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.

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.

ADHS Asks AZ Attorney General’s Office to Review the Legality of “Cannabis Clubs”

Thursday, July 14th, 2011

The Arizona Department of Health Services has serious concerns about the legality of so-called cannabis clubs. The information that we have regarding these “clubs” suggests that they are distributing marijuana to customers in a way that is inconsistent with the provisions of the Arizona Medical Marijuana Act, and the persons involved could be conducting illegal marijuana transactions.  For this reason, we have referred this issue to the Arizona Attorney General’s Office for review and analysis by its civil and criminal divisions.

New Medical Marijuana Memo from Justice

Monday, July 11th, 2011
The U.S. Department issued new guidance for federal prosecutors last week.  We had been anticipating a new memo from Justice for some time- hoping that it would clarify whether the dispensary portions of the Arizona Medical Marijuana Act are legal under federal law (the Controlled Substances Act).  We were also hoping it would help us figure out how risky it would be for us to issue dispensary applications.  Unfortunately, the new guidance didn’t help much. The guidance makes it clear that folks that facilitate large scale cultivation are at risk for prosecution. People that “facilitate” cultivation are also at risk for prosecution.  But, a key remaining question is what the word “facilitation” means.  Could it mean that issuing state approved licenses for cultivation and dispensing would put us at risk for prosecution?  We’re hoping that the upcoming Declaratory Judgment will answer this question (and others) once and for all.  You can check out the new memo from Justice on our website.