The Center for Law, Health and Society represents the culmination of research, educational and community outreach initiatives developed in the health law field at Georgia State University. For more information about the center, visit clhs.law.gsu.edu.

New blog post by CLHS Associate Director Stacie Kershner: “Registry for Medical Marijuana Use Launched in Georgia”

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kershner finalMany Georgia citizens with debilitating medical conditions are celebrating as the Department of Public Health launched the state’s “Low THC Oil Registry”on Tuesday, June 17.  Governor Nathan Deal signed House Bill 1, sponsored by House Representative Allen Peake, into law on April 16, allowing for a form of medical marijuana for eight diseases including cancer, seizure disorders, and sickle cell disease.  Under the new law, physicians signing up on the registry will be able to certify eligible adult patients or parents or legal guardians of eligible children to obtain an identification card allowing possession of up to 20 fluid ounces of the low THC oil.

The law is called “Haleigh’s Hope Act” in honor of a 5 year old girl with a severe seizure disorder with hundreds of seizures a day. The five medications she was on were not eliminating the seizures and were causing dangerous side effects that her doctor feared could be deadly. Learning of the anecdotal success of medical marijuana for treating other children suffering from uncontrolled seizures, Haleigh’s mother Janea Cox began fighting for access to cannabis oil in Georgia.  After an unsuccessful attempt to pass legislation in 2014, Cox made the difficult decision to move to Colorado where marijuana is legal. For financial reasons, her husband was unable to leave his job and stayed behind in Georgia. After only months on the medication, her seizures are drastically reduced and she even has some seizure-free days.  While she has been able to come off of many of the other seizure medications, the side effects have caused long term damage.

Sadly, Haleigh’s story is not unique – according to Peake, there are 17 families of “medical refugees,” who have moved away from Georgia in order to legally receive cannabis oil treatment. The hope is that these families will now be able to come home. However, limitations in the law – both Georgia’s and federal law – may leave this hope unrealized.

As the registry website explains, Georgia’s law is more limited than medical marijuana laws in other states (an interactive map of state laws on medical marijuana can be found at Public Health Law Research’s LawAtlas site, funded by the Robert Wood Johnson Foundation). The National Council of State Legislatures describes comprehensive state medical marijuana laws as including, among other elements, access to home cultivation, dispensaries or another system. The new Georgia law does not allow for the growth or sale of the oil in Georgia.

Instead, patients and families must still risk purchasing the oil from out-of-state sources and bringing it in state, which is a violation of federal law. An important next step in Georgia is to amend the law to allow for the growth of the cannabis plant and the manufacture and sale of the oil in this state. This will allow for state regulation and oversight of the oil production. This can help to ensure greater quality control of the final product and greater safety for patients using medical marijuana in Georgia. This may also encourage more medical refugees to come home if logistics prevent them from being able to live in Georgia but purchase the oil elsewhere.

Change in the federal law is also necessary.  Possession and sale of marijuana is a violation of the Controlled Substances Act, and the Supreme Court has established that this can include medical marijuana grown for personal use even if not transported across state lines; however, the Obama administration has stated in a series of memos that prosecution for possession of marijuana is not a priority but that corporate producers will be investigated on a case-by-case basis. Under the CSA, marijuana is a Schedule I drug, which are controlled substances deemed “to have high potential for abuse,” “no currently accepted medical use in treatment in the United States,” and “lack of accepted safety for use of the drug or other substance under medical supervision.” Because Schedule I drugs are highly restricted, it is difficult to develop research studies on the medicinal value of marijuana. This presents a “catch-22”: because there is little research on the use of marijuana for medical purposes, there isn’t a sufficient evidence base to consider moving marijuana off of Schedule I and reducing restrictions. Reclassification of medical marijuana would allow for robust research in the United States from which proper guidance for use can be developed, which would encourage pharmaceutical companies to produce it, doctors to recommend it, and insurance companies to cover it, all promoting safety and access for patients.

So why the hesitation to allow access to marijuana for medicinal purposes? In addition to other unintended legal consequences, some opponents fear diversion of medical marijuana to recreational users as well as enticement of teens to begin smoking marijuana.  While past research has had mixed results, a study published this week in The Lancet Psychiatry analyzed survey data of over a million 8th, 10th, and 12th graders in 48 states over a 24 year period and found no statistical difference of risk of marijuana use among adolescents within states before and after medical marijuana laws were implemented. The study did find a higher prevalence of marijuana usage by teens in states where medical marijuana was ever legalized compared to states where it has not been; however, this effect was found to be true of states even prior to legalization and suggests other characteristics may influence both marijuana use among adolescents and the passage of medical marijuana laws.

Additional research is needed on whether any relationship exists between legalization of low THC oil and recreational smoking of marijuana. If the risk is minimal, and there is potential benefit to individuals with debilitating illnesses, then the federal government should, at minimum, reclassify low THC oil, paving the way for legally manufacturing, selling, prescribing and using the oil safely in Georgia and across the country.

Stacie Kershner is the associate director of the Center for Law, Health & Society at Georgia State University College of Law.

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