DOTHAN, Ala. – A bill to allow people with chronic pain and more than a dozen other conditions to seek relief with medical marijuana products is a step away from becoming law in Alabama.
The Legislature passed the bill by a two-to-one margin, with support from lawmakers in both parties. About 40% of Republican legislators voted against it.
The bill went to Gov. Kay Ivey, who could sign it into law.
Ivey said last week the 102-page bill was under review. Ivey commended the sponsors of the legislation and said she hoped to sign it.
Alabama would be the 37th state to allow medical marijuana. The bill is by Sen. Tim Melson, R-Florence, a physician and medical researcher, and Rep. Mike Ball, R-Madison, who is retired from a career in law enforcement.
It would set up an intrastate system for businesses to grow, process, test, transport, and sell the products.
Attitudes have changed in eight years, since a medical marijuana bill was given the Shroud Award as the “deadest” bill in the House.
The law would be called the “Darren Wesley ‘Ato’ Hall Compassion Act,” in recognition of the son of Rep. Laura Hall, D-Huntsville, whose death from AIDS inspired her to proposed medical marijuana more than a decade ago.
Who could use the products?
Patients would receive certification by a doctor to obtain a medical cannabis card for about 15 categories of conditions and symptoms:
The legislation says medical marijuana should not be the first option, but should be used “only after documentation indicates that conventional medical treatment or therapy has failed unless current medical treatment indicates that use of medical cannabis is the standard of care.”
A certification for a medical cannabis card would be valid for up to 12 months.
What form would the products be?
They could be tablets, capsules, tinctures, or gel cubes for oral use. They could be gels, oils or creams for topical use. They could be suppositories, transdermal patches, nebulizers, or liquids or oils for use in an inhaler.
Raw plant material, products that could be smoked or vaped, or food products such as cookies or candies would not be allowed.
What about dosages, THC content?
Patients could buy up to 60 daily doses at one time and could have up to 70 in their possession.
Daily dosages would be initially capped at 50 milligrams of tetrahydrocannabinol, the mood-changing chemical in marijuana. Doctors could raise that to 75 milligrams for patients after 90 days. Patients with terminal illnesses could receive more than 75 milligrams but would have their driver’s licenses suspended.
The commission could limit the daily THC dosages for specific conditions.
Minors who are qualified patients could not use products with more than 3% THC content.
Would doctors write prescriptions?
No, they could not write prescriptions because medical cannabis is not approved by the Food and Drug Administration. They would issue recommendations to certify patients for medical cannabis cards.
How old would you have to be to buy or use medical marijuana?
Patients 19 or older with a qualifying condition could receive a medical cannabis card to buy the products. Parents and others could register as caregivers to obtain the products for minors.
What state agency would regulate medical cannabis?
The bill would create the Alabama Medical Cannabis Commission. The commission would have 14 members, appointed by the governor, lieutenant governor, legislative leaders, and others. Appointments would be subject to Senate confirmation.
The bill allocates the slots to appointees with certain professional backgrounds, such as medicine, agriculture, and pharmacy.
Public officials, candidates for public office, public employees, and lobbyists would not be eligible. Commission members could not have financial interest in companies that are part of the medical marijuana industry.
The commission would appoint a director and assistant director to run the program. Employees would be under the state merit system.
Where would patients buy the products?
At licensed dispensaries. The legislation allows up to 27 locations.
The commission would issue dispensary licenses to as many as four companies that could each have three dispensary sites in separate counties.
The commission would issue “integrated facility” licenses to up to five more companies that could each have five dispensary sites.
The commission could allow more dispensary sites later based on demand.
Could any doctor recommend medical marijuana?
Doctors would have to complete a four-hour training course and an examination and pay a registration fee to qualify. They would have to take refresher courses every two years.
The Alabama Board of Medical Examiners could adopt additional rules on qualifications.
Would there be a database showing who is using medical marijuana?
Yes. The bill would set of an Alabama Medical Cannabis Patient Registry. It would keep records of doctor certifications, patient registrations, medical cannabis cards, daily dosages and types of medical cannabis recommended by doctors, the dates and amounts of products sold to patients at dispensaries.
Access to the information in the registry would be restricted. It would be available to doctors, dispensaries, and pharmacists, as well as to law enforcement for investigations.
Patients would pay a fee of up to $65 to apply for registration. Those registered would receive a medical cannabis card with a photo. Cards would be valid only in Alabama.
Would medical marijuana be covered by insurance?
Insurance plans would not be required to cover it.
Would employers have to allow their employees to use medical cannabis?
No. Employers could refuse to hire a person and could fire a person for using medical cannabis. Companies could still have drug-testing policies to identify and prohibit marijuana use.
Would it be a crime to use or sell medical marijuana for purposes other than what’s allowed under the law?
Yes, it would be a illegal to distribute, possess, manufacture, or use medical cannabis or a medical cannabis product that has been diverted from a registered qualified patient, a registered caregiver, or a licensed cultivator, processor, secure transporter, dispensary, or a state testing laboratory.
Violators could be charged with a felony.
How would “seed to sale” regulation work?
The Alabama Medical Cannabis Commission would issue licenses to companies to cultivate, process, transport, test, and dispense the products.
The commission would issue “integrated facility” licenses for companies that perform all the functions.
There would be no more than 12 cultivator licenses, no more than four processor licenses, and no more than four dispensary licenses. There would be no more than five integrated facility licenses.
The Alabama Department of Agriculture and Industries would regulate and inspect the cultivators in collaboration with the commission.
Could cities and counties keep out medical marijuana dispensaries?
Yes, dispensaries could locate only in cities and counties whose governing bodies have approved them.
When could products be available?
The bill says the Alabama Medical Cannabis Commission must set up the rules to implement the program and allow people to begin applying for licenses by Sept. 1, 2022.
How would products be packaged?
The commission would approve a color image as a universal state symbol to go on all packages. Packages would list the content and potency of cannabinoids. They would be child-resistant and not designed to appeal to children. Oral doses could not be sugar-coated.
The packages would carry this warning: “This product may make you drowsy or dizzy. Do not drink alcohol with this product. Use care when operating a vehicle or other machinery. Taking this product with medication may lead to harmful side effects or complications. Consult your physician before taking this product with any medication. Women who are breastfeeding, pregnant, or plan to become pregnant should discuss medical cannabis use with their physicians.”
How would products be tested?
The state would issue licenses for state laboratories to test the cannabis from cultivators and the finished products. Products would be tested for cannabinoid content and potency, contaminants, and other qualities.
How would products be taxed?
There would be a 9% tax on gross sales of medical cannabis products. Businesses licensed to be part of the industry would pay an annual medical cannabis privilege tax.
How would the revenue be used?
The commission would use the revenue to cover the cost of regulating the program. Revenue in excess of what is needed for regulation would go to the state General Fund and a new Medical Cannabis Research Fund.
Who would do the research?
The bill would establish the Consortium for Medical Cannabis Research that would include the HudsonAlpha Institute for Biotechnology, the Southern Research Institute, and colleges designated by the Alabama Commission on Higher Education.
Why would the program be fully intrastate?
According to the legislation, that would reduce the risk of exposing companies to penalties under federal law, which has not approved medical use of marijuana.
How would the public know how the program is working?
The Alabama Medical Cannabis Commission would file annual public reports showing the number of patients, what conditions they are receiving medical cannabis for, the revenues and expenses of the program, updates on research, programs in other states, and changes in federal law, and other information.
