Pubdate: Tue, 09 Jul 2013
Source: Monadnock Ledger-Transcript (NH)
Contact: http://drupal.ledgertranscript.com/forms/letter-to-the-editor
Copyright: 2013 Monadnock Ledger-Transcript (NH)
Website: http://www.ledgertranscript.com/
Details: http://www.mapinc.org/media/5458
Author: Maxine Joselow

LEGISLATION SHOWS SHIFTING ATTITUDES

The Implications: Measure backed by Gov. Hassan will give patients 
access, but it will come with tight regulations

After almost five years of gubernatorial vetoes blocking medical 
marijuana legislation, New Hampshire is set to become the 19th state 
in the country, and the last in New England, to allow seriously ill 
people to use marijuana for medical purposes.

The state Legislature passed a bill sanctioning medical marijuana on 
June 26 , and the bill now awaits final approval of Democratic Gov. 
Maggie Hassan.

The Legislature passed two medical marijuana bills in 2009 and 2012, 
only to have former Democratic Gov. John Lynch veto them , but Hassan 
has said she will sign the recent medical marijuana bill into law.

"Medical marijuana will ease the suffering of New Hampshire's 
seriously ill patients," Hassan wrote in support of the bill in an 
email to the Ledger-Transcript Tuesday. "This is a compassionate 
policy that can help patients seeking relief from certain conditions 
when other treatments may not be effective."

House Bill 573 permits patients suffering from cancer, multiple 
sclerosis, HIV/AIDS and other conditions to possess up to two ounces 
of marijuana upon their doctors' recommendations. Patients will 
obtain the marijuana from one of four nonprofit, state-authorized 
"alternative treatment centers." The N.H. Department of Health and 
Human Services must license two alternative treatment centers within 
the next 18 months.

State Rep. Douglas Ley, (D-Jaffrey), said in an interview with the 
Ledger-Transcript on Wednesday he voted in favor of the bill because 
it had strong constituent support. He added that he hopes 
decriminalizing marijuana for medical purposes will lead to 
decriminalizing the drug for recreational use. "I support 
decriminalization of possession of marijuana in small amounts. 
Medical marijuana is just an opening," Ley said.

State Rep. Susan Emerson, (R-Rindge), said she too voted in favor of 
the bill, though for different reasons than Ley. Emerson said she 
backed the bill because she hopes medical marijuana will relieve 
seriously ill people's suffering.

"I really feel that this is a good thing for sick people. Why 
shouldn't we relieve a person's pain and agony?" Emerson said.

Emerson added that, unlike Ley, she only supports the 
decriminalization of marijuana for medical purposes. "I have always 
voted against legalizing marijuana, because I feel that it's a 
gateway drug to heroin and cocaine and other things. But I think it's 
a good thing for people who are suffering," Emerson said.

House Bill 573 was the result of a compromise between different 
versions of medical marijuana bills passed by the House of 
Representatives and the Senate. The compromise eliminated a provision 
that the House originally approved that would have let patients grow 
their own marijuana, instead of receiving it from alternative 
treatment centers. Hassan said she would not sign the bill if it 
included the home-grow option, citing concerns from law enforcement 
agencies about the difficulty of regulating home marijuana cultivation.

"I heard concerns from the law enforcement community regarding their 
ability to enforce a home-cultivation provision," Hassan wrote in her 
email to the Ledger-Transcript. "By eliminating this provision, I 
believe this bill provides the appropriate level of regulation needed 
for the use of medical marijuana."

The compromise also reduced the number of alternative treatment 
centers in the state from five to four, and eliminated post-traumatic 
stress disorder from the list of conditions eligible for medical 
marijuana treatment.

The Legislature dropped PTSD from the list of conditions because many 
legislators felt the most effective treatment for PTSD is consulting 
a physician, not using marijuana, Hassan wrote. "The use of medical 
marijuana by those who suffer from PTSD can discourage them from 
seeking appropriate mental health care," she wrote.

Emerson said she was pleased overall with the compromise, but she 
thought PTSD should have been included in the list of qualifying 
conditions. "I have encountered many, many young people coming back 
from the war in Iraq or Afghanistan with PTSD. It is a serious 
problem. ...I feel that [medical marijuana] is something our veterans 
should be entitled to," Emerson said. She added that she plans to 
speak with State Rep. Donna Schlachmann (D-Exeter), one of the bill's 
main sponsors, about amending the bill to include PTSD at the House's 
next session.

