By RICHARD HALSTEAD | Marin Independent Journal
PUBLISHED: September 26, 2021

MarinHealth Medical Center is calling on Gov. Gavin Newsom to sign a bill that would require hospitals and other health care facilities to permit terminally ill patients to use medical cannabis in their institutions.

The legislation, Senate Bill 311, has become known as Ryan’s Law – named after Ryan Bartell, who was forced to move from California to Washington state in order to use cannabis instead of coma-inducing morphine for his pain while in end-of-life hospice care. Jim Bartell, Ryan’s father, has campaigned tirelessly for a change in the law.

The bill passed with overwhelming support in the Legislature and was sent to Gov. Newsom on Sept. 17 for his signature. It would prohibit smoking or vaping as methods to use medical cannabis.

“Our district board unanimously voted in support of Ryan’s Law SB 311 this year and I am writing in support of that bill being signed into law,” David Klein, CEO of both MarinHealth Medical Center and the Marin Healthcare District, wrote in a letter to Newsom on Wednesday.

MarinHealth is a publicly owned hospital overseen by the publicly elected Marin Healthcare District board. Dr. Larry Bedard, a longtime member of the district board, has been championing the cause of medical cannabis for years. He is a member of the American Medical Association’s cannabis task force.

“Maybe MarinHealth can show some leadership and be one of the first hospitals in California, if not the country, to approve the use of cannabis,” said the retired emergency medicine physician.

Managers at Marin’s other two hospitals operated by Kaiser Permanente and Sutter Health did not respond to a request for comment.

Bedard said the district board voted in March to endorse Ryan’s Law and ask Klein to write a letter of support. In his letter, Klein notes that in 2016 the district board voted to explore allowing cannabis in MarinHealth facilities.

“This was done in recognition of the fact that patients and their families were already bringing cannabis to the hospital,” Klein wrote. “It was also put forward with the knowledge that medical cannabis could be treated like any other patient-submitted medication, or (over-the-counter) product, by our pharmacy and staff.”

Bedard said MarinHealth patients may be using cannabis without informing their physicians, risking dangerous interactions with other medications they are taking. He said cannabis can interact with anticoagulants, which thin blood to prevent strokes; painkillers such as Vicodin and Oxycontin; and anti-anxiety medications such as Valium.

“It’s really an argument for physician education,” Bedard said. “The vast majority of the physicians are completely unaware.”

The resolution approved by the district board in 2016 quoted from a Journal of the American Medical Association article, which reported that medicinal cannabis is significantly helpful with chronic pain, neuropathic pain, muscle spasms in multiple sclerosis and paraplegia, cancer chemotherapy nausea, and AIDS wasting syndrome.

Marin Public Health Officer Dr. Matt Willis wrote in an email, “Cannabis is a psychoactive substance, and while we have real concerns about the known harms of its use among youth, potential palliative effects at the end of life are a different question. If cannabis is being used by terminally ill patients, it makes sense for hospitals to find ways to take it into account in their pain management plan.”

In 2019, Gov. Newsom vetoed a nearly identical bill, SB 305.

“This bill would create significant conflicts between federal and state law that cannot be taken lightly,” Newsom wrote at the time. “Therefore, I begrudgingly veto this bill.”

The California Hospital Association, which opposed adoption of SB 305, has drafted a letter to the governor calling for him to veto Ryan’s Law.

“We do not oppose the use of medical cannabis — or even necessarily its use in a hospital — as a matter of principle,” the letter states. “While California has legalized both the medical and recreational use of cannabis, it remains a Schedule I controlled drug (no accepted medical use) and is illegal under federal law.”

The association notes that the law would require health care facilities to treat medicinal cannabis as a medication and comply with the same storage and dispensing rules required under state and federal law for other controlled substances by requiring a physician order and dispensing from the pharmacy.

“This puts the facility/pharmacist in direct violation of the federal Controlled Substances Act, as the DEA license does not allow for purchase or dispensing of Schedule I substances,” the letter states. “It also puts the pharmacist in charge in direct conflict with the federal Controlled Substances Act, which will put their personal professional license in jeopardy.”

