This piece originally appeared in the February 2018 issue of the Allegheny County Medical Society Bulletin.

Richard L. Holzworth writes:

In April 2016, Gov. Tom Wolf signed into law Pennsylvania’s compassionate medical cannabis legislation (Act 16), effectively legalizing medical marijuana in the Commonwealth. Since that time, the Pennsylvania Department of Health (DOH) has awarded 12 licenses to grow medical marijuana and 27 licenses to operate medical marijuana dispensaries. It is anticipated that the grow operations and dispensaries will be open for business in early 2018. Although the proponents of medical marijuana have enjoyed widespread support (as evidenced by the 29 states that have enacted a medical marijuana law, including six since 2016), those in the industry are left to trust that Pennsylvania physicians will register with the DOH and send patients to the dispensaries. In other words, now that the legal medical marijuana system is in place, the onus is on physicians to ensure that patients have access to treatment.

Patient and physician registration

It is important for medical professionals to understand that they are not permitted to “prescribe” medical cannabis products. Rather, physicians who have met the registration requirements of Act 16 are permitted to issue “certifications” to patients who qualify for medical marijuana treatment.

In order for a patient to qualify for medical marijuana treatment, the patient must obtain a certification from a registered physician stating that the patient suffers from one of the 17 “serious medical conditions” identified in Act 16. These conditions include:

• Amyotrophic Lateral Sclerosis;
• Autism;
• Cancer;
• Crohn’s Disease;
• Damage to the nervous tissue of the spinal cord with objective neurological indication of intractable spasticity;
• Epilepsy;
• Glaucoma;
• HIV/AIDS;
• Huntington’s Disease;
• Inflammatory Bowel Disease;
• Intractable Seizures;
• Multiple Sclerosis;
• Neuropathies;
• Parkinson’s Disease;
• Post-Traumatic Stress Disorder;
• Severe chronic or intractable pain of neuropathic origin or severe chronic or intractable pain in which conventional therapeutic intervention and opiate therapy is contraindicated or ineffective; and
• Sickle Cell Anemia.

Once a patient obtains a certification, then the patient must apply for a medical marijuana ID card through DOH. If the application is accepted, the patient (or a qualified, registered caregiver) may take the medical marijuana ID card to a state-licensed dispensary to obtain marijuana products.

In order for physicians to issue medical marijuana “certifications,” they must register with the DOH and complete a four-hour training course offered by DOH-approved providers. The DOH training course covers the following areas:

• Summary of Act 16;
• General information about medical marijuana under state and federal law;
• Scientific research on medical marijuana;
• Recommendations for medical marijuana, including pain management, risk management, palliative care, misuse of opioids and medical marijuana, and informed consent.

Physicians also are required to be licensed to practice medicine in Pennsylvania and be qualified, by training or experience, to treat at least one of the 17 serious medical conditions.

Once registered, the DOH will place the physician’s name, business address and medical credentials on the physician medical marijuana registry. The registry does not include contact information (telephone numbers or email addresses).

Importantly, registered physicians are not permitted to advertise that they are credentialed to certify patients for medical marijuana use. The DOH regulations have not provided much guidance in the way of what constitutes “advertising” or what is actually permitted, including whether physicians may list medical cannabis certification on their “menu” of services.Continue Reading A Physician’s Guide to Navigating Medical Marijuana Registration