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Here are the Changes to Prop 2 for the New “Agreement”


Libertas Institute has been involved in medical cannabis reform for five years, having started the effort in 2013. Since then, we have been heavily involved in shaping the policy proposals, and providing the strategy and messaging, that were part of Senator Madsen’s legislative efforts and now Proposition 2. Our goal is to ensure patients are not treated as criminals.

To that end, we have been negotiating with Prop 2 opponents for several weeks to identify areas of common ground and determine if there were ways to make amendments that would resolve concerns while preserving patient access. We have reached that goal. Here is the draft.

Below is a list of the major modifications from Prop 2 that have earned the support of the Governor, House and Senate leadership, The Church of Jesus Christ of Latter-day Saints, Utah Medical Association, and other stakeholders. They will be introduced in a special session in November, whether Prop 2 passes or fails.

Condition list

  • Hospice is added as a new condition
  • Terminal illness with less than six months to live is added as a new condition
  • “Other autoimmune disorders” is removed; HIV and AIDS remain
  • “Other gastrointestinal disorders” is removed; Crohn’s and ulcerative colitis remain
  • Pain is redefined as any pain lasting longer than two weeks that hasn’t substantially responded to non-opioid medication or physical treatment

Dispensaries

  • Minors not allowed inside
  • ID card must be provided
  • Must employ one pharmacist to consult with patients
  • Patient records will not be destroyed after 60 days
  • Renamed as “medical cannabis pharmacies” (a state legal definition; they’re not actual pharmacies)
  • Only five privately owned facilities will be licensed
  • A “state central fill pharmacy” will also be created, which is government owned and will ship products to local health departments for patient pickup
  • Date triggers pressuring the central fill to begin operations will expand the number of privately owned “medical cannabis pharmacies” up to 10 maximum, should the central fill be delayed or unable to open

Medicine Type

  • Flower is permitted but must be sold in blister packs with consistent weights between each flower so dosing can be more easily achieved
  • The only edible type permitted is a cube-shaped chewable gummy or dissolvable lozenge
  • Resin/wax is permitted as a tertiary delivery type; you must try, and not succeed with, two other methods before attempting this one
  • Maximum possession limit is a 30 day supply (four ounces flower or 20 grams THC in cannabis products)

Physicians

  • Only MDs or DOs can provide a recommendation
  • Must take four hours of training every two years, which can count towards their existing continuing education requirements
  • May optionally specify a dosage restriction for the patient; if specified, patient can only purchase that medicine type/quantity from the medical cannabis pharmacy
  • If no dosage is specified, patient must consult with the pharmacist to have dosage determined; purchased product is put into database so physician can later review and consult with patient
  • May not receive compensation (“kickback”) from cannabis businesses for their recommendation
  • First card issued has a one month maximum, first renewal can be for up to two months, and subsequent renewals up to six months

Triggers

  • Affirmative defense is extended through January 1, 2021 when medical cannabis pharmacies must be operational; only applies if you had a pre-existing diagnoses from a physician who believed you could benefit from cannabis at the time of arrest
  • Home grow provision is eliminated; if medical cannabis pharmacies are not operational by the above-mentioned date, medical decriminalization kicks in and patients may not be prosecuted for using medical cannabis in the forms allowed under Utah law
  • As mentioned above, should the state central fill pharmacy not be operational under the timeline required, more licenses will be issued to privately owned medical cannabis pharmacies
  • If cannabis is rescheduled, medical cannabis pharmacies will have one year to either cease operations or convert to a traditional pharmacy, which could then sell cannabis as well

Other

  • Patients only prohibited from getting a medical cannabis card if they were convicted of a felony for drug distribution
  • New crime created for patient diversion when giving medical cannabis products to others
  • Existing penalties apply to smoking; lower infraction penalty is removed
  • Liquid assets required to operate a cannabis business cut in half
  • Zoning restrictions for distance requirements of cannabis are removed; cities must zone medical cannabis pharmacies the same way they do for tobacco shops and liquor stores
  • Detailed annual reporting required to help advocates and elected officials analyze what’s working and what needs to be tweaked
  • Employers may not discriminate against medical cannabis cardholders for the mere fact that they are a patient
  • All cannabis products will carry a warning label

  • Killer Kowalski

    What happens if the cannabis helps me and I don’t die in the required six months?

