It’s been almost 15 years since the law was enacted, and Hawaii still doesn’t know what to do with its medical marijuana program. It’s actually less of a program than a policy, and that policy is: Hawaii residents can get a prescription for the drug, but filling it is another matter.
If the state had the concern that it should about maintaining the integrity of the program and quality control for the drug it provides, lawmakers would finally finish the work they started in 2000 by establishing a regulated dispensary system. The fact that it hasn’t yet done so means that anyone enrolled in the program is on their own, with no reasonable way to ensure the effectiveness or safety of what they’re using.
Hawaii, once thought to be on the vanguard of the movement to enable the legal use of marijuana for medical purposes only, now has fallen behind states such as Colorado and Washington, which have legalized it altogether. The changed landscape means most of the advocacy energy has shifted toward the goal of legalization or at least decriminalization.
But rather than rushing to follow those states, it makes more sense at this point to let them serve as the national pilot programs. Hawaii should learn whatever lessons their experience imparts. Implementation of recreational marijuana has not come without problems, not the least of which is unanticipated bad reactions to the drug infused in food products.
Some pitfalls, such as residents carrying marijuana while they cross lines into states where it’s still illegal, may be less of an issue in an island state. But there would still be repercussions here, demanding better surveillance at airports.
By now there have been ample opportunities to learn from other states about the best way to establish and regulate medical marijuana dispensaries, and lawmakers and advocates should let all that experience inform Hawaii in creating its own system.
The Medical Marijuana Dispensary Task Force was created through legislative resolution in the 2014 session to ride herd on just that project. A report is due out before the convening of the 2015 Legislature, but documents posted on the task force website (www.publicpolicycenter.hawaii.edu/projects-programs/hcr48.html) show some of the issues to be resolved.
For example, the group estimates the number of patients at 13,000 and is considering a network with a ratio of one dispensary per 500 patients, according to a preliminary report — large enough to reach everyone while being small enough to be manageable by regulation. This seems a prudent idea, aimed at avoiding the loosely controlled proliferation of dispensaries in California, for example.
Other issues to be resolved include how much to charge dispensaries in fees. Among the six states the task force studied, Nevada charged at the high end — $5,000 for the application, $30,000 for the license — while Oregon charged no such fees.
Where laboratory tests and quality control are concerned, New Mexico seemed to set the strictest standards. How each state manages a patient database is variable, too, as was the requirement for security at each dispensary.
But the most critical issue is the controls over the production and dispensing of the drug itself. If patients can’t grow their own, they resort to the black market.
This is hardly the expectation one should have of any system that appropriates the term "medical." Marijuana has been shown to have utility in countering the pain and discomfort of cancer treatments, and there has been work using a variant to lessen the seizures of epilepsy and other conditions.
Patients with such legitimate uses for the drug deserve the same standards as are applied to the distribution of other medications. For now, lawmakers need to set aside all the debate over legalization and finish the job they started in 2000, establishing a viable system for the medical use of marijuana.
