This week the first batch of medical marijuana should become ready for physicians to write “recommendations” (since any marijuana use runs contrary to federal law, a formal prescription puts a doctor’s medical license at risk) for prospective patients. And thanks to policy laxness, it’s primed for abuse.
The comedy of errors began in 2015, when the Legislature first rehashed laws on the books that permitted the presence of medical marijuana, but didn’t put in place a mechanism for its distribution. It provided such a vehicle, along with an initial short list of eligible conditions, and specified use could occur through any means except inhalation.
However, successive iterations not only greatly expanded the list, but then this year the Legislature stupidly added inhalation (through metered dosing, not lit up). And the state’s Board of Pharmacy contributed when it eliminated a cap on the number of patients for which a doctor could makes recommendations, a visitation follow-up requirement, and changed an initial dosing limitation of 100 mg of tetrahydrocannabinol (THC) in each bottle or 10 mg per dose in single packaging to no limit at all, thinking that these constraints would not effectively provide treatment.
Medical marijuana relies on the properties of cannabidiol (CBD), the other major active ingredient of cannabis and which has no psychoactive effects. But some amount of THC, which is the psychoactive element, is needed to deliver CBD. As a result of the change earlier this year, in Louisiana that proportion is left up to the two state-sanctioned producers.
Also of import, delivery methods matter for saturation. Applying oil or ingestion doesn’t efficiently infuse THC into the bloodstream. Smoking it more efficiently does so, but the method that gets it there quickest and amplifies most any dosage is – you guessed it – direct inhalation, just made possible by the Legislature and Gov. John Bel Edwards.
Finally, the lengthy list of eligible conditions makes potentially a lot of people eligible for use. This is despite that fact that research confirms almost none of these definitively are affected positively by medical marijuana, but policy-makers didn’t think a narrow range would entice enough production.
So, here’s the scenario. You have a relatively large pool of individuals (one estimate sets this at 100,000) who qualify, where any doctor can, with a single visit only, make the recommendation at any dosage level. It’s not difficult to envision some individuals who qualify but have no interest in using – but who do have friends who don’t qualify who would or, worse, associates willing to distribute the product. Add in enough clueless (or sympathetic) doctors writing enough recommendations and/or at high enough dosages for inhalation (even if that means having to inhale several dosages at a time), and you, your friends, and/or customers for profit are high as kites.
This won’t make a substantial portion of the state stoned, and most eventual users won’t abuse the privilege. But you can bet there will be a critical mass of unscrupulous individuals, and even a handful of unscrupulous doctors, who will manipulate the system this way, profiting the two manufacturers for sure (by increasing demand for the product), possibly themselves (if they deal), and corrupt doctors (if they demand a piece of the action).
The system developed into one ripe for abuse because policy-makers let their hearts overrule their heads. Bowing to the pleas of people desperate for some kind of relief who pinned their hopes on anecdotes rather than on scientific research, as well as a few special interests here and there who could make a buck off the setup, they will encourage illegal drug use and NORMaLize the practice. And once this genie is out of the bong, they will find it difficult to attenuate the size and scope of this usage and of the societal problems that will result.
Nevertheless, policy-makers from the governor to legislators to regulators must do that, rolling back the law and rules to something like what existed three years ago. Otherwise, the ills from current policy will outweigh the gains.