Concentrated regulation

Could the recently signed “Regulating Marijuana Concentrates” law be the end of Colorado’s medicinal marijuana?

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After months of contentious debate, close to 30 amendments in the Colorado legislative session, and a veto request letter from over 100 medical marijuana doctors and nurses, HB1317 “Regulating Marijuana Concentrates” was signed into law by Gov. Jared Polis on June 24. 

The controversial new legislation aims to get high potency cannabis out of the hands of Colorado’s youth and to learn more about the molecule’s effects on developing brains. It was crafted to fix a perceived problem with 18- to 20-year-old medical marijuana patients abusing concentrate THC products — like shatter, hash or wax — and illegally diverting them to minors, or others their age. 

However, opponents of the new law say it will effectively kill this state’s medical marijuana industry. They argue that this bill requires Colorado’s medical marijuana doctors to break DEA rules and it strips them of their ability to diagnose patients. Which is why Cannabis Clinicians Colorado (CCC) is suing the state, to stop its implementation. 

The bill was sponsored by House Speaker Alec Garnett (D) from Denver, and Rep. Yadira Caraveo (D) from Thornton. 

“The reality is that it’s too easy for Colorado’s youth to access high-potency marijuana when they shouldn’t be able to, and we don’t have the full picture of how these products impact the developing brain,” Garnett said at the bill’s signing.

The final version requires all medical marijuana licenses to include the “maximum THC potency” level recommended for the patient, as well as dosage form, daily authorized dosages and directions for use — none of which were previously included in a cannabis recommendation. 

Martha Montemayor says that puts doctors at risk of violating DEA law. Montemayor directs the CCC, a network of medical marijuana health-care professionals and patients. She explains that all of that extra information blurs the legal line between “recommendation” and “prescription.” And because cannabis is still a schedule I substance, that distinction is very important for doctors to maintain. 

“Doctors are allowed to talk to their patients about whatever they want,” Montemayor says. “So as long as it is a ‘recommendation’ and not a ‘prescription,’ it doesn’t violate federal law.” 

However, requiring authorized potency, recommended dosage and directions for use pushes medical marijuana doctors into risky territory, according to Montemayor.

Another big issue Montemayor points to is that it circumvents the Medical Practices Act, stripping marijuana doctors of their ability to diagnose patients. It also forces medical marijuana patients to pay for two separate medical visits: one to diagnose their “debilitating or disabling medical condition,” and another to get the cannabis recommendation written. And it requires physicians check the patient’s mental health history, as well as their medical history, before issuing the medical marijuana recommendation.

Not only does that make it much harder and more expensive for medical patients to get their medicine, but Montemayor points out that it becomes a social equity issue. People without health insurance likely won’t be able to afford both of those visits; and even if they can, without access to prior medical records, they won’t be eligible for a cannabis recommendation. 

“That makes it so that marijuana is only for people who have had health insurance consistently, and have access to their medical records,” Montemayor says. 

The new law also reduces the quantity of THC concentrates a medical patient can purchase in a day. Instead of being able to buy 40 grams of concentrate at once, medical patients — who use concentrates to treat epilepsy, chronic nausea, arthritis, insomnia and any number of other health issues — will be limited to purchasing just 8 grams in a day. Medical patients ages 18 to 20, however, will now be limited to purchasing just 2 grams a day. 

The Colorado School of Public Health (CSPH) will also begin a systematic review of scientific research on the “possible” mental and physical health effects of using these substances at a young age, plus an educational outreach campaign. 

Supporters of this bill argue these are logical regulatory steps to ensure that only 18-20-year-olds who really need access to cannabis concentrates are getting them. It also offers an opportunity for more research and a better understanding of how these substances affect developing brains. 

To pro-cannabis activists like Montemayor, though, HB1317 is excessive over-regulation from the state. And it’s all being based on unsubstantiated claims from lobbies representing concerned parents, health-care organizations and anti-legalization organizations, like “Smart Approaches to Marijuana” — which ushered this bill along from conception to passage.   

Montemayor says not a single cannabis specialist was consulted, however. 

While she and her colleagues are fully in favor of helping stop the diversion of cannabis to minors, and fully in favor of research on cannabis and education, they cannot support this bill, claiming it will end Colorado’s medical marijuana program. 

“We are suing the state to stop this bill from being enacted because it violates so many areas of the law,” she says. “It simply shouldn’t be implemented.”