Tag: medical marijuana

House gives initial passage to changes to Missouri medical marijuana provisions

The Missouri House has given initial approval to a bill addressing issues with implementing a medical marijuana industry approved by voters in 2018.  This comes as its Special Oversight Committee continues to explore problems in the issuing of cultivation licenses.

Representative Jonathan Patterson (Photo: Tim Bommel, Missouri House Communications)

House Bill 1896 would give the Department of Health and Senior Services authority to review criminal background checks to ensure no workers in the medical marijuana industry have committed a disqualifying felony criminal offense.  Article 14 of the Missouri Constitution, passed in 2018 by Missouri voters, includes the authority for DHSS to conduct criminal background checks, but the FBI does not share that information with non-law enforcement entities.

HB 1896 would give DHSS statutory authority to satisfy the FBI’s concerns.  It would also make it a Class-E felony for a state agency to share data about medical marijuana card applicants with the federal government.

The House on Thursday added a provision to the bill that would require a medical marijuana card applicant to meet in-person with a Missouri doctor in order to be certified.

That piece was proposed by Representative Jonathan Patterson (R), a Lee’s Summit surgeon, who said it would strengthen the fledgling program.

“Because if you are doing these certifications online or over the phone then the strength of the certification is really diminished, so as we’re starting this program we want everything to be above board,” said Patterson.

Some lawmakers opposed Patterson’s amendment, saying it took a narrowly focused bill to fix a problem holding up the system, and added roadblocks to some potential medical marijuana patients.

“The Department testified to us the other day that the ‘North Star’ of Amendment 2 and the ‘North Star’ of their implementation of this was patient access, and all I see in here is a limitation on the physician I can go to,” said Representative Peter Merideth (D-St. Louis).

Representative Peter Merideth (Photo: Tim Bommel, Missouri House Communications)

Merideth is also critical of Patterson’s amendment having first appeared on the House floor and not being the subject of a committee hearing.

“When people passed Amendment 2 do you think they had in mind an online doctor from some other country or another state?”  Patterson asked.

“I think we should ask them,” Merideth responded.  “That’s the point of a public hearing on something like this so that they can come in and say, ‘Here’s how it impacts me,’ so I can hear from a doctor, so I can hear from a patient.”

O’Fallon attorney, Representative Nick Schroer (R), said he believes Patterson’s amendment will lead to court challenges.

“This is going to prohibit the actual implementation of what the voters intended and what the voters requested,” said Schroer.

Other lawmakers said requiring certification from only Missouri doctors would be a burden to those who live near the borders and visit doctors from neighboring states.

Patterson argued his amendment would protect patients.

“The people of Missouri … wanted a safe program that provided patients access.  They wanted a safe program of Missouri-grown marijuana sold in Missouri to Missourians certified by a Missouri physician that is licensed to practice here,” said Patterson.

The House also added a provision to require DHSS employees involved in medical marijuana regulation to disclose any “actual or perceived” conflicts of interest to the Department.

Another favorable vote would send the legislation to the Senate.

The House Special Committee on Government Oversight has held several hearings into apparent inconsistencies in the approval of licenses to cultivate marijuana for medical use in the state.  More such hearings are expected as early as next week.

House approves limited medical marijuana proposal

The Missouri House has voted to allow those suffering from terminal and debilitating conditions to use medical marijuana.  The proposal now goes to the state Senate for consideration.

Representative Jim Neely sponsored HB 1554, a medical marijuana proposal, that the House sent to the Senate on May 1, 2018. (photo; Tim Bommel, Missouri House Communications – click for larger version)

House Bill 1554 would expand on a law passed in 2014 that allows the use of a cannabis extract, cannabidiol (CBD) oil, to treat intractable epilepsy.  If HB 1554 became law, a patient suffering from conditions including cancer, HIV, Parkinson’s disease, multiple sclerosis, and post-traumatic stress disorder could use medical marijuana if a doctor signs a statement saying he or she could benefit from its use and that all options approved by the Food and Drug Administration have been considered.

The House voted 112-44 to send that bill to the Senate, but some Republicans spoke against IT even though it is sponsored by one of their fellows.

Pacific Republican Kirk Mathews said the legislative process is not the proper way for a drug to be approved.

“I don’t know of any other medicines that become medicine by an act of the legislature versus the process that we’ve gone through for years in the history of our country and medicine in our country, with FDA clinical trials, double-blind studies, etcetera, etcetera,” said Mathews.

