A pair of Senate committees in Hawaii have advanced an amended medical cannabis bill that would, in its new form, allow healthcare providers to recommend marijuana for any debilitating condition they believe is “appropriate” for the treatment instead of only being able to help patients who have maladies on a specific list, as is the case under current law.
Hawaii’s governor has previously floated expanding access to medical marijuana in such a way while broader recreational cannabis legalization bills have failed to reach his desk.
The medical cannabis measure, HB 302 from Rep. Gregg Takayama (D), was approved by both the Senate Committee on Health and Human Services and the Committee on Commerce and Consumer Protection on Wednesday. It has already passed the full House of Representatives in earlier form.
As introduced, the proposal would also clarify that under state law, a medical marijuana recommendation would no longer need to be made by a doctor who had conducted “an initial in-person consultation” with a patient.
One of a handful of changes adopted by the panels before Wednesday’s votes, however, amended the definition of “debilitating medical condition” in the law’s section on qualifying conditions to mean “any condition determined by the certifying physician or [advanced practice registered nurse] to be appropriate for the medical use of cannabis.”
That effectively would open the door to wider access to patients who might have conditions that stand to benefit from medical marijuana but whose ailments haven’t been specifically recognized by state officials.
Karen O’Keefe, director of state policies for the advocacy group Marijuana Policy Project, told the panel in testimony at the hearing that “providers can prescribe far more dangerous medications off-label.”
“One in every five prescriptions is off-label in the U.S., which means for a condition other than the one it was approved for by the [Food and Drug Administration],” she said. “At least ten other medical cannabis states allow doctors to recommend cannabis for other conditions or all other serious conditions. We urge you to follow suit.”
Hawaii was the first U.S. state to legalize medical marijuana through its legislature, passing a law in 2000.
Sen. Joy San Buenaventura (D), who chairs the Health and Human Services Committee, explained some other changes adopted in the amended version of the bill.
“We have been in offline discussion with the dispensaries, and I noticed that they did not update their proposed amendments in their written testimony, so I’m going to have to give you a lengthy recitation as to what is going to occur,” she began.
One change would allow sales of cannabis and cannabis products to occur between licensed dispensaries in certain circumstances. Another would allow dispensary waiting rooms to sell products other than marijuana, “including, but not limited to hemp products and accessories for the use of medical cannabis,” the lawmaker explained.
No members of the two committees who were present at Wednesday’s hearing cast votes against the amended proposal.
The move to allow healthcare providers to recommend medical cannabis to patients for any condition they see fit is in line with a plan announced last year by Gov. Josh Green (D) to expand access to marijuana in light of the legislature’s failure to pass recreational legalization measures.
“This would make it very available—that’s marijuana—for those who choose it in their lives,” the governor said in an interview, “and it would still keep kids safe, which has been everyone’s priority.”
At the same time, Green reiterated his support for full recreational legalization.
“I think for adults who can responsibly use marijuana, it should be legal,” he said.
Last week in Hawaii, meanwhile, the House Health Committee amended and passed a Senate-approved bill to support clinical research on psychedelic-assisted therapies using substances such as psilocybin and MDMA. The panel first adopted a handful of changes suggested by the Office of Wellness and Resilience, most notably replacing a special fund with a two-year pilot program.
Separately, last month the Senate narrowly defeated a separate proposal that would have increased fivefold the amount of cannabis that a person could possess without risk of criminal charges. Had the measure become law, it would have increased the amount of cannabis decriminalized in Hawaii from the current 3 grams up to 15 grams. Possession of any amount of marijuana up to that 15-gram limit would have been classified as a civil violation, punishable by a fine of $130.
The House Committee on Labor in January unanimously voted to advance legislation that would protect state-registered medical marijuana patients from discrimination in the workplace. That bill, HB 325, has not yet been taken up in the Senate.
Another Senate bill that would have legalized marijuana for adults recently stalled for the session. That measure, SB 1613, had yet to make it out of its current committee despite a legislative deadline last month.
While advocates feel there’s sufficient support for the legalization proposal in the Senate, it’s widely believed that House lawmakers would ultimately scuttle the measure, as they did lasts month with a legalization companion bill, HB 1246.
Last session, a Senate-passed legalization bill also fizzled out in the House.
This past fall, regulators solicited proposals to assess the state’s current medical marijuana program—and also sought to estimate demand for recreational sales if the state eventually moves forward with adult-use legalization. Some read the move as a sign the regulatory agency saw a need to prepare to the potential reform.
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