mpp memo to senator bradley

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March 20, 2015 To: Senator Rob Bradley Chair of the Senate Committee on Regulated Industries Florida State Senate 404 S. Monroe Street Tallahassee, FL 32399 Re: Suggested amendments to SB 1030 Dear Sen. Bradley, On behalf of our more than 12,500 subscribers in Florida, the Marijuana Policy Project (MPP) submits the following comments on the state’s ongoing efforts to implement SB 1030 and your committee’s recent introduction of legislation — SPB 7066 — indicating an intent to revise the law “relating to lowTHC cannabis.” In its current form, SB 1030 will likely benefit very few individuals, while leaving behind many more with serious conditions that medical research has shown can be effectively alleviated by medical cannabis, such as neuropathic pain and wasting. 1 It is unclear whether SB 1030 will result in a workable program even for the limited class of patients it was crafted to protect. We urge you to work for a more comprehensive and workable program. As you probably know, 58 percent of voters supported Amendment 2 this past November. Amendment 2 would have created a workable medical marijuana program benefitting thousands of individuals across the state suffering from debilitating conditions. While the question did not receive the 60 percent of votes required for enactment, it received an overwhelming majority. Already, backers of Amendment 2 have made it clear that they intend to redouble their efforts in 2016, a presidential election year, which will help drive an overwhelmingly supportive demographic to the polls. Creation of a workable medical marijuana program by the legislature will allow lawmakers to have more control over the language and the process and will provide relief to the seriously ill sooner. States have taken a variety of approaches that MPP supports to provide safe access to medical cannabis for patients with serious medical conditions. Any number of approaches could meet the goal of allowing the seriously ill to safely access medical marijuana under a doctor’s recommendation. However the language is crafted, we strongly encourage the legislature to make sweeping amendments to SB 1030 in order to more closely align it with the medical marijuana statutes of the 23 states 1 See, i.e., MPP’s summary of medical marijuana research: www.mpp.org/assets/pdfs/library/MedConditionsHandout.pdf or the Center for Medicinal Cannabis Research’s completed studies, http://www.cmcr.ucsd.edu/index.php?Itemid=135.

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Official copy of the letter sent from the Marijuana Policy Project to Senator Rob Bradley, who chairs the Senate Committee on Regulated Industries.

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Page 1: MPP Memo To Senator Bradley

 March  20,  2015  

 To:     Senator  Rob  Bradley     Chair  of  the  Senate  Committee  on  Regulated  Industries     Florida  State  Senate     404  S.  Monroe  Street     Tallahassee,  FL  32399    Re:     Suggested  amendments  to  SB  1030    Dear  Sen.  Bradley,      On  behalf  of  our  more  than  12,500  subscribers  in  Florida,  the  Marijuana  Policy  Project  (MPP)  submits  the  following  comments  on  the  state’s  ongoing  efforts  to  implement  SB  1030  and  your  committee’s  recent  introduction  of  legislation  —  SPB  7066  —  indicating  an  intent  to  revise  the  law  “relating  to  low-­‐THC  cannabis.”  In  its  current  form,  SB  1030  will  likely  benefit  very  few  individuals,  while  leaving  behind  many  more  with  serious  conditions  that  medical  research  has  shown  can  be  effectively  alleviated  by  medical  cannabis,  such  as  neuropathic  pain  and  wasting.1  It  is  unclear  whether  SB  1030  will  result  in  a  workable  program  even  for  the  limited  class  of  patients  it  was  crafted  to  protect.  We  urge  you  to  work  for  a  more  comprehensive  and  workable  program.      As  you  probably  know,  58  percent  of  voters  supported  Amendment  2  this  past  November.  Amendment  2  would  have  created  a  workable  medical  marijuana  program  benefitting  thousands  of  individuals  across  the  state  suffering  from  debilitating  conditions.  While  the  question  did  not  receive  the  60  percent  of  votes  required  for  enactment,  it  received  an  overwhelming  majority.  Already,  backers  of  Amendment  2  have  made  it  clear  that  they  intend  to  redouble  their  efforts  in  2016,  a  presidential  election  year,  which  will  help  drive  an  overwhelmingly  supportive  demographic  to  the  polls.  Creation  of  a  workable  medical  marijuana  program  by  the  legislature  will  allow  lawmakers  to  have  more  control  over  the  language  and  the  process  and  will  provide  relief  to  the  seriously  ill  sooner.      States  have  taken  a  variety  of  approaches  that  MPP  supports  to  provide  safe  access  to  medical  cannabis  for  patients  with  serious  medical  conditions.  Any  number  of  approaches  could  meet  the  goal  of  allowing  the  seriously  ill  to  safely  access  medical  marijuana  under  a  doctor’s  recommendation.  However  the  language  is  crafted,  we  strongly  encourage  the  legislature  to  make  sweeping  amendments  to  SB  1030  in  order  to  more  closely  align  it  with  the  medical  marijuana  statutes  of  the  23  states                                                                                                                  1  See,  i.e.,  MPP’s  summary  of  medical  marijuana  research:  www.mpp.org/assets/pdfs/library/MedConditionsHandout.pdf  or  the  Center  for  Medicinal  Cannabis  Research’s  completed  studies,  http://www.cmcr.ucsd.edu/index.php?Itemid=135.    

