Cannabis cards in Utah: Calculating the risks
by AMIE SCHAEFFER
I am on the fence about applying for a medical cannabis card. Navigating the Utah Medical Cannabis Program can be a daunting task as a patient. As a first step, many turn to the Utah Department of Health's medical cannabis page. There is an overload of information for patients to wade through. An announcement on the top of the page states
Dr. Andrew Talbott, a Park City physician, specializing in pain management, recommended cannabis for patients by writing letters in the past. While commenting on the potential benefits, he did want to note that, like other medicine, this can cause some impairment.
"In my chronic pain practice, cannabis is a safer alternative to opioids for treating pain, and has the added benefit of potentially treating other symptoms (e.g., muscle spasms, anxiety, sleep)," stated Talbott. "There are very few interactions with other medications, and it cannot cause respiratory arrest or overdose."
Talbott is reluctant to become a QMP because he understands the possible liability that comes along with it. It is a situation that carries risks for physicians.
"When a physician actively enrolls their patient in the program, they are crossing a line drawn by the federal government, specifically the DEA. Every physician with a DEA certificate to prescribe controlled substances agrees not to prescribe any federally illegal drugs. Actively enrolling a patient in the program is prescribing cannabis. Unfortunately, Utah has created a law that forces physicians to violate this agreement and could result in the revocation of a physician's DEA certificate."
Because cannabis remains a Schedule 1 Controlled Substance by the federal government, there are risks for the doctors involved. Talbott would like to see cannabis changed to a Schedule 2 Controlled Substance (but preferably Schedule 3).
"I still provide counseling to patients regarding cannabis use, but I will not jeopardize my DEA certificate by actively providing the access. I am crossing my fingers that the US Senate will change this."
Requiring patients to use a QMP has little benefit to the patients noted Talbott. And patients have concerns about registering with a database that holds their medical information and who will have access to it.
"There is relatively little counseling occurring. There is usually a very high out of pocket cost in the order of hundreds of dollars per year. This cost is not necessary," said Talbott.
High costs create another hurdle for many patients. According to a Fox 13 report, two medical cannabis bills are being considered at the state legislature, including Senate Bill 170, Senate Minority Whip Luz Escamilla sponsors.
"There's a limited number [of QMPs] in the state. We were hearing cases of some of those physicians charging $600 an appointment," said Escamilla, during a legislative session on Feb. 11. "This, as you can imagine, was becoming a concern of access."
According to Talbott, another major drawback to the new requirements is limiting patients to only purchasing cannabis within state lines.
"It greatly impacts patients who need to use cannabis for their medical issues but don't want to violate state laws," stated Talbott. "The quality, selection, price, and availability of cannabis outside the state of Utah is superior to that in our licensed dispensaries here."
Talbott explained that the number of growers in Utah is not meeting demand leaving pharmacies understocked, ultimately impacting patients, sending some out of state.
"While I cannot condone this activity, I do understand why they do it. I think that the state of Utah should publicly state that they will not prosecute patients for possessing products from out of state."
Talbott's decision not to become a QMP is a multi-faceted one. The way the system is currently set up is not focused on the patient's best interest. The navigation is not patient-friendly, and it forces the patient to leave their comfort zone of being treated by their primary care physician.
"There should [be] no limits on how many patients a physician can treat. No other limits exist in this state limiting how a physician treats their patient. Limiting the way a physician treats their patient is unethical and potentially illegal," said Talbott.
Getting a medical cannabis card seems to come with a lot of strings attached. Will I get proper guidance from a QMP? Is the cost worth it? Do I want to be part of a database that can be accessed and potentially used against me? I still have a lot of hesitation and questions. In the coming weeks, I will continue talking to doctors and reaching out to dispensaries.