10 Smoke Signals Heralding The End Of Federal Medical Marijuana Prohibition

07/13/2016 01:03 pm ET Updated Jul 14, 2017

A little less than a year ago I wrote an article “10 Reasons Why Federal Medical Marijuana Prohibition is about to Go Up in Smoke” for the Huffington Post. While all the points in the article still reign true, I am happy to report that the list is still growing. In fact, there is so much happening on the topic that at times it is hard to keep up. Like the fact that today, Senator Lindsey Graham is holding a hearing on medical cannabis or that national polls show support for medical cannabis at 89% (81% for Republicans).

Putting this article together gave me an opportunity step back and observe the landscape that medical cannabis policy has created. The work of medical cannabis advocates and brave legislators is truly saving lives. Positive outcomes from medical cannabis policies are driving more states to create and improve programs. With more than 300 million Americans living in the 42 states, along with D.C., Guam, and Puerto Rico, where some kind of medical cannabis law has been passed, there is a strong platform for politicians to move forward on this issue.

After putting this list together, it is mind-blowing to me that Senator Grassley will not allow the Compassionate Access, Research Expansion, and Respect States (CARERS) Act (S. 683/H.R. 1538) a vote in the Senate Judiciary Committee, especially considering that 78% of people in his own state of Iowa support medical cannabis. Maybe this is one of the reasons he is struggling with his campaign for re-election. This important bill would remedy the state-federal conflict over medical marijuana law; allowing (not requiring) states that want to participate in medical cannabis programs to do so without breaking federal law.

Maybe Grassley just needs to see this list too…

1. CARERS has Growing Support from Mainstream Republicans, such as Senator Graham (R-NC) and Congressman Young (R-IA)

In March, Senate Judiciary Committee member, Senator Lindsey Graham (R-SC) joined the CARERS Act as a co-sponsor on the one-year anniversary of the bill’s introduction. His support for medical cannabis has not stopped there, today he is holding a Senate hearing, Researching the Potential Medical Benefits and Risks in the Judiciary Subcommittee on Crime and Terrorism. Last week Representative David Young (R-IA), Grassley’s former chief of staff, joined the House version as a co-sponsor and released this statement, "The federal government shouldn't stand in the way of Iowa patients making informed decisions about treatment options with their doctors. I`m pleased this bipartisan, bicameral legislation addresses this issue, by prioritizing our patients and medical communities, empowering our researchers, and allowing state governments to determine the best policies for their own communities."

2. National Patient Organizations Are Calling for Change in Federal Law

Yesterday, Americans for Safe Access (ASA) delivered a letter on behalf of 13 patient-based organizations to Senators Chuck Grassley (R-IA) and Patrick Leahy (D-VT) and Representatives Joe Pitts (R-PA) and Gene Green (D-TX) urging them to give the Compassionate Access, Research Expansion, and Respect States (CARERS) Act a vote in the United States Senate Judiciary Committee and House Committee on Energy and Commerce: Subcommittee on Health, respectively. The letter was signed by Americans for Safe Access, Citizens United for Research in Epilepsy (CURE), Danny Did Foundation, Epilepsy Foundation, Finding a Cure for Epilepsy and Seizures (FACES), Hope4Harper, Hope for Hypothalamic Hamartomas, Lennox-Gastaut Syndrome (LGS) Foundation, National Multiple Sclerosis Society, National Women’s Health Network, Realm of Caring, The Michael J. Fox Foundation, and Tuberous Sclerosis Alliance.

This letter follows another group letter sent in April addressed to DEA Acting Administrator Chuck Rosenberg stating “Moving cannabis from Schedule I in the Controlled Substances Act would lift federal barriers to research on cannabis, which would ultimately lead to new treatments as well as much needed information that can help families make informed choices about medical cannabis.”

3. States Keep Passing Medical Cannabis Laws

So far in 2016, Pennsylvania and Ohio have passed medical cannabis laws, with possibly two more (Arkansas and Missouri) passing initiatives in November. In April, Pennsylvania Governor Tom Wolf signed SB 3. The bill, introduced by Senator Mike Folmer, passed the House of Representatives on April 13 with a vote of 149-46. The bill will allow patients with cancer, HIV/AIDS, multiple sclerosis, PTSD, seizures, autism, sickle cell anemia, and intractable pain to obtain medical cannabis with a doctor’s recommendation. In May, the Ohio Senate passed HB 523 by a vote of 18-15, which will create a retail dispensary framework for medical cannabis in the state.

4. States Continue to Improve Medical Cannabis Laws

Many states with existing medical cannabis laws are working to make those programs even better. In February, the Virginia Senate passed SB 701 by a vote of 37 to 2. This bill will allow for the production and manufacturing of cannabidiol (CBD) and THCA extracts. This was a big step towards creating safe access for patients and their caregivers. In April, the Maryland Senate passed HB 104, Medical Cannabis - Written Certifications - Certifying Providers by a vote of 36-10 allowing podiatrists, nurse midwives and nurse practitioners, in addition to physicians, to provide written certifications for medical cannabis to qualifying patients. Florida voters will be deciding on improvements to their program this November through a referendum.

