Cannabis, CBD & Low THC Oil Part 2: Medical Marijuana legalities

First and foremost, we are not legal scholars or attorneys and the following should not be considered advice or recommendations. We strongly suggest you seek the advice from legal professionals or your local medical professional. The responsibility for any use of the following information, or for proper medical treatment, rests with you.

PART TWO of THREE PARTS on Cannabis, CBD and Low THC Oil.

General Legalities

As noted in last week’s Part ONE blog, documents dating to the early 1600's provide evidence that marijuana was brought to North America by the Jamestown settlers.  Marijuana, the American populace and the judicial system have had a complex, and at times, tumultuous relationship since.  The continued use of cannabis through Colonial times into the first century of US history led to the addition of marijuana to the US pharmacopeia in 1850 and later the passage of a marijuana tax act in 1937.  However, increasing concerns about its usage ultimately led to the removal of marijuana from US pharmacopeia in 1942.  Subsequent legislation including both the Boggs Act of 1952 and Narcotics Control Act of 1956 lead to the criminalization of marijuana possession.

Based on anecdotal data supporting the medicinal benefits of cannabis, California became the first state to legalize medicinal marijuana in 1996 and in 2012, Colorado became the first state to legalize it's recreational use. On April 16, 2015, Haleigh's Hope act was signed into law by Governor Nathan Deal in the state of Georgia making it the first state in the union to allow the use of medicinal marijuana in mitochondrial disease patients, one of 8 specified diseases approved for treatment.

Under federal law, cannabis is still a schedule 1 substance and illegal. State specific legalities regarding marijuana are complex and varied.  However, the current administration has provided amnesty from legal prosecution for patients in states with laws allowing legal Medical Marijuana provided the states have enacted strict regulatory measures for overseeing their programs and provided safeguards to protect children.

Following the signature of HB1 into law by Governor Nathan Deal, Georgia became the 36^th State to allow the use and possession of some forms of medical cannabis. Nationwide, 23 states have comprehensive medical marijuana programs, indicating that patients have access to several strains of marijuana, multiple locations to purchase the available product, have the ability to legally grow their own marijuana and have no limitations on the amount of THC available in their various preparations.  An additional 13 states, including Georgia, have limited programs, which restrict the amount of THC allowed in available products and limit the mechanism of delivery to oil only. In those 13 states patients can only acquire their medical cannabis out of state or risk prosecution under federal law.

However, a few companies are now offering to ship their products out of state.  Some “hemp” oil distributors claim their product is legal in all 50 states declaring that the oil is a dietary supplement. Unfortunately, ascertaining medical marijuana is not as simple as going on line and ordering a product. Although several companies are now shipping cannabis these distributors are subject to prosecution through the Drug Enforcement Agency should they elect to enforce federal law.   Despite many of the positive changes in the legalities surrounding the possession and use of medical cannabis, the DEA’s position remains firm:  they do not differentiate between CBD and THC and  ALL products containing any cannabinoids are classified as schedule 1 under the Controlled Substance Act (CSA) making their use illegal. Understanding the laws from a legal professional and not this post will protect you and your loved ones should you decide to utilize medical marijuana.   

The New Georgia Law

Georgia HB 1, Haleigh’s Hope Act, became law on April 16, 2015, establishing a medical cannabis program in the state of Georgia. Currently, State of Georgia agencies are promulgating the regulations and logistics of their medical cannabis program which should be completed no later than September 1, 2015. There are three components to the Georgia law: 1) Epidolex trial;  2) Possession of cannabis oil; and 3) Creation of an in depth plan by December 31^st, 2015 for a cannabis in state cultivation and distribution program. 

1) Epidolex is a highly purified CBD extract in liquid formulation created by GW Pharmaceuticals.  The law dictates participation in ongoing clinical trials utilizing this compound in the treatment of seizures and possibly other conditions.

2) Possession of cannabis for medicinal use is permitted in Georgia with 8 qualifying disorders:

1. Cancer,
2. Amyotrophic Lateral Sclerosis (ALS),
3. Seizure disorders,
4. Multiple sclerosis,
5. Crohn’s disease,
6. Mitochondrial disease,
7. Parkinson’s disease,
8. Sickle cell anemia.

Patients with one of these conditions can legally possess cannabis oil if they register with the Georgia Department of Public Health and carry the registration card with the cannabinoid product.  In order to register, a doctor must support and sign documents attesting to the presumed benefit of cannabis use in a given patient.  Cannabis oil is a schedule 1 substance which cannot be prescribed by a MD - merely recommended by a treating physician who has an existing relationship with the patient.  Although an “existing relationship” is poorly defined in the legislation,  the verbiage is meant to prevent inappropriate cannabis distribution from non-treating physicians to patients. The oil must be in a pharmaceutical container labeled with the percentages of THC and CBD in the compounded mixture.  A patient cannot possess more than 20 ounces of the oil and it cannot contain more than 5% THC with at least the same amount of CBD. 

3) The last component of the law legislates the creation of an in depth plan by the final day of 2015 for the development of Georgia’s instate cannabis cultivation and distribution program.

Upcoming Changes in Federal Regulations?

Clearly, the laws surrounding cannabis use are complex and vary from state to state.  The CARERS (Compassionate Access Research Expansion and Respect States) act of 2015, a bipartisan bill, has recently been introduced in the House of Representatives (H.R. Bill 1538) in Washington DC by Rep Steve Cohen of Tennessee. The bill’s goals are to allow states to legalize marijuana for medical use without federal interference, permit interstate commerce in cannabidiol (CBD) oils, reschedule marijuana to schedule II, allow banks to provide checking accounts and other financial services to marijuana dispensaries, allow VA physicians to recommend medical marijuana to veterans, and eliminate barriers to medical research. For patients this law would allow them to legally travel with prescribed medical cannabis without fear of prosecution or imprisonment.  Overall, the bill passage would ease federal and interstate regulations currently interfering with access of many patients to a potentially helpful substance.  Patients and families in support of easier access to medical cannabis should contact their congressmen in support of HR Bill 1538.

This topic has been expanded from 2 parts to 3 parts. Part 3 will be on the preparation and dispensing of cannabinoid products. Dr Kendall will also discuss cannabis topic on Friday May 15 in a MitoAction telephone conference/podcast, please see MitoAction.org for details.

Sincerely,

Fran Kendall, M.D. & Sebastien Cotte

This post is not meant to be a recommendation or a substitute for professional advice and services rendered by qualified doctors, allied medical personnel, and other professional services. The responsibility for any use of this information, or for proper medical treatment, rests with you.