVE ISSUES



Medical marijuana use laws in other states vary. Those states that have passed laws related to the medical use of marijuana have done so with the same intent and findings provided in this bill. Sufficient scientific evidence exists to cause 35 states to enact favorable laws addressing the medical use of marijuana. Issues from the experiences of these states that should be noted are:







POSSIBLE QUESTIONS



1. Will legal medical use of marijuana impact the perception of the state as a tourism destination?



2. Would passage of the bill necessitate the need for stronger substance abuse education, including the potential for abuse by program participants and for those who are dispensing the marijuana?



3. Will the program address the potential for victimization of an individual with a developmental disability or dual diagnosis participating in the program?



4. Why dismantle the Lynn Pierson Therapeutic Research Program currently allowed for under the Controlled Substances Therapeutic Act given that this program has already met federal regulations and secured required permissions from the Drug Enforcement Agency and the Food and Drug Administration for prescription and distribution of marijuana for therapeutic research? Repealing the Controlled Substances Therapeutic Act rather than amending provisions of the existing program may require new application for the required permits and licenses.



RAE/njw