    • Michael Melendez

      Terminal illness is an additional condition, not a required condition.

      • Killer Kowalski

        Right, but if the reason that I’m allowed to get cannabis is because I’ve been diagnosed as terminal, and then I don’t die, am I now guilty of fraud?

        • Michael Melendez

          No, because being terminal is a doctor’s best guess, not a personal claim.

  • Jeremy Manning

    This sounds quite reasonable. It will be interesting to see how it actually comes together and what effect the 130 pages of details has on these larger points.

  • Ihavenouseforaname

    There is a lot of stupid shit in this.
    The only edible type permitted is a cube-shaped chewable gummy or dissolvable lozenge. WHY?
    Resin/wax is permitted as a tertiary delivery type; you must try, and not succeed with, two other methods before attempting this one. Two other methods? Like smoking flower or eating edibles? What other two methods are there?

    • Why? Because without such restrictions, the options would have been removed altogether due to opposition.

    • bakron2

      I think the developers of this legislation do not want the MMJ fo look too much like candy perhaps. But kids love gummy bears. It also may be easier to quantify dosage.

  • Ihavenouseforaname

    This doesn’t look like it was put together by health professionals. Looks like it was drafted by a bunch of clueless crusty old men that want to control us, that have no experience with it, and no medical expertise at all.

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  • I appreciate the efforts of the Libertas Institute and others for supporting Proposition 2 and patient access to therapeutic cannabis in Utah this far.

    I will be voting for Proposition 2 as an insurance policy for patient access to cannabis.

    The compromise appears to create the opportunity for some good interim progress.

    That said, here are my initial concerns with the compromise as described above:

    *Who decides whether a patient’s pain “hasn’t substantially responded to non-opioid medication or physical treatment”?

    *Why was this provision — “Patient records will not be destroyed after 60 days” — agreed to by Proposition 2 supporters?

    *”Only five privately owned facilities will be licensed” Who decides who gets the licenses? Would this compromise create the kind of “cartel” to further unjustly enrich the politically-connected that Ohio voters rejected in 2015?

    *The every-six-months frequency of subsequent renewals seems unduly costly and burdensome. “First card issued has a one month maximum, first renewal can be for up to two months, and subsequent renewals up to six months”

    *”Patients only prohibited from getting a medical cannabis card if they were convicted of a felony for drug distribution” This provision seems needlessly cruel to a person who otherwise qualifies as a patient.

    *Does the compromise keep Proposition 2’s protections for patients who are custodial parents by proposing to amend sections 30-3-10, 62A-4a-202.1 and 78A-6-508 of the Utah Code?

    • Partially answering my last question, the compromise legislation does appear to maintain the protections for patients who are custodial parents … and then some.

      The amendment to 30-3-10 reads:

      2961 (7) In considering the past conduct and demonstrated moral standards of each party
      2962 under Subsection (1)(a)(i) or any other factor a court finds relevant, the court may not
      2963 discriminate against a parent because of or otherwise consider the parent’s:
      2964 (a) lawful possession or use of cannabis in a medicinal dosage form, a cannabis
      2965 product in a medicinal dosage form, or a medical cannabis device, in accordance with Title 26,
      2966 Chapter 61b, Utah Medical Cannabis Act; or
      2967 (b) the parent’s status as a:
      2968 (i) cannabis production establishment agent, as that term is defined in Section
      2969 4-41b-102;
      2970 (ii) medical cannabis pharmacy agent, as that term is defined in Section 26-61b-102;
      2971 (iii) a state central fill agent, as that term is defined in Section 26-61b-102; or
      2972 (iv) a medical cannabis cardholder in accordance with Title 26, Chapter 61b, Utah
      2973 Medical Cannabis Act.

