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Abstract

Permitting the use of marijuana for medical purposes in South Carolina is a divisive issue with well-intentioned people on both sides of the debate. We at Palmetto Family realize that each side has valid reasons for their stance, and many hold a position that is forged out of personal experiences with a loved one – both positively and negatively. Our desire at Palmetto Family is not to divide people of good will or demonize anyone taking a sincere position on medical marijuana, but rather to inform the public regarding this issue as it is currently being proposed to the Palmetto State and to give thoughtful, well-researched analysis.

On the one hand, many feel it would be unkind and uncompassionate to withhold effective treatments from those in need. On the other, there are many who hold valid concerns that releasing a psychoactive drug on society could have harmful unintended consequences. In addition, the explosive rate at which states are embracing, not just medical cannabis, but the complete legalization of marijuana for recreational use carries with it even greater social concerns.

We understand and appreciate the concerns from both sides, both personally and professionally. Some may say that Palmetto Family has taken too strong of a stance regarding medical cannabis and others might argue we should take a much stronger position. We hope, ultimately, that our contribution to the discussion will contribute to the best possible benefit of South Carolinians.

We appreciate the work and thoughtfulness the bill’s author has devoted to this topic in evaluating how similar bills have been introduced in other states, and in addressing many concerns expressed here in South Carolina. We pray our leaders will find the wisdom and guidance needed for making the best decisions on this issue.

1. Minors access to cannabis dispensaries

The bill does address oversight for minors, but it stops short of stating that minors should not, personally, hold a medical cannabis card or have access to a dispensary. It should be clear that minors under the age of 18 should never be allowed access to a dispensary without a parent or legal guardian present.

Allowing minors access to a dispensary or the ability to purchase medical cannabis without a parent present would create a path for abuse among minors. The current wording of the bill could possibly allow a 15-year-old to purchase medical cannabis flower, leaves or edibles on his own.

2. No religious exemptions

The bill removes any ability for a faith institution to prevent their employees from engaging in the use of medical cannabis. There are many faith institutions in the state that hold religious beliefs regarding alcohol, illegal drugs, smoking and other activities contrary to their faith. This bill would force such institutions to act in a way that violates their faith.

We must remember that medical cannabis is still illegal, federally. This bill also makes it difficult for employers to terminate an employee who is under the influence of cannabis during work hours. The bill does allow an employer to discipline an employee for such activity but states “No employer may discharge, threaten, refuse to hire, or otherwise discriminate or retaliate against an employee regarding an employee’s compensation, terms, conditions, location, or privileges solely on the basis of the employee’s status as a cardholder.”

These sections need clarification and should state that an employee can be terminated for such activity while at work. The bill possibly creates issues at faith-based institutions of higher learning. The bill allows for students to vape and use medical cannabis in their dorm rooms. This would force faith-based schools to violate their beliefs if an exemption isn’t permitted within the bill.

3. Loophole for reckless driving under the influence

There is currently no technology or medical device that objectively determines if a person is impaired by marijuana. There are also no standards that state what amount in a person’s system would constitute being “under the influence.”

This bill creates a dangerous exemption that the “presence of cannabis metabolites” shall not deem a person under the influence. This exemption could create a framework for preventing a person from being prosecuted for driving under the influence of marijuana.

It would be practically impossibly, from a prosecutorial stance, to prove someone was illegally under the influence of marijuana. Even if they were involved in an accident or killed someone while operating a vehicle, it would be difficult to prosecute because of this exemption and other factors.

The bill even states that if someone is found driving under the influence of marijuana, they face a one-year loss of their medical cannabis card and not a permanent loss regardless of the number of prior offenses.

4. Smoking of cannabis

While this bill makes it “unlawful for a cardholder to smoke cannabis,” it actually facilitates the smoking of cannabis by making available for legal purchase “all parts…of the cannabis genus of plants” and allows specifically for the legal sale and purchase of the “cannabis flower.” It also permits the sale of paraphernalia which could include bongs and pipes that are solely used for smoking.

The bill also reduces or decriminalizes the charge of smoking cannabis to a maximum of $150 dollar fine and does not state that a card holder would lose their access by smoking cannabis. To say someone should not smoke cannabis, but make allowances for everything to smoke cannabis (including decriminalization) opens the door for cannabis to be obtained with the intent of smoking.

The bill does state that smoking cannabis is not permitted, but stronger safeguards should be considered. Another concern is that the bill does allow the vaping of cannabis.

5. Decriminalization of marijuana

This bill decriminalizes the possession of marijuana to only $150 for amounts over 2 ounces. Reducing marijuana possession to a civil fine would allow any card holder to have rights and protections above other citizens.

It could also encourage anyone who illegally sells or transports marijuana to become a card holder to possibly avoid prosecution for possession. This could make it problematic for law enforcement to prosecute those who traffic marijuana. It could also be seen as the General Assembly’s push for recreational use of marijuana by decriminalizing cannabis for amounts over 2 ounces.

