Regulators crafting Louisiana's medical marijuana policies affecting physicians expressed concern Monday that key rules still need to be revised, while the growing number of state-approved treatable conditions will likely cause the state’s nascent program to grow significantly.
Questions linger about how the drug will be administered, such as determining the appropriate dosage for a 30-day supply, and whether to lift an existing cap on the number of patients that doctors can recommend to be treated using medical marijuana.
Currently, the Louisiana State Board of Medical Examiners has a 100-patient cap on each doctor, a limitation that some industry advocates believe could hamstring the program once the program begins in earnest. The board discussed the possibility of lifting that cap, possibly as much as threefold, but no action was taken.
At the board's first meeting since the new laws expanding treatable conditions were approved, several members acknowledged that revising the policies was likely the board's biggest task of the year.
“We want to get ahead of this and make sure that we flesh out some of these issues,” said Dr. Christy Valentine, the board’s president.
At least one member expressed skepticism about the use of marijuana for treating some of the newly-approved medical conditions.
“This is a huge mess, an absolute huge mess,” said Dr. Mark Henry Dawson, who questioned whether the program would continue expanding, and was critical of whether marijuana is an appropriate treatment option in many of the circumstances.
Determining an appropriate dosage for a 30-day supply of marijuana is an issue that needs to be resolved by the board in the coming months. State law allows for a physician to recommend marijuana for a patient — rather than write a prescription, a delicate workaround because marijuana remains illegal under federal law — but it’s limited to a 30-day supply.
Recommending what's needed to alleviate one person’s condition may be different for another, creating a gray area that needs to be resolved.
“It depends on how much the patient wants to take. That’s the issue,” Philip Bergeron, an attorney for the board, said at the meeting.
Even though some members questioned, to varying degrees, whether the state Board of Medical Examiners needed to be at the helm of setting the rules, Bergeron acknowledged that the program was created by lawmakers and regardless of board members’ personal views of marijuana, it was up to them to regulate it.
“The Legislature has spoken, and since the Legislature has deemed this to be the case, the board is obligated to follow the law,” he said.
Recent legislation signed by Gov. John Bel Edwards has expanded the once-narrow program into a model that’s closer to a full-blown medical marijuana industry seen in other states, experts say, a move that they believe could grow the industry by millions of dollars.
Newly-added conditions made eligible for medical marijuana in Louisiana include intractable pain, glaucoma, severe muscle spasms, PTSD and Parkinson’s disease, as well as some people with autism spectrum disorder.
The original list of eligible treatments was limited to cancer, HIV, AIDS, cachexia or wasting syndrome, seizure disorders, epilepsy, spasticity, Crohn's disease, muscular dystrophy or multiple sclerosis.