Louisiana’s governor’s race: What the candidates say about medical marijuana

Louisiana Republican gubernatorial candidates Eddie Rispone and Ralph Abraham are more reserved about medical marijuana than Democratic Gov. John Bel Edwards is. The three men will run against each other in a statewide election in October.

Four years ago, the state Legislature legalized the use of marijuana for medicinal purposes, making Louisiana the first state in the Deep South to authorize a medical marijuana program. Since then, patients have been waiting for the drug to reach the market, as the state's program faced multiple delays.

On Tuesday, one of the state's two growers will finally release the first round of marijuana tincture bottles to pharmacies, which will start doling the medicine out to patients. 

The state's medical marijuana law includes reams of restrictions. It only allows for two growers of the drug: the Agricultural Centers at LSU and Southern University. Regulators have handed out nine licenses to pharmacies that will dispense the drug in regions throughout the state. Around 80 doctors were licensed to "recommend" the drug to patients as of late July. 

Medical marijuana has technically been legal since 1978 in Louisiana, but the state had no framework for dispensing it before 2015. Since then, more legislative changes and repeated delays have kept product from reaching the market — until now.

Here are some answers to common questions about the program. 

Finally, I can get it and light up, right?

The drug can only be sold under Louisiana law in certain nonsmokable forms. 

For now, the product will only be available in a tincture mixed with coconut oil. There are three different formulations in the first batch, with varying levels of THC, the compound that elicits psychoactive effects. 

Patients will put the recommended liquid dose of tincture under their tongue and let it dissolve.

GB Sciences, the company hired by LSU to grow the plant, said it is looking into selling the product in other forms besides tinctures. The Legislature recently softened its laws slightly, allowing for use of metered-dose inhalers to ingest the drug. 

State law also allows the medication to be dispensed in a liquid, capsules or pills, chewables, topical applications, trans-dermal patches or suppositories. 

When can I get it? 

GB Sciences and LSU will release the first shipments of products to pharmacies Tuesday. Multiple pharmacy owners said they have a waiting list and are advising patients to wait until they are contacted with information that their medicine is ready to be picked up. 

It will also depend on where you live. Baton Rouge's marijuana pharmacy, Capitol Wellness Solutions, will open Tuesday. The northshore region pharmacy, in Madisonville, will also open Tuesday, while the Lafayette pharmacy will open Wednesday. 

The only pharmacy in the New Orleans region, H&W Drug Store, will not open until Aug. 12, said owner Ruston Henry. He will do a soft open for specific patients by appointment only this week. 

In the coming weeks, GB Sciences said it will be harvesting more crops, beginning the process of manufacturing its next batch of tinctures. The products must be tested multiple times by the Louisiana Department of Agriculture and Forestry before being released to patients. 

John Davis, president of GB Sciences Louisiana, said the firm will hold back some of its inventory to control the supply chain during the first release of product. Still, Davis and pharmacy owners say they are confident there will be enough product to meet initial demand. 

How do I know if I qualify for medical marijuana?

Medical marijuana is available to people with a qualifying medical condition. 

Under state laws, which have been loosened since first being enacted in 2015, the drug is available only to people with these conditions: intractable pain, cancer, AIDS, Cachexia or wasting syndrome, seizure disorders, epilepsy, spasticity, Crohn's disease, muscular dystrophy, multiple sclerosis, glaucoma, severe muscle spasms, PTSD, Parkinson's and certain people with autism spectrum disorder.

Can my doctor prescribe medical marijuana?

Doctors will technically not "prescribe" the drug. Instead, authorized doctors will issue "recommendations" (as opposed to prescriptions) — an effort to assuage fears from physicians groups that they may be putting their medical licenses in jeopardy because marijuana remains illegal under federal law.

So far, 84 doctors have received permission from the Louisiana Board of Medical Examiners to recommend marijuana to eligible patients. A list is available at https://online.lasbme.org/#/verifylicense. (Under "practitioner type," select "therapeutic marijuana registration permit." Then select "active" under the "license status" tab.  

To get access to medical marijuana, patients need a recommendation from one of those qualifying doctors. 

Then I just pick it up at the pharmacy? 

Not just any pharmacy. There are only a few that are authorized to dispense the drug. 

The Louisiana Board of Pharmacy has handed out nine initial licenses for medical marijuana pharmacies in different regions throughout the state: Baton Rouge, New Orleans, Lafayette, Houma, Lake Charles, Alexandria, Monroe, Shreveport and the north shore.

