It’s not a question of if, but when medical marijuana will be allowed in Pennsylvania.
A bill to legalize medical marijuana in Pennsylvania could be voted on soon by the state Senate, which has approved medical marijuana before. The state House also gave the green light to the practice, most recently in a March 149-43 vote of support.
Gov. Tom Wolf has said he will sign medical marijuana into law once a bill is on his desk. He can’t do that until the House and Senate pass the same legislation, the sticking point that has delayed Pennsylvania from joining more than 20 other states in legalizing medical marijuana.
The Senate has held off on voting on the bill to review it and determine whether to make amendments.
The House’s bill would enable the state to license up to 25 growers and twice as many dispensaries. The eligible conditions — there are 17 — in the bill include cancer, epilepsy, glaucoma and post-traumatic stress disorder.
It could be taken in pills, oils and vaporized forms, but smokable medical marijuana would not be allowed.
Auditor General Eugene DePasquale praised legislative efforts to enable regulated medical use of cannabis in Pennsylvania.
“Such legislation is long overdue,” DePasquale said in a statement after the House’s March vote. “For the thousands of Pennsylvania children and adults suffering from seizures, uncontrollable pain and a host of other ailments, allowing the use of medical marijuana — with the appropriate regulations in place — could be life-altering.”
The long-debated issue is whether medical marijuana is beneficial to some patients. Legalizing the recreational use of marijuana is not on the table for discussion.
Regional medical care providers declined to comment on whether they would support medical marijuana and also would not discuss the different bills passed by House and Senate.
William Trescher, the chief of pediatric neurology at Penn State Hershey, said it is too soon to discuss how people could be prescribed for medical marijuana, because legislation is still tied up in Harrisburg.
“Our priority is to protect our patients, and we abide by the strictest regulations and laws to ensure patient safety, including those regarding medications,” Mount Nittany Health Director of Pharmacy John Rossi said. “According to the federal Drug Enforcement Administration, marijuana is a Schedule I controlled substance. We will not speculate on pending legislation, nor how decisions by lawmakers will translate in to how we care for our patients. Our mission is to make people healthier, and we will continue to do that every day.”
I think it can definitely be a benefit to some, but it is not the cure and not without its potential problems.
Geisinger Health System declined comment, and Penn Highlands Healthcare did not respond to requests for comment.
Trescher said evidence suggests that medical marijuana is “likely beneficial and probably going to work” for some conditions due to cannabidiol, a chemical extract from cannabis. Cannabidiol is also commonly referred to as CBD, which he said could help treat epilepsy.
“The belief is that CBD is the most effective compound for controlling seizures,” Trescher said.
He also noted that there are cannabis plants in Colorado and California in which marijuana is specifically bred to have high CBD content.
“A lot of people have reported benefiting from these plant-based concoctions,” Trescher said. “In fact, I have at least one patient who is on one preparation and the treatment with it has been linked to the treatment of the child’s epilepsy symptoms.”
The catch is that the plants will still have tetrahydrocannabinol, also known as THC, which is illegal. It may cause psychological effects such as disorientation and drowsiness at small doses. It can cause image distortion and psychosis at high doses, according to the federal government.
The risks of medical marijuana, Trescher said, are difficult to understand.
“There are children born to mothers who used marijuana during pregnancy, and it’s not definitive but there are indications the children born to mothers who used marijuana have some cognitive and behavioral problems,” he said. “That gives us some pause and concerns about the effects of marijuana for those children. Does marijuana have the same effect on a fetal brain as it does a 3- or 5-year-old, a teenager, an adult?
“There’s long been a lure that teens who abuse marijuana have potential problems, but even that data is not as clean as we’d like. We can’t a make grand, definitive pronouncement that it’s deadly and can cause you irreparable harm. It’s really an open question.”
A lack of data would also pose an issue for physicians.
“First of all, most compounds that we as physicians use, somebody else has religiously studied the benefits and side effects,” Trescher said. “We can read in a fairly quick way what it does and learn about it quickly. In this situation the data isn’t available for the average physician, so it’ll be different for us to prescribe this.”
Another challenge would be required training for doctors to certify medical marijuana users.
“If the state legislature puts in a requirement to go through four-hour training course, that’s going to be prohibitive,” Trescher said. “That’ll be a big hurdle to go through. I don’t want to complain, but we’re barraged with all kinds of training already. Just to maintain my status I have to take multiple courses. That’s just for basic stuff and not just my own learning. I can’t imagine everyone will just say they’ll take the course.”
Trescher also raised concerns over how the plants are grown and where liability lies if a person certified to use medical marijuana becomes ill.
“The biggest problem is pesticides, because companies growing plants don’t want insects destroying what they’re growing so they put on pesticides,” Trescher said. “How pure and free of other substances will it be? That’s something that needs to be addressed, related to what happens if a physician endorses a compound coming from Pittsburgh and my patient gets sick from it.”
Trescher repeated that medical marijuana could be beneficial but stressed it wouldn’t be the cure some might hope for.
“It can be a tool in treatment and probably can do the same for other conditions, but my concern is that people will think it’s a natural cure for epilepsy and that it’ll be better than all the pharmaceuticals we use,” Trescher said. “The things in cannabis are chemicals, just like the drugs we use now are chemicals. I think it can definitely be a benefit to some, but it is not the cure and not without its potential problems.”