Pennsylvania’s medical marijuana dispensaries only began distributing product a week ago, but the state may soon move to expand access and choices for patients by allowing medical marijuana plant sales for vaporization and by increasing the number of qualifying medical conditions.
Pennsylvania currently limits medical cannabis to be sold as pills, oils, topicals, tinctures, liquids and other forms used for vaping. A final decision on whether to allow plant flower sales would fall to Department of Health officials.
While emphasizing that no final decisions have been made, Pittsburgh physician I. William Goldfarb said this week, “My sense is that we will probably move forward with a recommendation [that] we provide access to leaf.”
Dr. Goldfarb is one of 15 members of the Pennsylvania medical marijuana program’s advisory board and one of five members serving on the board’s medical subcommittee.
The state law authorizing the medical marijuana program stipulates the board must submit a report to Gov. Tom Wolf and state legislators in May with recommendations for any changes.
So far, more than 19,600 patients have registered for the program and more than 5,000 have been certified by a physician to access medical marijuana by one of the half-dozen dispensaries currently open. State officials say more than 1,300 patients have purchased medical marijuana during the first week of sales.
The medical subcommittee is specifically looking at whether patients should have access to the plant form of medical marijuana.
It also is considering whether the current list of 17 designated qualifying medical conditions should be changed, expanded or reduced.
“I do not believe that we’re going to recommend any reduction,” said Dr. Goldfarb. He said the subcommittee is looking at possibly adding to the list.
If adopted, access to the raw flower and an expanded menu of qualifying medical conditions would closely follow recommendations that advisory board members heard last week from physician Sue Sisley, president of the Scottsdale Research Institute in Arizona. She is the lead investigator in an FDA-approved study looking at the safety and efficacy of whole plant marijuana in treating combat veterans with post-traumatic stress disorder.
“Sick patients need access to options,” said Dr. Sisley during a visit to Cresco Yeltrah’s Butler dispensary before its opening last week. “You can’t force patients to use oils if they don’t help.”
The dried flower gives patients more control over dosage and has greater therapeutic effect than the alternative forms, she said. Also, she noted that it is expensive to process the raw flower into oils — an expense that gets passed on to consumers.
If costs are too high, consumers may decide they can’t afford them.
“I would worry this program will not survive,” Dr. Sisley said. “This business needs to be able to thrive in order for the patients to continue to get medicine.”
Of the 29 states that have legalized medical marijuana in operation, only Pennsylvania and Minnesota do not allow sale of the raw plant, she said.
“The [oil] concentrates are far more dangerous than raw flower. It’s really hard to overdose on raw flower.”
She also said the concentrates are more likely to be targeted for illicit, non-medicinal purposes.
“At this point, people know that concentrate is where the action is, especially super potent formulatons. They can make you really high.”
The medical subcommittee also is looking at whether the program should change the types of medical professionals who can certify patients; whether to adjust the number of licensed grower/processors or dispensaries; and how to assure “affordable patient access” to medical marijuana.
Dr. Goldfarb said one concern is a coordination of care between a patient’s primary care physician and the medical professional who certifies the patient has a qualifying condition.
Under current law, physicians must actively choose to participate in the medical marijuana certification process and undergo a four-hour training session.
