Senators in Hawaii on Wednesday gave approval to a medical marijuana bill that would, among other changes, allow healthcare providers to recommend cannabis to treat any condition they believe it would benefit.
The full Senate chamber voted 24–1 to approve HB 302, from Rep. Gregg Takayama (D).
According to the proposed amendment, it would be clarified that, according to state law, an initial consultation in person with a patient is not required before a recommendation for medical marijuana can be given.
Last month however, a couple of Senate committees changed the bill so that it could be used for any medical condition that a physician or an advanced practice registered nursing (APRN), believes would benefit from its use. Presently, providers are only allowed to recommend marijuana for certain maladies listed by a state.
This provision defines “debilitating condition” as “any condition that is determined to be suitable for medical cannabis use by a certifying doctor or registered advanced practice nurse.”
This would allow patients with conditions which could benefit from the use of medical marijuana to have access to it, even if their ailments are not recognized by officials.
The bill was not discussed by senators before the vote on Tuesday. Brenton Awa was the lone senator to cast a no vote.
The move to allow healthcare providers to recommend medical cannabis to patients for any condition they see fit is in line with a plan announced last year by Gov. Josh Green (D) to expand access to marijuana in light of the legislature’s failure to pass recreational legalization measures.
“This would make it very available—that’s marijuana—for those who choose it in their lives,” the governor said in an interview, “and it would still keep kids safe, which has been everyone’s priority.”
Green also reiterated that he supports the full legalization of recreational marijuana.
“I’m of the opinion that adult marijuana users who use it in a responsible manner should have access to legal cannabis,” said he.
State Department of Health is not happy with the current medical marijuana bill.
In a previous written statement, the Department stated that “while it supports the ability of medical professionals to diagnose and treat patients using their professional judgement,” there is little scientific evidence in support of the use cannabis in conditions other than those listed by statute. The Department has a particular concern about the potential risk to patient safety. This includes adverse drug interaction between cannabis and an existing patient’s treatment plan.
The department suggested an amendment to address these concerns. It stated that only the patient’s consent could be used. Treatment provider be authorized to certify patients for nonspecified conditions—a suggestion lawmakers have so far declined to take up.
Nevertheless, some reformers have expressed concerns about other sections of the law. Hawai’i Alliance for Cannabis Reform, for instance, opposed a proposed new Class C felony for running a dispensary with no license.
The group said in general, however, that HB 302 “would make it easier for HawaiʻResidents who may benefit from using medical marijuana should speak with an expert, apply for the program and register, then purchase lab-tested medicines.”
With the Senate’s passage, the bill next returns to the House, where lawmakers will consider the Senate amendments—including the provision expanding qualifying conditions.
Karen O’Keefe of the Marijuana Policy Project’s director of State Policies urged members to sign the new policy.
In an email, she said that the Hawai’i House of Representatives had let voters down by refusing to legalize marijuana. However, there is still a chance to make significant progress with medical cannabis. The House should take the Senate’s example and let practitioners certify any patient with a medical condition as eligible for medical marijuana.
O’Keefe pointed out that, with most pharmaceuticals, doctors can prescribe medication off-label for conditions it is not approved to treat.
“Doctors are allowed to prescribe far more dangerous drugs ‘off-label'” than marijuana, she wrote. They should also be trusted to tell their patients if cannabis could help them.
A bill to create a pilot two-year program for clinical research on psychedelics-assisted therapy, which includes substances like psilocybin or MDMA, has also been advancing through the legislative.
Lawmakers also recently sent a bill to the governor that would help speed the expungement process for people hoping to clear their records of past marijuana-related offenses.
That measure, HB 132, from Rep. David Tarnas (D), would expedite expungements happening through a pilot program signed into law last year by Gov. Josh Green (D). It would, in particular, remove any distinction made between marijuana and Schedule V drugs when it comes to the program of expungement.
Bill’s supporters say that the existing wording in the law requires state officials manually to search through thousands of criminal histories to determine which records are eligible to be expunged under the pilot project.
Hawaii’s Senate, in February of this year, narrowly defeated another proposal which would have allowed a person to possess five times as much cannabis without the risk of criminal prosecution. The body voted 12–11 against the decriminalization measure, SB 319, from Sen. Joy San Buenaventura (D).
The amount of cannabis that is decriminalized on Hawaii would be increased to 15 g if the law had been passed. The possession of up to 15 grams of marijuana would be considered a civil offense punishable with a $130 fine.
Separate Senate legislation that would legalize marijuana for adults has meanwhile been stuck in the legislature. SB 1613 had not yet been passed out of the current committee, despite an expiration date last month.
While advocates feel there’s sufficient support for the legalization proposal in the Senate, it’s widely believed that House lawmakers would ultimately scuttle the measure, as they did last month with a legalization companion bill, HB 1246.
While it’s not clear whether legislators will use them, some observers have pointed out that there are still legislative maneuvers to be pursued in order to bring back the Senate legalization legislation this session.
Last session, a Senate-passed legalization bill also fizzled out in the House.
The House vote to stall the bill came just days after approval from a pair of committees at a joint hearing. The panels had received almost 300 pages of testimonies from various state agencies, advocacy groups and the general public.
Meanwhile, legislation is advancing this session to allow healthcare providers to recommend cannabis to treat any condition they believe it would benefit, instead of only those maladies on a specific list, as is the case under current law.
Separately, the House Committee on Labor in January unanimously voted to advance legislation that would protect state-registered medical marijuana patients from discrimination in the workplace. This bill (HB 325) hasn’t yet been considered by the Senate.
This past fall, regulators solicited proposals to assess the state’s current medical marijuana program—and also sought to estimate demand for recreational sales if the state eventually moves forward with adult-use legalization. The move was interpreted by some as an indication that the regulators were preparing for a possible reform.
Hawaii passed a medical cannabis law through the state legislature in 2000, making it the first U.S. states to do so.
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Mike Latimer provided the photo.