Medical Marijuana News

Friday, January 17th, 2014

We published our mid-year update of the medical marijuana annual report this week.  It contains different data than our  standard annual report in that we’re reporting aggregate dispensary transaction data.  In the report you’ll see that there were about 422,000 transactions made at dispensaries in ‘13 among the 40,000 patients (about 10 transactions/patient/year).   Dispensaries sold 2,700 Kg of marijuana in ’13 for an estimated gross revenue stream of about $33M.  Transaction data is broken down by age group as well.   Fridays are the busiest day of the week at dispensaries.  

In other news, we completed our review of the latest petitions to add debilitating medical conditions to the official list this week.  As you recall, the AZ Medical Marijuana Act charges us to periodically accept petitions to add new medical conditions to the list that qualifies folks for a card.  Last summer we accepted petitions from the public to add new medical conditions for PTSD, depression and migraines. We also received a lot of informal comments regarding adding PTSD; depression & migraines and heard in person testimony from dozens of folks at our public hearing in October. 

We also contracted with the U of A College of Public Health to do an evidence review of published scientific studies.  You can see the UA’s analyses for depression; migraine headaches and PTSD on our petition website.  Our ADHS Medical Advisory Committee reviewed and analyzed the data, as in past submission periods, and provided me with recommendations earlier this week. 

Our literature review found limited scientific evidence to support permanently adding the petitioned conditions to the statutory list of qualifying debilitating conditions identified in the Act.  I didn’t approve the petitions because of the lack of published data regarding the risks and benefits of using Cannabis to treat or provide relief for the petitioned conditions.  We’ll be accepting petitions again January 27 – 31, 2014.

Medical Marijuana Edibles

Wednesday, September 4th, 2013

Last week I posted a blog that points out that the words “Marijuana” in the Arizona Medical Marijuana Act and “Cannabis” in the Arizona Criminal Code have different definitions…  and that the distinction may be an important one for Qualifying Patients. 

The major difference is that the definition of “Useable Marijuana” in AMMA includes “… dried flowers of the marijuana plant, and any mixture or preparation thereof…” without specifically addressing the “resins” and “extracts” identified in the Criminal Code.

Dispensary Ruling

Wednesday, July 31st, 2013

The Superior Court judge ruled this morning that our requirement for Registration Certificate holders (dispensaries) to get an approval to operate within one year in order to renew their certificates is unreasonable.  Because of today’s ruling, we’re going to accept renewal requests for all the current dispensaries in the state, whether they’re open or not.  The initial year for dispensaries is over next week.

The ruling also means we’ll need to rewrite our rules – but that’s not a simple process.  We’ll begin the process of adjusting our regulations to be in accordance with today’s ruling, but it will likely take several months to have everything in line.  Today’s ruling will also delay our decision about how to proceed with “year 2” dispensary applications.

Dispensaries in AZ this Summer?

Wednesday, January 25th, 2012
Right now, it looks like a qualified “yes”.  As you know from earlier blog posts a the judge has ruled in a state case that had challenged our dispensary applicant selection criteria.  We’ve been reviewing our options- and decided yesterday not to appeal  the case- which puts us back on track to licensing dispensaries under the Arizona Medical Marijuana Act. Our teams are busy dotting the i’s and crossing the t’s right now on an express rule package that would remove the dispensary selection criteria that was struck down last week (AZ residency, child support, previous bankruptcies etc.) and to set new dates to accept dispensary applications.  Our goal is to accept applications this April.  We’d then have 45 days to review and award dispensary licenses- so we could potentially have awarded up to 125 dispensary licenses by mid-June. If someone is pretty much ready to go at that point, we could see medical marijuana dispensaries operating in July or August. It’s been awhile since we talked about dispensaries and the certificate process.  The place to start your refresher course is by reading our 53 Frequently Asked Questions summary sheet and our dispensary webpage.  In the meantime, there are several things that won’t change and are still outlined in rule.  Folks will need to have a business plan, security information, staff information, medical director and a plan to distribute information to patients, plus a letter from the locality saying the address is in compliance with local zoning rules. So while we’re busy tying up loose ends with the rules and the FAQs, I imagine prospective dispensary owners will be busy too. One of the key provisions we settled on was to use zones to spread the dispensaries throughout the state.  There were a few reasons for this – one to keep them from clustering in urban areas, another was to make sure that qualifying patients in the more rural areas of the state had access to a dispensary.  Since we started issuing cards to qualifying patients and designated caregivers, we’ve been mapping where they live by zone.  That information is available in a monthly report on our website.

