Blue Flower

Four Years ago, Medical Marijuana was signed into Ohio law, It still needs a lot of work! As the Executive Director of Ohio Patient Network (OPN), I testified more than anyone else, was asked more questions by the legislators, and have continued to push the bureaucrats running the program to make it even better. But as I have said, there is a lot more work to do! You can help by speaking up to the legislative candidates that are running for office this fall. You can also help OPN by making a tax-deductible donation or by adding Ohio Patient Network to your Amazon account using their donation program at Smile.Amazon.com, and they will make a small donation based upon purchases. Best Wishes to all, and let us all work to make this law a better one for all of Ohio.

Frankly, it should just be legalized.

The Board of Pharmacy has proposed a series of changes to Ohio's Medical Marijuana Control Program. The main change is eliminating the confusion between the 90 day supply and the 1 day supply.  Ohio Patient Network has complained several times about the current rule and what I would call "Dazed and Confused Cannabis Math."  They have made the rules consistent now, so after it goes into effect when you purchase a one day supply, it will count as 1 day and not 2, as it does currently.  It changes a one day supply to 2.52g from 2.83g.  You can listen to their discussion on this matter, starting at time mark 7:30 minutes via the link at the bottom of this writeup.  
 
There are also collapsing to a single Tier system, rather than the current two Tier system and going to a split 45 day system.  Both of these items caused a lot of confusion, so eliminating confusion is a good thing, generally speaking. On the other hand, they are decreasing the 90 day supply limit from 10 oz Tier I or 6.6 oz Tier II to 8.9 oz regardless of the percentage THC for those that are terminally ill.   Note the original rules were a confusing mess from the start.
 
In addition to the above, there is a simplification regarding how a Veteran Identification is supported, along with other rules being amended that are listed below.
3796:7-1-01: Provides the definitions for the rule chapter on medical marijuana patients and caregivers.
3796:7-2-01: Provides for a process for medical marijuana patient registration.
3796:7-2-04: Establishes the process for the purchase of medical marijuana.
3796:7-3-01: Establishes the fee structure for patients and caregivers.
3796:8-1-01: Provides the definitions for the medical marijuana form and method chapter.
3796:8-2-03: Defines forms and methods of medical marijuana that may be attractive to children.
3796:8-2-06: Provides the requirements for portions, dosing, and units of medical marijuana sold at a dispensary.
And the totally new rule replacing the old rule 90 day supply is 
3796:8-2-04: Establishes the maximum 90-day supply for all approved forms of medical marijuana. 
 
To read the actual proposed rules text use this link or the URL below see 
https://www.pharmacy.ohio.gov/Documents/LawsRules/ProposedRules/CommonSense/CSI%20-%20BIA%20-%20Medical%20Marijuana%20(Comments%20Due%205.25.20).pdf
 
To watch the video Board of Pharmacy discussion made available by Ohio Cannabis Live see the video on Facebook at 
 
You can comment on these changes by sending your comments by May 25th to both of the following email addresses 
This email address is being protected from spambots. You need JavaScript enabled to view it. and This email address is being protected from spambots. You need JavaScript enabled to view it.
It is important to send comments to both emails above.

With the Ohio Medical Marijuana Program somewhat operational, below are a list of issues that needs correction. The biggest issue is the extreme cost of medical marijuana here in Ohio.

At last report, there were 83,857 recommendations with 78,376 registered patients and 55,617 Unique Purchasers who on average has made a little over 8 purchases at an average of $128.70. Given all that information, there are a number of serious concerns that are strangling the program’s success.

• Foremost is the excessive cost due to extraordinary high fees on the various business operations. This is directly reflected in the low number of purchases that have been made to date.

• The extremely slow process of the program becoming operational has caused patients to lose faith in the Ohio government's commitment to making this program a success. The administrative burden on the dispensaries has made long delays in making the program operational.

* Distance to the nearest dispensary is still an issue for some as a consequence of the slow process.

* Extra delays effectively increases the cost burden on the patients.