6. Cannabis with limited medical oversight

The bill could grant a cardholder the ability to acquire cannabis for a whole year with no ability to require or monitor medical oversight or follow-up appointments with a physician. This bill only recommends that a patient follow up with their doctor within 3 months, but nothing in the bill requires the patient to keep or seek the medical follow-up.

The patient does not face restricted access to cannabis or the expiration of their card once their treatment plan has concluded (if less than one year). This does not treat medical cannabis like any other pharmaceutical which requires that when a prescription has concluded, a patient must have the prescription renewed or changed. Someone could qualify for medical cannabis for a limited condition (30 days) but continue to access medical cannabis for an additional 11 months beyond what a doctor would recommend.

This section is highly problematic because it could lead to addiction and an epidemic similar to what we are seeing from prolonged use of opioids. The card holder tracking system must clarify that such safety measures would be required because none currently exists in the bill.

7. Unlimited amounts of medical cannabis

The patient registry and/or the “Seed to Sale” registry does not clarify that there is a system in place for a dispensary to know in real time if a patient has exceeded their limit of 2 ounces every 14 days. The registry only require a dispensary to verify if the cardholder is authorized. It does not require enabling technology for a dispensary to track in real time if a cardholder has exceeded their limit of medical cannabis within the allotted time.

A card holder could hypothetically acquire 2 ounces of medical cannabis from every dispensary in the state every 14 days. That could amount to a minimum of 122 ounces of medical cannabis every 14 days or 3,172 ounces of medical cannabis a year. The bill addresses the tracking methods from growers, processors, and retail establishments but does not address how, or provide the ability to track card holders in real time. It only states that a card holder shall not exceed 2 ounces within a 14-day window but does not provide any penalties (other than a civil fine) for a card holder who knowingly violates this limit.

There is nothing in the bill that states DHEC or a dispensary has to verify if a patient has exceeded their 2 ounce restriction every 14 days. There must be a real-time electronic monitoring system (like our pseudoephedrine monitoring system) which flags and prohibits individuals from purchasing in excess of legal amounts.

8. Lack of local government oversight

This bill removes local regulation of dispensaries. It also prohibits many options that local governments currently enjoy when it comes to the regulation of industries within their jurisdiction. By removing oversight from local communities, protections under Home Rule are disregarded and extraordinary power is given to DHEC over local governments.

Local governments should have final say over what is acceptable conduct in their communities. They should have the ability to regulate such institutions as they do with any other place of business. Other states that have adopted more liberal medical cannabis bills have even allowed for local governments to have control. It is important for citizens in their communities to have the ability to voice their concerns regarding this topic.

9. Access for patients with substance use and mental disorders

The bill only states a physician “may” require specialized assessment and treatment. There are numerous medical reports and studies which show that patients with these types of conditions could be dramatically harmed by cannabis use. This is problematic if patients with a history of these disorders are not required to have specialized medical professionals evaluate their conditions before such a substance is given.

The bill gives thoughtful consideration in this area, but it does not require it to be followed. Physicians should be required to follow the procedures set forth by the bill once one of these medical concerns is identified.

10. Out-of-state residents purchasing cannabis

This bill forces DHEC to provide South Carolina issued medical cannabis cards to all out-of-state residents who possess their state’s medical cannabis card or equivalent identification. Other states allow card holders to qualify for medical cannabis via online portals with little or no oversight or medical consultation. This could allow individuals, who’s intent is not for medical purposes, access to medical cannabis.

11. Unregulated cannabis paraphernalia

The bill allows the sale of paraphernalia if it is to be used for cannabis. There are no guidelines or restrictions as to what type of paraphernalia could be prohibited. This would open the door for dispensaries to sell paraphernalia such as bongs, pipes and other devices which are not authorized for medical purposes.

12. Homeless access medical cannabis

This is problematic because there would be no way to follow up with the patient and would lead to greater issues in the homeless community. This would also make card holders who are homeless targets on the streets for individuals seeking marijuana. Additionally, it could create problems for law enforcement when dealing with individuals who are impaired or intoxicated while using medical cannabis in public.

13. Unregulated cannabis at dispensaries

Unlike every other prescription pharmaceutical, which requires oversight by a licensed pharmacist on site, this bill removes that important oversight and safeguard. This bill does not require a medical professional to be onsite at a dispensary, or that any employee dispensing medical cannabis have appropriate medical licensing or training.

The bill does develop training materials for dispensary personnel but does not require the same type of education required for all other pharmaceuticals. Cannabis is a complex compound that can range in potency and have significant impact on one’s health. A patient could have serious health problems if they are given a compound which is not prescribed or dosed properly. This could be particularly devastating for a minor who is sold cannabis which may not be properly prescribed or dispensed. How does a patient know how much of an “edible” to ingest in order to achieve the desired medical outcome without over-ingesting an amount which could harm the patient?

When a patient is prescribed medicine at a pharmacy, they are given detailed instructions regarding the dosage level and when to take it. This bill allows anyone employed by a dispensary to recommend what a patient should take.

Palmetto Family

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