Lawmakers Hope To Provide Vermonters With 'More Realistic Access' To Medical Marijuana

Nov 16, 2016

More than 2,000 people in Vermont are enrolled in the state’s medical marijuana registry, but some lawmakers say many eligible patients still have trouble obtaining medical cannabis.

Proposed legislation would lower some of the barriers to access.

Bennington County Sen. Dick Sears, chairman of the Senate Judiciary Committee, got an email last week from a 70-year-old constituent with glaucoma.

“He can’t get his eye doctor to fill the card that he needs in order to get medical marijuana, because evidently the eye doctor isn’t as familiar with the program as he could be,” Sears says.

Vermont’s medical marijuana law has undergone numerous changes since lawmakers first adopted the program back in 2004. The state now has four medical marijuana dispensaries. And the list of conditions eligible for legal cannabis treatments has grown considerably.

Sears, however, says stories like the one from his elderly constituent demonstrate that hurdles to remain. And he says a bill he and others plan to introduce in January will help patients clear them.

“It just provides more realistic access and more conditions that might be able to be treated … with medical cannabis,” Sears says.

The latest version of the bill would open up the legal cannabis pipeline to people suffering from post-traumatic stress disorder and Parkinson’s disease. It would, in fact, allow a patient to qualify for the registry for any medical condition or symptom, so long as their doctor thinks cannabis might help ease their suffering.

"It just provides more realistic access and more conditions that might be able to be treated ... with medical cannabis." — Bennington County Sen. Dick Sears

Expanding the list of eligible conditions, however, won’t solve the problem for Sears’ constituent. Glaucoma is already on the list of eligible conditions.

The problem, Sears says, is that the man’s doctor is unwilling to provide the physician’s signature needed for him to get his medical cannabis card.

Sears says that by requiring doctors to get formal training on the cannabis registry as a treatment option, previously reluctant doctors will be more open to signing off.

“Providing information is powerful,” he says.

Information may indeed be powerful. But the language in the bill might not necessarily have the intended effect.

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Dr. Patricia Fisher, the Medical Director of Case Management and Medical Staff Affairs at the University of Vermont Medical Center, told Sears and other lawmakers this week that she’s familiar with the medical marijuana registry. She’s signed off on access to medical cannabis for three patients so far.

But Fisher says knowledge of the registry isn’t enough to convince doctors that it is an appropriate option for their patients.

“The tricky thing with marijuana for physicians is there’s not a lot of evidence in the literature for what it’s used for,” Fisher said.

Fisher says there are only two approved medical uses for cannabis — nausea prevention and appetite stimulation.

And just because a patient has glaucoma, for example, doesn’t mean a physician is going to feel comfortable facilitating their access to medical cannabis, according to Fisher.

“I don’t know if it’s actually going to help his glaucoma. I don’t know if it’s going to help with whatever symptom relief he’s looking for,” Fisher said.

Existing law requires doctors to have at least a three-month relationship with their patients before they can sign off on access to the registry. The new legislation ponders doing away with that requirement in certain instances.

"The tricky thing with marijuana for physicians is there's not a lot of evidence in the literature for what it's used for." — Dr. Patricia Fisher, UVM Medical Center

Fisher told lawmakers that marijuana isn’t a harmless drug, and that they’ll want to contemplate the consequences of their legislative actions.

“[An] 18 year old with low back pain from a soccer injury — are they going to be able to get medical marijuana? I’m not sure we want to start that,” Fisher said.

More liberal medical cannabis laws in places like California and Colorado served as end runs to legalized recreational marijuana use. Sears says residents need not worry about that happening here.

“Vermont hasn’t gone the route of California or Colorado, and this proposed legislation wouldn’t put us anywhere in that realm,” Sears says.

The proposed legislation would also increase the number of dispensaries in Vermont, from four to six. And it would allow patients to purchase up to three ounces of marijuana, instead of the existing cap of two ounces.

The legislation would also allow medical cannabis dispensaries to operate at for-profit enterprises – they’re currently required to be nonprofit.

Additionally, the bill would allow dispensaries to grow cannabis outdoors in secure facilities hidden from public view. Existing law requires cultivation to occur indoors.