5. New CDC Guidelines Instruct Pain Doctors Not to Test for THC

In March, the Centers for Disease Control and Prevention, made a bold statement in their guidelines for prescribing opioid medications for pain, instructing clinicians not to dismiss patients from care due to THC in their system. “Experts noted that there might be uncertainty about the clinical implications of a positive urine drug test for tetrahyrdocannabinol (THC)...Clinicians should not dismiss patients from care based on a urine drug test result because this could constitute patient abandonment and could have adverse consequences for patient safety."

For many years patients have been denied or terminated from receiving medications for pain due to their use of medical cannabis, and in some cases, positive THC results also had legal consequences. While the CDC is not saying that clinicians should never test for THC, the guidelines recommend that clinicians should only test for substances for which results would be used to guide patient management.

6. Largest Pharmaceutical Retailer Acknowledges Medical Benefits of Cannabis

In April 2016, Walgreens, the largest retailer of pharmaceuticals in the U.S. with stores in all 50 states, posted “What is medical marijuana?” by Dahlia Sultan, PharmD, Resident Pharmacist for Walgreens and the University of Illinois at Chicago on the Walgreens Tumblr site. Much like statements made by the National Cancer Institute last year, the post talks about the many conditions that medical cannabis can treat, methods of delivery, possible side effects, and how to obtain the medicine, while encouraging the reader to “talk with your doctor” for more information. The post illustrates the reality for healthcare professionals such as pharmacists who are dealing with the growing interest in cannabis therapies despite federal prohibition.

7. Politicians Breaking Political Boundaries for Medical Cannabis

Georgia Representative Allen Peake who authored Georgia’s current law known as Haleigh’s Hope Act (HB1), publicly admitted to breaking the law to bring medical marijuana to patients in Georgia. The current Georgia law does not provide for cultivation, production, and distribution in the state, so patients and caregivers must go elsewhere to obtain the oils and bring them back to Georgia. So Peake, a Republican, did it for them.

In May, the Utah Democratic Party's nominee for governor, Mike Weinholtz, revealed that his wife is facing a criminal investigation for using medical cannabis to treat arthritis and chronic pain. In a brave statement, Weinholtz said that they were “happy to be the public face for this issue now” in the hope it will help others in their state. If elected, Weinholtz said he would sign a medical marijuana bill.

Also last month, while giving a speech on Capitol Hill, Representative Dana Rohrabacher (R-CA) admitted that he began using a medical cannabis topical a few weeks before to treat arthritis pain, telling the group that it was "the first time in a year and a half that I had a decent night’s sleep because the arthritis pain was gone.”

8. Studies Continue to Show Public Health Benefits in States with Medical Cannabis

Studies have shown that state-run medical cannabis programs have little to no negative impacts on public health, but instead, positive effects on public health outcomes. A recent study from University of Georgia found Medicare experienced a savings of $165.2 million on prescription drugs across the then 17 states and the District of Columbia with medical cannabis laws. The report suggests that this savings would have reached $468 million if all states had medical cannabis programs. This is exciting news for the country!

But benefits to the public are not just financial. The Journal of American Medicine found that “States with medical cannabis laws had a 24.8% lower mean annual opioid overdose mortality rate compared with states without medical cannabis laws.” This study backs up a 2015 National Bureau of Economic Research report that found, “providing broader access to medical marijuana may have the potential benefit of reducing abuse of highly addictive painkillers.”

9. Both Presidential Candidates Support Medical Cannabis

On the campaign trail both Trump and Clinton pledged their support for the state medical cannabis programs.Although a Governor Christie lead transition team or serving as Attorney General could put a damper on medical cannabis policies.  

Last week, the Democrats added medical cannabis policy to the platform:  “Because of conflicting laws concerning marijuana, both on the federal and state levels, we encourage the federal government to remove marijuana from its list as a Class 1 Federal Controlled Substance, providing a reasoned pathway for future legalization”

10. Opponents Know they are Losing this Fight

In June, a new bill, the bipartisan Medical Marijuana Research Act of 2016, was introduced. Surprisingly, this bill was sponsored by several known medical cannabis opponents, including Representative Andy Harris (R-Md.), one of Congress's most vocal opponent of legal marijuana, Other sponsors included, Earl Blumenauer (D-OR), Sam Farr (D-CA), and Morgan Griffith (R-VA), and in the Senate; Brian Schatz, (D-HI), Orrin Hatch (R-UT), Chris Coons, (D-DE), and Thom Tillis (R-NC). While it should be commended that they are making a step towards removing federal barriers to medical cannabis research, this bill does nothing to protect state programs and patients. It is their way of saying, we are losing this fight, so we must give something in return.

Ending the conflict between state and federal medical cannabis laws is the most important goal for keeping patients safe, and for that reason, it is important to remain focused on passing the CARERS Act, which would protect existing state programs and patients. While more research is certainly desirable, patients cannot wait for the years or decades it may take for the results of this research to drive further Federal policy changes. 

And there you have it! 10 reasons that clearly show the end of Federal Medical Marijuana Prohibition is near, and that also show how out of touch Senator Grassley is on this issue. ASA and many other advocates have worked hard to make the changes mentioned above possible. If just a small portion of the 89% of Americans who support medical cannabis let their members of Congress know, then this may be the last year for federal prohibition of medical cannabis.