The Case for A Robust Therapeutic Cannabis Program in Louisiana

Photo by Circe Denyer

It has been almost four years since the latest attempt to create a viable therapeutic cannabis program in Louisiana. The first bill to allow for medical cannabis was passed in 1978 – let that sink in for a minute. Then in  1991, the legislation was amended to include spastic quadriplegia, but the entire effort died on the vine and no program was ever made available to the citizens of Louisiana. Both efforts predate the California program which launched in 1996 and is recognized as the first in the nation. Since Louisiana rarely is the first to do anything positive in the United States, kudos to California for leading the way.  Nonetheless, this has been an option in our state for forty years, yet our elected officials have refused to bring a program online. How many Louisianans have unduly suffered because of the stubbornness or wrongheadedness of our elected officials? How many have had no other option but a heavy regimen of pharmaceuticals? These are the same pharmaceuticals that patients testified had limited success in dealing with their illnesses? How many have suffered the negative side effects that have affected their quality of life? Too many, for way too long. It is time to reform the program adopted most recently so that it meets the needs of thousands of patients in Louisiana. Why reform a program just getting off the ground? Not one national cannabis, drug law reform, civil rights, or good governance organization recognizes the current program as a viable one. Let us explore how this program got to where it is today.

In 2015, SB 143 (also known as the Alison Neustrom Act) was introduced to the state legislature to get a therapeutic cannabis program moving forward. This law was adopted by the legislature and signed by Governor Bobby Jindal. However, there was a so-called poison pill embedded in the law. In the wording of the law, Cannabis was to be prescribed by a doctor. Considering that cannabis is a Schedule I controlled substance under the federal Controlled Substances Act (allegedly no therapeutic value and a high propensity for abuse), doctors can lose their ability to prescribe any controlled substances if they prescribe cannabis in a traditional prescription format. In every other state that has functioning medical marijuana programs (over 30 states so far), the laws state a doctor recommends cannabis to a patient. The legislature was well aware of this fact, yet choose to move forward anyway. This enabled the law’s opponents to claim they responded to their constituents,  while not offending The Louisiana Sheriffs and District attorneys Associations who lobbied hard against this bill. These organizations lobbied on a public health matter, even though they are supposed to be criminal justice-focused organizations. SB 143 only covered ailments covered in the 1991 version of the bill: glaucoma, symptoms resulting from the administration of chemotherapy cancer treatment, and spastic quadriplegia.

In the 2016 legislative session, three bills were filed concerning the therapeutic cannabis program. Senator Fred Mills (The author of SB 143), authored two of these bills. SB180 fixed the wording issue from the last session’s bill to replace “prescribe” with “recommend.” SB 271 was another bill authored by Senator Mills and extended the program to include additional debilitating medical conditions (cancer, positive status for human immunodeficiency virus, acquired immune deficiency syndrome, cachexia or wasting syndrome, seizure disorders, epilepsy, spasticity, Crohn’s disease, muscular dystrophy, and multiple sclerosis). The law also gives the right of first refusal to LSU and SU schools of Agriculture as the growers of medical cannabis for the program. Both bills were signed into law by Governor John Bel Edwards. State Representative “Ted” James also authored HB 1112 in that session. HB 1112 was a sensible cannabis bill that would have created a comprehensive program in Louisiana. Representative James’ bill would have brought a nationally recognized program to Louisiana. As the “gold standard” we utilize the criteria set forth by Americans for Safe Access, a national organization that is solely focused on therapeutic cannabis and patients’ rights. Their main criticisms of the Louisiana program were that chronic pain was not listed as a qualifying ailment (nationally, a majority of patients use therapeutic cannabis for pain relief) and that the methods of delivery allowed under the program (tinctures, topicals, gelatin-based edibles, and oil-based pills) were too limited. At the very least, a program must allow for inhalation of cannabis extracts such as oil – commonly referred to as vaporization. HB 1112 would have addressed these shortcomings and many others in our program, as well as helped patients with a method of delivery that would be quick acting. A patient suffering from a seizure does not have the luxury of waiting 45 minutes for a digestible delivery method to take effect. Once again, the Sheriff’s Association and the District Attorney’s Association lobbied hard against HB 1112. To the detriment of Louisiana patients, HB 1112 died in committee. The fact remains that a functional program has been offered to the state legislature but “power players” have continuously short-circuited any attempts to bring a robust and nationally recognized program to Louisiana. In the end, it is the patients of Louisiana who suffer because of incremental and half-hearted steps to make a functional system.  As of this moment, the Louisiana medical marijuana program is still not counted among the 30+ states with a functioning system in place.

