Expanding Medical Marijuana

In Brief

  • Medical use of marijuana in New Hampshire was authorized in 2013.
  • The law set forth a list of qualifying conditions and symptoms. Purchases are restricted to two ounces every ten days at one of four state licensed alternative treatment centers.
  • Though the list of qualifying conditions was expanded by law in 2015, 2016 and 2017, debate continues over whether use of the drug should be allowed for more patients.
  • Pro: Medical marijuana can be a safe and effective treatment for the symptoms of terminal illness and chronic diseases.
  • Con: As a drug that lacks FDA approval, medical marijuana can be unpredictable in its effects, difficult to control in dosage, and potentially addictive.

Detailed Summary

Medicinal marijuana refers to using the marijuana plant or derivatives of it to treat symptoms of disease and other conditions. The U.S. Food and Drug Administration (FDA) has not recognized or approved the marijuana plant as medicine.

New Hampshire’s medicinal marijuana law (HB 573) permits use for patients diagnosed with a qualifying condition or who suffer from severe pain or other symptoms. 

Patients must get a certification letter from a doctor with whom they have an established relationship, and can then apply for a medical marijuana card from the Department of Health and Human Services. Learn more about applying.

Additional conditions are considered on a case-by-case basis when the patient’s provider submits a written request to the state’s Department of Health and Human Services.

Qualifying patients can purchase up to two ounces of medicinal marijuana every ten days at one of four alternative treatment centers, which are located in Lebanon, Dover, Merrimack and Plymouth.  The law limits the number of alternative treatment centers to four, but each center is permitted to have a second location for cultivation of marijuana.

Patients may also designate a caregiver who is authorized to purchase and administer the drug for them.

New Hampshire is one of only two states in New England where medicinal marijuana is legal, but growing marijuana at home is not permitted.

History of Medical Marijuana in NH

Before HB 573, medicinal marijuana laws passed the Legislature in 2009 and 2012. Both bills were vetoed by Governor John Lynch. In 2012, Gov. Lynch cited concerns about the proliferation and distribution of medicinal marijuana as reasons for his veto.

The passage of HB 476 in 2015 expanded qualifying conditions to include epilepsy, lupus and Parkinson’s disease. Ulcerative colitis was added by the passage of HB 1453 in 2016, and 2017 saw hepatitis C, post traumatic stress disorder, and chronic pain included as well. 

There was a controversial delay in implementation of the law, with medical marijuana cards finally being issued in December 2015 and the state’s alternative treatment centers opening in 2016.

Federal law 

Despite the fact that 29 states have legalized medicinal marijuana and another 16 states have laws allowing the medical use of a marijuana extract, the federal government views marijuana as an illegal drug.

However, in 2009, the Department of Justice issued a memo to all federal prosecutors recommending they “not focus federal resources in your states on individuals whose actions are in clear and unambiguous compliance with existing state laws providing for the medical use of marijuana.” This has been interpreted as an instruction that federal prosecutors not pursue cases against medical marijuana users or providers who are acting in accordance with the laws in their states.

Law in other states

Of the 29 states where medicinal marijuana is legal, 16 states allow patients to grow marijuana at home. Four other states allow home cultivation under a certain set of conditions, such as distance to nearest dispensary, financial hardship, etc.

An additional 16 states have laws that allow the use of Cannabidiol (CBD) extract for medical purposes, but not the cannabis plan itself. CBD is the main non-psychoactive chemical component of marijuana. It is considered a controlled substance by the DEA. New Hampshire’s law does not address CBD.

Areas of Contention

Doctor’s Discretion

California allows medicinal marijuana for any chronic or persistent medical symptom “that substantially limits the ability of the person to conduct one or more major life activities (as defined by the Americans with Disabilities Act of 1990s),” essentially giving doctors sole discretion. Massachusetts has a similar provision in its law.

Access and Distribution
New Hampshire law requires medicinal marijuana be purchased at one of the state’s four licensed dispensaries. Driving distance can be burdensome for some, as can the cost since medicinal marijuana is not covered by insurance. Some states, such as Massachusetts, require a patient live a certain distance from the nearest dispensary or qualify for financial hardship before they are permitted to grow marijuana at home. All states that allow home growth limit the number of plants cultivated, usually within a range of 6-12.

Some supporters of broadening access to the drug argue that allowing patients to grow marijuana at home could eliminate travel issues and make marijuana more affordable for patients. Opponents express concerns that the quality and safety of home-grown marijuana could vary, or that home grown marijuana could be a lure for increased criminal activity.   

Distribution via pharmacy and vending machines are two scenarios currently being considered in Canada. 

PROS & CONS

"For" Position

“New Hampshire should expand its medicinal marijuana law.”

  • Allowing the use of cannabis for a greater list of conditions would provide patients with a safe, natural alternative to opioids, which can be highly addictive.
  • Though there have not yet been solid clinical trials in the U.S., preliminary data indicates that cannabis can be effective for treating many conditions.
  • If there were negative side effects from using medical marijuana, evidence of that would have surfaced.
  • For patients who start using the drug as an adult for medical purposes, there is almost zero risk of addiction.
  • Limiting access to the drug to a list of conditions excludes those suffering from other ailments or more complex combinations of health issues whose symptoms could be alleviated by cannabis.