      The amendment to 62A-4a-202.1 reads:

      3674 (ii) the possession or use, in accordance with Title 26, Chapter 61b, Utah Medical
      3675 Cannabis Act, of cannabis in a medicinal dosage form, a cannabis product in a medicinal
      3676 dosage form, or a medical cannabis device, as those terms are defined in Section 26-61b-102.

      The amendment to 78A-6-508 reads:

      3751 (3) Notwithstanding Subsection (2)(c), the court may not discriminate against a parent
      3752 or otherwise consider a parent’s lawful possession or consumption of cannabis in a medicinal
      3753 dosage form, a cannabis product in a medicinal dosage form, or a medical cannabis device, as
      3754 those terms are defined in Section 26-61b-102, in accordance with Title 26, Chapter 61b, Utah
      3755 Medical Cannabis Act.

  • Steven Feil

    There are no LEADERS in government. There are only SERVANTS OF THE PEOPLE.

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  • wilson67

    So no oils or tinctures?
    No vaping??
    Only 5 “pharmacies”? Where are they going to be located? The rural community will be hurt by the limitations…unless you plan to put them all in rural areas and hurt us city folk. By the way.. stupid compromise calling it a pharmacy.

    Hate that you limited autoimmune and gasrtrointestinal diseases… you cut out a huge number of people who could benefit from cannabis by this change.

    I dont see this as a great compromise. I see this as caving to the church. So disappointed!!

    • Vaping appears to be authorized … and references to vaping devices appear in two places in the compromise bill, compared to once in Proposition 2:

      2187 (b) A medical cannabis pharmacy may sell a medical cannabis device that warms
      2188 cannabis material into a vapor without the use of a flame and that delivers cannabis to an
      2189 individual’s respiratory system.

      2552 (b) The state central fill medical cannabis pharmacy may sell a medical cannabis
      2553 device that warms cannabis material into a vapor without the use of a flame and that delivers
      2554 cannabis to an individual’s respiratory system.

      Regarding oils and tinctures, see

      1089 (25) (a) “Medicinal dosage form” means:
      1090 (i) for processed medical cannabis or a medical cannabis product, the following in
      1091 single dosage form with a specific and consistent cannabinoid content:
      1092 (A) a tablet;
      1093 (B) a capsule;
      1094 (C) a concentrated oil;
      1095 (D) a liquid suspension;
      1096 (E) a topical preparation;
      1097 (F) a transdermal preparation;
      1098 (G) a sublingual preparation;
      1099 (H) a cube that is designed for ingestion through chewing or holding in the mouth for
      1100 slow dissolution; or
      1101 (I) for use only after the individual’s qualifying condition has failed to substantially
      1102 respond to at least two other forms described in this Subsection (25)(a)(i), a resin or wax;
      1103 (ii) for unprocessed cannabis flower, a blister pack, with each individual blister:
      1104 (A) containing a specific and consistent dosage amount that does not exceed one gram
      1105 and that varies by no more than 10% across the blister pack; and
      1106 (B) labeled with a barcode that provides information connected to an inventory control
      1107 system and the individual blister’s content and weight; and
      1108 (iii) a form measured in grams, milligrams, or milliliters.
      1109 (b) “Medicinal dosage form” includes a portion of unprocessed cannabis flower that:
      1110 (i) the medical cannabis cardholder has recently removed from the blister pack
      1111 described in Subsection (25)(a)(ii) for use; and
      1112 (ii) does not exceed the quantity described in Subsection (25)(a)(ii).

      But see

      1113 (c) “Medicinal dosage form” does not include:
      1114 (i) any unprocessed cannabis flower outside of the blister pack, except as provided in
      1115 Subsection (25)(b); or
      1116 (ii) a process of vaporizing and inhaling concentrated cannabis by placing the cannabis
      1117 on a nail or other metal object that is heated by a flame, including a blowtorch.

    • Oils, tinctures, and vaping are allowed. Medical cannabis pharmacies will be geographically dispersed. If the central fill opens up, it will distribute to health departments around the state. If it does, then there will be 10 retail medical cannabis pharmacies making it easier.