In 2017 the only bill that pertained to cannabis at all was SB35 by Senator Yvonne Colomb. It provided legal protections to patients in possession of legally procured Louisiana medical cannabis. This bill also gave protections to people working in the state-sanctioned program. This bill was successful in getting signed into law by the Governor

The 2018 legislative session saw more changes to the therapeutic program. Louisiana State University and Southern University had opted in to oversee control of the cannabis grows and had chosen the subcontractors to do the actual growing. They choose this method rather than risk losing federal grant monies flowing to the universities had they grown the cannabis themselves. Also, in 2018, the Louisiana Board of Pharmacy awarded licenses to the nine pharmacies that would provide medicine to patients (a tenth will be awarded based upon which district has the most demand). Once again, Representative James put forth a bill, HB579, to bring our program more in line with programs across the nation. The bill added Post Traumatic Stress Disorder (PTSD), intractable pain, Parkinson’s Disease, Glaucoma, and severe muscle spasms as ailments covered by the program. The original bill also included vaporization as a method of delivery. In an epic fight to get this piece of legislation passed, a compromise was reached that dropped vaporization but preserved adding the new ailments as qualifying conditions to the program. Once again, we came close to getting a recognized program in place, but some of the most powerful organized forces in our state who are opposed to any form of cannabis as medicine again prevailed. Representative Rodney Lyons authored HB627, which added spectrums of autism as an ailment covered under the state’s program. Despite heavy resistance at first, the heart-wrenching testimonies of families that have not seen significant progress for their children prevailed. These patients have been suffering debilitating side effects from various pharmaceuticals, and eventually, the legislature listened and passed the legislation. There were a few other bills introduced (one to increase the number of pharmacies and another to lift a THC cap) but none made it out of committee. Overall, a successful year but still short of a nationally recognized therapeutic cannabis program that actually functions to aid suffering patients in a meaningful way.

Like the 2017 legislative session (odd years are focused on budgetary and tax issues with legislators only allowed five unrelated bills), the 2019 session most likely will not see much in the way of bringing our program up to national standards. Not to say that activists will not try and push for further reforms, but the odds are stacked against us. We do hope that some legislators will have the courage to continue to fight for patient access in a manner respecting what over sixty percent of Americans already have access to. Most activists have focused on getting therapeutic cannabis to the pharmacies for patients to access. Delay after delay has kept this program from launching. The regulations on the producers and the pharmacies have added delays and costs to all involved that eventually will be borne by the patients of our state. This is a real concern that will be realized when the products are finally available, and the prices charged can finally be compared to similar products available in other states. The methods of delivery allowed under our program will also affect the results of patients participating in the program. There is a lot of well-founded fear that the products that are available will either be financially out of reach or ineffective for a large number of patients.

In my outreach work across our state, I often get asked why our program is so strict and overly-regulated when we look at states in our region that are launching robust therapeutic cannabis programs: Oklahoma, Arkansas, and Florida. Mississippi will be voting in 2020 on a very robust program as well. Those states all have the ballot initiative option that Louisiana lacks and despite their legislatures being opposed to such programs. They have had to respect the wishes of their voters (sometimes state courts have had to keep their legislatures in check. We have recently seen attempts at giving the citizens of our state the right to vote directly on cannabis laws, but none of these attempts have been close to successful. Until we have the ability to vote directly via ballot initiative, or we elect legislators willing to honor the will of voters on these issues, I fear we will be in a never-ending battle to create a program that effectively meets the needs of the patients of Louisiana. To add insult to injury, the state will not issue cards to patients that certify their status as cannabis patients. This means that patients can’t travel to states that allow cardholders from other state programs to use their dispensaries (Oklahoma, Arkansas, and most likely Florida). If you want to see a robust therapeutic cannabis program in Louisiana, you must join us to engage in lobbying (or simply calling or contacting and pressuring) our elected officials to finally do what’s right. Until that happens on a large scale, the change we see will be measured in inches rather than feet or yards, and the patients of Louisiana will continue to suffer unnecessarily.

Kevin Caldwell is a New Orleanian who has been fighting for access to cannabis for five years in Louisiana. He is the president and founder of CommonsenseNOLA, a grassroots cannabis rights organization. He is also a board member of Sensible Marijuana Policy for Louisiana (SMPL) a nonprofit organization. If you would like to work with these groups, both have robust social media sites as well as websites to keep you updated on the progress of cannabis reform in Louisiana. Join us and become part of the solution.

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