Wednesday, July 10, 2019

Safe Access New Mexico Public Comment on Proposed Rule Changes for New Mexico's Medical Cannabis Program (MCP)




Jason Barker
SafeAccessNewMexico@gmail.com



Wednesday, July 10th 2019


Andrea Sundberg
NM Department of Health
Medical Cannabis Program
P.O. Box 26110
Santa Fe, NM 87502-6110
MCP.comment@state.nm.us



Introduction: The Medical Cannabis Program Plant Count and Adequate Supply MUST be protected from and kept entirely separate from any future Recreational Cannabis law, and this should be written in the Rules in Regulations. A review of 15 medical cannabis producers menus shows that the medical cannabis program is not providing an adequate supply of cannabis derived CBD products for the over 80, 000 medical cannabis patients. This one day review of menus showed 919 Total THC Products to only 90 Total CBD Products available on that day. Another survey conducted by the Medical Cannabis Program exposed how 55% of producers said they have been unable to keep pace with patient demand for cannabis and related products. Doctors on the state’s Medical Cannabis Advisory Board and the program Medical Director could also be taking the time, at least once quarterly, to visit dispensaries to see what products are available to the patient community.

Public Comment For:
  • Revisions to nonprofit producer licensure requirements, including cannabis plant limits, licensing fee requirements, and the specification of certain quarterly reporting requirements;
[NMAC 7.34.4 - Medical cannabis licensing requirements for producers, couriers, manufacturers and laboratories. https://nmhealth.org/publication/view/rules/4987/]

Cannabis Plant Limits: Making revisions to the proposed licensing requirements for medical cannabis licensed producers with a plant count that sets a standard for the amount of cannabis CBD strains/plants to be grown per licensure requirement. Making revisions limiting use of the medical cannabis program LNPP’s licensure and plant count for that of the medical cannabis program and only the medical cannabis program. That is the Purpose of the Act.

Proposed Revision: A non-profit producer that operates a facility and, at any one time, is limited to a combined total of no greater than [2,500] 1,750 cannabis [mature female plants, seedlings and mature male] plants, with 17% (percent) of all cannabis plants grown being that of cannabis derived CBD plants; not including seedlings, and an inventory of usable cannabis and seeds that reflects current patient needs[, and that shall sell cannabis with a consistent unit price, without volume discounts or promotional sales based on the quantity purchased]. A non-profit producer may possess any quantity of seedlings, as defined in this rule. A non-profit producer shall not possess a quantity of cannabis [either mature female plants or seedlings and mature male] plants that exceeds the quantities authorized by their licensure and associated licensing fee. A licensed non-profit producer may sell and distribute usable cannabis to a person or entity authorized to possess and receive it. A licensed nonprofit producer may obtain plants, seeds and usable cannabis from other licensed non-profit producers. A licensed non-profit producer may only use the cannabis plant for the operations of the state’s medical cannabis program and can only be used in that medical cannabis program.
Or
Making revisions to licensing requirements for medical cannabis licensed producers with a plant count for patients and producers properly structured and increased: Medical cannabis CBD strains at ratio of; 1.5 thc(or lower) : 1 cbd (or higher) being removed from patient and producer allowable plant count.



Survey:A review of 15 medical cannabis producers menus shows that the medical cannabis program is not providing an adequate supply of cannabis derived CBD products for the over 80, 000 medical cannabis patients. This one day review of menus showed 919 Total THC Products to 90 Total CBD Products available.

Each and every qualifying health condition for the medical cannabis program requires the use of cannabis derived CBD in one form or another.

LNPP Menus Review of THC and CBD Products
Cannaceutics (Bernalillo) http://www.cannaceutics.org/ : Flower was 105 THC products and 5 CBD products; Extracts was 6 THC Products and 2 CBD Products; Edibles was 26 THC products and 8 CBD Products; Topicals was 3 THC products and 0 CBD products.

CG Corrigan (Bernalillo) https://www.cgoodinc.com/ (DoH has wrong web address listed) : Flower was 11 THC Products and 1 CBD product; Extracts was 12 THC products and 1 CBD product; Edibles was 28 THC products and 0 CBD Products.

Everest Apothecary (Bernalillo) https://everestnm.com/ : Flower was 5 THC products and 0 CBD products; Edibles was 9 THC products and 0 CBD products; Extracts was 9 THC products and 2 CBD products; Topicals was 1 THC product.

