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DATE TYPED: |
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HB |
242/aHJC/aHFL#1/aHFL#2 |
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SHORT TITLE: |
Lynn Pierson Compassionate Use Act |
SB |
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FY04 |
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(Parenthesis
( ) Indicate Expenditure Decreases)
Responses
Received From
Department
of Health (DOH)
Health
Policy Commission (HPC)
The House
Judiciary Committee amends the bill as follows:
Synopsis
of Original Bill
House Bill 242 provides for the regulated use of medical cannabis by individuals suffering from specific debilitating illnesses including cancer, HIV/AIDS, glaucoma and epilepsy. The Lynn Pierson Compassionate Use Program would be administered by the Department of Health. Physicians would make application to the program on behalf of patients who suffer from the defined debilitating illnesses and who might benefit from medical cannabis. Patients enrolled in the medical cannabis program would not be subject to arrest, prosecution or penalty for the possession of an amount of cannabis that was adequate to meet their medical needs. Their private physician would supervise the use of medical cannabis.
Oversight of the program would be
provided by an advisory board of five practitioners designated by the Secretary
of Health and nominated by the New Mexico Medical Society who
would define debilitating medical conditions eligible for enrollment, issue
recommendations concerning rules for enrollment, and recommend quantities of
cannabis that constitute an adequate supply to meet medical needs.
HB 242 would also amend the New Mexico Controlled Substances Act, Schedules I and II to except the use of cannabis for purposes of the Lynn Pierson Compassionate Use Act.
Significant
Issues
According to DOH, some people living with
cancer, HIV/AIDS, neuromuscular diseases, multiple sclerosis and spinal cord
injury also suffer from chronic pain or anorexia or spasticity. In some instances, using available
prescription medications cannot adequately control the suffering associated
with those symptoms. Many patients have found that these symptoms are well controlled
by the use of medical cannabis, and scientific evidence provides reasonable
support for the contention that cannabis can play a therapeutic role in the
treatment of these serious medical conditions.
HPC provided the following information relative to
positions in support of medical use of cannabis:
·
There is a wealth of literature available
concerning medical conditions that may respond to a therapeutic use of
marijuana under controlled circumstances.
Such conditions include: “wasting syndrome,” nausea, and other side
effects of AIDS and chemotherapy; glaucoma, multiple sclerosis, and Chron’s disease.
·
Glaucoma is among the most thoroughly
researched conditions for which medical use of marijuana applies and was one of
the two conditions for which the therapeutic research program was originally
established in
·
The National Institute of Health has
issued a report reviewing the scientific data concerning the potential
therapeutic uses for marijuana and the need for, and feasibility of, additional
research.
·
Marijuana has potential therapeutic
efficacy in the following clinical medical conditions:
§
Analgesia
§
Neurological and movement disorders
§
Nausea and vomiting associated with
cancer chemotherapy
§
Glaucoma
§
Cachexia and appetite stimulation in
patients with AIDS or cancer
The following positions against the medical use of
cannabis were provided by HPC:
FISCAL IMPLICATIONS
The bill does not contain an appropriation and DOH indicates that the program will be difficult to administer without proper funding. DOH acknowledges the need for funds for staff, space, materials and support services.
ADMINISTRATIVE IMPLICATIONS
DOH anticipates that program enrollment will be in the range of 50 to 200 patients. The following activities were noted by DOH as significantly increasing program workload.
·
The advisory board, consisting of five
practitioners, would make recommendations to the Department regarding the rules
and regulations governing the Program.
·
The Medical Director of the Infectious
Diseases Bureau would review all applications made to the program for
appropriate medical indications for the use of cannabis.
·
The program would review and approve
applications, issue registry identification cards to qualifying patients, maintain
a registry of enrolled patients, and be available to verify patient enrollment
to law enforcement agencies if an individual patient’s enrollment is in
question.
·
Administration of the program would
require a full-time medical care administrator.
·
The Office of the General Counsel,
Department of Health, would be responsible for promulgating program rules and
regulations.
In addition,
DOH expresses concerns around the full implementation of HIPPA regulations and
requirements both at the federal and state level. Application of HIPPA regulations to this
program may significantly impact upon the data collected and the
Department’s legal responsibilities.
.
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.
TECHNICAL ISSUES
HB242 makes no
provision for the acquisition of cannabis by patients under the Lynn Pierson
Compassionate Use Act, nor does the bill provide regulation of persons
who may legally distribute marijuana to registered patients, including relief
from arrest or prosecution. Without a
means to legally acquire cannabis for treatment, patients would be unable to
benefit from the Act
Federal
regulation of therapeutic research programs is very specific as to where and
how marijuana may be obtained and distributed for use in a state program. Issues of distributing marijuana to be used
for medicinal purposes to be considered are:
1. Legal sources of marijuana for research
purposes include:
·
Receiving it from the National Institute on Drug
Abuse (NIDA);
·
Importing it from specific sources with
permission from the DEA;
·
DEA permission to cultivate it; and
·
Using
confiscated marijuana supplied by the state police.
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.
3. The state of
The definition
of “practitioner” in HB242 is limited to physicians. Other practitioners
licensed to prescribe controlled substances who may be treating patients with
the defined “debilitating medical conditions” may therefore be prohibited from
prescribing cannabis as a legal and viable treatment for their patients under
the Act.
OTHER SUBSTANTIVE ISSUES
DOH states that the medical use of cannabis is entirely analogous to the therapeutic use of other powerful medicines (including Morphine and Valium) in the relief of pain and suffering. As is the case with those powerful prescription medications, a clear distinction should be drawn between the proper medical therapeutic use of cannabis and its illegal recreational use. As is the case with any medication, the benefits of medical cannabis must be weighed against its potential adverse effects in thorough discussions between a patient and their physician.
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. HPC reports that 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:
·
·
Laws in
·
·
5 states, including
·
9 states, including
·
15 states, among them
DOH
recommends the following amendments to the bill:
Section
3, paragraph B. definition of “debilitating medical conditions”. Review of the medical literature about
medical cannabis in the
Section
3, paragraph B. definition of “debilitating medical conditions”. The
Section
6, paragraph D states, “the department may deny an application only if the
applicant did not provide the information required pursuant to Subsection C of
this section, or if the department determines that the information provided is
false.” The Medical Director of the
Program should be given the authority to review applications by private
physicians on behalf of their patients seeking enrollment in the program. The Medical Director of the Program should
have the option to reject the application if the Medical Director judges that
there is insufficient evidence to support the potential benefit of medical cannabis
in that patient’s case. The advisory
board of patient enrollment should review acceptances and rejections of
individual applications by the Medical Director of the program quarterly.
Section 3.
Definitions
On
page 4, line 1, change “person” to “resident of
On
page 4, line 7, change “person” to “resident of
Rationale:
This is in accordance with a letter from the NM Attorney General’s Office last
year on SB 8, suggesting that a
On page
8, line 6, change “
On
page 9, lines 5 – 9; Add as grounds for Department of Health denial of a
registry card that
the
applicant does not demonstrate that he or she has a “debilitating medical
condition” as
defined
in Section 3.B. of the bill.
POSSIBLE QUESTIONS
1. Could 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?
2. Will the program address the potential for victimization of
an individual with a developmental disability or dual diagnosis participating
in the program?
3. Does the bill need language that clearly prohibits the compassionate use of medical marijuana at all school-sponsored activities, including those events that may occur in a non-public place such as booster club pre-game events?
BD/prr/sb