Arkansas Lawmakers Consider Federally Funded Report On Growth Of State’s Medical Marijuana Program

“There’s been very little clinical research because there’s no federal money flowing for clinical research.”

By Tess Vrbin, Arkansas Advocate

More than half of Arkansans using medical marijuana in 2021 used the drug as a pain reliever, and a large proportion of patients have used it to treat post-traumatic stress disorder, according to study findings presented to state lawmakers Wednesday.

The study, conducted by the Arkansas Center for Health Improvement, is the first ever population-based study of medical marijuana funded by a federal health agency, the National Institutes of Health.

As of this month, more than 3 percent of Arkansas adults have received permission from physicians to use the drug to treat one or more of the state’s 18 qualifying medical conditions. The state currently has more than 105,000 cardholders, an increase of roughly 29,000 in three years, according to ACHI’s study.

Lawmakers on the Joint Public Health, Welfare and Labor Committee asked ACHI CEO Dr. Joe Thompson for more specific data and expressed concerns about some of the information in the study, such as the fact that one-third of the certifications for medical marijuana cards in 2021 came from just seven doctors, with little evidence of a physician–patient relationship in many cases.

Thompson said ACHI is seeking another federal grant to do further research on medical marijuana use, including rates of substance use disorder among users.

“There’s been very little clinical research because there’s no federal money flowing for clinical research, so we don’t really know much about marijuana other than anecdotal reports and small studies,” Thompson said.

Arkansans voted to legalize cannabis for medicinal use via a constitutional amendment in 2016, though the first products were not sold until 2019. Five years later, medical marijuana has grown to be a billion-dollar industry with 37 dispensaries throughout Arkansas.

Marijuana is federally illegal because it is classified as a Schedule I controlled substance. The Drug Enforcement Administration has recommended that the Department of Justice reclassify it to Schedule III, the category for regulated but legal substances.

Thirty-eight states and the District of Columbia have legalized marijuana to some extent, and Arkansas is one of 14 states in which the drug is legal only for medicinal purposes.

Physicians are not allowed to prescribe specific amounts or dosages of marijuana because of its current federal status compared to other drugs, said committee co-chair Sen. Missy Irvin (R-Mountain View), in response to some lawmakers’ questions.

Cardholders visit dispensaries every 11 days on average, and the amount of product sold daily “far exceeds existing clinical recommendations” for consumption, according to the report.

All dispensaries are required to have consultant pharmacists who can provide advice on the distribution of marijuana, but most of them work remotely, and several facilities employ the same few pharmacists, Thompson said.

Findings and concerns

The study relied on a variety of data sources, including the state medical board’s licensure database and the All-Payer Claims Database, which tracks “how and where healthcare is being delivered and how much is being spent,” according to its website.

The APCD showed that in 2021, about 92 percent of medical marijuana cardholders had seen a physician in the previous year, and 62 percent had seen a physician regarding a diagnosed condition that they used medical marijuana to treat, the report states.

The study examined the clinical impact of medical marijuana on conditions it is frequently used to treat, and data showed that there was no significant difference in prescription medication use for PTSD patients whether they did or didn’t use medical marijuana, according to the report. However, non-users of medical marijuana were hospitalized more frequently for PTSD symptoms than those who used the drug for the illness.

Researchers have not found proof that medical marijuana use plays a role in the opioid epidemic, Thompson said in response to a question from Sen. Fred Love (D-Mabelvale).

Thompson gave the committee several policy recommendations from the results of the study, such as strengthening the requirements to prove physicians’ relationships with the patients they are certifying for a medical marijuana card, altering purchase limits based on consumption recommendations and creating stronger enforcement policies to discourage users from giving away or selling unconsumed products.

Rep. Zack Gramlich (R-Fort Smith) said he was concerned that the growth of the medical marijuana industry might unintentionally give children access to marijuana products. Medical marijuana cardholders must be at least 18 years old.

“Kids who would never normally be around this stuff are now getting connected to it,” said Gramlich, citing his experience teaching middle school.

Thompson said he was aware of the “real challenge” parents and educators face trying to keep children away from controlled substances but was not aware of any existing ways the state can identify which medical marijuana cardholders have children.

Sen. Linda Chesterfield (D-Little Rock) said she wanted more state oversight of the medical marijuana industry to confirm that “from seed to sale, we are making sure that the product is a good product.”

She also said she was more concerned about “the industry itself” and dispensaries being managed by very few people despite there being dozens of facilities and owners throughout the state.

A Little Rock law firm was sued last year in Pope and St. Francis counties over fraud and legal malpractice claims regarding the creation of ownership groups to obtain four of the state’s first 32 dispensary licenses in 2019. The defendants responded with a defamation lawsuit in Pulaski County Circuit Court. Both cases are still pending.

This story was first published by Arkansas Advocate.

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Photo courtesy of Mike Latimer.