• The 90-day supply tracking program has been a mess. I commend Grant Miller for stepping in where he can and fixing individual patient’s records, but the system needs a major overall and to be simplified. OPN suggest a 90-day rolling average versus the current system that is prone to error and has everyone confused.

* Here is a small example, buying a one-day supply of three different Tier I products counts as 6 days. Hopefully, with proposed change to the rules on 3796:8-2-04 Part A and Part B of the supply rule will fix that issue.

* Buying a one-day unit of Tier I 45 days in a row will cause you to be locked out for the rest of the period.

• The depth of knowledge by the dispensary agents is uneven, some are knowledgeable, and some are not.

* Improve the educational level of dispensary agents and state employees as well. Perhaps attending some of the better conferences would be a benefit.

* There have been heavy-handed limits by the pharmacy board regarding educating the patients.

• The lack of reciprocity with other states, in particular with Michigan, Pennsylvania, and West Virginia is lacking and should be finalized by this time.

• Law enforcement needs training for interacting with card holding patients with marijuana or marijuana from an out of state source.

• Good product labeling is important for those with food sensitivities. Suggest similar format to foods or supplements to include active and inactive ingredients

• Bedridden patients have a very difficult time to obtain a Medical Marijuana Recommendation. OPN recommends a change in the law to the State Legislature regarding Doctor's in-person only visit. There are homebound patients that cannot physically get to a remote doctor for a recommendation. OPN recommends a temporary emergency rule change to cover this situation.

• The Common Sense Initiative (CSI) review has been blind to the administrative burden that has been implemented.

Below are a few items of note for the Ohio Medical Marijuana Control Program. The most important right now is that CTR doctors can use Telemedicine during the ongoing Coronavirus situation.

1) The State Medical Board of Ohio (SMBO, Medical Board) met on Wednesday, March 18, 2020, and voted on allowing Physicians to respond and provide essential health care during the COVID-19 pandemic use of Telemedicine for renewal or making recommendations. As of March 18, 2020, the Medical Board suspended enforcement of any regulations requiring in-person visits between providers and patients.

2) The 90 day supply issue was supposed to have been simplified by this time, but it appears that it has not.

3) The last is important for those whose recommendations are to expire soon. You may not be able to purchase any Medical Marijuana even though your card says it not expired. The expiration date on your card is not the same as the original recommendation. For instance, if your card expires on 4/30/2020, but your initial recommendation from your doctor was on 4/15/2019, and then if you attempt to purchase on 4/20/2020, you will be denied. This is another example of the convoluted and frustrating rules here in Ohio.

Ohio Patient Network has once again submitted a formal petition to the Ohio Medical Board to add Opioid Use Disorder (AKA Opiate Addiction) to the list of conditions where Medical Marijuana may be recommended by an Ohio Certified Physician.  The biggest impact should be on patients using a pain clinic.  
 
Currently, Pain Clinics force patients to sign a “Pain Contract” that threatens termination of treatment for using Schedule one drugs such as black-market marijuana.  Note all Ohio authorized Medical Marijuana products are schedule II per HB523 and this should not be a concern to pain clinic doctors.  Unfortunately, they are either unaware or do not care and still threaten patients with treatment termination.  
 
There are enough studies and data (which have been provided to the Medical Board) that strongly indicate a large number of patients can either reduce or replace using opioids with cannabis.  This would be a very positive step in limiting the Opioid Overdose issue Ohio currently faces and help people live a more positive life.
 
We ask Ohio patients to talk to their Physicians and have them contact the Medical Board and approve the petition to add Opioid Use Disorder (AKA Opiate Addiction) to the list of conditions for the Ohio Medical Marijuana Control Program.
Ohio Patient Network has submitted a petition as passed by Ohio's Medical Marijuana law HB523 and as defined by the Ohio Medical Board (OMB) rules to add a qualifying condition. The rules laid out 5 requirements to be submitted; they are as follows..
 