Kaitlyn Smith of Greenfield, an occupational therapist, echoed 
Emerson's concerns about the fate of PTSD patients in New Hampshire 
in an interview with the Ledger-Transcript in downtown Peterborough 
on Tuesday. Smith said she has worked with veterans with PTSD in 
Colorado and Rhode Island, where small amounts of medical marijuana 
are legal, and has witnessed the positive effects the drug had.

"I worked very closely with them, so I could see how much better they 
slept and acted when using it. I've seen it work," Smith said.

Smith also has a personal motivation for supporting medical marijuana 
access for PTSD patients, since her boyfriend has the condition. He 
lives in Rhode Island and enjoys legal access to medical marijuana to 
reduce his symptoms. "My boyfriend gets stuck in a trance and has 
night terrors. I've seen firsthand how terrifying it can be. It's 
definitely something I wouldn't want to experience," Smith said.

The bill is raising other concerns among local law enforcement 
officers. Rindge Police Chief Frank Morrill said in an interview with 
the Ledger-Transcript on Friday he was worried the decriminalization 
of medical marijuana would make police officers' jobs harder.

"There's a significant amount of time and resources that we spend on 
marijuana cases as it is," Morrill said, noting that 
marijuana-related crimes account for a third of all incidents that 
come before the Rindge Police Department each year. "Putting more 
people out there with legitimate access to marijuana for medical 
reasons may potentially complicate our jobs."

Kenny Finn of Greenfield said he fears the bill will let more 
marijuana reach the black market. "I hope it's not abused, and people 
won't be using legitimate prescriptions just to get high," Finn said 
in an interview with the Ledger-Transcript in downtown Peterborough on Tuesday.

But Morrill said it is unlikely that marijuana meant for patients 
with medical conditions will be diverted to recreational users, since 
tight regulations will govern medical marijuana's distribution. He 
said he was more concerned that police officers would waste their 
time and resources attempting to arrest legal medical marijuana 
users. "If someone is sitting out on their front porch smoking a pipe 
or a joint out in the open, it might draw attention, and people will 
report it, and law enforcement will respond, only to find that it's 
justified by medical reasons," Morrill said.

The bill is also sparking a conversation among local health care 
professionals. No physicians at Monadnock Community Hospital are 
currently prescribing medical marijuana, since the bill is brand new 
and no alternative treatment centers have been licensed yet, said 
Laura Gingras, the hospital's vice president of philanthropy and 
community relations, in an interview with the Ledger-Transcript on 
Monday. But physicians at MCH may soon have the option of prescribing 
medical marijuana for patients with cancer, Crohn's disease, multiple 
sclerosis, muscular dystrophy, glaucoma and other conditions.

"As the regulations are laid out by the state, if other hospitals 
find a safe and appropriate way to do this, it's likely that 
Monadnock may as well," Gingras said. "Medical marijuana will be 
heavily regulated by the state, and we will look to them to provide 
guidance for both physicians and patients regarding appropriate use 
of this new treatment option."

But patients will not likely be able to rely on health insurance or 
medical assistance programs, such as Medicaid, to cover the cost of 
medical marijuana.

"House Bill 573 does not mandate that health plans pay for the 
expense of medical marijuana," said Keith Nyhan, director of consumer 
services at the N.H. Department of Insurance, in an interview with 
the Ledger-Transcript on Wednesday.

"You cannot require insurance companies to cover this, so it's going 
to be up to people," Ley said. "It's not a perfect solution by any 
means...and that's true under any state," he said, noting that all 18 
states that have already legalized medical marijuana do not require 
health insurance companies to cover it.

The bill will not have a financial impact on New Hampshire taxpayers, 
though. The medical marijuana program will be self-funded by the N.H. 
Department of Health and Human Services, meaning the department will 
use revenue generated by the program to cover all expenses of the 
program, said John Williams, director for legislative affairs at the 
Department of Health.

The Department of Health estimates that establishing alternative 
treatment centers, hiring additional staff to run the centers, and 
issuing identification cards to qualifying patients will cost 
approximately $204,000 in fiscal year 2014, Williams said. This cost 
will be offset by certification fees paid by qualifying patients, 
licensing fees paid by private contractors for opening alternative 
treatment centers and private donations from wealthy individuals, he said.

The whole program is not expected to be up and running for another 
year to a year and a half.
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MAP posted-by: Jay Bergstrom