Page 2: MPP Memo To Senator Bradley

 

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that  currently  have  these  programs.  Lawmakers  have  a  chance  to  show  their  compassion  for  some  very  unfortunate  constituents  and  to  ensure  that  the  seriously  ill  in  your  state  do  not  have  to  wait  until  passage  of  a  constitutional  amendment.      With  all  that  in  mind,  MPP  makes  the  following  recommendations  to  SB  1030,  the  Charlotte’s  Web  bill.    Physician  Language:  As  drafted,  SB  1030  uses  problematic  language  concerning  Florida  physicians  ordering  medical  marijuana  oils  on  behalf  of  their  patients.  (FL  Stat.  §  381.986(2))  None  of  the  workable  medical  marijuana  programs  in  other  states  rely  on  physicians  “ordering”  or  prescribing  medical  marijuana  to  their  patients.  Several  states  have  laws  that  involve  doctors  “prescribing”  marijuana,  but  they  have  not  been  implemented  due  to  federal  law.  Instead,  in  states  with  workable  laws,  physicians  provide  their  qualified  patients  with  a  recommendation  to  use  medical  marijuana.  Simply  recommending  use  of  medical  marijuana  is  a  right  physicians  have  based  on  a  First  Amendment  right  to  free  speech.  Conant  v.  McCaffrey  affirmed  this  right  to  recommend  marijuana  for  treatment,  but  said  nothing  about  the  legality  of  a  physician  “ordering”  medical  marijuana.      Using  this  unusual  language  about  “ordering”  cannabis  oils  could  have  a  chilling  effect  on  the  number  of  physicians  who  are  willing  to  participate  in  such  a  program.  It  is  far  better  to  simply  have  the  doctor  state  his  or  her  First  Amendment-­‐protected  opinion  that  the  patient  could  benefit  from  the  medical  marijuana.  Then,  the  patient  can  get  an  ID  card  from  the  state  and  obtain  the  cannabis.    

