The Hawaii Senate this week approved a bill to expand the state’s medical cannabis program by permitting doctors to recommend medical cannabis for any medical condition they believe it will help. The legislation, House Bill 302, was passed by the Senate on April 8 after receiving approval in the Hawaii House of Representatives last month.
The version passed by the House permitted healthcare professionals to recommend medical cannabis without the need for “an initial in-person consultation” with a patient. When the measure was taken up by the Senate, two legislative committees amended the proposal to open the state’s medical cannabis program to more patients who may benefit from the therapy.
The bill would redefine “debilitating medical condition” to mean “any condition determined by the certifying physician or advanced practice registered nurse to be appropriate for the medical use of cannabis.” Under current law, patients must be diagnosed with one or more specific qualifying debilitating medical conditions to use medical cannabis.
Governor Seeks Medical Cannabis Program Expansion
The amended bill is consistent with a plan to expand access to the state’s medical cannabis program announced last year by Hawaii Gov. Josh Green after legislation to legalize recreational cannabis failed to gain approval in the legislature. Under the plan, medical professionals would be permitted to recommend medical cannabis for any condition they deem appropriate.
“This would make it very available—that’s marijuana—for those who choose it in their lives,” the governor said in a recent interview, “and it would still keep kids safe, which has been everyone’s priority.”
Green also repeated his support for legalizing recreational cannabis.
“I think for adults who can responsibly use marijuana, it should be legal,” he said.
Prior to HB 302’s passage in the Senate, the Hawaii Department of Health told lawmakers in written testimony that it is opposed to allowing all healthcare professionals to recommend medical cannabis for any patient they believe it will help.
“While the Department supports allowing medical providers to use their professional judgment in diagnosing and treating patients,” it said in previous written testimony, “there is limited scientific evidence supporting the use of cannabis for conditions beyond those currently listed in statute. The Department is particularly concerned about potential risks to patient safety, including adverse drug interactions between cannabis and a patient’s existing treatment plan.”
The Health Department added that its concerns could be addressed by only allowing a patient’s treating physician to recommend medical cannabis for conditions not included in the state’s list of qualifying conditions. However, no such change has yet been made to the bill.
Cannabis Advocates Express Support for Bill
Cannabis advocates have expressed concerns about some provisions of House Bill 302. The Hawai’i Alliance for Cannabis Reform (HACR) noted that it opposes a provision that would create a new Class C felony offense for operating an unlicensed cannabis dispensary.
Overall, the group said, the legislation “would make it easier for Hawaiʻi residents who could benefit from medical cannabis to consult with a knowledgeable provider, qualify for and enroll in the state’s medical cannabis program, and purchase lab-tested medicine.”
Karen O’Keefe, director of state policies for the cannabis policy reform advocacy group Marijuana Policy Project, encouraged state lawmakers to approve the legislation.
“Although the Hawai’i House of Representatives let down voters by failing to legalize cannabis, it has an opportunity to make important progress on medical cannabis,” she wrote in a statement to Marijuana Moment. “The House should follow the Senate’s lead and allow practitioners to certify patients with any medical condition for medical cannabis.”
O’Keefe noted that currently, physicians are permitted to prescribe medications for conditions the drugs have not been approved to treat, a practice known as off-label prescribing.
“Doctors are allowed to prescribe far more dangerous drugs ‘off-label’” than marijuana, she wrote. “They should be similarly entrusted to advise their patients on whether they could benefit from cannabis.”
House Bill 302 has been returned to the Hawaii House of Representatives, where lawmakers will consider the amended version of the legislation passed by the Senate.
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