The State Department of Public Health will issue its draft regulations for medical marijuana Friday, and many are waiting to see where the state will go from here.
What defines a 60-day supply? What defines a bona fide patient relationship? How tightly controlled will be the list of qualifying conditions? How will dispensaries and cultivation sites be regulated?
Those are among the questions that many hope to have answered Friday.
The draft regulations follow a series of listening sessions held in February across the state and open the door for additional public comment before they are adopted in May.
Massachusetts voters passed Question 3 — also known as “An Act for the Humanitarian Medical Use of Marijuana” — in November. Advocates for and against the use of marijuana as medicine have offered their input to the DPH as it has worked to create its draft regulations.
Among those waiting are George and Allison Jones of Rutland. Mrs. Jones, a registered nurse, was nearly crushed to death in an accident three years ago when a car landed on top of her as she helped the victim of an accident. She was left with myriad broken bones — including her spine and pelvis, which were broken in two places, and nearly all of her ribs — and a laundry list of high-powered drugs to manage the pain: morphine, OxyContin, oxycodone, Dilaudid and Percocet, to name just a few.
“I was put in the precarious position of being both her spouse and her caregiver,” Mr. Jones said, adding that he managed dispensing her pills. “When you see someone that you love hurting that badly, it is so hard to say you have to wait another two hours. And the last thing I wanted to see was her hooked on prescription drugs.”
They were drugs Mrs. Jones wanted to get off of, especially after a drug interaction caused her kidneys to fail.
She turned to medical marijuana and, in a year’s time, is now free of all prescribed controlled substances.
“I was so impressed with how much better I felt physically and emotionally now that all of these chemicals were out of my body,” Mrs. Jones said. “It has helped me so much that I would like to see people have that option. I know it may not be for everyone, but I have been helped so much by it.”
Mrs. Jones said she is happy to see the state moving quickly in issuing its regulations and hopes doctors will be comfortable recommending medical marijuana to their patients.
Meanwhile, Dr. Richard V. Aghababian, president of the Massachusetts Medical Society, said there is still much research to be done to prove the efficacy of the marijuana leaf as medicine. But now that this is a law, he said, the Massachusetts Medical Society is working with the DPH to provide patients with the relief they need as well as protecting doctors who are still taking a risk if they support marijuana treatment for their patients. This is because it still violates a federal law.
“Doctors are in a quandary, “Dr. Aghababian said. “Doctors are being put in a position to do something that a patient is asking them to do, but it puts the physician in a position that violates federal law. I am not saying they shouldn’t do that, but those who do so, do it with some risk.”
While the medical society remains opposed to the recreational use of marijuana, it did adopt new policies for the clinical use of marijuana in December, and supports a “responsible implementation” of the law.
“We want to make certain that the process is based on sound scientific decision-making and the physicians issuing the certification have done a thorough work-up on the patients for which they are issuing a certification,” Dr. Aghababian said. “We want to make sure it is in the hands of the people who need it according to the law.”
Dr. Aghababian said the medical society will look for the regulations to ensure that safeguards are in place to prevent doctor- and prescription-shopping, and that marijuana will only be used for medicinal purposes and not diverted to teenagers or resold.
In addition, the medical society would prefer that the marijuana plant undergo the same rigorous testing that other botanical drugs are subject to before it is widely available.
“There are medical applications that appear, anecdotally, to be beneficial, but that is so antithetical to the approach we use with biologicals in that they have to go through a course of rigorous study to make sure there are no long-term adverse effects,” Dr. Aghababian said. “We are certainly willing to work with the DPH to figure out how all this will work. Like anything, there is a risk-benefit assessment. If the potential benefit outweighs the risk, then we’d like to have that substantiated by science.”
Dr. Aghababian added that as recently as a few weeks ago, the federal Drug Enforcement Administration wrote that it would not reconsider reclassifying marijuana and that it would remain a Schedule I drug, meaning one classified as having a high level for abuse and no accepted medical use in the United States.
“The government doesn’t feel that there is sufficient research to justify using botanical marijuana,” Dr. Aghababian said.
The Massachusetts Medical Society will continue to offer its comments and concerns throughout the comment and hearing process.
The Massachusetts Patient Advocacy Alliance — the group with which the Joneses are involved — plans to continue to work with patients as well as educating the public on what it sees as the medical benefits of marijuana.
“We want to ensure that patients continue to have a voice,” said Matt Allen, executive director of the Massachusetts Patient Advocacy Alliance.
The Public Health Council will formally present the draft regulations to the Department of Public Health for discussion and feedback. A public hearing is scheduled for April 19, and the public comment period will close on April 20.
The Department of Public Health is then expected to act on the revised regulations, which are expected to go into effect on May 24.