He also argued that the bill is too broad in what conditions it would allow medical marijuana to be used for, because it would allow the Department of Health and Senior Services to add conditions to that list if at least ten physicians sign a petition calling for it to be added.

“We don’t know what conditions we are allowing this to be used for if we pass this bill,” said Mathews.

Representative J. Eggleston (R-Maysville) said passing HB 1554 would send Missouri down a similar path to that the nation has taken with opioids.  Those are now seen as the crux of a health crisis, but they started off as a way to treat pain.

Representative Kirk Mathews (photo; Tim Bommel, Missouri House Communications – click for larger version)

“Surely the companies behind them would only care about relieving others’ pain and doctors would only prescribe for that reason, and the recipients would only use them for that reason and not use them for that reason and not use them for recreational fashion, and surely it wouldn’t get away from us to where other people would rob medicine cabinets or things like that, and yet all of that stuff is happening.  Now we’re having to deal with the aftermath of those unintended consequences,” said Eggleston.

The bill was sent to the Senate on the strength of bipartisan support.  Representative Clem Smith (D-Velda Village Hills) told bill sponsor Jim Neely (R-Camdenton), who is a doctor, that he hoped the bill would become law.

“I know in your career you’ve seen a lot of different things, seen a lot of people that have been impacted, and maybe in your thinking, you’re like, ‘Hey, this might help them get through life or increase their standard of living,’ so just wanted to thank you for it,” said Smith.

The bill also earned support from some in House leadership, including the Majority Floor Leader, Rob Vescovo (R-Arnold).

“I think [Representative Neely] has done a fantastic, fabulous job, channeling this down to what the members of this body wanted to see,” said Vescovo.  “I’m going to go ahead and cast my vote for the terminally ill in my district and across the state.”

HB 1554 goes to the Senate with less than three weeks remaining in the legislative session.

Earlier stories:  

Missouri House considers legalizing medical use of marijuana

Bill to legalize limited medical marijuana heard in House committee

Missouri House considers legalizing medical use of marijuana

The Missouri House is one vote away from proposing that Missouri legalize the medical use of marijuana by people suffering from certain terminal or debilitating conditions.

Representative Jim Neely (photo; Tim Bommel, Missouri House Communications – click for larger version)

House Bill 1554 would expand on a law passed in 2014 that allows the use of a cannabis extract, cannabidiol (CBD) oil, to treat intractable epilepsy.  If HB 1554 became law, a patient suffering from conditions including cancer, HIV, Parkinson’s disease, multiple sclerosis, and post-traumatic stress disorder could use medical marijuana if a doctor signs a statement saying he or she could benefit from its use and that all options approved by the Food and Drug Administration have been considered.

The bill is sponsored by Representative Jim Neely (R-Cameron), who is also a doctor.

“There’s a lot of people in my world, from the hospice and the long-term care world, that feel that this would be appropriate for people to ease the pain, suffering, and the side-effects of the opioids and this might be the best way to go,” said Neely.  He said the bill would give people, “another option at the end stages of life.”

House members including Travis Fitzwater (R-Holts Summit) spoke about loved ones that might benefit from the legislation, such as his mother and sister who have multiple sclerosis.

Fitzwater said their neurologist, who he knows and trust, has said they should have the option of using marijuana for pain treatment.

“I trust his opinion.  He went to medical school.  He knows what he’s talking about.  He’s spent his career focused on multiple sclerosis and his patients are mainly multiple sclerosis patients,” said Fitzwater.  When he tells me that … [my] mom or [my] sister should have the option to come to their neurologist and discuss treatment options for pain – and this is a gentleman who is as professional as anybody I’ve ever met – they ought to have that opportunity.”

“Patients that have these debilitating diseases ought to have an option … when the doctors agree and there are professionals involved that know more about what’s going on with those patients than we do,” said Fitzwater.

Representative Gina Mitten (photo; Tim Bommel, Missouri House Communications – click for larger version)

Representative Gina Mitten (D-St. Louis) said a colleague of hers who is a practicing attorney must break her oath to uphold the law by using marijuana to treat her epilepsy, rather than use the prescription drugs that caused her to have a psychotic episode among other side effects.

“How is it that it’s okay to have to spend a night, or two nights, or three nights in a hospital due to medication that’s been prescribed and creates all kinds of other side effects, as opposed to something that we know in other states has worked very well for this disease?” asked Mitten.

