SALT LAKE CITY — The Utah Medical Association recently blasted proponents of a pending medical cannabis ballot initiative for wanting to profit from the highly lucrative business, as well as seeking to open the door to recreational use.
“Although UMA supports the use of FDA-approved cannabis-based medicines, this initiative is not about medicine. Supporters have used images and stories of suffering patients to disguise their true aim: opening another market for their products and paving the way for recreational use of marijuana in Utah,” the UMA statement said.
The UMA joined forces with Gov. Gary Herbert to oppose the initiative, downplaying the broad public support of medical cannabis legalization in Utah.
“As the largest organization representing physicians in Utah, UMA unequivocally states its opposition to the current initiative and applauds Gov. Herbert for speaking out in opposition as well, fulfilling his role in protecting public health and safety,” the statement said.
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Herbert publicly came out against the initiative in late March — a time when polls consistently indicated support for legalizing medical marijuana hovered around 75 percent.
The two-page statement from the UMA board of directors, released April 3, contained several claims worth fact-checking. Here the Standard-Examiner scrutinizes eight, rating them on a sliding scale as gospel truth, some truth, matter of opinion, or pure rubbish (since “pants on fire” was already taken by PolitiFact).
STATEMENT 1: “The Utah Initiative would allow possession of 4 times the amount of marijuana than most other ‘medical’ marijuana states.”
We rated this as PURE RUBBISH.
A summary of the lengthy ballot initiative limits a medical cardholder’s possession to 2 ounces of cannabis or 10 grams of cannabidiol or tetrahydrocannabinol from a licensed dispensary during any 14-day period.
The question is how that compares to other states that legalized medical cannabis. According to National Conference of State Legislatures, 29 states plus the District of Columbia, Guam and Puerto Rico have now legalized medical cannabis.
In checking three online sources (leafly.com, healthcare.findlaw.com and leafbuyer.com), we found some states exceed Utah’s proposed limits — such as California, where medical marijuana patients can purchase up to 8 ounces at a time, or Colorado, which allows 2 ounces per day. Delaware’s limit is 6 ounces per month, Hawaii 4 ounces every 14 days, Illinois 5 ounces per month, Massachusetts up to 10 ounces every two months, Nevada 2.5 ounces every two weeks, New Hampshire up to 6 ounces per month, and Oregon with a robust high (pardon the pun) of 24 ounces of marijuana flowers.
More conservative states include New Jersey (2 ounces per month), North Dakota (not yet fully operational, but up to 2.5 ounces in 30 days) and Washington, D.C. (2 ounces in 30 days).
In a few cases, these sites contained conflicting information, but we did not find a source that supported UMA’s claim.
STATEMENT 2: “Anyone could avoid prosecution simply by saying (whether true or not) they have some illness that they are using marijuana to treat as an affirmative defense, regardless of whether or not there is any scientific basis for such treatment.”
We rate this MATTER OF OPINION because ultimately, the legal system is already highly variable.
According to the ballot initiative summary, the measure would establish an electronic verification system administered by the Utah Department of Health, would require state-issued medical cannabis cards to qualifying patients and would track the amount/frequency of cannabis purchased by patients and caregivers.
Sections 26-60b-102, 103 & 107 of the full initiative detail how that electronic verification system is intended to work, with physicians and patients completing the medical card application process electronically in the doctor’s office. The proposed law dictates that the system be operational no later than March 1, 2020. Section 26-60b-107 defines physician qualifications in detail.
The reference to “affirmative defense” in the UMA statement is also addressed in the initiative. DJ Schanz directs the political issues committee backing the initiative called Utah Patients Coalition. He said the only chance for a person to avoid prosecution for marijuana-related charges would be if they proved they have “verifiable condition” and explain they’re participating in a system that isn’t set up yet.
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Ultimately, the decision to keep or dismiss charges would still be up to a judge.
Accepted “verifiable conditions” are listed in the initiative and must be confirmed by a physician. (See Fact Check 3.)
“So the sooner they get that (electronic verification) system in place, the more secure the process will be,” Schanz said. “We’d like to see this (affirmative defense) provision not exist at all, but we realize implementation will take time — and we’d like to give the state incentive to get the verification system up and running as quickly as possible.”
STATEMENT 3: “The initiative language also allows marijuana use by anyone, even children, for whom there is no safe level of THC (the main active ingredient in most cannabis products) for their developing brains.”
This claim starts with a falsehood (no, there won’t be a marijuana free-for-all) and ends with fact, so we’re rating it as SOME TRUTH. An April 2017 publication from the American College of Pediatricians warns of THC’s detrimental impacts on youth: “Marijuana is addicting, has adverse effects upon the adolescent brain, is a risk for both cardio-respiratory disease and testicular cancer, and is associated with both psychiatric illness and negative social outcomes.”
The initiative would allow someone under the age of 18 with a qualifying condition to access medical cannabis if a caregiver obtains a medical cannabis card on their behalf — so long as that comes with a doctor’s recommendation.
Anyone 18 and older must go through that same qualifying process.