Ultra Health - NM Top Organics (Bernalillo) https://ultrahealth.com : Flower was 8 THC Products and 1 CBD product; Edibles was 9 THC products and 1 CBD product; Extracts was 4 THC products and 2 CBD products; Topicals was 1 THC product and 2 CBD products.

PurLife (Bernalillo) https://www.purlifenm.com/ : Flower was 39 THC and 2 CBD products; Extracts was 24 THC products and 0 CBD Products; Edibles was 31 THC products and 0 CBD products.

New Mexicann Natural Medicine (Santa Fe) https://www.newmexicann.com/ : 41 total THC products and 10 total CBD products.

Pecos Valley Production (Dona Ana) https://pecosvalleyproduction.com/ (DoH has wrong website listed): 37 total THC products and 10 total CBD products.

MJ Express-O/PurLife (Dona Ana) https://www.purlifenm.com/location/203-s-foch-st-t-or-c-nm-87901/ : 65 total THC products and Zero CBD products.

Verdes Foundation (Bernalillo) https://www.verdesfoundation.org/ : Flower was 7 THC products and 3 CBD products; Edibles was 9 THC products and 4 CBD products; Extracts was 7 THC products and 7 CBD Products.

R. Greenleaf (Bernalillo) https://rgreenleaf.com : Flower was 17 THC products and 3 CBD products; Edibles was 19 THC products and 13 CBD products; Extracts was 24 THC products and 4 CBD products; Topicals was 4 THC products and 0 CBD products.

Southwest Wellness Center (Taos) https://www.southwestwellnesscenter.com : Flower was 9 THC products and 1 CBD product; Extracts was 13 THC products and 1 CBD product; Edibles was 12 products and 0 CBD products.

New Mexico Alternative Care (San Juan) http://www.newmexicoalternativecare.com : 56 Total THC products and 2 total CBD products.

Minerva Canna Group (Santa Fe) https://minervacanna.com/ : 53 Total THC products and 2 total CBD products.

Sacred Garden (Dona Ana) https://app.trybaker.com/shop/1738?provider=1738 : 67 Total THC products and 5 total CBD products.

Organtica (Bernalillo) http://organtica.com/ : 45 total THC products and 7 total CBD products.

919 Total THC Products to 90 Total CBD Products
Source:
Medical Cannabis Licensed Non-Profit Producer List https://nmhealth.org/publication/view/general/2101/


Article: Surveys on medical pot detail New Mexico supply shortages | BY ASSOCIATED PRESS | Published: Tuesday, May 14th, 2019 at 8:14am | https://www.abqjournal.com/1315387/provider-says-medical-cannabis-sales-trail-enrollment-growth.html
  • “In results obtained Tuesday, 55% of producers said they have been unable to keep pace with patient demand for marijuana and related products.”
  • “Of the patients surveyed, about one in four said they were unable to purchase cannabis within the past 90 days because it was out of stock. Shortages were more pronounced in eastern New Mexico, with about four in 10 patients citing shortages.”
Why not use Hemp CBD?
Testing standards and safety protocols for Hemp derived CBD are non-existent in New Mexico and the serious lack of regulation poses a health risk for patients in the medical cannabis program.


Article: “Hemp Derived CBD vs. Cannabis Derived CBD”
“For many reasons, CBD-rich cannabis is a better source of CBD than industrial hemp. The only reason CBD derived from hemp is gaining any notoriety is as an attempted end-run around federal law. When cannabis prohibition is ended and cannabis is treated like any other agricultural product, CBD will be extracted from the best source of cannabidiol—CBD-rich cannabis. The need to derive CBD from industrial hemp will end.”
[https://culturemagazine.com/hemp-derived-cbd-vs-cannabis-derived-cbd/]



Conclusion:“Adequate Supply” can be achieved, if it is approached that the supply must be available if Every Patient ALL went out and purchased on the same day. And plants counts should be based on plant canopy and square footage instead of counting individual plants.

For ensuring safe access to all areas of the state of New Mexico and proper administering of the Lynn and Erin Compassionate Use Act, by the New Mexico State Department of Health, this can be achieved by opening applications for producer licensure specific to rural expansion in the state and by providing a new plant count structure to provide adequate supply as follows;

First, not all medical cannabis plants are the same. The cannabis plant contains dozens and dozens of cannabinoids. The most well known cannabinoid for a long time has been tetrahydrocannabinol (THC), but as more scientific research is conducted involving cannabis and its ability to be used as a medicine, more and more people are learning about other cannabinoids, in particular cannabidiol (CBD). Some plants have THC and others produce CBD, THC has psychoactive properties that affect your brain and give you a ‘runner’s high’ while CBD does not.

