Federal legalization of cannabis must target medical use
THELegislation to legalize cannabis at the federal level recently proposed by Senator Chuck Schumer (DN.Y.) and a group of Senate Democrats is long overdue. While it aims to right the injustices done to communities of color that have been most affected by the war on drugs, it excludes a very important demographic: patients.
The bill is presented as a “comprehensive” reform of cannabis. It makes cannabis legal in the United States for recreational purposes and contains many provisions to develop the cannabis industry. It also adds taxes that provide revenue for the federal government and stipulates that part of the money raised must be used to improve the lives of communities most affected by the failed war on drugs.
Leaving patient care aside is neglecting the larger group of people who will or may be affected by this new law.
It is estimated that 115 million Americans over the age of 50 will develop one or more diseases such as osteoarthritis, anxiety, insomnia, or cancer that can be treated with cannabinoid drugs. Failure to include them in the draft discussion underscores that lawmakers do not pay attention to the needs of patients, the differences between patients and recreational users, and how a recreational paradigm fails to support necessary clinical care.
My colleagues and I from the Association of Cannabinoid Specialists, a professional organization dedicated to the scientific training of clinicians and legislators in the use of cannabinoid drugs, believes that a medical cannabis paradigm should include four key components, which we shared with Schumer and colleagues.
First, the legislation should separate medical and recreational cannabis. While the legalization of recreational cannabis may meet the needs of healthy people, it does not meet the medical Needs. People need competent care that is grounded in solid science and aligned with the same core values that apply in all areas of medicine, including respecting patients’ choices through informed consent, beneficence through sound medical advice that ensures patients benefits while minimizing harm, issuing accurate prescriptions to ensure patients receive the right medications and justice by ensuring that everyone is treated fairly and that all have the right same treatment opportunities.
Second, national standards must govern the production and safety of cannabis-based medicines. Packaging should be consistent across the country with ingredient and potency labeling that is accurate and easy to read. Many states have already established their own standards to address some of these concerns, but these rules vary from state to state. We believe that part of the role of federal law should be to incorporate the best of these policies into a national standard. This is commonly referred to as the harmonization of standards, and my colleagues and I believe it will be welcomed by many state legislators and regulators.
To ensure that national standards allow innovation in the field of cannabinoid drugs, the Association of Cannabinoid Specialists encourages continued research and collaborative efforts among industry, scientists, clinicians and regulators.
Third, all states, even those without medical cannabis programs – must allow individuals to freely cross state borders with cannabis-based drugs, which they are currently prohibited from. People with nationally recognized prescriptions under a new federal law should be free to use and travel with their medications across jurisdictions and state borders, including by air, in all states and US territories.
Fourth, there must be a clear set of rules for properly advertising cannabis products, whether sold in the recreational or medical markets. These rules should include a restriction on distributors giving point-of-sale medical advice – only qualified and licensed healthcare professionals should guide patient care. Sellers should also be required to fill prescriptions for medical cannabis as written, without attempting to sell additional or different products.
Federal rules should also prohibit advertising that is misleading, false, fraudulent, or creates a misleading impression – whether directly or through omission or ambiguity – or that promotes overconsumption or encourages the consumption of more potent products.
With so much emphasis on cannabis as a business opportunity and a method to correct social injustice, it’s easy to forget that cannabis is also a medicine and that patient support is about social justice.
When creating and implementing cannabis legalization, the health and safety of patients who depend on cannabis to treat many physical and mental illnesses cannot be forgotten. The guidelines we have proposed for federal regulation will ensure that cannabis patients are not forgotten and that they – like any other patient – will have easy access to safe and effective treatments.
Jordan Tishler is a physician of internal medicine, founder of the inhaleMD medical practice in Cambridge, Mass., Medical instructor at Harvard Medical School and president of the Association of Cannabinoid Specialists.