Medical Marijuana Dispensary Update

Thursday, January 19th, 2012
  With the recent ruling in Maricopa Superior Court, ADHS is analyzing the best way to responsibly begin accepting applications for medical marijuana dispensaries. Last week, the Governor instructed ADHS to proceed with the dispensary portion of the AMMA. One of the stumbling blocks was the pending Compassion First vs. Arizona case, which challenged some of ADHS’ rules for prospective dispensary owners. Now that the judge has ruled, ADHS is working to determine the next steps to begin accepting dispensary applications.

New Debilitating Medical Condition Applications

Tuesday, January 17th, 2012
The Arizona Medical Marijuana Act (36-2801.01) directs us to accept and review applications to add new debilitating medical conditions that qualify folks to hold patient registration cards.  We outlined the requirements and review procedures in the Rules we adopted (R9-17-106)- which say that we’ll accept applications every January and July.  We’re planning to accept applications during the last week of January (January 23-27th). Here’s the process: Once we receive an application, we’ll notify the requester that the application was received, and we’ll begin our review.  In order for an application to be successful, the submitters will need to provide evidence as outlined in the R9-17-106 Rule, including: 1) evidence that the medical condition impairs the ability of the individual to accomplish activities of daily living; 2) evidence that marijuana provides a therapeutic or palliative benefit for the condition; and 3) whether conventional medical treatments provide a benefit for the medical condition.  Applicants need to include data from peer-reviewed scientific journals to support the application. We plan on partnering with the U of A’s Mel & Enid Zuckerman College of Public Health and Biomedical Campus teams to review the requests. They’ll be providing us with valuable support, including researching the applications and providing us with summary reports and recommendations using students, faculty and their extensive public health and medical expertise. If the information provided by the applicant meets the requirements, we’ll schedule a public hearing to discuss the request and provide a date for the hearing.  If the information provided doesn’t meet the requirements, we’ll notify the requester with reasons and provide for a process for requesting judicial review.  You can see more information about the process in our Fact Sheet on submitting petitions.

Medical Marijuana Dispensary Application Process to Proceed

Friday, January 13th, 2012
Last May (after receiving a threatening letter from the Arizona U.S Attorney’s Office) the Governor suspended the dispensary portion of the Arizona Medical Marijuana Act with a genuine concern that state employees would be federally prosecuted.  Last year, we asked the federal court to provide us with guidance regarding the obvious conflicts between the Arizona law and the federal Controlled Substances Act.  The federal court’s refusal to address the issue on the merits left many unanswered questions regarding these conflicts.  It’s unfortunate that the Federal court and the Arizona U.S Attorney’s Office couldn’t provide clarity for us on this issue.  However, after careful consideration, the Governor has asked us to implement the dispensary portion of the AZ Medical Marijuana Act. Our first step will be to review the rules for accepting dispensary applications.  Our rules had originally stated that we’d accept dispensary applications last June.  Obviously, that’s no longer possible- so we’ll need to set new application dates using the State’s rulemaking process.  We’re working on those rules right now. The process is complicated by the fact that a lawsuit called Compassion v. Arizona is challenging the scope and constitutionality of our medical marijuana rules.  If that lawsuit is withdrawn or settled quickly, we could begin accepting dispensary applications this Summer.