A 10th permit will be handed out sometime in the future in a high-demand area. Here are the approved pharmacies in south Louisiana and their locations: H&W Drug Store, 4718 Paris Ave., New Orleans; Capitol Wellness Solutions, 7491 Picardy Ave., Baton Rouge; The Apothecary Shoppe, 620 Guilbeau Road, Suite A, Lafayette; Willow Pharmacy, 1519 Highway 22 West, Suite 5, Madisonville; Green Leaf Dispensary, 6048 W. Park Ave., Houma; and Medicis LLC, 1727 Imperial Blvd., Building 4, Lake Charles.

How much will it cost? 

Medical marijuana is not covered by insurance. That means patients must pay for the drug out of pocket. 

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Randy Mire, owner of the Baton Rouge area pharmacy, Capitol Wellness Solutions, said the prices will range between the $90s and nearly $200 per 30mL bottle, depending on the formulation. 

The bottles with a higher THC content will be the most expensive, Mire said. Other pharmacies are expected to have similar prices. 

Other retail pharmacies are setting their prices independently, but they are expected to be similar to Mire's. The Monroe area pharmacy owner told a TV station its highest-priced bottle will be $250.

What if I don't live anywhere close to a pharmacy?

As of now, there are no plans for additional pharmacies. The Louisiana Board of Pharmacy is expected to eventually hand out a 10th permit for a marijuana pharmacy in a high-demand area. 

Beyond that, lawmakers will have to change the law to allow for additional pharmacies to open. 

Will I get high?

The tincture bottles do include THC, the compound of the marijuana plant that gets users high. The amount of THC varies depending on the formulation. 

Davis said individual patient experience and tolerance "profoundly influence the recommended starting dosages and the potential effects on the body." He said there are medical reports of patients consuming 1 mg of THC who experience a "high" and symptom relief, while others consume as much as 2,000 mg of THC to achieve relief. 

He said patients should consult their doctor to discuss finding the optimal dosage and formulation. The best practice, Davis said, is to "start at a low dose, go slowly, and stay at a low dose." 

The first release includes three distinct formulations of the drug. One will include a higher level of THC, the compound in marijuana that elicits psychoactive effects. That formulation is recommended for patients with intractable pain, Parkinson's, glaucoma, PTSD and others conditions, according to a paper released by GB Sciences.

Another formulation includes higher levels of CBD, the compound that does not elicit a high. That formulation is designed for patients with epilepsy and seizure disorders, as well as Autism spectrum disorder. There is also a "balanced" formulation recommended for patients with intractable pain, multiple sclerosis and muscular dystrophy. 

Who grows it?

State law only allowed LSU and Southern University to grow the drug in Louisiana. Both universities then hired private companies to handle their growing operations. 

LSU picked GB Sciences, which is the company rolling out product this week. The firm faced repeated delays and clashed with state agriculture regulators over rules for their operations. 

Southern picked Advanced Biomedics, but the company made virtually no progress before a majority majority stake was sold late last year. The new company, Ilera Holistic Healthcare, said it is aiming to have product available this fall. 

Patients are not allowed to grow plants on their own. 

How big a deal is this?

One market research firm estimates the North American legal cannabis market will attract $16 billion this year.

Louisiana's industry represents only a small fraction of that. But investors here, including those opening marijuana patient clinics and nine state-approved pharmacies, hope getting in on the ground floor will pay off eventually as the sector grows.

Louisiana's program is also unique because universities are deeply involved in producing the drug. That has raised the possibility of large-scale studies and research — something the medical marijuana field has lacked. 

Early estimates of how many patients would use the drug in Louisiana ranged from less than 2,000 patients to north of 20,000. Davis, of GB Sciences, said he expects between 5,000 and 10,000 will seek the drug in the first months of the program, but the market will mature to between 100,000 and 150,000. 

Will products be taxed?

Not at the consumer level. Originally, medical marijuana was set to be taxed because it was not technically a "prescription," which are exempted from sales taxes in Louisiana. However, lawmakers passed a bill this year that specifically excludes medical marijuana from state sales taxes. 

The drug will still have a 7% fee assessed at the wholesale level. That money is now dedicated to services for people with disabilities. 

What's the future hold?

The medical marijuana law is set to "sunset," or expire, in 2025. 

That means lawmakers must vote to extend the program before then, otherwise it will stop being legal in Louisiana. 

Advocates still want to see the program loosened. Some want to see lawmakers allow marijuana that can be smoked or vaped. Bills are introduced each year in the Legislature to loosen laws surrounding medicinal marijuana and to allow for recreational marijuana. The GOP-led Legislature has so far been reluctant to do so.

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Email Sam Karlin at skarlin@theadvocate.com