Legalizes the possession, manufacture, use, delivery, transfer, transport or administration of marihuana by a certified patient or designated caregiver

Summary of specific provisions

Section 1. Legislative findings and Intent.

Section 2. Amends Public Health Law Article 33 by adding a new Title V-A, Medical Use of Marihuana.

§3360 defines certified medical use, certified patient, certification, designated caregiver, public place, serious condition, medical marihua- na, registry application, registry identification card, and usable mari- huana. A serious condition is defined as a severe debilitating or life- threatening condition or a condition associated with or a complication of such a condition, or its treatment.

§3361 allows a licensed practitioner (the defined term in the Public Health Law for people who may prescribe controlled substances) to certi- fy that a patient has a serious condition that in the practitioner's judgment can and should be treated with the medical use of marihuana. A copy of the certification will be placed in the patient's medical records and the patient will get the original. A prescriber is not allowed to certify medical marijuana for himself or herself. A certif- ication will be valid for a maximum of one year from the date it is written.

§3362 allows the possession of up to two and one half ounces of marihua- na by a certified patient in possession of a valid registry identifica- tion card, for medical use. A designated caregiver may possess that amount for each patient for whom her or she is the caregiver. Use of medical marihuana is not allowed in a public place.

§3363 directs the Department of Health to issue registry identification cards to certified patients and designated caregivers. No individual shall be a designated caregiver for more than five patients.

§3364 creates registered organizations for the purpose of acquiring, possessing, manufacturing, selling, delivering, transporting or distrib- uting marihuana for certified medical use. A registered organization may be a pharmacy; an Article 28-licensed facility (hospital, clinic, etc.); a not-for-profit corporation organized to be a registered organization; the Department; a local health department; or a registered producer (an entity that produces marihuana, solely for sale to other registered organizations).

§3365 establishes guidelines for the registering of registered organiza- tions. Allows the department to suspend or terminate a registration on

grounds, and using procedures under this article relating to a license, to the extent consistent with this title.

§3366 requires registered organizations to report to the commissioner all sales, deliveries or distributions of medical marihuana to certified patients or designated caregivers during a particular period.

§3367 directs the Health Department to contract with a third party to conduct an evaluation of the operation of the law.

§3368 applies other provisions of Article 33 to this title. Where a provision of this title conflicts with another provision of Article 33, this title applies. The bill does not require any public or private health plan to cover medical marihuana. Re-states the rule that reason- able good-faith actions in compliance with this title, absent some other element, would not subject a person or entity to criminal or civil liability or professional discipline.

Section 3 of the bill amends Section 853-g of the General Business Law to allow for the sale, furnishing and possession of materials used in the lawful administration of medical marihuana to a certified patient.

Justification

Thousands of New Yorkers have serious medical conditions that may benefit from medical use of marijuana. The National Academy of Sciences' Institute of Medicine concluded in a 1999 report that "nausea, appetite loss, pain and anxiety..all can be mitigated by marijuana." Doctors and patients have documented that marijuana can be an effective treatment - where other medications have failed - for at least some patients who suffer from HIV/AIDS, cancer, epilepsy, multiple sclerosis, and other life-threatening or debilitating conditions. Although other drugs are more effective than marijuana for some patients, the Institute of Medicine noted that "there will likely always be a subpopulation of patients who do not respond well to other medications." Medical marihua- na must be available to those patients.

The active ingredient in marijuana, THC, has been approved for medical use by the Federal Food and Drug Administration and the Drug Enforcement Agency since 1986 in synthetic pill form. But consuming it in natural form - which many physicians say is more effective - continues to be illegal. In an editorial in the January 30, 1997 New England Journal of Medicine, Dr. Jerome P. Kassirer, editor of the Journal, explained that inhaling THC is more effective than taking the synthetic pill: "smoking marijuana produces a rapid increase in the blood level of the active ingredients and is thus more likely to be therapeutic." It also enables tighter control of the amount ingested. According to the Institute of Medicine, "it is well recognized that (the) oral route of administration hampers its effectiveness because of slow absorption and patients' desire for more control over dosing."

Legalizing the medical use of effective medicine does not undermine the message that nonmedical use of illegal drugs is wrong. Many controlled substances that are legal for medical use (such as morphine, Valium and

steroids) are otherwise illegal. In the same New England Journal of Medicine editorial, Dr. Kassirer argued that "it is also hypocritical to forbid physicians to prescribe marijuana while permitting them to use morphine and meperidine to relive extreme dyspnea and pain."

The bill amends the Public Health Law rather than the Penal Law because the Penal Law's controlled substances provisions all relate back to the Public Health Law. Thus, all the acts that the bill makes lawful under the Public Health Law would, by definition, be legal under the Penal Law.

Prior legislative history

1997-98 : A.6407 - referred to Health 1999-00: A.8082 - referred to Health 2001-02: A.5878 - referred to Health 2003: A.5796 - reported to Rules 2004: A.57960-A - reported to Rules 2005-06: A.8265 - reported to Rules 2007-08: A.4867-A and -B - passed Assembly

Fiscal implications

Minimal administrative expenses, largely covered by registration fees and substantial Medicaid savings.

Effective date

Sixty days after it shall become law.