Pacific Republican Paul Curtman sponsored adding PTSD to the legislation.  He described what he knows some of his fellow comrades in the Marine corps faced, and said leaving this issue facing veterans out of the bill would be a “travesty.”

He spoke about a fellow Marine from Missouri whose experience overseas included having to routinely wash the blood of friends out of the back of a Humvee.  Curtman said the man was prescribed by the Veterans’ Administration drugs that had numerous side effects.  For a time he used marijuana and that worked for him, but he was arrested and forced to return to the drugs prescribed by the VA.

“The VA came by and said if you ever [use marijuana] again you’re jeopardizing your ability to use any of your VA benefits.  So, after being on house arrest for a while with the VA checking up on him to make sure that he was taking the synthetic drugs that the VA wanted him to take, his father came home just a few weeks later only to find that his son had put a gun to his head and pulled the trigger,” said Curtman.

Under the bill the Missouri Department of Health and Senior Services would issue medical cannabis registration cards to approved patients, or to parents in the cases of minor parents.  The bill would only allow the use of smokeless forms of marijuana.  HB 1554 also lays out how marijuana could be legally cultivated by licensed growers under the supervision of the Department of Agriculture.

Another favorable vote would send the legislation to the Senate.  Two years ago the House rejected a bill that would have asked voters whether to legalize the limited, medical use of marijuana.

Bill to legalize limited medical marijuana in Missouri heard in House committee

Again this year the Missouri House has heard testimony on whether the state should legalize marijuana for limited medicinal use.

Representative Jim Neely (photo; Tim Bommel, Missouri House Communications)

Cameron doctor and state representative Jim Neely (R) has proposed allowing the use of marijuana to treat terminal conditions.  Neely said his House Bill 1554 would expand on legislation that became law in 2014 that allows the use of a cannabis extract, cannabidiol (CBD) oil, to treat intractable epilepsy.  It would also expand on Missouri’s “right to try” law that allows doctors and patients to use drugs that haven’t completed the approval process of the federal Food and Drug Administration.

The House Committee on General Laws heard from people who said marijuana did help or could have helped their loved ones.  Jane Suozzi said her daughter Kim was diagnosed with brain cancer shortly before she graduated with two degrees from Truman State University in 2011.

After studying and pursuing multiple experimental treatments Kim turned to marijuana shortly after her diagnosis.

“Kim viewed marijuana the same as all the other experimental options she pursued.  She didn’t enjoy it but it gave her some additional hope and sometimes relieved her nausea,” Jane Suozzi testified.  “I appreciate Doctor Neely’s efforts to afford people like Kim potentially life-extending access to experimental treatments including medical cannabis.”

The committee also heard from a number of veterans and organizations that represent them.  Kyle Kisner served in the Missouri National Guard for seven years and spent tours in Iraq and Afghanistan.  He said for years he was treated with opioids for pain and benzodiazepines for depression, during which time he said his personality was altered and he twice attempted suicide.

“Cannabis allows me to focus.  It’s allowed me to consistently hold some kind of employment for the past few years, and for the past year-and-a-half I’ve gone back to school and I’m currently finishing up two bachelor’s degrees at Lindenwood University; something I couldn’t do when I was nodding out on three to four hours a day taking some kind of opioid or something for anxiety,” said Kisner.  “There’s thousands of veterans out there that are taking that.  You guys asked if this is medicine.  I say, ‘Yes, absolutely, without a doubt this is medicine.’”

The Missouri Prosecutor’s Association spoke against the proposal.  Its lobbyist, Woody Cozad, said for Missouri to pass legislation legalizing marijuana at any level would fly in the face of federal statute.

“Nullification was decided by the Civil War.  Whether this legislature has previously attempted to nullify federal gun law or anything else doesn’t alter the fact that under our system of government, the system for which all of these veterans including myself fought, the states don’t nullify federal laws,” said Cozad, “and it just creates a confusion that at least our members can have a lot of difficulty dealing with.”

Legislators noted that Missouri already has laws that conflict with federal laws, and questioned whether prosecuting people like those who testified for the bill – veterans and those with serious medical conditions – would be a priority for any prosecutors.

Kansas City Democrat Jon Carpenter told Cozad several states have already legalized marijuana to some extent, in spite of federal law, “and I don’t see the mass confusion happening, so I’m not sure why we would anticipate having a different experience if we were to go down this path in Missouri.”

Neely said his bill, as it is written, is about improving quality of life for patients.

