A new bill that proposes changes to the Utah medical cannabis program will be brought before the 2021 Utah Legislative session in January. It expands the number of Qualified Medical Providers (QMP) and adds cannabis to the Utah controlled substances database. In this article I will define the recommendation letter and the affirmative defense letter. I will also discuss why physicians have been reluctant to become medical cannabis providers and the new guidelines for QMPs. Finally, I will explain why cannabis has been added to the controlled substances database.
There are two provisions of the Medical Cannabis Act that will be rescinded on December 31, 2020. Starting on January 1, 2021 all Utah medical cannabis patients will be required to have a state-issued medical card and may purchase products only from Utah pharmacies.
Recommendation Letter
On March 25, 2020 the Utah Department of Health (UDOH) announced that the Utah Legislature finalized a new law signed by Governor Gary Herbert. It allowed qualifying patients to use a recommendation letter rather than a medical cannabis card in order to purchase medical cannabis until December 31, 2020. They must adhere to the following rules:
- Patients must present the letter at the pharmacy and it must be supplied by an approved licensed medical professional
- All medical cannabis must be purchased from the same pharmacy (dispensary) until the receipt of their medical cannabis card from the UDOH
- Patients must be a resident of Utah
- The pharmacy must also have received confirmation from the medical provider to validate the letter
- Patients must show a valid photo ID at the pharmacy; driver’s license, passport, passport card, or US military ID card.
Affirmative Defense Letter
Any licensed physician may issue an affirmative defense letter to qualifying medical cannabis patients after a review of their medical records. This letter protects them from prosecution for cannabis possession. They can purchase cannabis outside Utah and bring it across state lines which is technically a federal crime. Without the letter, patients could face criminal charges for cannabis possession.
More Utah Providers Will Be Able To Recommend Medical Cannabis
The bill was heard on November 18, 2020, by the Interim Health and Human Services Committee and will be presented for consideration at the next Utah Legislation Session in January 2021. It would expand the number of providers allowed to recommend medical cannabis to qualifying patients. It is sponsored by two Republican lawmakers; State Representative Ray Ward, (R-Bountiful) and State Senator Majority Leader Evan Vickers.
Legislators did not anticipate how popular the program would be. As a result, they did not educate enough medical providers on medical cannabis usage. This has led to a shortage of providers willing to recommend cannabis and to many frustrated prospective patients who are forced to spend time and money finding a QMP.
There are several major reasons for the lack of certifying providers:
- They have been taught that cannabis is a “dangerous drug”
- There is pressure inside and outside the medical field discouraging them from prescribing a “dangerous drug”
- They are prohibited from advertising that they are QMPs
- They do not feel they are educated enough to recommend cannabis
- Due to the language in the law, there is still much confusion about what is legal
- Many feel that the existing Utah law fails to adequately protect them from prosecution or liability
- They object to completing the licensure and paperwork required to service small numbers of patients. There is an initial fee of $100 and a 4-hour training session with the UDOH to become a QMP.
The new ruling would allow:
- Providers who forego the training to serve up to 15 patients
- Providers who complete specialized state training to serve up to 275 patients
- Providers to refer a patient directly to a pharmacy and at the discretion of the provider, the pharmacy may enter the patient into the system and make dosage recommendations.
The new legislation does not allow for the addition of any qualifying conditions nor will there be an increase in monthly limits.
Addition of Cannabis to the State-Controlled Substances Database
One of the provisions of the bill would be to add cannabis to the Utah State-Controlled Substances database. Representative Ward, a family practice physician, sees this as a positive development. He believes it is a good way to get more providers to feel comfortable recommending cannabis if it is treated like a narcotic or like any other controlled substance. Furthermore, he thinks this will help attract larger numbers of providers by giving them more credibility. Many were worried that they would be perceived as running “cannabis specialty clinics.”
Moreover, he defends its addition into the controlled substances database by equating cannabis to other medicines like narcotics. “If this is a medicine, let’s treat it like a medicine. Other controlled substances are in the controlled substances database,” said Rep. Ward, who has recommended cannabis usage to many of his patients.
In addition, he believes that having cannabis on the controlled substances list ensures that providers and pharmacies will not be subject to patients who are merely looking for a doctor who will easily recommend medications.
However, many patients are very unhappy about the idea of having their names appear in the state database which will be available to law enforcement officers. They want to be assured that safeguards will be in place to protect them from scrutiny by the police by requiring officers to obtain a warrant in order to examine the database.
Senator Vickers quelled any prospects of considering cannabis decriminalization by saying that the Utah Legislature had no plans to address such a proposal in 2020.
Sources:
fox13now.com, More Utah Doctors Will Be Able To Recommend Medical Cannabis Under New Bill, Ben Winslow, Nov. 17, 2020
hightimes.com, Utah Lawmakers Considering Medical Cannabis Program Expansion, Thomas Edward, Nov. 18, 2020
hightimes.com, Utah Lawmakers Amend Medical Cannabis Laws To Grant Access To More Patients, Thomas Edward, March 26, 2020
kutv.com, Medical Cannabis Law Doesn’t Require Some Physician Letter Referral Regulation Until 2021, Jim Spiewak, Nov. 21, 2019
fox13now.com, Utah Doctors Can Recommend Medical Cannabis, But Patients Struggle To Find Those Willing To, Ben Winslow, Nov. 17, 2020
deseret.com, Utah’s New Medical Marijuana Program More Popular Than Officials Expected, Ashley Imlay, Sept. 27, 2020