The preceding points were made by former state Rep. Joseph LaChance and Dr. Gil Fanciullo of the Pain Management Center at Dartmouth-Hitchcock Medical Center during an episode of NHPR’s The Exchange on August 24, 2016. 

"Against" Position

“New Hampshire should maintain or scale back its medicinal marijuana law.”

  • Herbal marijuana meets none of the criteria used to ensure that other drugs are safe and effective, including extensive studies, careful monitoring of production and delivery, and  monitoring after approval for side effects or other negative outcomes.
  • It’s impossible for doctors to safety prescribe and monitor marijuana because the levels of active cannabinoids are unpredictable and delivery methods—such as smoking, eating, or vaporizing—also effect dosage.
  • Regular use of marijuana does have negative side effects, including impaired brain development in young people, and has been associated with psychological problems and poor work and school performance.
  • More individuals in the U.S. seek addiction treatment for marijuana than for any other drug except alcohol.
  • If used at all, medical marijuana should be limited to patients whose symptoms do not respond to approved medications and procedures.

The preceding points were made by Dr. Seddon Savage of the Dartmouth Center on Addiction, Recovery & Education in her testimony against New Hampshire’s medical marijuana law, made on behalf of the New Hampshire Medical Society. 

LEGISLATIVE HISTORY

Signed by Governor

Adds hepatitis C without antiviral treatment to the qualifying medical conditions for medical marijuana.

Passed House

Permits qualifying patients and registered caregivers to grow medicinal marijuana at home.

Died in Conference Committee

Changes the medicinal marijuana law to allow marijuana for injuries or conditions that result in qualifying symptoms, not just injuries that significantly interfere with daily activities. The House and Senate incorporate language from this bill into HB 160.

Killed in the House

Adds myelitis disorder or disease to the qualifying medical conditions for medical marijuana.

Killed in the House

Makes various changes to the medical marijuana law, for example adding PTSD and opioid addiction to qualifying medical conditions, and removing the requirement of a 3-month medical relationship between doctor and patient before medical marijuana is prescribed.

Tabled in the House

Allows medicinal marijuana for "severe pain that has not responded to previously prescribed medication or surgical measures or for which other treatment options produced serious side effects."

Signed by Governor

Adds community living facilities for people with developmental disabilities or mental illnesses to the definition of "facility caregiver" in the medical marijuana law.

Signed by Governor

Adds chronic pain to the qualifying medical conditions for medical marijuana.

Killed in the House

Adds opioid addiction to the qualifying medical conditions for medical marijuana.

Killed in the House

Adds fibromyalgia to the qualifying medical conditions for medical marijuana.

Signed by Governor

Adds post-traumatic stress disorder to the qualifying medical conditions for medical marijuana. The Senate amended the bill to also include every other change to the state's medical marijuana law that passed this year. This bill was also amended to include language from SB 144, allowing marijuana for injuries or conditions that result in qualifying symptoms, not just injuries that significantly interfere with daily activities.

Killed in the House

Adds post-traumatic stress disorder to the qualifying medical conditions under the medical marijuana law.

Signed by Governor

Adds ulcerative colitis to the list of qualifying conditions for medical marijuana.

Killed in the House

Allows two additional medical marijuana treatment centers.

Killed in the House

Allows the Department of Health and Human Services to authorize medical marijuana use for a medical condition that is not listed in the law on a "patient by patient" basis rather than "case by case" basis.

Signed by Governor

As originally written, this bill would allow providers in neighboring states to prescribe medical marijuana, and would change the amount of marijuana dispensaries may have on location. The Senate amended the bill to instead revise confidentiality requirements for law enforcement requests for information about registered medical marijuana patients. The House then amended the bill to make a number of changes to the medical marijuana law, such as limiting criminal background checks to felony convictions.

Signed by Governor

Allows a person obtaining a driver's license to choose whether the license complies with the federal Real ID Act of 2005.

Killed in the House

Allows physician assistants to prescribe medicinal marijuana.

Killed in the House

Broadens the medical conditions that qualify for medicinal marijuana to include many general symptoms.

Signed by Governor

Adds epilepsy, lupus, Parkinson’s disease, and Alzheimer’s disease to the list of medical conditions qualifying for medicinal marijuana.

Signed by Governor

As introduced, this bill would allow satellite marijuana dispensaries. The bill was amended to only clarify certain procedures in the law governing therapeutic use of cannabis.

Interim Study

Permits qualifying patients and registered caregivers to grow medicinal marijuana at home.

Interim Study

Permits qualifying patients and registered caregivers to grow medicinal marijuana at home.

Signed by Governor

Allows medicinal use of marijuana, without allowing home growing.

Should NH expand its medical marijuana law?

Comments

Timothy Sweetsir's picture
Timothy Sweetsir
- Ashland

Tue, 05/23/2017 - 10:28pm

My own personal opinion is that, although we have much more serious problems facing our state, I don't believe giving people a green light to get stoned is the way to go. I do not agree with the medical marijuana AT ALL, I am a three time Lung Cancer survivor and have never resorted to Marijuana, nor have I had the need to, Today's medical technology is far more advanced and getting better all the time.

Thank you

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Issue Status

New Hampshire now allows medical marijuana to treat patients with chronic pain, post-traumatic stress disorder, or hepatitis C. 

A bill to allow growing medical marijuana at home, HB 472, passed the House but was tied up in the Senate—it could resurface in 2018. 

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