A plant count that is based on ratio of patients to serve with inclusion of empirical data for varying amounts cannabis plant material needed to manufacture different forms of medical cannabis medicine.

The Medical Cannabis Program Plant Count and Adequate Supply MUST be protected from and kept entirely separate from any future Recreational Cannabis law, and this should be written in the Rules in Regulations.

Issues such as access, police harassment, and the price and quality of medicine will still be relevant to the patient community despite the adoption of a policy of legalization for recreational use. The federal refusal to recognize the medical efficacy of cannabis causes more harm and difficulty for patients than any failure by local or state governments to adopt policies of legalization of cannabis for recreational use. Any system of recreational cannabis regulation should not be built on the backs of current medical cannabis laws.

The legalization of cannabis for recreational use is a separate issue from safe and legal access to cannabis for therapeutic use. We caution policy makers against letting the debate surrounding legalization of cannabis for recreational use obscure the science and policy regarding the medical use of cannabis.

The State’s Medical Cannabis Program expansion is now “Medically Necessary”and the State needs to allow the Department of Health to open the application process, the State needs to increase the Licensed Non Profit Producer plant count, add more licensed non-profit producers, in conjunction with other measures to ensure safe access to medicine and to be compliant with the law. Currently there is Less Than ⅓ of a cannabis plant per person in the medical cannabis program and 55% of Program LNPP’s can not meet patient demand.

For ensuring safe access to all areas of the state of New Mexico and proper administering of the Lynn and Erin Compassionate Use Act, by the New Mexico State Department of Health can be achieved with “adequate supply” as follows:
  • Adequate supply of medical cannabis properly defined, structured, and increased.
  • Maximum quantity of usable cannabis increased to 425.243 grams per 3 months ( 2.5 ounces every two weeks ).
  • Inclusion of empirical data for determining adequate supply for varying amounts cannabis plant material needed to manufacture different forms of medical cannabis medicine for proper dosage. 

Example revisions to licensing requirements for the medical cannabis program LNPP’s & PPL's :
  • Plant count for patients & producers properly structured and increased.
  • Cannabis CBD strains at ratio of; 1.5 thc (or lower) : 1 cbd (or higher) not counted against patient/caregiver or LNPP allowable plant count.
  • Clones and Cuttings provided to qualified patient / caregiver with a PPL by a LNPP’s not counted against LNPP allowable plant count.
  • Plant Count that is based on ratio of patients to serve AND inclusion of empirical data for varying amounts cannabis plant material needed to manufacture different forms of medical cannabis medicine. 
  • Patient / Caregiver PPL plant count increased to allow for 6 immature seedlings /clones / cuttings, 6 plants in vegetative stage, and 6 plants in flowering stage for a total of 18 cannabis plants.
  • The addition of Cooperative/Collective PPL’s (Example Below)Washington State Medical Cannabis Program Cooperatives (Established 7/2016) Medical cannabis cooperatives allow up to four medical cannabis patients or their designated provider to join together to grow cannabis for the patients’ personal use. Every member must be entered into the medical cannabis authorization database and have a medical cannabis recognition card. The total number of plants authorized for the participants may not exceed 60 plants. Cooperatives must register with the Washington State Liquor and Cannabis Board (WSLCB) and follow all regulations. Cooperative members may ONLY:Be in a cooperative if they have a valid medical cannabis recognition card. Form a four member cooperative. Participate in a cooperative if they are at least 21 years of age. Grow up to the total number of plants authorized, with a maximum of 60 plants. Belong to one cooperative. Grow plants in the cooperative and not anywhere else. Use the cannabis and its products, and not sell or give away cannabis or cannabis products to anyone who is not in the cooperative.  A cooperative must be: Located at one of the member’s homes or personal property. Limited to one cooperative per tax parcel. Enclosed by an 8-foot fence, if outdoors, and cannot easily be seen or smelled. Learn more with Washington’s Collectives: A Patient's Guide to Medical Marijuana Cooperatives (PDF).


“Section 2. PURPOSE OF ACT.—The purpose of the Lynn and Erin Compassionate Use Act is to allow the beneficial use of medical cannabis in a regulated system for alleviating symptoms caused by debilitating medical conditions and their medical treatments.”

The focus on cannabis policy in 2019 should be on the medical cannabis program expansion, education about medical cannabis and the program, and protecting the program like Governor Lujan Grisham promised.