HIV Becomes a Chronic Disease

Thursday, December 1st, 2011
Chronic disease often calls up bad images for people because it means living with the disease for a long time.  But…  there was a time when cancer wasn’t chronic disease because people got sick and died pretty quickly.  The same goes for HIV.  When it was first discovered in the early 80s people quickly transitioned to AIDS and died shortly after diagnosis.  Now science and medicine have advanced so far, that HIV and AIDS are both more like chronic diseases.  They’ve even come close to what could be considered a vaccine – a discovery so important researchers released it before the rest of the study was finished.  The CDC celebrated World HIV day this week by releasing a new issue of Vital Signs. We’re also keeping up with the times and changing how we handle HIV & AIDS.  The folks who work in HIV/AIDS prevention are moving into our Bureau of Tobacco and Chronic Disease.  This makes so much sense – a lot of the messaging is the same.  People need to learn to control the symptoms, reduce the stressors (like tobacco use or high blood pressure), exercise, eat well and get regular health screenings.   We’ll continue with our surveillance efforts in our Bureau of Epidemiology and Disease Control.

Is Marijuana Medicine? Information for Doctors

Tuesday, September 20th, 2011
Next month, the U of A College of Medicine Phoenix is going to host a lecture about marijuana and whether it is medicine.  Dr. Sue Sisley, St. Joseph’s Hospital, will be giving the presentation at the Phoenix Theatre on October 11th at 5:30. In an earlier blog, Dr. Laura Nelson, ADHS’s Chief Medical Officer, and I shared what we had compiled about the medical research concerning marijuana.  We talked about how patients will likely ask their primary care doctor or go to their medical home to discuss whether marijuana is an option for them.  And we emphasized how important it is to keep Arizona’s Medical Marijuana Program – Medical. Hopefully, physicians will be able to take advantage of Dr. Sisley’s information in October as she examines “Marijuana – Is It Medicine?”  The presentation is free, but you have to RSVP to Brigitte Jordan at bjordan1@email.arizona.edu or (602) 827-2018.

AZ Physicians Referred to Licensing Boards due to Questionable Medical Marijuana Certifications

Friday, August 19th, 2011
One of the criteria on our official medical marijuana Physician Certification Form includes an attestation by a physician that they’ve reviewed their patient’s profile on the Arizona Board of Pharmacy’s Controlled Substances Prescription Monitoring Program database before signing the certification.  We included this requirement to ensure that physicians are acting in their patient’s best interest- and making sure that they’re using best practices and checking to see whether their patient has been prescribed other controlled substances before signing the marijuana certification.  Another requirement that we included asks physicians to attest that they’ve reviewed the patient’s medical history including examining the last 12 months of the patient’s medical records before signing.  We also think these requirements are important because other states that have medical marijuana programs have found that some physicians are more focused on getting revenue from signing certifications than on their patient’s health. As a routine quality check in our certification system, we’ve been asking the Board of Pharmacy to verify whether or not certifying physicians are actually accessing the system (as they have attested).  We’ve identified 3 MDs and 5 Naturopaths that have been routinely attesting that they’ve checked the Controlled Substances Prescription Monitoring Program when they appear to have not checked that regularly.  Dr. Nelson and I sent letters to their licensing boards recently notifying them that it looks like these 8 physicians may be falsely attesting that they’re checking the Prescription Monitoring Program database.  In each case, they appear to have written more than 100 certifications (some several hundred) that included attestations that cannot be verified by the Board of Pharmacy. Our larger concern is that if these physicians aren’t completing this simple requirement (and making false attestations)- it’s likely that they’re taking other short-cuts that may be jeopardizing their patient’s health- such as not reviewing the patient’s medical history before writing medical marijuana certifications (also required in the series of attestations).  Since these 8 physicians have signed nearly half of the 10,000 medical marijuana medical certifications, we think it’s important that the boards know about this so they can decide if the physician is acting in the patient’s best interest.  The referrals may also have a side effect of discouraging physicians from writing recreational certifications.