Pubdate: Sun, 03 Feb 2013
Source: Boston Globe (MA)
Copyright: 2013 Globe Newspaper Company
Contact: http://services.bostonglobe.com/news/opeds/letter.aspx?id=6340
Website: http://bostonglobe.com/
Details: http://www.mapinc.org/media/52
Author: Kay Lazar

STATE MAY MISS DEADLINE TO ISSUE MEDICAL MARIJUANA RULES

The November ballot referendum that legalized marijuana for medical 
use in Massachusetts required that regulations be issued by May 1 to 
implement the law, but state health officials say the complexity of 
the issue has proven so daunting that they are unlikely to complete 
final rules by that deadline.

The referendum left dozens of -crucial details to be decided by 
regulators, including the ailments for which patients could use 
marijuana, whether permits should have an expiration date, and 
whether dispensaries that sell marijuana brownies should be inspected 
like restaurants.

"We have to be conscious of balancing the needs of patients with the 
very real potential for unintended consequences that can come with 
this kind of program," Dr. Lauren Smith, interim public health 
commissioner, said in an interview.

Smith said she wants regulations crafted to minimize the risk of 
marijuana becoming widely available for recreational use, especially 
by teenagers.

Some studies have shown that rates of marijuana use among young 
people have increased in states that have allowed use of marijuana 
for -medicinal use.

She said her department is talking to health leaders in many of the 
other 17 states that have legalized medical marijuana to learn what 
has worked and what has not.

The department is also gathering comments from the public, doctors, 
local governments, and other interest groups.

Public health officials -believe that the law gives them some leeway 
on the timing of regulations, because they are broadly interpreting 
the word "issue" to mean that rules must be proposed by May, but not 
necessarily adopted.

"We are going to have the -final regulations done as close to May as 
possible," Smith said. She declined to say when she thought final 
rules would be in place.

Supporters of medical marijuana said any delay is unjustified and 
would cause patients to suffer needlessly.

"The existing timeline allows the state sufficient time to implement 
the law so patients get the medicine they need, communities are safe 
and -secure, and the will of over 63 percent of the voters is 
followed," Matt Allen, executive director of the Massachusetts 
Patient Advocacy Alliance, said in an e-mail.

The law went into effect Jan. 1, so patients can already get a 
certification from their doctor that would allow them to use and grow 
a limited amount of marijuana for their own medical needs, but no 
marijuana dispensaries can open yet.

Meanwhile, state lawmakers, who say they have been inundated by 
voters worried about public safety and health concerns, have filed a 
flurry of proposals to change the law, which was passed easily by 
voters. One bill would delay the law's effective date to Sept. 1, 
giving health officials until the end of the year to finalize 
regulations. And a growing number of municipalities have passed 
zoning rules seeking to ban medical marijuana dispensaries in their 
communities.

It is not clear that the law would allow communities to entirely ban 
the dispensaries, but some of the legislative proposals would give 
communities the right to prohibit the facilities near schools, 
churches, and municipal buildings.

With mounting community opposition to marijuana dispensaries, Senator 
John F. Keenan of Quincy has proposed an unusual compromise. -Instead 
of the 35 storefront -operations statewide envisioned in the 
referendum, Keenan's bill suggests there be no more than 10 secure 
warehouse--type centers to fill patient orders via courier.

He said the proposal would address community concerns about higher 
crime rates reported around retail marijuana dispensaries in other states.

It would also eliminate the need to -allow disabled patients to grow 
their own marijuana, he said, -because transportation would not be an 
issue in a courier-run system.

"It will make marijuana available to those with debilitating 
conditions," Keenan said.

Smith, the interim health commissioner, said the warehouse idea is 
intriguing, but added that her department is still studying Keenan's 
bill, which includes several other proposals.

It would, for instance, -require that identification cards needed to 
purchase marijuana expire one year after they are -issued by the state.

That provision addresses one of the many concerns of the 
Massachusetts Medical Society, the state's largest physician trade 
group, which recently met with state health officials to outline 
physician suggestions for the pending regulations.

Bill Ryder, the society's legislative and regulatory counsel, said 
prescriptions for other types of medications typically run 30 or 60 
days and no longer than one year, so cards allowing patients to buy 
medicinal marijuana should similarly have to be renewed after one 
year if the patient still needs marijuana.

"Even if it's something like cancer - presumably some of these 
patients go into remission - but does their certification last in 
perpetuity?" Ryder said.

Leaders of the Massachusetts Municipal Association have also 
discussed concerns with state health officials and are preparing 
written suggestions, said association executive director Geoffrey Beckwith.

One of the association's recommendations would require marijuana 
dispensaries to get approval from local health depart-ments for any 
food products, such as medical marijuana brownies and lozenges, which 
are envisioned for patients who are -unable to smoke.

"We want to makes sure all the appropriate local procedures and 
processes that are in place are honored by the depart-ment," Beckwith said.

States that have legalized dispensaries have run into problems with 
edible marijuana products, said a 2011 report by the US -Substance 
Abuse and Mental Health Services Administration, which met with 
leaders from 15 states to record their experiences with medical marijuana.

"They are often dispensed without FDA or health department oversight 
or without quality control systems in place to identify who made the 
items, when they were made, or how they were made," the report said.

It noted that some states have encountered instances in which edible 
products were found to be contaminated by mold or "other potentially 
harmful ingredients."

Even in states that have had laws on the books for years, new issues 
are arising. In California, where medical marijuana has been legal 
since 1996, two cities faced lawsuits from several disabled residents 
who said that more recent local bans on marijuana dispensaries 
hampered their ability to use the service, violating the Americans 
with Disabilities Act. But a federal appeals court has ruled that the 
act does not protect the rights of disabled -patients to use medical 
marijuana, even when prescribed by a doctor.

Fearing similar challenges in Massachusetts, Representative Cleon 
Turner, a Dennis Democrat, has filed four bills that, he says, will 
protect the rights of cities, towns, and property owners who prohibit 
medical marijuana smoking in public and private places, such as 
apartments and parks, that -already ban tobacco smoke.

"It is unfair to cities and towns and private property owners to 
leave these obvious issues unclear and have them face the costs of 
litigation," said Turner, a lawyer and former Dennis police officer 
and selectman.

The experience of some other states also suggests that, it may be 
some time before the first dispensary opens its doors.

In New Jersey, where the Legislature approved a law in January 2010, 
the first dispensary did not open until nearly three years later, in 
December 2012.
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MAP posted-by: Jay Bergstrom