Medical cannabis patients in New Mexico deserve safe access to their medicine at ALL schools before the state legalizes cannabis for other people to party with in a recreational market.

Medical cannabis patients in New Mexico deserve safe access to medical cannabis in hospitals and medical facilities, like little kids going through the horrors of cancer treatment at UNM, before the state legalizes recreational cannabis use.

Medical cannabis patients in New Mexico deserve safe access to medical cannabis in hospice care facilities and senior retirement communities before the state legalizes cannabis for other people to have fun with recreationally.

Our Military Veterans and First Responders deserve safe and equal access to medical cannabis before the state legalizes cannabis for other people to party with.

Any state educational institution of higher learning should have safe access to research medical cannabis and the state’s medical cannabis program before legalization ruins that potential research.

All doctors and prescribing medical professionals in the State of New Mexico should have safe access to recommend the use of medical cannabis to their patients or patient's caregiver before recreational cannabis legalization. 



Proposed Rules Hearing Public Comment - Part II

Introduction: New Mexico medical cannabis patients are denied restrocity participation in other state programs (ie. D.C.) due to language stating the medical cannabis cards are valid only to “engage in the intrastate possession and administration of cannabis for the sole use of the qualified patient.”

Public Comment For:• Various revisions and additions to definitions in all three rule parts.
NMAC 7.34.3 - Medical cannabis registry identification cards.
https://nmhealth.org/publication/view/rules/4986/

Proposed Revision: “Registry identification card”: The Registry identification card shall be valid for use in New Mexico and other state medical cannabis programs with valid reciprocity and participation for out of state qualified patients. 

From Page 3 https://nmhealth.org/publication/view/rules/4986/ : 
SS. [RR.] “Registry identification card” means a document issued and owned by the department which identifies a qualified patient authorized to engage in the use of cannabis for a debilitating medical condition or a document issued by the department which identifies a primary caregiver authorized to engage in the intrastate possession and administration of cannabis for the sole use of the qualified patient. The Registry identification card shall be valid for use in New Mexico and other state medical cannabis programs with valid reciprocity and participation for out of state qualified patients. 

References:DC Health List 
https://dchealth.dc.gov/sites/default/files/dc/sites/doh/page_content/attachments/Reciprocity%20Chart%20-%20Functionally%20Equivalent%20-%204-11-18.pdf

State Medical Cannabis Laws from National Conference of State Legislatures
(Updated) 7/2/2019
Table 1. State Medical Marijuana/Cannabis Program Laws with details on which states recognizes Patients from other states
http://www.ncsl.org/research/health/state-medical-marijuana-laws.aspx




The public comment provided above for plant counts was derived from the following Sources:Petition: Medical Treatment; Adequate Supply: LNPP Plant Count Increase | http://lecuanmmcpmcabpetitions.blogspot.com/2017/09/petition-lnpp-plant-count-increase.html | By Safe Access New Mexico

Petition Introduction: Requesting for the Medical Treatment; Adequate Supply: Remove CBD from Plant Count | http://lecuanmmcpmcabpetitions.blogspot.com/2017/03/petition-introduction-requesting-for.html | By Safe Access New Mexico

“Patient's Guide to CBD”. The Patient’s Guide to CBD is a comprehensive resource that covers a wide range of topics, including, available forms for use, what to look for on package labels, how to read a certificate of analysis, how CBD interacts with the endocannabinoid system, the current state of research, the compound’s legal status, and how to talk to one’s doctor about CBD. [https://www.safeaccessnow.org/patientscbd]

Americans For Safe Access [http://www.safeaccessnow.org/policy_shop]

Stith, S. S., Vigil, J. M., Brockelman, F., Keenan, K., & Hall, B. (2018). Patient-reported symptom relief following medical cannabis consumption. Frontiers in Pharmacology, 9, 96. [https://www.frontiersin.org/articles/10.3389/fphar.2018.00916/full]

Colorado Medical Marijuana Program [https://www.colorado.gov/pacific/cdphe/medicalmarijuana]

Colorado Department of Revenue- An assessment of physical and pharmacokinetic relationships in marijuana production and consumption in Colorado [https://www.colorado.gov/pacific/sites/default/files/MED%20Equivalency_Final%2008102015.pdf]

Cannabis Yields and Dosing by Chris Conrad (court qualified cannabis expert) [http://chrisconrad.com/],

Hawaii Medical Cannabis Program-Medical Marijuana Dispensary Task Force Study 2015 [http://files.hawaii.gov/auditor/Reports/2014/14-12.pdf]




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