The medical-marijuana law, passed by ballot initiative last month, lays the hard work of fleshing out regulatory details on the doorstep of the most beleaguered entity in Massachusetts government: the Department of Public Health (DPH). The department has very little time, many issues to cover, a world of distractions, and some very concerned interest groups trying to influence its decisions.
DPH is currently in the hands of an interim commissioner, Lauren Smith, since John Auerbach left amid a still-growing scandal at the state crime lab. And that fiasco, with indictments expected soon, has been overshadowed by the meningitis outbreak traced to the New England Compounding Center. Last week, in just the latest shoe to drop, DPH announced an overhaul of the Board of Registration in Pharmacy.
In the midst of all this and more, the department must now create a full regulatory scheme for medical marijuana by May 1, just 120 days after the law takes effect. People at DPH profess confidence in meeting the goal, but as of this writing, a month after the election, no decision had been made about who in the department will head the effort, and through which office or agency.
In fact, conversations about postponing the deadline have already begun. Doing so would probably require a legislative bill, which, given state lawmakers' historical preference for delay on this issue, might seem like a no-brainer.
However, the law stipulates that, until the regulations are in place, patients may grow their own supply with a physician's recommendation. Giving DPH a few extra months to work would essentially green-light rampant basement cultivation in the Commonwealth; I would bet heavily against that making it out of the Public Health Committee.
DOCTORS SPEAK UP
The Massachusetts Medical Society (MMS), representing 24,000 physicians and medical students, is accustomed to holding a lot of sway on Beacon Hill — partly because they are the leading authority on medical issues, and partly because doctors write a lot of campaign-contribution checks.
MMS's strident opposition to medical marijuana helped prevent passage in the legislature, but could not defeat the ballot initiative. So, earlier this month, it officially shifted its focus to influencing the DPH regulations. It issued a slate of resolutions, outlining the priorities MMS will lobby DPH to include.
Much of the concern, MMS president Richard Aghababian tells me, stems from the vagueness of the criteria for doctors to issue certificates to their patients. As he notes, the state demands strict accountability for physicians prescribing other pain medications. But with marijuana, doctors have virtually no guidance, from the state or medical research, to screen out patients who might be poor candidates for the drug; to compare expected efficacy with other available treatments; or to determine appropriate dosage for a particular condition.
But some medical-marijuana advocates suspect that MMS is actually trying to ensure that its members get the influx of business from patients seeking certificates. Many of the MMS resolutions certainly seem designed to exclude the kinds of specialty clinics that have opened in some other states with medical-marijuana laws.
It only adds to the skepticism to learn that the MMS resolutions were written by Dr. Jay Broadhurst, who chaired the coalition opposing the ballot question and was frequently quoted in the media denouncing the proposed law in harsh terms.