Doctor discusses business opportunity of medical cannabis

Wednesday, May 9, 2018

Current federal law presents challenges to legal states

With discussion about putting medical cannabis on the ballot for Missourians to legalize due to its documented merit for medicinal use, some discussions are now turning toward the business opportunity, and inherent challenges, within that initiative.

Last week, the Missouri House of Representatives voted 112-44 in favor of allowing anyone over 18 to use smokeless medical marijuana, such as patients with Alzheimer's disease, cancer, post-traumatic stress disorder and other ailments. The bill moved to the State Senate with less than three weeks left in the legislative session.

The medical cannabis ballot initiative proposed by New Approach Missouri, which announced on May 4 that it submitted 374,483 signatures or more than double what was required, would allow the use of marijuana for medical purposes, and create regulations and licensing/certification procedures for marijuana and marijuana facilities; impose a 4 percent tax on the retail sale of marijuana; and use funds from the taxes for health and care services for military veterans by the Missouri Veterans Commission and to administer the program to license/certify and regulate marijuana and marijuana facilities.

"It would have a huge impact on our economy, especially in the Cassville area, if we had a cultivator or dispensary, and in bringing people to the area," said Dr. Lisa Roark, of Roark Family Health.

Roark recently attended two New Approach Missouri fundraising events in Springfield to discuss that opportunity, and has been vocal at other local events, including a town hall-style meeting in Monett to discuss all of the benefits and challenges legalizing medical cannabis would bring.

Dr. Jason Strotheide, founder and president of Noah's Arc Foundation in St. Louis, one of two dispensaries licensed by the state to cultivate industrial hemp to dispense CBD oil to treat seizures, was one of several speakers at a Springfield event.

"He spoke about his experiences and government regulations and the difficulties to be expected," Roark said. "The potential is huge. A lot of was about networking with others who feel strongly about medical cannabis as an option or who sell CBD products and are thinking about having a business. Assuming it gets put on ballot, it limits people who can become cultivators or dispensaries and has very strict requirements. And you have to have strict transportation between the cultivator and dispensary because if someone got into that vehicle, they could take marijuana products. It's a lot to think about.

"For example, one of Dr. Strotheide's issues was that medical cannabis is illegal in Missouri, but he has the right to start growing hemp, but where do you get the seeds, if you can't cross state lines? With laws being different in each state, and its illegal federally if you cross state lines with either hemp or marijuana plants or seeds, you are breaking federal law, so if you're the first person to be allowed to cultivate hemp in the state, how do you purchase the seeds? That will be the same issue we will have how will cultivators start their plants?"

Such a law makes no sense, Roark said.

"It's very strange having a federal law that prohibits what the states are doing," she said. "And federally, if they chose to, they could seize plants and shut down cultivators. If someone went to Colorado where it's recreational and medicinally legal, purchased it and were driving home and got pulled over, they would be prosecuted. I don't know if it will take every single state legalizing before the federal government will agree."

Another problem is the way cannabis is classified by the government.

"[The CBD products] are not enough for medical conditions such as seizure disorder," Roark said. "CBD alone will decrease them but you need a higher level of THC to completely stop them. Yet it's still considered a Schedule 1 Drug federally meaning a drug that has no medicinal use. That's where LSD and heroin are categorized so with deadly drugs, when it is a completely safe medical option it will not kill a person. So to say it has absolutely no medicinal use is ridiculous because, without a doubt, for years it was used medicinally. There is significant research showing it is medically useful. CBD is legal in all states but it has to be below 0.3 percent of THC, so basically none.

"Currently, THC is illegal in Missouri, so anyone who has CBD products has to have lab testing to prove there is no THC in their product. So, one portion of the plant is legal, the other is not. It's not logical. My 11-year old has said, 'Mom, none of this makes any sense. If it's a plant and kids are having seizures, why can't kids use it?'"

If medical cannabis is legalized, patients will be required to obtain a medical marijuana card, Roark said.

"I'll certainly be one of the physicians to determine if someone qualifies for a medical marijuana card," she said. "Only people who have a card will be able to purchase from dispensaries. You have to go to a physician to have an exam and see if you qualify with one of the conditions, such as fibermyalgia, terminal illness, migraine disorder, anxiety, or any of the chronic medical conditions that a physician deems fit to be treated."

Roark expects doctors will see a rush of patients not getting relief from current medical options asking for cannabis.

"Not all doctors will agree to do the medical cards, because if they work for a larger institute, it may be frowned upon," she said. "So, I think there will be independent doctors who will do evaluations to determine if someone is medically appropriate for a card. Doctors will have to learn how it will be used medicinally because right now, there's no education."

Roark believes the reason some doctors have not spoken about medical cannabis is fear.

"Literally Cox or Mercy could say, 'This is illegal in Missouri, you no longer have a job,'" she said. "We have tons of research that supports this, so to me, I don't have any concerns about speaking my opinions. New Approach Missouri's site has links to a bunch of different studies.

"We're in middle of opiate epidemic a lot of people are dying. We have to have another option. They're starting to track who is taking narcotic pain meds. If they deem a patient is being prescribed more pain meds than what they think is appropriate, it will be sent to the medical board, and they will chose whether to take a way a doctors license."

Those with a medical marijuana card would likely get prescriptions from a dispensary.

"The state will decide how many dispensaries there will be and will choose which ones they will accept," Roark said. "Say we have a 100 people in Barry County who get their medical card; if there are no dispensaries locally, they'll have to drive to Kansas City or St. Louis. Look at Arkansas and the situation they're in. Their law passed, but still no one can get medical marijuana because the government has halted all efforts. So no cultivators or dispensaries have been able to get established.

"Big pharmacy pays millions of dollars to lobbyists so it's in some peoples' best interests to keep feeding it. I think the biggest thing is people getting and physicians educated. We have to go from the opinion that medical marijuana is a gateway drug to a medicinal option."

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