“I remember, I may have been an intern, a doctor telling me that his goal as he was near the end of his life as a physician, what he did in life was to provide some comfort to people, and I guess that resonated with me,” said Neely.  “I think that’s what I’m after is that I’ve seen people struggle.  Narcotics aren’t effective, pain control, anxiety, depression, a variety of other issues that the marijuana may be beneficial.”

The committee has not voted on Neely’s bill.  Last year he filed the same language in House Bill 437 and it was voted out of two committees but was not debated in the full House.

House members again asked to consider legalizing medical marijuana in Missouri

The Missouri House is again being asked to consider legalizing marijuana for some medical purposes.

Representative Jim Neely (right) listens as Jackson County Sheriff Mike Sharp (left) testifies in favor of Neely's medical marijuana legislation, HB 437. Jackson said he has a nephew that could benefit from medical marijuana. (photo; Tim Bommel, Missouri House Communications)
Representative Jim Neely (right) listens as Jackson County Sheriff Mike Sharp (left) testifies in favor of Neely’s medical marijuana legislation, HB 437. Jackson said he has a nephew that could benefit from medical marijuana. (photo; Tim Bommel, Missouri House Communications)

House Bill 437 would allow the use of marijuana to treat irreversible debilitating diseases or conditions.  Its sponsor, Cameron Republican Jim Neely, said it would expand on two Missouri laws.  One allows the use of a cannabis extract, cannabidiol (CBD) oil, for treating intractable epilepsy.  The other is the “right to try” law that lets doctors and patients use drugs that haven’t completed the approval process through the federal Food and Drug Administration.

The bill would have the Missouri Department of Health and Senior Services create a list of conditions for which patients could be allowed to use medical marijuana.  That list would have to include any conditions or diseases for which a clinical trial of medical marijuana has completed its first phase.

The bill would allow the Department to issue medical cannabis registration cards to Missourians 18 and older for whom a doctor has signed a statement saying the individual suffers from epilepsy or an irreversibly debilitating disease, could benefit from medical cannabis, and has considered all other treatment options.  Parents would be allowed to obtain registration cards for their children.

The House Committee on Health and Mental Health Policy heard from Doctor Adrianne Poe, who told the committee cannabis-based pain treatments would be safer than commonly used opioid-based medications.  She cited a report from the National Academy of Sciences, which said that cannabis is safe and effective in treating pain.

“That is in direct opposition to all of the literature that we have that shows there is not a shred of evidence for the safe and effective use of chronic opioids for chronic pain,” said Poe.  “According to the CDC guidelines which tell us that the very first thing that physicians need to do is find an alternative therapy to opioids for the treatment of chronic pain.  The National Academies has given us an answer on that and the answer is cannabis.”

Heidi Rayl told lawmakers Missouri should not stop with the passage of the law that has allowed her to treat her son’s seizures with CBD oil.

“This is where our state is lacking.  One type of medication does not treat everyone.  I, as Zaden’s mother, should have the right to choose what is best for him,” said Rayl.

Legislators were also told the passage of medical marijuana legislation would put Missouri’s laws in conflict with federal laws.

Jason Grellner with the Missouri, and National, Narcotics Officers' Association testifies against medical marijuana legislation. (photo; Tim Bommel, Missouri House Communications)
Jason Grellner with the Missouri, and National, Narcotics Officers’ Association testifies against medical marijuana legislation. (photo; Tim Bommel, Missouri House Communications)

Jason Grellner with the Missouri, and National, Narcotics Officers’ Associations, told the committee, “If you pass legislation that is in violation of the Supremacy Act of the United States regarding scheduled drugs, I don’t think you want me choosing which laws I enforce and which ones I do not.”

He also said passing a medical marijuana law would mean bypassing the FDA and its consumer protections.

“If I go to a Wallgreen’s in L.A. and buy a Tylenol and I go to a Wallgreen’s in New York City and buy a Tylenol, I am assured under FDA regulations that that is the same drug.  If I walk into a medical marijuana shop and buy purple Kush on Wednesday, there is really no assurance in any state that has medical marijuana that if I go back on another day or to another medical marijuana shop that I am getting the same drug, because there is no standardization of dose,” said Grellner.

Last year the House came the closest it’s ever been to passing medical marijuana legislation, but finally rejected a bill that would have allowed medical marijuana use only by terminal cancer patients in hospice care.

The committee’s chairman, Representative Keith Frederick (R-Rolla), said he is “contemplating” whether to have the committee vote on HB 437.