NOTE: The Liquor Control Board (LCB) has been working with the departments of Revenue and Health to develop recommendations for the Legislature regarding the interaction of medical marijuana regulations and the emerging recreational marijuana system. The WSMA is currently reviewing and assessing the draft recommendations the Liquor Control Board recently released. The WSMA will submit comments regarding the recommendations. The final LCB recommendations will be released by January 1, 2014. Check back for more information as this issue develops.
Since the passage of Initiative 692 in 1998, Washington State law allows some patients and their primary care givers who have certain qualifying conditions to possess and use a limited amount of marijuana for medical use. It is still against federal law to obtain, possess, or cultivate marijuana for any purpose. Marijuana is currently classified as a Schedule I drug, which means that it has no generally recognized medical use.
SB 5798, passed by the legislature in March, 2010, adds additional health care professionals to those who may authorize the use of medical marijuana. Besides physicians, the following licensed health care professionals may authorize use of medical marijuana:
- Physician assistants;
- Osteopathic physician assistants;
- Naturopaths; and
- Advance registered nurse practitioners.
In addition, SB 5798 also sets out criteria for tamper resistant paper that must be used for the authorization. The paper must meet one or more of the following industry-recognized features:
- One or more features designed to prevent copying of the paper; or
- One or more features designed to prevent the erasure or modification of the information on the paper; or
- One or more features designed to prevent the use of counterfeit valid documentation.
Note: SB 5798 also amends the statute so a copy of the authorization from a health care provider is no longer considered to be a valid authorization, a copy of the patient's medical records is no longer a valid substitute for a signed authorization from a physician or other authorized licensed health care professional, and requires a date on the authorization form.
Who is a qualifying patient?
A patient must be under the care of a health care professional (MD, DO, PA, ARNP or ND) licensed in Washington state, must be diagnosed by that health care professional as having a terminal or debilitating condition, must have been a resident of Washington state at the time of diagnosis, must have been advised by that health care professional of the risks and benefits of the medical use of marijuana, and was advised by that health care professional that he/she might benefit from the medical use of marijuana.
What terminal or debilitating conditions qualify?
The law is very specific about the conditions for which the medical use of marijuana might be appropriate. They are:
- Human immunodeficiency virus (HIV);
- Multiple sclerosis;
- Epilepsy or other seizure disorder;
- Spasticity disorders;
- Intractable pain which is unrelieved by standard medical treatments and medications;
- Glaucoma, either acute or chronic, limited for the purposes of this law to mean increased intraocular pressure unrelieved by standard treatments or medications;
- Crohn's disease with debilitating symptoms unrelieved by standard treatments and medications;
- Hepatitis C with debilitating nausea or intractable pain unrelieved by standard treatments or medications; or
- Chronic renal failure; or
- Any disease, including anorexia, which results in nausea, vomiting, wasting, appetite loss, cramping, seizures, muscle spasms, and/or spasticity, when these symptoms are unrelieved by standard treatments or medications.
The Washington State Medical Quality Assurance Commission (MQAC) may approve other conditions. Check their site for more information.
What is a limited amount?
The law is not very specific; it only states that a qualifying patient or designated provider may possess no more than fifteen (15) cannabis plants and (i) no more than twenty four(24) ounces of useable cannabis; or (ii) no more cannabis product than what could reasonably be produced with no more than twenty four (24) ounces of useable cannabis; or a combination of useable cannabis and cannabis product that does not exceed a combined total of twenty four (24) ounces of useable cannabis. If an individual is both a qualifying patient and a designated provider for another qualifying patient, the individual can possess no more than twice the amounts described above.
What does the law allow physicians and the other licensed health care professionals to do?
The statute protects physicians and the other listed health care professionals from being penalized under state law for advising a qualifying patient about the risks and benefits of the medical use of marijuana and providing a qualifying patient with documentation that the medical use of marijuana might be beneficial.
Does this mean that physicians or the other licensed health care professionals may prescribe marijuana?
No, physicians or the other authorized licensed health care professionals must not prescribe marijuana. It is prohibited under federal law to knowingly or intentionally distribute, dispense or possess marijuana. The terms "distribute" and "dispense" have been broadly interpreted, and physicians and the other authorized licensed health care professionals may be found in violation of federal law for writing a prescription for a substance, such as marijuana, for which federal law has no recognized medical use. Violation of federal laws can bring significant penalties, including imprisonment and fines. In addition, violating federal law (or aid and abet in its violation) may result in other federal sanctions, such as a revocation of a health care provider's DEA registration.
What documentation should physicians or the other licensed health care professionals give to qualifying patients?
The law defines valid documentation as a statement signed and dated by the qualifying patient's physician, or one of the other authorized licensed health care professionals, written on tamper-resistant paper, which states that, in the physician's (or other listed licensed health care professional's) professional opinion, the patient may benefit from the medical use of marijuana. Valid documentation also includes proof of identity such as a Washington state driver’s license or identicard as defined in law.
Must a physician authorize the use of medical marijuana?
No, there is nothing in the law that requires any physician, or any of the other listed licensed health care professionals, to authorize the use of medical marijuana for a patient.