Medical Marijuana Rule Changes

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Several changes are being considered for Arizona’s Medical Marijuana program, including the possible use of the drug for those suffering from Post-Traumatic Stress Disorder. Public input is being sought on the changes. Arizona Department of Health Services Director Will Humble will discuss the potential changes.

Ted Simons: Several changes are being considered for Arizona's Medical Marijuana program, including the possibility of allowing post-traumatic stress disorder to be included as a qualifying condition. Arizona department of health services director Will Humble joins us to discuss the potential changes. Good to see you again.

Will Humble: Good evening. Thanks.

Ted Simons: Why is it medical marijuana approved for PTSD now?

Will Humble: Well, when the voters approved the law back in November of 2010, they approved a preset list of debilitating medical conditions that qualify people, but inside the language of the initiative was a provision that said and, by the way, folks can petition the department of health services to add new conditions over time. So we built regulations around the process by which people could apply or basically petition us to add new medical conditions. So PTSD wasn't on the original list, but over the last however long, what has it been, three years, we've gotten several petitions to add PTSD, and this is the most recent petition that's come through.

Ted Simons: And I know that the lack of evidence or the lack of research that it really does help these folks is a factor as far as you're concerned. Correct?

Will Humble: Right. So we received a petition back in October of 2013 to add PTSD to the list. We looked at the evidence, and I denied that petition back in January of 2014. There was a group of folks called the Cannabis Nurses Association, who appealed my decision, it's called an appealable agency action. So they went to the office of administrative hearings and had an administrative hearing about that decision to not add PTSD to the list. That judge issued his recommendation about a week or so ago saying that we -- That I inappropriately denied that petition because I didn't consider some of the anecdotal evidence that was presented during the petition, and during the hearing.

Ted Simons: So that means now you reconsider?

Will Humble: Right. So it means that I have until July 9th to reconsider that decision from January, I have -- I could take the judge's recommendation, I could not take it, or I could modify that recommendation. I haven't decided what I'm going to do yet. I'm still looking at the evidence. There's a new article that came out in a journal just a couple days ago about some research in New Mexico, so I'm going to look at that. But again, I have until July 9th, and I think I'm going to use all that time, because I want to make sure I get this right.

Ted Simons: The initial decision, your initial decision to refuse to include that, what was that based on? Why did you say no?

Will Humble: Well I just said no because there's a lack of published evidence in the medical literature that it's helpful for PTSD, and specifically as treatment. There is more evidence, there's some evidence I should say, that it is helpful for some people, for -- for temporary relief, it's called palliative care, but temporary relief of some of the symptoms for PTSD. That's what the petitioners were arguing, that's what the appeal was based upon. Not so much treatment, but rather does it help at least temporarily to alleviate some of the symptoms of PTSD. So it's really sort of a nuanced distinction, but it's an important I think.

Ted Simons: Well does that mean now will you reconsider like depression, and migraines, I mean aspects of PTSD? How far does this go?

Will Humble: Well, the appeal was just for the decision on PTSD, because as you know I've turned down -- I've denied petitions for depression, skin cancer, a host of other things that I've turned down petitions for. This is the only one where we've had an appeal to the office of administrative hearings, and so obviously this is the first time that a judge has recommended that we reconsider and change that decision.

Ted Simons: I guess my question would be if you do reconsider and you look at new evidence, whatever that evidence may be, does something like depression then pop up as a possibility for you? Forget the petition, for you to say you know I'm starting to see some things here?

Will Humble: Well, one of the things that -- Remember, go back to the voter approved law, there was a line in there that said that the department shall consider over time new petitions to add debilitating medical conditions. So this is part of that process. And that cycle will come up again, in fact every six months we accept new petitions. So any time an agency director whether it's me or our future director would deny a petition, folks have an opportunity to appeal as soon as the new evidence comes in. So it's an evergreen type of model. There's one nuance, however, which is, directors can't take things off the list. Remember, so there was a voter-approved list, those voter-approved conditions that people voted on, they're on the list. If I were to add PTSD to the list, there's no way for me or a future director to pull it off the list. In other words, it's a one-way street.