When Bedard testified before the State Assembly Committee on Health on June 8, he said, ““The Center for Medicare and Medicaid Services does not prosecute hospitals for in-facility use. They have no federal mechanism to do so.” Donald Lyman, a retired physician and former board member at the California Medical Association (CMS) who testified at the same hearing, said, “They (CMS) have no regulatory mechanism for penalizing medical facilities regarding cannabis use. Nor is there any record of the CMS ever penalizing a facility for cannabis use.”

By ALEX VEIGA AP Business Writer
Photo: Bridgette King poses for a portrait at a “Joints for Jabs” event in New York. (AP Photo/Mark Lennihan)

Uncle Sam gave marijuana lovers more reason to celebrate this week as a bipartisan group of lawmakers in the House of Representatives passed a bill that would make it easier for cannabis companies to do business in states where sales are legal.

The vote on the Secure and Fair Enforcement (SAFE) Banking Act took place a day before April 20 — or 4/20 — the unofficial holiday that commemorates all things marijuana.

The cannabis industry is making strides in other ways as well. Since the November elections, several states, most recently New Mexico and Virginia, have taken steps to legalize marijuana sales for adult recreational use. Others, including New York, New Jersey and Arizona, have also gone that route. And more states are expected to follow suit.

“From a policy perspective, state by state, municipality by municipality, there’s more political will to legalize, which is going to help bring on more markets and add to the sales we have,” said Jason Wilson, banking and cannabis expert at exchange-traded funds provider ETFMG.

The flurry of states legalizing cannabis prompted analysts at Cowen to update their forecast for the U.S. recreational cannabis market to $41 billion by 2025, an increase of $1 billion from Cowen’s previous forecast.

Including illicit and medical marijuana sales, analysts expect the total market for cannabis in the U.S. will climb to $80 billion by 2025 from a projected $65 billion this year.

Another bright spot for the industry: robust demand. Adult recreational marijuana sales climbed sharply in the first three months of this year in California, Massachusetts, Illinois and a few other states that have been allowing such sales for at least a year.

Sales in California, the nation’s biggest legal cannabis market, jumped 36.4% to $1.2 billion in the first quarter versus a year earlier, according to industry tracker Headset. In Michigan, sales skyrocketed almost fivefold to $232.07 million, while Colorado’s sales more than doubled to $439.7 million.

All told, 16 states allow marijuana sales to adults now. Some of the recent converts, including New Mexico and New York, are not expected to begin allowing sales until next year. All but a few states already allow some form of access for medical use.

Cowen’s analysts expect that Connecticut and Rhode Island will be next to legalize adult-use cannabis.

The industry is eager for changes to federal laws that limit cannabis companies’ access to banking and other services. Progress at the federal level would also help drive cannabis stocks higher, said Greg Bassuk, CEO of AXS Investments.

“The environment has been ripe ever since the last election, but the catalyzing move for bigger jumps in stock prices is going to be total federal approval,” Bassuk said.

Cannabis stocks surged last fall after voters in New Jersey, Arizona and three other states cleared the way for expanding legal sales of marijuana. Medical and adult-use cannabis sales combined jumped 58% in the U.S. last year to about $19.2 billion, according to Cowen.

Recently, cannabis stocks have lost ground amid uncertainty over whether President Joe Biden will budge on his opposition to legalizing marijuana at the federal level. Biden has said he would decriminalize — but not legalize — the use of marijuana. In addition, a rally in cannabis stocks fueled by the same social media chat rooms that sent GameStop shares skyrocketing in January faded after peaking in mid-February.

The ETFMG Alternative Harvest ETF, which has more than $1 billion in assets under management, has fallen 56.4% since Feb. 10. The ETF, which focuses on cannabis stocks, is still up about 80% from 12 months ago. Shares in some of the biggest marijuana companies, including Tilray, MedMen Enterprises and Aphria, have doubled this year.

Meanwhile, the benchmark S&P 500 index is up about 11% this year and 52.5% above where it stood a year ago. “If you look at just the last two months, you’ll see a lot of stocks have sold off pretty sharply,” said Garrett Nelson, senior equity analyst at CFRA. “We view this as a buying opportunity.”