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Source: The Granite State Poll, sponsored by WMUR-TV and conducted by the University of New Hampshire Survey Center.




Medical cannabis: a long way off
Many disappointed as ID card deadline approaches

06/19/14



 Manchester resident Scott Sieper’s 2-year-old son suffers from a form of epilepsy that causes him to have hundreds of seizures a day. The seizures are severe and prevent him from learning to crawl, walk, or even hold up his head. 

Despite Sieper’s best efforts to find help — trying 12 different drugs and taking his son to specialists at Massachusetts General Hospital and Dartmouth Hitchcock Medical Center  — nothing has proved successful. 
So Sieper started looking for alternative options. When he discovered success stories of patients who used a marijuana-based medication called Epodiolex, he was hopeful. The drug can’t get anybody high but is said to calm overactive receptors in the brain to reduce seizures and has been approved by the FDA for investigational studies. 
Last July, Gov. Maggie Hassan signed House Bill 573, which legalizes medical marijuana for people with a specific set of clinical illnesses and conditions, and sets into action rulemaking and licensing processes for patient identification cards and the creation of four alternative treatment centers. New Hampshire was the last New England state to do so. 
For Sieper, that was good news. 
“I was optimistic in seeing them put forth a date within a certain period of time for rules and regulations, that the intent was to help people,” he said. “But I’m not optimistic now.”
That loss of optimism is widespread amongst patients with severe illnesses, medicinal cannabis advocates, and the bill’s sponsors, who had expected the Department of Health and Human Services to make patient identification cards available by a July 23 deadline. But the IDs won’t be issued anytime soon, according to DHHS. 
 
Protection vs. legality 
DHHS officials are in the process of making the rules that will form the content of the application for issuing and renewing I.D. card registration, provider’s written certification, and procedures for considering, approving and denying application, according to Michael Holt, rules coordinator for DHHS. 
The department won’t, however, apply the new rules or issue the ID cards by July 23. 
Back in February, Senior Assistant Attorney General Michael Brown issued an advisory statement that reviews and interprets RSA-126X and asserts that issuing the cards would support illegal activity.
“Without operational ATCs [Alternative Treatment Centers], there is no legal means for a qualifying patient or designated caregiver to obtain cannabis,” Brown wrote. 
That’s an opinion DHHS intends to honor. 
“We received guidance from the Attorney General’s Office telling people we should not issue cards until dispensaries are operating. We plan to abide by that,” Holt said. 
That’s going to mean waiting until sometime after January 2015, the legislation’s cutoff date for dispensary licenses to be issued.
Mary Castelli, DHHS director of operations support, said the Attorney General’s Office is the Department’s  legal counsel, and it advises them on how to interpret the law. 
“They did provide us with a careful and thoughtful analysis of a law regarding therapist cannabis and the issuance of the cards and the proper timing, and that is why we follow their advice,” she said. 
But the Attorney General’s interpretation varies drastically from what legislators intended the bill to mean, said Exeter state Rep. Donna Schlachman, who was the primary sponsor of the legislation and told the Hippo she could not express how disappointed she is with the Attorney General’s interpretation. 
“The intention of the cards was to protect patients so if for some reason they get stopped and there’s a question about whether marijuana is on them or in them, they will be protected,” she said. “It’s just to make sure we are identifying those patients who are legally possessing marijuana. The card issue date is prior to the opening of the dispensaries, so our intention was to completely protect patients.”
According to Schlachman, the language of the legislation states that ID cards must be issued by July 23. That language remained even after a stipulation in the initial legislation, House Bill 573, was taken out. It allowed patients to grow up to three mature marijuana plants in their homes, but Gov. Maggie Hassan refused to sign the bill unless it was removed — leaving patients with ID cards no legal way to access marijuana in the state until dispensaries are in place, Brown said in a phone interview.
“That ‘home-grown’ provision was taken out. So that, if you look at the totality of the law, it is intended to have medical marijuana highly regulated, highly controlled, and it’s very clear that without the possibility of cultivating your own product that the only way under the law to legally purchase is the dispensaries,” Brown said.
At a late May public hearing, the DHHS decision to honor the Attorney General’s advice was strongly questioned. The meeting was attended by 16 people — members of the New Hampshire Medical Society and The New Hampshire Civil Liberties Union, patients, and others.  
Public hearings are required every time new rules are made, Holt said. 
“It’s not like we felt like we needed [a special public hearing],” he said. “It was fairly well-attended. Most of the hearings aren’t attended at all, so that’s kind of nice.”
At the meeting speakers noted that the ID cards should be issued as soon as possible in order to protect patients who already use or want to use cannabis for medicinal purposes. They referred to laws established in New Jersey, Connecticut and Delaware, where patients have been issued ID cards before a legal source of cannabis was established. 
“The ID cards were supposed to be issued by July at latest,” New England Political Director and Legislative Analyst for Marijuana Policy Project Matt Simon, who was in attendance at the hearing, told the Hippo. “We were told it would be sooner. It was everybody’s understanding having the patient registry was a priority.”
That’s how legislators who created the bill understood it too, said Schlachman. 
“It was never our expectation that patients would only get and only have the option of getting it from dispensaries,” she said. “And even with the home-grown option, we never pretended that patients would not continue to get it where they are getting it now.”
DHHS is in the process of considering public comment on this issue and other concerns, like patient confidentiality rights and the strictness of restrictions on which conditions and symptoms people must exhibit in order to be issued ID cards (New Hampshire’s law is one of the strictest in the country).  
 
Still lots to do
The cards won’t be available until the ATCs become operational, Holt said. Since legislation requires the department to both write the rules and regulations for four dispensaries and issue licenses and certifications by January 2015, DHHS is working on those regulations too. 
“We were given 18 months to write rules and to issue licenses. … That’s impossible to do, so we moved up our work on the licenses-for-dispensaries rules. We’re working on that now and hope to make it public later this month,” Holt said. 
Come January, getting ID cards into the hands of patients will still be a long way off. Once dispensary licenses are distributed, the companies will still need to go through zoning departments to secure locations, render and construct the buildings, create security infrastructure and grow the product. 
That’s too much waiting, said Chris Lopez, a paraplegic who said he already purchases and uses marijuana to alleviate muscle spasms. 
“I do need my medicine. I do get it, and of course it’s dangerous,” Lopez said. “I’m forced into the black market, so the longer they wait, the longer I’m susceptible to arrest, and harm. It makes me angry.” 
 
As seen in the June 19, 2014 issue of the Hippo.





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