Sunday, December 17, 2017

Medical Cannabis Law Packed With Questions on Patient Access

By on July 31, 2017

Editor’s note: The following article originally appeared in the July 27 print edition of Caribbean Business.

SAN JUAN — After signing the law to Improve the Study, Development & Research of Cannabis for Innovation, Applicable Norms & Limits (a.k.a. the Medicinal Act)—which regulates the use of the cannabis plant in its medicinal modality in Puerto Rico—there is uncertainty about how the central government will establish patients’ access to the substance.

Although the government maintained its initial prohibition on the use of cannabis for recreational purposes—as stated in Health Department Regulation 8766—the flower, or “crown,” of the plant raised great controversy between the executive and legislative branches. The questions were whether the flower should be included as part of the alternatives offered to patients who want to use it or that cannabis should be limited only to substances derived from it, which created an impasse during the legislation’s approval.

The point of convergence between the two positions to make the Medicinal Act a reality was Article 5-A2, which offers the option of making the flower available to patients with terminal diseases, among other meritorious cases, as long as this is stipulated after a medical evaluation. Many sectors in favor of medicalization say this provision is absurd.

In this Aug. 19, 2015 file photo, a customer checks the aroma of a jar of medicinal marijuana at Canna Care, a medical marijuana dispensary in Sacramento, Calif. (Rich Pedroncelli, File/AP)

Nevertheless, attorney Goodwin Aldarondo Jiménez, president of Puerto Rico Legal Marijuana—the organization in defense of medical cannabis—believes the Medicinal Act constitutes an advance in terms of using the plant on the island, although he admitted several of its provisions fail to address patients’ real needs.

Aldarondo explained that the greatest achievement obtained through the signing of this legislation was making the rules that regulate cannabis on the island into a law, since Puerto Rico is the only U.S. jurisdiction where a regulation existed without an appropriate legal framework.

“Who would have predicted that in 2017, under a New Progressive Party administration, we would have a cannabis law under such a conservative party. I think it is a huge advance,” the attorney said.

“The other positive aspect is that five government agencies are being integrated [during this process] to create a new regulation, and that is positive in the sense that these other agencies are [working together]—the departments of Economic Development, Treasury, Agriculture and Health…,” he said.

However, Aldarondo expressed concern regarding the composition of the regulatory body over medical cannabis. First, because he believes nine members—five agency heads and three people directly appointed by the governor—would delay the permitting process and, second, because he believes the patient community and medical cannabis industry must have a presence on that regulatory body.

Board to Establish Regulations

The Medicinal Act will create a board attached to the Health Department to be in charge of implementing the law. This board will regulate matters assigned to it by law, including issuing patient and dispensary licenses, among others. It will also have oversight duties and the power to issue fines.

However, the lawyer explained that until such a regulatory board is designated, the government must continue using Regulation 8766 as a basis to address patients’ needs as well as those of the newborn industry.

“Right now, the current regulation will prevail until this board creates a new regulation. So everything stays the same until they become organized. That can take them one or two years, easy. [Former Gov. Alejandro] García Padilla did it alone in less than a year because only the Health secretary had to create the regulation. But when there are nine members, when they have to appoint a medical advisory committee, then make the new regulation, take it through public hearings, make the [necessary] amendments, we are easily talking about one year—and that’s being conservative,” he said.

Aldarondo explained that changes and amendments within the regulation are inevitable since in the United States these types of medical cannabis laws are extremely dynamic and subject to amendments as frequently as weekly or monthly. The attorney even predicted more amendments regarding the use of the cannabis flower.

No Patient Representative

“The board aspect needs to be refined within that law, to see if we are going to feature a patients’ representative. That is indispensable because how is it possible that we have a nine-member board but none of them represents patients? The governor said he would include some patient representatives and that is indispensable. Some industry representation would also be prudent—an organization that represents the businesses,” he said. The governor also explained that the Medicinal Act creates the parameters so new regulations can be established, but leaves the door open for the board in terms of interpreting methods of consumption, what conditions are regarded as debilitating, how many licenses would be issued and other aspects.

“We are awarding huge power to that board, and we don’t know the names of the persons who are going to become its members, which could hurt the industry, because if we have people on that board who know nothing about cannabis, their decisions may be wrong,” he said.

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