Qualifying categories (section 26-60b-105) include:
• Alzheimer’s disease
• Amyotrophic lateral sclerosis
• Chronic conditions that cause physical wasting, nausea or malnutrition
• Chronic and debilitating pain
• Crohn’s disease
• Epilepsy or a similar seizure-causing condition
• HIV/AIDS or an autoimmune disorder
• Multiple sclerosis or a similar condition causing muscle spasms
• Post-traumatic stress disorder
• Ulcerative colitis
The initiative also establishes a five-member Compassionate Use Board to consider additional case-by-case approvals.
STATEMENT 4: “In fact, there are few real restrictions or liability for either possession, distribution or manufacture of cannabis products by anyone.”
We’re rating this as PURE RUBBISH.
State laws provide a patchwork of varied cannabis legalization, but federal law still classifies marijuana as a Schedule I drug where sale, possession or use is considered a crime. So black market activity outside the initiative’s confines could still be prosecuted under existing state and federal law; the initiative would not have to re-invent that wheel.
The initiative would bar felons from owning or working at a medical cannabis business. It also maintains existing prohibitions on public use, driving under the influence, and smoking cannabis.
The initiative’s multiple pages also include detailed parameters, safeguards, penalties and fines for growing, processing, distributing and tracking cannabis products sold to card-holders.
STATEMENT 5: “The Libertas Institute has stated, falsely, that Utah’s is the most restrictive initiative out there.”
We’re ranking this statement as MATTER OF OPINION because the UMA has consistently opposed previous efforts by Utah lawmakers to advance similar legislation. Both sides could debate this point ad nauseam.
The Washington, D.C.-based Americans for Safe Access (ASA) — a medical cannabis advocacy organization established in 2002 — evaluates state marijuana laws in a wide range of categories. Utah’s proposed initiative received a 61.8 percent score or a D- grade.
By email, ASA Legislative Counsel David Mangone described Utah’s ballot initiative as among the nation’s most conservative, “as it would rank as the lowest-scoring comprehensive program in the country.”
Connor Boyack, founder and president of Libertas Institute, said the proposed law was purposely drafted to garner conservative support.
“The Utah Medical Cannabis Act prohibits smoking, home grows and using cannabis in public view. It also restricts physicians and medical cannabis establishments from advertising, and limits how many patients a doctor can recommend for treatment,” Boyack said. “It also gives law enforcement significant oversight, tracking every aspect of the plant in a database and allowing inspections of cannabis establishments at any time.”
STATEMENT 6: “People assume that physicians would have some idea of how to prescribe or recommend it safely, for which diagnoses, and understand the contraindications, drug interactions and dosing guidelines for a plant that is wildly diverse and inconsistent in active ingredients. None of this is the case with what is being proposed in the Utah Initiative. Physicians cannot prescribe it at all.”
Since this explanation is another true/false hybrid, we’re ranking it MATTER OF OPINION.
The Medscape website discusses legal risks for physicians who recommend marijuana: “After contacting national and regional malpractice insurance carriers, along with several state medical societies, we couldn't find a single instance of a physician being sued for malpractice over the negligent recommendation for medical marijuana.”
That said, Medscape noted a handful of doctors around the country who lost their medical licenses, plus dozens more reprimanded by state medical boards for “writing certifications for medical marijuana use in an improper or unsafe manner.”
Andrew Talbott, a pain management doctor who practices in Park City, pointed to a 9th Circuit Court of Appeals decision in 2002 (Conant v. Walters) that draws the line for what physicians can and cannot do regarding cannabis.
“They ruled that a physician speaking to a patient and recommending cannabis is protected free speech, so a provider can do that legally,” Talbott said. “But that doesn’t extend to a physician distributing or aiding the patient in obtaining the cannabis. And part of that has to do with writing a prescription. That would cross the line into what is not acceptable.”
Physicians having ownership in a dispensary also constitutes a problem, Talbott added.
Information about contraindications and potential drug interactions also exist. Talbott said he took a continuing medical education (CME) course in cannabis caregivers certification taught by Dr. Stephen Corn, a board-certified pain physician working with Americans for Safe Access. There is educational material out there, but it’s not ubiquitous.
STATEMENT 7: “The initiative also allows various non-physician practitioners to recommend marijuana for clients.”
This statement refers to allowing dispensary staff to describe the products they have on hand. In that context, we’re ranking it as GOSPEL TRUTH.
But two sentences later, UMA states, “For real patients, this model is fraught with dangerous consequences,” and that portion ranks as MATTER OF OPINION.
Amid the nation’s opioid epidemic, about 23 Utahns die each month from prescription drug overdoses, according to the Utah Department of Health. But a federal Drug Enforcement Agency fact sheet cited no reported deaths from marijuana overdoses.
STATEMENT 8: “There are other legitimate cannabis-based medicines already available and being developed.”
This statement is true in a one-size-fits-all sense, so we’ll rate it as GOSPEL TRUTH.
An FDA-approved synthetic THC product called Marinol is available, along with a few other Cannabidiol (CBD) products. But Talbott believes they fall short because “you need the cannabinoids working in concert for the entourage effect.”
“The products out there that have only one or two of the cannabinoids, such as THC or CBD, are not enough. It’s a good start, but doesn’t work well enough,” Talbott said, noting the more than 100 phytocannabinoids plus terpenes or volatile organic compounds that work in concert to affect the human endocannabinoid system.
Contact reporter Cathy McKitrick at 801-625-4214 or firstname.lastname@example.org. Follow her on Twitter at @catmck.