The past year was a tremendous challenge for consumers and the economy, but it also gave us an opportunity to test new ways of doing business and accomplishing our goals. During the COVID-19 crisis, almost every state made exceptions to existing regulations to facilitate social distancing and ease access to medical care. These exceptions spanned many areas, from loosening HIPAA requirements for telemedicine to allowing takeout alcoholic beverages at restaurants. Many experiments were enormously beneficial for both our way of life and the environment.
For instance, employers discovered allowing their employees to work from home was not only feasible but also the most efficient option for their bottom line. At the same time, during the height of the pandemic, traffic was so minimal that smog in several major cities dissipated.
As states reopen, lawmakers and industry leaders are considering how we might keep some of these unexpected benefits—a small silver lining in otherwise stormy times. We have a few ideas for improvements in today’s game-changing, post-COVID cannabis sector as well. The loosened regulations during the pandemic gave us a chance to push the limits and challenge outdated stigmas that created overly restrictive laws. Now it’s time to implement those positive changes on a more permanent basis.
Here are five ways we can do that and improve cannabis patient access.
Allow telemedicine
Restrictive telemedicine laws are a disservice to patients with compromised immune systems. Patients in many states are forced to see doctors face to face despite the risk of catching an illness in a busy waiting room. This isn’t just a matter of inconvenience; it’s a life-or-death issue for patients with cancer, HIV, or other immune challenges. For most doctor visits, this risk is entirely unnecessary. When physical visits are warranted, it is much safer for contagious or at-risk patients to be seen virtually.
During the pandemic, telemedicine has allowed patients in many states to access medical care without the risk of contagion. Telemedicine needs to become permanent and universally available. While it’s not possible or even recommended to avoid all physical visits to the doctor, this is a judgment call that should be available to all physicians for their patients’ safety.
Allow virtual forms and ID cards
Some states still send physical medical marijuana (MMJ) IDs in the mail and require paper recommendations and ID applications. This not only unnecessarily increases the risk of disease transmission but also has a negative impact on the environment.
Many states now allow documents to be delivered electronically, but other states still require recommendations to be completed on paper and signed in a particular color of ink. While the need to reduce fraud is understandable, this is no longer the most efficient or effective way to do so; recommendations easily can be verified over the internet 24/7.
Requiring physical delivery also wastes natural resources and causes delays in treatment while patients wait for paperwork to arrive via snail mail. Practitioners should use all technological methods at their disposal to improve patient care and decrease wait times.
Allow product delivery
Immunocompromised patients risk illness every time they leave their homes. Anything that reduces the need for unnecessary trips lowers their risk and reduces collateral medical costs.
During the pandemic, many states began permitting delivery or curbside pickups, at least for MMJ patients, to reduce the risk of exposure to COVID-19. As our lives return to normal, many regulators are overlooking the fact some people always need to avoid exposure to contagions, especially in the MMJ community. Now that we’ve had a taste of what life is like for these patients, how could we even consider taking this option away?
Broaden the scope of qualifying conditions
All patients have the right to try cannabis for their medical conditions. Many states incorporate heavily regulated lists of qualifying conditions into legislation, and the lists do not take into account recent medical research. Why should legislators without medical training be making medical decisions? Those should be left to physicians.
Legislators are reluctant to give physicians the option to choose whether MMJ may be beneficial for patients because lawmakers feel such freedom might blur the line between medical and recreational use. But this isn’t about opening recreational floodgates. It’s about improving quality of life for patients with chronic conditions. Is a patient with Parsonage-Turner syndrome or trigeminal neuralgia less deserving of pain relief than a patient with osteoarthritis or multiple sclerosis?
Granted, many states can add new conditions to their qualifying conditions list at will, but the process is lengthy and places an undue burden on patients with relatively uncommon forms of chronic pain. These patients are often left to suffer for months or even years before their condition is added by regulators.
This was a problem before the pandemic, and it’s still a problem now. Unfortunately, more people now have chronic conditions due to the lasting effects of COVID-19 infection. It’s always been discriminatory and unfair for legislators to allow cannabis treatment for some medical conditions while denying it for others, often arbitrarily and with little or no scientific guidance. It’s time for this practice to end.
Provide clear guidance
As the country returns to “normal,” states must provide clear guidance for physicians and dispensaries regarding regulatory changes and deadlines for compliance. Pennsylvania set a good example by being proactive and communicative as the legislature considers making certain regulatory exceptions permanent.
If a legislature plans to codify pandemic-related exceptions, the emergency regulations should be extended until legislatures have adequate time to pass new laws. States also should clearly communicate deadlines and timelines for the changes so stakeholders can adjust their services accordingly.
In this effort, legislators must consider staffing and hiring requirements if they choose not to keep telemedicine as an option. Failing to do so will result in costly disruptions in patient care; it may take months for dispensaries to transition back to a brick-and-mortar-only operation, especially in today’s extremely tight job market. Community stakeholder surveys can give regulators a better idea of the timelines required for a return to pre-COVID business practices.
Arkansas, California, Maine, Missouri, Montana, Nevada, New Jersey, New York, North Dakota, Oklahoma, and Pennsylvania allowed telemedicine for medical cannabis before the pandemic. Colorado, Connecticut, Massachusetts, Michigan, Minnesota, New Hampshire, Ohio, and Rhode Island all chose to allow telemedicine for initial visits during the COVID-19 crisis. These forward-thinking policies likely saved countless people from exposure to illness, thus saving lives and medical costs.
Illinois provided incredible leadership by outlining clear guidance for dispensaries and doctors. The state also granted an exception allowing cannabis sales outside the limited access areas for medical patients, as did California, Colorado, and several other jurisdictions.
Advocates in Pennsylvania are now pushing legislation that would codify curbside pickup, telemedicine, and other COVID-19-era program improvements. The bill, which recently passed out of a state House committee, also allows caregivers to deliver marijuana to an unlimited number of patients.
Policy changes like these are dispelling the misbegotten myths that drive the archaic and nearly unworkable patchwork of restrictive cannabis regulations in the United States. We’re finally seeing a light at the end of the tunnel as states begin to recognize cannabis’s legitimate medical value and make it more easily accessible to all patients.
Debbie Tharp, director of compliance at NuggMD, has been an activist since the age of 18. Since running for the California State Assembly while in college, she has authored, qualified, and assisted with more than a dozen local legalization ballot initiatives. Tharp recently completed a law degree and will begin practicing in 2022.
