ARIZONA MEDICAL MARIJUANA PROPOSED RULES RELEASED

The state health department released its first draft of
medical-marijuana rules late Thursday, providing a glimpse at how the
program may work in Arizona.

The rules spell out who may qualify for medical marijuana, establish
operating criteria for dispensaries and provide strict guidelines for
doctors who may recommend marijuana.

The release kicks off a three-week public-comment period, but the
Arizona Department of Health Services will have final say on how to
implement a medical-marijuana program in the state.

In November, voters passed Proposition 203, which will allow
qualifying patients with certain debilitating medical conditions to
receive up to 2 1/2 ounces of marijuana every two weeks from
dispensaries or cultivate up to 12 marijuana plants if they live 25
miles or farther from a dispensary.

The state health department must finish drafting the rules by April
13. The agency will then review applications from people who want to
use medical marijuana or operate a dispensary. The program should be
fully functioning by summer 2011, when dispensaries have had time to
grow the plants.

ADHS Director Will Humble said the department had two goals: Make the
rules strict enough to prohibit people who don't have serious medical
conditions from abusing the system without impeding patients' access
to marijuana, and ensure that medical experts are deeply involved in
the process of patients obtaining and using marijuana.

"I'm taking this seriously that this is the medical-marijuana act, not
the recreational-marijuana act," Humble said.

The rules cover everything from the definition of "current photograph"
for identification cards to the number of hand-washing sinks a
dispensary must have.

ADHS officials spent the past four weeks writing the 47-page draft,
which is available on the department's website.

Staffers researched other states' medical-marijuana rules and reviewed
rules for other state programs.

But because the medical-marijuana program is unlike any other existing
program, officials used their creativity and their personal experience
of crafting other state protocol, said Tom Salow, acting manager of
administrative counsel and rules at ADHS.

Doctor involvement

According to Prop. 203, qualified patients or their designated
caregivers could get a doctor's recommendation to receive medical marijuana.

Doctors must certify in writing that their patient likely will benefit
from using marijuana as a medicine to treat his or her debilitating
disease. These conditions include cancer, HIV/AIDS, hepatitis C and
multiple sclerosis.

Marijuana is not a federally-approved medicine. But department
officials drafted rules so that doctors would oversee the program and
be held accountable for patients' access to marijuana, Humble said.

Here are some key proposals related to physician involvement in the
program:

- - Requires a medical director.

ADHS wants all dispensaries to hire a medical director who will be
on-call or on-site at the facility.

Medical directors would make sure patients or their caregivers
document changes in their symptoms and track their marijuana usage.
They also would ensure dispensaries provide educational materials,
such as how to administer marijuana safely, signs of substance abuse
or dependency, and possible side effects.

Medical directors would not be allowed to write medical-marijuana
recommendations for patients.

- - Defines physician-patient relationship.

The department wants to require doctors to have an ongoing
physician-patient relationship before they recommend marijuana.

That means the patient would need to have seen the doctor for at least
one year and had at least four visits for the debilitating condition,
or the doctor assumes primary responsibility for managing the
patient's debilitating condition and for providing routine care.

- - Specifies "severe and chronic pain."

Medical-marijuana opponents have expressed concern that Prop. 203
lists "severe and chronic pain" as a symptom that would qualify a
patient to receive medical-marijuana recommendations.

The department's proposal specifies the patient must have severe and
chronic pain as a result of a chronic or debilitating disease or its
treatment.

- - Holds physicians accountable.

Physicians will be the "gatekeepers" of Arizona's medical-marijuana
program, Humble said. The department wants physicians to thoroughly
assess the risks and benefits of their patient's marijuana use and
make sure only patients who truly need marijuana for medical use have
access to it.

The department's proposal does not require doctors to provide proof,
such as MRIs and X-rays to prove chronic pain, in addition to their
medical-marijuana recommendations. This means the rules "put the onus
on the physician to practice ethical procedures," said Laura Nelson,
ADHS chief medical officer.

Regulating system

Even before Election Day, entrepreneurs looking to cash in on the
state's medical-marijuana industry had been preparing to open
non-profit dispensaries.

Prop. 203 caps the number of dispensaries in the state: Only one
dispensary is allowed for every 10 pharmacies.

The department's rules do not specify how it will review and approve
dispensary applications, but officials expect to decide on a process
by the time they begin accepting applications.

The rules are designed to provide oversight on dispensaries.
Requirements include:

- - The department will require an electronic security system that
consists of panic buttons and video surveillance that ADHS can access
and monitor at any time.

- - Dispensary applicants must provide a slew of documents and records,
including security policies; floor plans drawn to scale locating each
hand-washing sink, panic button and video camera; a business plan that
details the dispensary's ongoing viability; and even whether a
dispensary board member has any unpaid court-ordered child support.

- - A dispensary must grow at least 70 percent of the marijuana it
provides patients. It may not acquire from or sell to other
dispensaries more than 30 percent of its marijuana.

- - Dispensaries also must follow specific guidelines for inventory
control. A dispensary agent must document at the beginning and end of
each day how much marijuana the dispensary acquires, harvests, sells,
disposes of and disburses. Among other requirements, the agent must
specify the date and method of disposal, date and amount of harvested
pot, and the estimated amount of marijuana infused in edible products.

Looking forward

The public-comment period ends Jan. 7. The department will release a
new draft of the rules Jan. 31 and hold public meetings
mid-February.

Prop. 203 requires the department to develop an electronic data and
verification system to keep track of patient and dispensary
information. Law-enforcement and dispensary agents must be able to
access this system at any time.

The department will focus on developing this system starting next
week.

Salow said he hopes a wide variety of people submit their opinions,
especially those who opposed Prop. 203. He said department officials
will read and review every comment.

Humble said he is open to changing any part of the initial draft, as
long as the suggestion fits under the department's goals for the program.

"We're not going to change our goal, period, no matter what anyone
comments. Our overall goal is to make this a medical-marijuana law. So
whatever comments that we get in have to fit within that framework,"
Humble said.

Read the draft rules:

http://www.azcentral.com/ic/pdf/arizona-medical-marijuana-draft-rules.pdf

Send your opinion on rules to the state

http://azdhs.gov/prop203/