 No  requirement  for  independent  lab  testing:  Another  glitch  in  the  law  is  the  lack  of  mandatory  testing.  While  the  cultivators  and  dispensaries  are  allowed  to  grow,  possess,  and  process  marijuana  and  qualified  patients  are  allowed  to  possess  and  use  low-­‐THC  marijuana,  there  is  no  provision  to  allow  independent  laboratory  testing.      Independent  testing  ensures  that  medicine  produced  for  some  of  the  most  seriously  ill  in  Florida  has  been  grown  and  produced  free  from  contaminants.  Additionally,  independent  testing  ensures  that  medical  cannabis  is  properly  labeled  so  that  patients  know  the  ratio  of  cannabinoids  in  their  medicine.      Limited  Conditions:  The  current  law  allows  for  only  a  limited  number  of  patients  to  access  the  medicine.  However,  cannabis  has  been  shown  to  alleviate  several  other  debilitating  conditions  and  symptoms  that  are  not  included  in  the  law’s  list  of  qualifying  conditions.2  It  is  unnecessary  to  deny  those  suffering  from  conditions  for  which  medical  marijuana  has  proven  beneficial,  especially  when  individuals  in  other  states  are  able  to  legally  use  medical  marijuana  to  treat  the  same  conditions.  MPP  strongly  recommends  that  Florida  expand  its  list  of  qualifying  conditions  to  include  PTSD,  Crohn’s  disease,  intractable  pain,  glaucoma,  severe  nausea,  and  wasting.                                                                                                                        2  See:  http://www.mpp.org/assets/pdfs/library/MedConditionsHandout.pdf.    

Page 3: MPP Memo To Senator Bradley

 

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 Low-­‐THC  Only:  This  is  perhaps  the  most  serious  flaw  of  SB  1030.  There  is  no  reason  to  place  an  arbitrary  cap  on  the  amount  of  THC  that  medical  marijuana  may  contain,  especially  when  most  of  the  studies  conducted  demonstrating  cannabis’  medical  efficacy  have  used  marijuana  with  concentrations  of  THC  far  greater  than  what  Florida  law  allows.      Marinol  —  which  is  100  percent  synthetic  THC  —  is  a  Schedule  III  drug  approved  for  nausea  and  vomiting  in  cancer  patients  and  appetite  loss  in  AIDS  patients.  In  other  words,  although  SB  1030  includes  cancer  as  a  qualifying  condition,  it  fails  to  include  strains  that  are  rich  in  the  cannabinoid  that  has  been  shown  to  alleviate  cancer-­‐related  nausea.  Natural  marijuana  is  far  preferable  to  Marinol  for  many  nauseated  patients  —  pills  can  take  45  minutes  to  take  effect  and  can  be  difficult  to  keep  down.  In  addition,  marijuana’s  other  compounds  are  also  beneficial;  they  operate  synergistically  and  moderate  the  “high.”      Meanwhile,  another  qualifying  condition  in  Florida’s  law  —  severe  and  persistent  muscle  spasms  —  also  has  been  shown  to  respond  to  higher  proportions  of  THC.  Four  countries,  including  Canada,  have  approved  a  prescription  spray  called  Sativex,  which  has  a  1:1  CBD/THC  ratio,  for  multiple  sclerosis-­‐related  spasticity.  Yet  patients  in  Florida  are  allowed  to  use  only  strains  of  marijuana  with  a  far  lower  proportion  of  THC.      This  push  to  enact  low-­‐THC  laws  is  a  direct  result  of  the  very  public  and  moving  story  of  Charlotte  Figi,  who  was  able  to  find  relief  from  intractable  epilepsy  by  using  a  strain  of  marijuana  that  contains  low  amounts  of  THC  and  high  amounts  of  CBD.  However,  Charlotte’s  experience  is  just  that  —  her  personal  experience.  There  are  many  parents  of  similarly  situated  children  who  have  tried  and  failed  to  treat  severe  seizure  disorders  with  CBD-­‐only  medical  marijuana.  In  fact,  many  of  these  parents  find  higher  amounts  of  THC  necessary.      Additionally,  limiting  the  amount  of  THC  in  medical  marijuana  will  greatly  reduce  its  ability  to  curb  pain  and  enhance  appetite  for  those  suffering  from  cancer  (one  of  the  current  conditions).  While  it  is  true  that  THC  carries  with  it  an  intoxicating  effect,  it  is  no  more  inebriating  than  the  intoxicating  effects  that  many  of  our  prescription  drugs  induce.  The  effect  has  most  commonly  been  described  as  a  feeling  of  euphoria.  Since  when  has  it  been  standard  medical  practice  to  deny  patients  medicine  that  could  improve  both  their  physical  and  emotional  well-­‐being?      Unreasonable  restrictions  on  when  a  doctor  may  “order”:  The  law  also  insists  that  the  doctor  only  recommend  marijuana  if  all  other  alternatives  have  failed.  This  is  unnecessary  and  unreasonable.  The  state  of  Florida  licenses  its  trained  physicians  to  make  the  difficult  decision  of  what  treatment  is  best  for  their  patients.  Many  medications  commonly  prescribed  for  serious  medical  conditions  can  carry  with  them  severe  side  effects,  including  the  risk  of  fatal  overdose.  Marijuana  has  never  once  caused  a  fatal  overdose.  If  a  physician  thinks  their  patient  will  derive  the  same  

