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Alabama and Kentucky Poised to Legalize Medical Marijuana? Not So Fast

Four states may allow limited access to cannabidiol while maintaining existing legal restrictions on the whole cannabis plant.
 
 
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Lawmakers in several states are poised to enact legislation in the coming weeks aimed at providing patients—primarily children with forms of intractable epilepsy—with strains of cannabis and/or cannabis extracts high in the compound cannabidiol (CBD).

Cannabidiol is an organic cannabinoid that posseses therapeutic efficacy in a wide range of preclinical models, but has been subject to little clinical investigation. In safety evaluations, the short-term administration of CBD has been shown to be relatively safe and well tolerated; unlike THC, the compound is not psychoactive. Anecdotal reports suggest that ingesting concentrated quantities of CBD in tincture reduces the quantity and severity of seizures in children with treatment-resistant form of epilepsy, such as Dravet’s syndrome. 
 
In response to these growing number of anecdotal reports, and to the emotional testimony of the parents who care for these children, lawmakers in a number of states have pushed forward specific proposals intended to provide limited access to CBD while simultaneously maintaining existing legal restrictions on the whole cannabis plant. Though well intentioned, these measures should not be conflated with the legalization of medical marijuana. They do no such thing. In all likelihood, these limited proposals will prove to be largely unworkable and will provide little if any relief for the patient community they are intended to serve.
 
Here’s a closer look at some of the more prominent CBD-only measures making their ways through the states and why these proposals will likely not meet the needs of patients.
 
Alabama: Senate lawmakers have unanimously approved SB 174, aka "Carley’s Law," which seeks to allow investigators at the University of Alabama to study CBD in FDA-approved trials. But no change in state law is actually necessary to permit state university researchers to conduct clinical trials on cannabidiol. Such FDA-approved protocols are already permitted under federal law, but they require the added approval of regulators at the DEA, NIDA (National Institute on Drug Abuse), and PHS (Public Health Service). However, since CBD (like marijuana) is classified as a Schedule I substance under federal law, these agencies have historically been reticent to allow such studies to go forward, a fact that will likely remain unchanged even if House members similarly sign off on Carley’s Law. 
 
Georgia: A Senate panel last week amended and approved House Bill 885, aka "Haley’s Hope Act." As previously passed by the House, the measure sought to authorize academic medical centers to grow high-CBD strains of the plant and develop non-inhalable extracts of the cannabinoid. That plan would have butted up against federal law, which according to the present administration, forbidsany provider of cannabis for research purposes outside of the federal government. The amended Senate plan removes any references to marijuana cultivation and instead only provides for an exemption from state prosecution for those who obtain CBD oil from a legal medical marijuana state and transport it back to Georgia.

In theory, this would allow Georgia parents to visit a state like Colorado to obtain medicine for their children. But in practice, Colorado’s medical marijuana law only allows those who are state residents and who possess a state-issued patient identification card to legally purchase such products. In other words, Georgia parents would have to violate Colorado law to obtain CBD-oils (which are likely to only be available from a medical dispensary, not a retail cannabis market). Colorado medical marijuana dispensaries would also be in violation of not just the letter of the law, but also the spirit of the law by providing a product they know is intended to be transported across state lines—a clear violation of the guidelines put forward in the August 2013 Department of Justice memo which call for “preventing the diversion of marijuana from states where it is legal in some form to other states.”
 
Kentucky: Senators last week gave unanimous approval to Senate Bill 124. The measure now awaits action from the House. Like Alabama’s proposal, the bill calls on University of Kentucky researchers to study CBD in clinical trials—something they could do with or without passage of a new state law, if the necessary federal agencies agreed to it. The measure also seeks to allow physicians at state teaching hospitals to recommend CBD to patients. However, past experience from other states indicates that this latter scenario is unlikely. In 2013, Maryland lawmakers enacted legislation to allow physicians at the state’s limited number of teaching hospitals to dispense cannabis. To date, no Maryland hospitals have taken up the state’s invitation to do so. A separate measure introduced in Kentucky this year that sought to allow patients with their physicians’ authorization to possess and grow whole plant marijuana was tabled by lawmakers.
 
Utah: House and Senate lawmakers have given final approval to House Bill 105, aka, "Charley’s Law." Utah’s governor is expected to sign the measure into law imminently. Like Georgia’s proposal, the Utah law, which sunsets in 2016, provides protection from state prosecution for parents who can acquire CBD-oil for their epileptic children, assuming a neurologist has authorized the treatment. But, as will be the case in Georgia, Utah patients will likely only be able to obtain CBD from out of state, an act that would violate neighboring states’ medical cannabis laws. The Utah proposal also calls on the state Department of Agriculture to grow industrial hemp for the purposes of one day producing cannabis medicines. However, it remains to be seen whether such industrial crops can yield therapeutically effective CBD-extracts or whether federal lawmakers would even allow such a state-sponsored research project to move forward. 

 
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