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Cannabis Act takes effect on Wednesday, two years before program

GETTING IN LINE — In this July 31, 2015, file photo, people line up to be among the first in Nevada to legally purchase medical marijuana at the Silver State Relief dispensary in Sparks, Nev. West Virginia is in the early stages of implementing its own medical marijuana law. -- Associated Press

WHEELING — The West Virginia Medical Cannabis Act officially goes into effect on Wednesday, but a program to offer medicinal forms of marijuana statewide won’t begin until early 2019.

In preparation, the state Bureau for Public Health has established a Medical Cannabis Advisory Board and has started to develop regulations for implementation of the new law.

Members of the advisory board were named Thursday. They include Dr. Arvinder Bir of Huntington; Col. Jan Cahill, West Virginia State Police superintendent; Michael J. Deegan, a social worker from Cross Lanes; Michelle R. Easton, a pharmacist from Charleston; Dr. James Felsen of Great Cacapon; W. Jesse Forbes of Charleston; Dr. Rahul Gupta, commissioner and state health officer, Bureau for Public Health; Joseph Hatton, horticulturalist for the West Virginia Department of Agriculture; Kimberly Knuckles, a pharmacist from Beaver; Dr. Rudy Malayil of Huntington; D. Keith Randolph, prosecuting attorney from Madison; Dr. Joseph Selby of Morgantown and Russell A. Williams, a patient advocate from Nitro.

“The appointment of West Virginia Medical Cannabis Advisory Board members is an important step in the development of the program in our state,” Gupta said. “The board is part of a transparent and accountable process critical to ensuring a comprehensive system that will help citizens suffering from debilitating diseases like cancer.”

Toby D. Wagoner, the bureau’s public information officer, said, “The Bureau for Public Health commissioner’s office is in the preliminary stage of developing an implementation plan, including a legal determination of what rules will be necessary to fully implement the act. There are many considerations, such as program operation, and how applications are to be submitted by growers/processors, dispensaries, patients and caregivers, and physicians.”

Dr. William Mercer, Ohio County health director, has mixed feelings about the use of medical cannabis, but he has visited dispensaries in Colorado, where marijuana is legal for both medicinal and recreational use. Mercer is not serving on the advisory board, but said Gupta has expressed interest in using his input for developing the state program.

Mercer said, “I definitely see that there are benefits to (medical cannabis).” However, he is concerned about a lack of studies regarding volume of dosage, potency of supplies and quality control in the growing process.

Dr. Stephen Wright, a prescribing physician in Colorado, gave Mercer a tour of medical cannabis facilities last fall, when the health officer attended the American Public Health Association’s annual meeting in Denver.

Mercer observed a sharp contrast in dispensaries. He said, “One looked like a dirty old dive bar. Others looked like CVS, with video cameras, well-dressed employees, one aisle for medical marijuana and one aisle for recreational use.”

Of concern, he said, was an apparent lack of pharmaceutical input in Colorado for prescribing medical cannabis.

“When I prescribe (medications), I rely on pharmacists for help,” he said.

Since the legalization of marijuana in Colorado, the number of car accidents has increased in that state, but the number of people driving under the influence has decreased, he said. However, Mercer cautioned that blood and urine testing is not advanced enough to determine level of impairment from marijuana use.

Also unanswered, Mercer said, is the question of whether prescribing medical cannabis can reduce dependence on opioids. “Can we reduce opioid abuse and opioid deaths? I’m not sure,” he said.

Comprehensive rules for prescribing and using medical cannabis in West Virginia are necessary, he said, adding, “We’re certainly not in favor of people just getting a joint and smoking it.”

The new West Virginia law limits medical cannabis to these forms: pill; oil; topical forms, including gels, creams or ointments; a form medically appropriate for administration by vaporization or nebulization; tincture; liquid or dermal patch.

The statute defines “serious medical condition” qualifying for medical cannabis in West Virginia as cancer; positive status for HIV or AIDS; amyotrophic lateral sclerosis; Parkinson’s disease; multiple sclerosis; “damage to the nervous tissue of the spinal cord with objective neurological indication of intractable spasticity”; epilepsy; neuropathies; Huntington’s disease; Crohn’s disease; post-traumatic stress disorder; intractable seizures; sickle cell anemia; “severe chronic or intractable pain of neuropathic origin or severe chronic or intractable pain in which conventional therapeutic intervention and opiate therapy is contraindicated or has proved ineffective as determined as part of continuing care” or terminal illness that is defined as “a medical prognosis of life expectancy of approximately one year or less if the illness runs its normal course.”

According to the law, the Bureau of Public Health will issue up to 10 grower permits (with up to two locations each), up to 10 processor permits, and up to 30 dispensary permits.

Counties will have the authority to ban medical cannabis businesses or limit their locations.

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