Mapping medical marijuana: state laws regulating patients, product safety, supply chains and dispensaries, 2017

Abstract

Aims 1) To describe open source legal datasets, created for research use, that capture the key provisions of U.S. state medical marijuana laws. The data document how state lawmakers have regulated a medicine that remains, under federal law, a Schedule I illegal drug with no legitimate medical use. 2) To demonstrate the variability that exists across states in rules governing patient access, product safety, and dispensary practice. Methods Two legal researchers collected and coded state laws governing marijuana patients, product safety, and dispensaries in effect on February 1, 2017, creating three empirical legal datasets. We used summary tables to identify the variation in specific statutory provisions specified in each state’s medical marijuana law as it existed on February 1, 2017. We compared aspects of these laws to the traditional Federal approach to regulating medicine. Full datasets, codebooks and protocols are available through the Prescription Drug Abuse Policy System (http://www.pdaps.org/; http://www.webcitation.org/6qv5CZNaZ). Results Twenty-eight states (including the District of Columbia) have authorized medical marijuana. Twenty-seven specify qualifying diseases, which differ across states. All states protect patient privacy; only 14 protect patients against discrimination. Eighteen states have mandatory product safety testing before any sale. While the majority have package/label regulations, states have a wide range of specific requirements. Most regulate dispensaries, with considerable variation in specific provisions such as permitted product supply sources, number of dispensaries per state and restricting proximity to various types of location. Conclusions The federal ban in the USA on marijuana has resulted in a patchwork of regulatory strategies that are not uniformly consistent with the approach usually taken by the Federal government and whose effectiveness remains unknown.

Impact of co-administration of oxycodone and smoked cannabis on analgesia and abuse liability

“…Another significant consideration is that the current study used smoked cannabis because this is the most common method of medical cannabis use [52]. However, the therapeutic utility of smoked cannabis may be limited by respiratory risks including chronic bronchitis [53], the presence of combustion by-products [54,55], a lack of regulation regarding medical cannabis strength (i.e., THC concentration) and other cannabinoid content [56], and subjective effects related to abuse liability which are not as apparent with other methods of administration (i.e., [47]). Adverse respiratory effects and combustion by-products would be avoided by vaporizing cannabis [61,63,64], while the superior bioavailability of THC afforded by the intrapulmonary route relative to oral administration would be preserved [57].…”

Diverse TRPV1 responses to cannabinoids

“…Unregulated "medical marijuana" use for pain covers multiple demographics and disorders, even reaching historically underserved groups such as seniors facing undertreatment of pain at end-oflife [23]. However, safety, efficacy, and consistency of plant-derived medicines such as medical Cannabis do not yet approach traditional pharmaceutical standards for widespread therapeutic deployment [16,[24][25][26][27][28]. Thus, there is a need for well-defined compositions of secondary metabolites from Cannabis that selectively relieve pain.…”

De Facto or De Jure? Ethnic Differences in Quit Responses to Legal Protections of Medical Marijuana Dispensaries

“…State medical marijuana laws differ along a variety of dimensions, which have been discussed at length in several prior studies (Bradford and Bradford, 2018;Klieger et al, 2017;Pacula et al, 2015;Pacula and Smart, 2017;Sabia and Nguyen, 2018;Wen et al, 2015). While little is known about the extent to which many of these dimensions are associated with access by recreational users (Pacula et al, 2015;Smart, 2016), those related to dispensaries have received the greatest research attention given their demonstrated association with changes in prices, potency and market size (Anderson et al, 2013;Sevigny et al, 2014;Smart, 2016).…”

“…The rules and regulation surrounding the licensing of retail sale and distribution of medical marijuana has become more complex and burdensome. For example, the vast majority of states today regulate dispensary density, location and product source, while nearly half also regulate stocking levels (Klieger et al, 2017). Structural requirements for dispensaries, cultivators, and processors are also imposed, with regulations related to safety and security, ventilation systems, hand washing stations, and even disposal.…”

“…Today, legal protections provided to patients and suppliers through MMLs differ along a variety of other dimensions as well, including covered illnesses, registration requirements, cultivation allowances and rules, product safety and licensing (Klieger et al, 2017). The specific privileges and requirements related to each of these dimensions have also varied widely across states and even within states over time.…”