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

Summary of specific provisions

This would allow medical use of mari- huana under a health care practitioner's care, for patients with cancer and other severe debilitating or life-threatening conditions. The bill would set up a tightly regulated and controlled medical marihuana system.

A practitioner (licensed physician, physician assistant, or nurse prac- titioner) could certify that a patient has a severe debilitating or life-threatening condition that can and should be treated with the medical use of marihuana. In making a certification, the practitioner would have to consider the form of medical marihuana the patient should consume, including the method of consumption and any particular strain, variety, and quantity or percentage of marihuana or particular active ingredient, and appropriate dosage. The certification would state any recommendation or limitation the practitioner chooses to make concerning the appropriate form of medical marihuana and dosage for the certified patient.

Certified patients would register with the Health Department. Certify- ing and dispensing medical marihuana would be included in the I-STOP system for controlled substances enacted in 2012.

Medical marihuana could not be smoked by patients under 21, vaporization and other forms notwithstanding. Medical marihuana could not be produced in confections, carbonated, beverages or products marketed toward minor. children.

The Health Department would license and regulate "registered organiza- tions" to produce and dispense medical marihuana for certified patients. They could be for-profit businesses or not-for-profit corporations. They would be required to comply with detailed "seed to sale" security controls and regulations.

The bill would impose an excise tax on manufacturing and dispensing medical marihuana; the tax would be seven percent of the retail price of the medical marihuana dispensed. Forty five percent of the revenue would go to the State. Forty five percent of the revenue would go to the locality where it is manufactured or dispensed (divided equally between the New York State County where it was manufactured and the New York State County where it was dispensed). Five percent would be transferred to the Office of Alcoholism and Substance Abuse Services for additional drug abuse prevention, counseling and treatment services. Five percent would be transferred to the Division of Criminal Justice Services for a

program of discretionary grants to state and local law enforcement agen- cies that demonstrate a need relating to this Title; these grants could be used for personnel costs of state and local law enforcement agencies.

Justification

Thousands of New Yorkers have serious medical conditions that may benefit from medical use of marihuana. 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 marihuana 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 for many patients other drugs may be more effective than mari- huana, the Institute of Medicine noted that "there will likely always be a subpopulation of patients who do not respond well to other medica- tions," medical marihuana must be available to those patients.

The active ingredient in marihuana, 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. Massirer, 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 non-medical 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 meoeridine to relieve extreme dysp- nea and pain."

The bill amends the Public Health Law rather than the Penal Law because the Penal Law's controlled substances provisions ail 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

2013 - died in Health Committee; P-Assembly.

Fiscal implications

Substantial revenue for the State and relevant Counties would be raised by an excise tax on medical marihuana, plus administrative fees. There would be minimal administrative expenses.

Effective date

Immediately.