Page 4: MPP Memo To Senator Bradley

 

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benefits,  without  the  serious  side  effects,  from  medical  marijuana  as  opposed  to  a  different  treatment  course,  he  or  she  should  be  allowed  to  treat  that  patient  without  having  to  first  subject  their  patient  to  a  treatment  course  they  think  is  more  dangerous  or  less  likely  to  work.      Smoking  prohibited:  Under  current  law,  patients  are  prohibited  from  smoking  medical  marijuana  as  a  delivery  method,  despite  the  fact  that  it  is  the  most  common  and  quickest  way  patients  introduce  medical  marijuana  into  their  system.  In  addition,  it  is  also  the  least  expensive,  which  is  crucial  considering  the  seriously  ill  are  likely  to  have  significant  health  care  costs  as  is.  Concerns  about  the  health  effects  of  smoking  are  somewhat  legitimate,  but  that  should  be  a  decision  that  a  patient  makes,  not  the  state  legislature.      While  heavy  marijuana  smoking  is  linked  to  bronchitis,  marijuana  smoking  is  not  linked  to  lung  cancer  or  to  chronic  obstructive  pulmonary  disease.3  Patients  and  doctors  should  be  trusted  to  weigh  all  of  the  risks  and  benefits  of  various  means  of  administration.  Prohibiting  a  patient  with  terminal  cancer  from  finding  quick,  cheap  relief  from  nausea  with  a  marijuana  cigarette  seems  nonsensical  given  that  they  may  legally  smoke  tobacco,  which  kills  400,000  Americans  each  year.    Unreasonably  high  barriers  to  entry  for  producers:  The  restrictions  on  who  can,  and  more  importantly  cannot,  apply  to  produce  medical  marijuana  are  unreasonable.  Limiting  the  program  to  five  producers  total  is  a  recipe  for  conflict  in  the  licensing  process,  and  requiring  those  applying  to  have  at  least  30  years  of  contiguous  operation  as  a  horticultural  nursery  will  automatically  prevent  many  otherwise  qualified  individuals  from  seeking  a  license.  In  addition,  the  $5,000,000  bond  requirement  offers  no  protections  to  patients  and  will  simply  prevent  qualified  individuals  who  lack  excessive  resources  from  applying.  Medical  marijuana  producers  and  cultivators  licenses  should  be  merit-­‐based,  not  based  on  which  entities  can  meet  the  unnecessarily  high  hurdles.  This  program  should  be  about  getting  safe  and  affordable  medicine  to  some  of  Florida’s  most  ill  residents.        Thank  you  so  much  for  your  time  and  attention  to  this  matter.  Please  do  not  hesitate  to  contact  me  should  you  have  any  questions.      Sincerely,      Robert  J.  Capecchi  Deputy  Director  of  State  Policies    Marijuana  Policy  Project    [email protected]  202-­‐905-­‐2007                                                                                                                    3  See:  DP  Tashkin,  “Effects  of  marijuana  smoking  on  the  lung,”  Annals  of  the  American  Thoracic  Society,  2013.  

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cc:  Sen.  Jeff  Brandes,  Sen.  Greg  Steube,  Sen.  Aaron  Bean,  Sen.  Andy  Gardiner,  Rep.  Steve  Crisafulli,  Rep.  Katie  Edwards,  Rep.  Jason  Brodeur,  Rep.  Matt  Gaetz,  Mr.  Tim  Cerio