Pubdate: Mon, 29 Jun 2015
Source: Baltimore Sun (MD)
Copyright: 2015 The Baltimore Sun Company
Contact:  http://www.baltimoresun.com/
Details: http://www.mapinc.org/media/37
Author: Meredith Cohn

MEDICAL CANNABIS MOVING CLOSER

With the state publishing draft regulations for medical marijuana and 
an infrastructure for growing and distributing it coming into view, 
Marylanders who suffer from chronic pain or debilitating disease 
could gain access to the drug by the middle of next year.

The rules developed by the Maryland Medical Cannabis Commission, 
which cover doctor registration, licensing, fees and other concerns, 
were published last week. The state is accepting public comment on 
the rules through July 27.

"This is a big step in the right direction," said Del. Dan K. 
Morhaim, a physician who championed the legalization of medical 
marijuana in the General Assembly. "This should make the program 
operational, though there should be adjustments every year or so for 
the next few years as we learn from our experience."

States have approved the use of marijuana for conditions as disparate 
as nausea from chemotherapy, post-traumatic stress disorder, multiple 
sclerosis and anorexia.

The draft regulations apply to smokable and liquid forms of cannabis, 
but not edible forms, which won't be allowed in Maryland.

The rules set fees for two-year licenses at $125,000 for growers and 
$40,000 for dispensaries. Those fees, second only to those of 
Illinois, are intended to make the program self-sufficient as 
required by law. Hannah Byron, executive director of the Maryland 
Medical Cannabis Commission, said she does not expect much change to 
the rules during the 30-day comment period. That means by the end of 
September, the commission could begin accepting applications for 15 
licenses to grow marijuana, an unlimited number of licenses for 
processors and licenses for two dispensaries per senatorial district.

They would be given preliminary approval and up to a year to develop 
an acceptable operation. They would need to acquire real estate, gain 
local zoning approvals, build a facility, install equipment, and hire 
and train staff.

Some operations might combine growing, processing and distributing.

Any doctor in good standing would be able to refer patients, but 
Morhaim expected the most interest from those who treat pain, cancer 
and other devastating diseases.

As with any other drug, doctors would follow the latest research to 
ensure that marijuana is appropriate for each patient. Doctors would 
be able to certify patients to get the drug from a dispensary.

Byron said she has heard interest from companies, doctors and 
patients across the state.

A group that specializes in cultivating marijuana for medical use 
wants to set up a growing facility that would employ up to 100 people 
in Easton.

CBD Wellness Group made a presentation to the Easton Town Council 
this month. The group plans to apply for one of the 15 growing licenses.

Maryland, unlike most states, will require doctors to register to 
write referrals. The state plans to offer an online course for 
doctors prescribing the drug but has dropped a proposal to make 
training mandatory.

That is one reason that Kevin Sabet opposes medical marijuana programs.

Sabet, a former adviser to the Clinton and Bush administrations, runs 
the Drug Policy Institute at the University of Florida and co-founded 
the advocacy group Smart Approaches to Marijuana.

He says doctors need training in prescribing marijuana because the 
drug is complex and the research insufficient.

In a review of studies published in the Journal of the American 
Medical Association in June, researchers found mixed benefits from 
medical marijuana.

Analyzing 79 clinical trials with more than 6,000 participants, they 
found "moderate quality" evidence of benefits in treating chronic 
pain and the effects of multiple sclerosis but said there was not 
good evidence that the drug was effective against nausea and vomiting 
from chemotherapy, weight gain from HIV infection, sleep disorders or 
Tourette syndrome.

"This drug is different from other drugs," said Dr. Deepak Cyril 
D'Souza, a professor of psychiatry at Yale who studies cannabis. "It 
consists of almost 400 compounds, not one or two like other drugs we 
prescribe."

He said marijuana strains vary in potency, and could pose troublesome 
interactions and side effects.

Marijuana has not been approved by the U.S. Food and Drug 
Administration. There are no dosing guidelines, D'Souza said, and 
research on the therapeutic effects is "really mixed."

D'Souza sits on a panel in Connecticut that considers which 
conditions may be treated with medical cannabis there. He said the 
experience has made him "a naysayer despite my belief in the drug's promise."

Morhaim, a Baltimore County Democrat, said, "This is about patient 
care. Thousands of Marylanders are suffering needlessly. These are 
our friends, family and neighbors. This is about getting relief for them."

Sabet said members of the medical community should not give up on 
marijuana as a therapy for a broad range of conditions.

"We know that there are likely elements of marijuana that have 
medical promise," he said. "That is what we're trying to do research on."
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MAP posted-by: Jay Bergstrom