  1. Information from experts who specialize in the disease or condition
  2. Relevant medical or scientific evidence pertaining to the disease or condition
  3. Consideration of whether conventional medical therapies are insufficient to treat or alleviate the disease or condition
  4. Evidence supporting the use of medical marijuana to treat or alleviate the disease or condition, including journal articles, peer-reviewed studies, and other types of medical or scientific documentation
  5. Letters of support provided by physicians with knowledge of the disease or condition.

We addressed each requirement in exacting detail and share them with you below.

Information from experts who specialize in the disease or condition
Opioid Use Disorder/Opioid Addiction is the physical and psychological reliance on opioids found in prescription pain medications and illegal drugs like heroin and fentanyl derivatives. Addiction occurs when dependence interferes with daily life. Symptoms include uncontrollable cravings and inability to control opioid use. People may experience whole body craving, sweating, euphoria or general angst. Some common effects are constipation, nausea, and death due to overdose. See complete response at http://www.ohiopatientsnetwork.org/Data/Petition/Section1.pdf

Relevant medical or scientific evidence pertaining to the disease or condition
Included in the attached Section 2 PDF file is a variety of government reports detailing the relevant medical evidence of Opioid Use Disorder with reference links to the original reports. The documents address the scope and the science of addiction, including a commentary by Nora D. Volkow, M.D., Director, NIDA and more. The attachment also includes the most recent report from the National Center for Health Statistics listing Ohio as the second-highest in the nation for overdose. See complete response at http://www.ohiopatientsnetwork.org/Data/Petition/Section2.pdf

Consideration of whether conventional medical therapies are insufficient to treat or alleviate the disease or condition
Opioid Use Disorder is a complex condition that is not easily treated successfully. The patient usually has other associated mental and/or physical issues. According to NIDA the relapse rate for patients going through drug addiction treatment ranges from 40% to 60%. Twelve Step Facilitation programs have mixed success and are not well documented. The indisputable fact that we have such a tremendous number of overdose deaths indicates that conventional medical therapies are insufficient. See complete response at http://www.ohiopatientsnetwork.org/Data/Petition/Section3.pdf

Evidence supporting the use of medical marijuana to treat or alleviate the disease or condition, including journal articles, peer-reviewed studies, and other types of medical or scientific documentation.
In New York and Illinois, doctors can recommend medical marijuana for conditions where they prescribe an opioid. Pennsylvania & New Jersey permit patients to use medical marijuana for Opioid Use Disorder. These studies show a significant reduction in opioid prescriptions in states with marijuana states vs non-marijuana states.  Included are newer studies done in 2019 that continue to show a significant reduction in opioid prescriptions in states with marijuana states vs non-marijuana states. Also included is a rebuttal of a study that undermined the numerous other studies' positive impact of Medical Marijuana on Opioid Use Disorder. You can also find reports that link medical marijuana to a reduction in the risk of opioid overdose and increased treatment retention. See complete response at http://www.ohiopatientsnetwork.org/Data/Petition/Section4.pdf

Letters of support provided by physicians with knowledge of the disease or condition.
Included in this section are PDF copies of physicians’ letters supporting adding Opioid Use Disorder/Opiate Addiction as a qualifying condition as well as a reference to 22 other Physicians. One is from Dr. Ethan Russo, a neurologist with drug development experiences and leadership positions in international research medical organizations. Dr. Blatman is an Ohio based pain practitioner and Dr. Sawyer is certified in Suboxone therapy. Dr. Kollman was co-author of the American Legion National 2017 Resolution that changed the policy towards medical marijuana in Veterans Administration Medical Facilities. Also included are three more Ohio Licensed physicians. All the physicians’ medical licenses have been independently verified and clear of any blemishes or negative reports. See Complete response at http://www.ohiopatientsnetwork.org/Data/Petition/Section5.pdf

 
  1. Opioid Addiction submitted as a Qualifying Condition for Ohio's Medical Marijuana Program
  2. FDA asking for your comments on Cannabis International scheduling
  3. Medical Board of Ohio playing fast and loose with the MMJ Petition process
  4. Medical Marijuana Patients Ongoing Items of Concern
  • You are here:  
  • Home