Medical marijuana patients would face new restrictions under bill aimed at curbing teen use of high-potency products


Colorado House Speaker Alec Garnett speaks about proposed legislation to address youth access to high-potency cannabis products at the Colorado Capitol on May 18, 2021. (Faith Miller/Colorado Newsline)

A bitter debate over proposed new medical marijuana restrictions brought hours of passionate testimony from Colorado parents on both sides of a state bill, keeping lawmakers at the Capitol long after 10 p.m. Tuesday.

The legislation in question, House Bill 21-1317, grew out of bipartisan concerns about children’s use of high-potency marijuana products, also known as concentrates, such as shatter, wax and oil. But parents of children who depend on medical cannabis for conditions like epilepsy say it would create insurmountable barriers to care.

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Speaker Alec Garnett of Denver, the top Democrat in the House, is sponsoring HB-1317 with Rep. Yadira Caraveo, a Thornton Democrat and pediatrician who’s spent months working on the proposal. Senate sponsors include Sens. Chris Hansen, a Democrat from Denver, and Paul Lundeen, a Republican from Monument.

“For many years, I have been concerned about the impact of high-potency cannabis on the developing brain,” Garnett said in a Tuesday statement. “This bill will help us get the answers, and it will crack down on the loopholes that allow for easy diversion of high-potency cannabis to black and grey market where our youth are getting their hands on products that are intended for adults.”

Lawmakers on the House Public and Behavioral Health and Human Services Committee unanimously approved HB-1317 with some amendments, sending the bill to the House Finance Committee.

The legislation — introduced May 14 — would require any doctor recommending medical marijuana for anyone to do so through an in-person appointment and based on a diagnosis within the doctor’s own area of expertise.

Doctors would need to review patients’ mental health history along with their medical history, which is already required, before recommending the substance. HB-1317 would require all physician authorizations for medical marijuana to include the THC potency level, daily quantity and directions for use, and the Colorado Department of Public Health and Environment would need to certify the authorizations.

Colorado law currently restricts retail marijuana, which can be purchased without a doctor’s advice, to people 21 and older, but children and young adults with certain qualifying conditions can access medical marijuana with a doctor’s recommendation. HB-1317 would also place new restrictions on medical marijuana for young adults in the 18-to-20 group, who the bill’s supporters say are most likely to sell the products to children. Underage kids can’t get prescriptions without the help of parents and caregivers.

THC shatterThis 73% THC shatter was for sale in Colorado in 2018. The product is for dabbing. (THC Photos via Flickr/CC BY-ND 2.0)

In the same way 18-year-old high school seniors could have easily provided nicotine vaping products to younger kids — until the Colorado General Assembly raised the legal age to purchase such products — “a high schooler who can sell to other high schoolers … and our middle school ages is a real concern for us,” said Danielle Felder, executive director at Boys and Girls Clubs in Colorado, which supports the bill.

For medical marijuana patients ages 18 to 20, HB-1317 would require two physicians from different medical practices to diagnose the patient with the condition qualifying them for a medical card. At least one of the physicians would need to identify potential risks and benefits. The patient would require a follow-up appointment every six months. An amendment Garnett introduced in the committee hearing would remove the every-six-month requirement for people who’d had a medical card before turning 18.

Conditions that could qualify someone for medical marijuana in Colorado:

• cancer
• glaucoma
• HIV/AIDS
• chronic or debilitating condition that causes one or more of the following symptoms: cachexia, or wasting disease; severe pain; severe nausea; seizures, including those characteristic of epilepsy; persistent muscle spasms, including those characteristic of multiple sclerosis
• post-traumatic stress disorder
• autism spectrum disorder

“I’m on the side of having a child that utilizes medical marijuana, so this medicine has been a lifesaving intervention for him,” said Michelle Walker, a longtime medical marijuana advocate who testified against HB-1317. Her son, now 13, uses medical marijuana to treat his epilepsy and autism.

“We tried a bevy of pharmaceutical drugs, and none of them worked, and it turned into a life and death scenario for him,” Walker continued. “Medical marijuana saved him in the most literal sense.”

But HB-1317 as introduced would prevent Walker and her son from accessing the medicine he needs to prevent uncontrollable seizures, she said. The bill would require the doctors recommending his medicine to specialize in treating epilepsy or autism, and Walker said she’s not aware of any Colorado-based pediatricians specializing in those conditions who would be willing to recommend marijuana.

Another provision of the bill would bar dispensaries from selling more than 8 grams of concentrated marijuana products to any one person in a single day — or no more than 2 grams if the person is between 18 and 20 years old and has a medical marijuana card. The bill would exempt from those limits for homebound patients, those with higher amounts recommended to them by a physician, and those for whom making a daily purchase would represent a “significant physical or geographic hardship.”

Marijuana concentrates feature higher proportions of tetrahydrocannabinol, or THC, than regular marijuana flower. THC is the main cannabinoid molecule — out of more than 100 found in the cannabis plant — that gets a person “high.” Other molecules, such as cannabidiol, are touted by industry representatives and patients as providing their own unique health benefits without delivering the same psychoactive effects as THC.

Under current Colorado law, medical marijuana patients can purchase no more than 40 grams of marijuana concentrate in a single day unless they have an exemption from a doctor and register with the dispensary. Retail marijuana consumers are limited to 8 grams of concentrate per day.

HB-1317 would also implement a tracking system for medical marijuana — which sponsors said would be similar to the database pharmacies and doctors use for keeping track of the pharmaceutical medications someone is prescribed, and when they pick them up from the store. The system would include a patient’s quantity limits and the potency level recommended for the patient by a doctor. Dispensaries would immediately enter any medical marijuana purchase into the system and make sure patients didn’t exceed their daily limit.

Garnett said the sponsors were open to discussion on another section of the bill dictating that a gram of concentrate should be divided into 10 portions. Industry representatives and patients argued during testimony that the provision would create mountains of packaging waste without doing anything to prevent people from heating too much wax when smoking a dab, for example. Dabbing involves inhaling high-THC vapor produced by heating marijuana concentrate on a device with a metal or ceramic plate.

Another part of the bill would direct the Colorado School of Public Health to review existing research on high-potency marijuana, and fill in the gaps as needed to cover “health implications” and “concerns” of such products.

“When I began seeing patients in clinic who were experiencing significant health issues after using high-potency products, I knew we had to take action,” Dr. Caraveo said in a statement. “The absence of a robust federal research effort into the impact of high-potency THC on the developing brain means we still don’t have all the pieces.”

CDPHE recently conducted its own review of existing research into high-potency products. A report published in August 2020 concluded that insufficient scientific evidence exists to determine whether concentrates are more dangerous than other types of marijuana.

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