      “We” didn’t limit autoimmune/gastro. Recognize that the opposition wanted to gut far more than this. The pain definition can be a catchall for those with pain, and the compassionate use process can allow non-qualifying people to still get one-off access with physician support.

      • wilson67

        Oils, tinctures and vaping are allowed now, in its presently written form, who know how it will be changed when the rewrite this bill.

        This has undercut the process of the people and I am sure that those legislators who gave you their word will have no problem going back on it and gutting this whole thing.

  • Chronichealspain

    What happens if someone already has doctor approval to use, before this is put in place? The edible deal was dumb as well with gastrointestinal, many people use it for those reasons.

    • Can you be more specific about the gastrointestinal condition?

      If a gastrointestinal condition is accompanied by a qualifying condition, then the patient qualifies.

      I agree that there’s way too much bureaucracy in Proposition 2 or the compromise bill, but both options represent progress for Utah patients in the current political climate, and the compromise bill ushers in that progress much sooner than Proposition 2 would.

      As to approval by a doctor before the compromise bill is enacted, can you be more specific? As far as I know, in Utah a doctor cannot currently approve a person’s possession or use of cannabis.

      • ChronicKillsPain

        I know someone who had a conversation with their doctor recommending the use of cannabis. Either way if they were to decide to use it, would there be any lesser charges if they were to begin using it. I am asking for a friend they would really love to know.

        • Lesser charges right now? As far as I can tell, no … your friend could still face charges in Utah even with a doctor’s recommendation.

          With the enactment of the compromise bill, your friend may have affirmative defenses to such charges.

        • Tazz Man

          The way I read the compromise bill you would have to go out of state and get a recommendation. This doesn’t appear to be the case with the proposition, the proposition seems to just a require you have a qualifying condition diagnosed prior to, and then you could have any charges dropped should they file them (affirmative defense).

          Also if the bill doesn’t pass you will be out of luck. Once the proposition passes it appears that it would cover any changes even if they happened before the bill was passed.

  • ChronicKillsPain

    if someone already has doctor approval to use medicinal cannabis, Is there anything that has changed to protect them as a patient until this is put into place? ie, if they were to start using would this give them a lesser charges e to use in the mean time after it passes on the ballot? Also, it seems like they are limiting many ways of consumption. I know many that don’t smoke and would prefer to make their own edibles, are there any limitations on using it their own way?

    • Patients will be covered by the affirmative defense provision provided they had a diagnosis before arrest and were using cannabis in a form approved under Utah law (that would be sold once medical cannabis pharmacies are operational).

      • Tazz Man

        So basically you have to buy weed in blister packs that don’t exist or get busted anyways?

  • DisabledFlarkin

    Forgive the figure of speech, but what are they smoking? The unmodified proposal was very conservative. Are all of these additional roles (and laws) necessary? This is feeling like the Zion curtain and 3% beer.

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  • Why do pharmacies need to keep our records past 60 days?

  • The_Unbeliever

    How will obtaining a medical recommendation card in Utah affect a Utah issued Concealed Carry Permit or other 2nd Amendment rights in Utah by State or Local authorities?

    • Tazz Man

      18 USC §922(g)(3) & 21 USC §812 (schedule I(c)(10)) make it a crime to have a firearm if you use weed.

      “Any person who uses or is addicted to marijuana, regardless of whether his or her state has passed legislation authorizing marijuana use for medical purposes … is prohibited by federal law from possessing firearms or ammunition,” ATF spokeswoman Janice L. Kemp said in an email to The Associated Press.

      https://www.thecannabist.co/2018/01/15/marijuana-users-gun-ownership/96741/

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  • Keli

    So people can theoretically use it starting December. Getting it from out of state seem a legal nightmare. I suspect medical marihuana dispensaries require cards, Utah people won’t have. That leave recreational stores. The closest ones is far. People can only have small quantities, so people would have to go at least once a month. I don’t think it’s legal to bring it over state borders. I don’t think it’s legal to order over the internet or have it shipped. In practical terms how does patients get it without violating laws

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