On today's program: PA’s Health Secretary considers how medical cannabis could expand; a pain medicine specialist is concerned about how quickly the program has already expanded; dispensary pharmacists have a unique job; and how can differing state and federal cannabis laws co-exist?
PA Health Secretary open to expanding medical cannabis
(00:00 — 10:37)
It’s been almost two years since physicians began prescribing their patients medical marijuana in Pennsylvania. According to the state Department of Health, in 2019 alone, the number of certified patients more than doubled from 70,000 in January to 153,000 today.
“Actually we have expected this level of demand,” says state Secretary of Health Rachel Levine.
A total of 23 medical conditions have been approved for treatment with medical marijuana including chronic pain, cancer, epilepsy and anxiety. Dr. Levine says anecdotal feedback from certified physicians has been positive but more research is needed regarding the proper dosage and form of the medical marijuana administered.
There are eight medical centers that will participate in research, including the University of Pittsburgh, in an effort to answer some of those questions. The University is expected to partner with an approved grower in early 2020.
Usually new drugs take years of research and testing and then need federal approval before going to market, but because cannabis is currently classified as a Schedule 1 drug by the Drug Enforcement Administration, it is not going through the usual process, and much of the research is being done after the medication is readily available.
“I think that it would be best if the DEA would reschedule medical marijuana,” but given that it has yet to do so, the current way of doing things is “the only way that a medical marijuana program can exist,” Levine says.
Pain medicine specialist wants to slow down expansion of medical cannabis
(11:15 — 21:49)
Medical cannabis certification is a tricky process, says Dr. Ajay Wasan, a pain medicine specialist and psychiatrist with UPMC and the University of Pittsburgh School of Medicine. If the patient is a good candidate for medical marijuana, the physician makes a recommendation and then does follow up visits to make sure the patient is using the substance responsibly.
“It’s an unusual process for a physician to basically make a recommendation and not actually be in charge of the conduct of the treatment,” Wasan says. Dispensary pharmacists can alter medical cannabis treatment plans, which is unique from other drugs.
But Wasan says that important questions remain about appropriate timing, dosage and frequency when it comes to medical marijuana.
Physicians and patients should be cautious when recommending or using marijuana as a medical treatment, Wasan tells The Confluence’s Megan Harris. “Not to heighten fears, but the reality is that this is a controlled substance for a reason,” says Wasan. “It may be useful in pain and other conditions, but there can be significant harms.”
Wasan says that he understands the rationale behind Health Secretary Rachel Levine’s approval of 23 medical conditions for medical cannabis, but “when a state says something is approved for use, it implies there is sufficient evidence to justify that use, and that can’t be said.”
Medical marijuana dispensaries are hiring their own pharmacists
(21:51 — 26:25)
Pharmacists know a lot about how drugs work in the body, but they have no authority to change a patient’s dosage or prescribe a different form of a drug. Unless that drug is marijuana. As part of our series The State of Cannabis, 90.5 WESA’s Liz Reid looks at how pharmacists are embracing the medical marijuana industry and making it safer in the process.
The conflict between federal and state cannabis laws can be confusing
(26:30 — 42:53)
Though medical marijuana is legal in 33 states including Pennsylvania, it remains illegal at the federal level. As Pennsylvania continues expansion of its medical marijuana program, the discrepancies between the state and federal laws are sowing confusion for some patients and causing unforeseen consequences for business owners and lawmakers.
The federal government “seems to be taking largely a hands off approach,” to prosecuting patients who use medical marijuana according to Michael Sampson, a partner with Reed Smith and co-chair of the firm’s cannabis law team. “Although much of what’s going on technically violates the Federal Controlled Substances Act or other statutes,” Sampson says.
Concerns about the implications of medical marijuana for people on probation and others who might be drug tested, and the lack of regulations on marijuana products have further complicated the roll out of Pennsylvania’s medical marijuana program, says Paula Knudsen, investigative reporter for The Caucus, which hosted a forum on marijuana this fall.
Despite these difficulties, Sampson says it’s just a matter of time before marijuana is decriminalized or even legalized on the federal level. “The bottom line is that the financial incentives are just too great to move back on,” he says.
Pennsylvania Governor Tom Wolf, Lieutenant Governor John Fetterman and Auditor General Eugene DePasquale have all called for legalizing recreational marijuana. But House Republican leaders issued a statement saying they have no interest in considering the proposal.
“Our state is in the midst of an opioid epidemic,” a statement by House Republicans reads. “We do not believe easing regulations on illegal drugs is the right move in helping the thousands of Pennsylvanians who are battling drug addiction.”
90.5 WESA’s Julia Zenkevich contributed to this report.
The Confluence, where the news comes together, is 90.5 WESA’s daily news program. Tune in weekdays at 9 a.m. to hear newsmakers and innovators take an in-depth look at stories important to the Pittsburgh region. Find more episodes of The Confluence here or wherever you get your podcasts.