Ted Simons: Even if the research all of a sudden came back walloping showing this is terrible for these people, you can't do that?

Will Humble: Not -- A petition to add

Ted Simons: Yes.

Will Humble: Not to delete.

Ted Simons: Not to delete, okay. Interesting. All right. New regulations on snacks and drinks and edibles, and what are we talking about here?

Will Humble: Well the edible portion of the medical marijuana law has sort of evolved over time. There were some questions about the legality of edibles, brownies, for example, lemon bars, salsa I've even seen. So there's some questions that arose in 2012 and 2013 about the processes that dispensaries could use to develop those edible products that involve resins and extracts. There's a lot of detail to it, but there's criminal code, Title 13 marijuana, and then there's Title 36 Arizona medical marijuana. There was a conflict between those two statutes. It worked its way through the courts, and the courts about six months ago said, dispensaries can make edibles, so that cleared up the question around, you know, are lemon bars, brownies and the like okay for dispensaries to make and for people to buy? So now what we're going through in our rule making process is to try to better -- Try to find ways to better inform customers at dispensaries, patients at dispensaries, about the strength of that marijuana. So let's say you have a debilitating medical condition and you smoke marijuana for your medical condition. You get an immediate feedback loop right, because you smoke the marijuana, you feel the effects immediately, it's easy to self-regulate. That's more difficult with something like a brownie or other kind of edible, because you don't really know how much you're eating, you might eat too much, and it takes a long time to get into your bloodstream, so it's easy to overmedicate. So I'm going to be working with some of the stakeholders over the coming weeks to try to identify ways to better label the edibles, so that we're in a better position to keep people from overmedicating when it comes to stuff like lemon bars and that.

Ted Simons: And I read somewhere that the secret shoppers might be included in here?

Will Humble: Well --

Ted Simons: Make sure everyone's I's are crossed and T's are dotted?

Will Humble: That's something I talked to Howie Fischer about who's on your Journalist's Roundtable.

Ted Simons: Yes.

Will Humble: Maybe even this week again, um it's something that we're exploring, but I don't think I have the statutory authority to send somebody in.

Ted Simons: So if someone wanders in there looking a little -

Will Humble: On the QT

Ted Simons: Okay, before we let you go, I know you're trying or there is an attempt to lower the cost for some, real quickly what's that about?

Will Humble: So one of the issues we have with the program is we have too much money. So we have $9 million in the medical marijuana fund, all of it is from the sale of cards and for the fees that we charge for dispensaries. We're exploring ways to bring our revenue closer in line with what our expenses are, so we're exploring lowering the cost of the cards to certain subgroups of people. Seniors, for example, veterans, people on SSI or SSDI government assistance programs and the like. We've already got discounted cards for people that are on food stamps. So we're -- So then our draft regulations were proposing to lower the cost of those cards, but keeping it for everybody else at $150 a year.

Ted Simons: So the program seems to be strong as it stands, correct?

Will Humble: I think we're doing as good a job as we could have done given the voter approved language that we have. Our staff is professional that we've recruited, I think we're making some good decisions. Financially we're doing very well. Like I said we have too much money, and we need to bring those -- The revenue a little bit down closer to what our expenses really are.

Ted Simons: Interesting. All right. Good to have you here. We'll look forward to that July decision. Thanks for joining us, we appreciate it.

Will Humble: Thanks.

Ted Simons: Tomorrow on Arizona Horizon, find out about Mesa's plans to develop a new technology corridor. And here about increasing concerns over the sustainability of Arizona's ground water supply. That's Tuesday evening 5:30 and 10:00 right here on Arizona Horizon. That is it for now. I'm Ted Simons. Thank you so much for joining us. You have a great evening.

Will Humble:Director, Arizona Department of Health Services;

ASU/Starbucks Online Degree

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