It is very clear from statewide polling data that the majority of Missourians want access to medical marijuana if they have a terminal illness or are suffering from a debilitating medical condition.
While I appreciate the opinion expressed in a recent Star editorial that a legislative solution is preferable to a constitutional amendment for addressing the legality of medical marijuana in Missouri, I respectfully disagree. I fail to see any similarity between the ballot initiatives that have received tremendous popular support from our citizens and Missouri HB 1554, which was passed by the House on May 1 as a last-second attempt by the General Assembly to ensure that Missourians will have the absolute minimum possible access to medical marijuana.
Criticism that the House bill is narrow and restrictive is at best an understatement. HB 1554 is crippling preemptive legislation that essentially removes medical marijuana from the reach of just about any patient who might benefit.
The bill creates a complex scheme through which medical cannabis is declared to be an investigational drug, which may be recommended or prescribed by a physician to treat patients with a terminal illness or a debilitating medical condition after all other treatments have been considered. The focal point of this bill is the requirement that medical cannabis is to be prescribed only in keeping with an ongoing clinical trial specific to the patient’s condition.
Here is the first catch: There are relatively few clinical trials involving cannabis. They are not known to most physicians in private practice (who have no time for and little interest in clinical trials). They are relatively brief, and they are specific to very limited clinical conditions. Many of the conditions listed in the bill as “debilitating medical conditions” are not consistently the subject of ongoing cannabis research.
Here is the second catch: Many physicians, myself included, have no desire to be held responsible for recommending or prescribing unproven therapies (including federally illegal cannabis) to patients. Under HB 1554, health care providers are specifically liable to their patients for civil actions for damages related to recommending cannabis for the treatment of debilitating medical conditions. Most physicians are likely to conclude that they are better off not participating in this program.
For the exceptional patients who manage to receive prescriptions for medical cannabis under the provisions of HB 1554, they can’t smoke it. They have to use it exactly as it was used in the clinical trial, and they have to stop using it when the trial is concluded. What they absolutely cannot do is go purchase some weed, smoke it, and see if it helps.
HB 1554 is an attempt by our elected officials to make sure that medical marijuana never becomes anything more than a rarely encountered aberration. The vast majority of physicians will be unable or unwilling to recommend medical cannabis for their patients. The vast majority of Missourians will not have access to medical marijuana.
This legislation is a far cry from the ballot initiative sponsored by New Approach Missouri, which requires nothing more from physicians than a certification that their patients do indeed have a covered medical condition in order to qualify for treatment with medical marijuana. This is simple and straightforward. This is the same model used in many states across the U.S., and it is the model that has the demonstrated support of the people of Missouri, as evidenced by ballot signatures and statewide polling data.
David W. Clark is a full-time practicing physician and a graduate of the University of Missouri-Kansas City School of Law.