If and when Pennsylvania passes a medical marijuana bill, it could well exclude the most common delivery methods: smoking and vaporization.
A hearing for state's medical marijuana bill has been scheduled for February 25 in Harrisburg. The Senate State Government Committee will hear testimony on SB3, the bill sponsored by Senators Mike Folmer (R-Lebanon) and Daylin Leach (D-Montgomery).
The bill is a carryover of very limited concept that passed the senate last year in a 43-7 vote. It restricted the list of qualifying medical conditions to just 10, eliminating ailments like HIV/AIDS. It also limits forms of medical cannabis to only include edible and topical products.
Folmer and Leach have promised amendments to expand the bill so physicians would have more freedom to recommend marijuana to a wider range of patients. Still, there is no word yet on whether smoking will be back in the mix.
Gov. Tom Wolf added his unequivocal support for the legislation after meeting with advocates last week. Wolf promised to sign the bill if it passes floor votes in both houses and reaches his desk. It could be a Catch-22 for patients, though, if the law he signs is too limited in scope.
Public support for medical marijuana stands at 85 percent among Pa. voters. But when residents are asked about the topic they likely assume that patients will be able to use the age-old method of ingesting it.
Inhaled cannabis is the most preferred method among patients for several reasons: Instant relief, ease of dosing and better control of intake.
One way is vaporization. This is a very specific method where the plant material is heated up to about 400 degrees Fahrenheit. The cannabioids, the active ingredients that include THC and CBD, vaporize out of the plant before it catches fire. The vapor is then inhaled. This is the safest and most efficient delivery method, getting the maximum amount of cannabioids out of the plant material with little going to waste.
The most studied vaporizer is a device called the Volcano. It has been used in several medical trials on patients. Manufactured in Germany, it is a steel cone filled with heaters and cooling fans about the size of a large blender. It needs to be plugged in to the wall and is a bit clunky to transport. The Volcano is also expensive at about $500.
Smoking is still the easiest method for inhalation. Numerous studies have shown no adverse health effects even for chronic cannabis smokers.
In 2005, a study was released by Dr. Donald Tashkin indicating that moderate marijuana consumers had a lower frequency of lung cancer than people who smoked nothing at all.
Somehow there is a misconception that smoking cannabis is the same as smoking cigarettes. Nothing could be further from the truth.
Just last month, a report published in the Annals of the American Thoracic Society showed people who smoked an average of one joint per day for 20 years had no adverse impact on lung function.
The authors of that report stated, "[T]he pattern of marijuana's effects seems to be distinctly different when compared to that of tobacco use."
Rolling up some cannabis in a hemp paper or putting it into a pipe is also cheap and easy, compared to vaporization.
There is also a profound difference between eating cannabis and inhaling it. When orally ingested cannabinoids are metabolized in the liver, they can take several hours to take effect and then can last for 8-12 hours. But when inhaled the effects are instant and also wear off within several hours.
Patients need the full range of options. Those suffering from seizure disorders need the long lasting impact of oral ingestion. Those suffering from neuropathic pain or nausea can't choke down an edible or oil. They need the instant relief from inhalation.
Heavily processed marijuana products are also more difficult and expensive to produce and regulate compared to dried plant material.
New York State passed a limited "no-smoke" medical marijuana law last year that also only covers ten conditions. It is already running into trouble. At a community forum held last week sponsoring legislators and advocates decried the hurdles in the law and regulations form the NY Department of Health.
New York City Council member Mark Levine summed up the difficulties; "The current law excludes many diseases for which there is medical consensus that marijuana can truly benefit patients. Even worse, the bill does not allow patients to smoke marijuana, which advocates agree is the cheapest and most efficient way to consume it, thus adversely impacting low-income patients."
Pennsylvania legislators should heed the warnings from New York. The point of passing these laws is to bring patients out of the underground market. Too many restrictions will leave our severely ill family members and neighbors buying marijuana on the street and facing arrest.
We can do better.