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Health

Medical Marijuana Legislation Could Put NC In The Green, Advocates Say

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This story was originally published by North Carolina Health News.

A bipartisan bill in the North Carolina Senate would make medical marijuana legal for people with a set group of diseases. But for Principal Chief Richard Sneed of the Eastern Band of Cherokee Indians, it’s a race against time to beat the state in joining the budding industry.

The bill is set to face its next hurdle before becoming law in a Senate Committee on Finance meeting Tuesday, July 20, one of several committees it needs to pass before going to the Senate floor.

The Eastern Band of Cherokee, which has tribal land in Western North Carolina’s Qualla Boundary, took its first step in legalizing marijuana in May when it decriminalized possession of up to one ounce of marijuana for people 21 and older on tribal lands. Sneed has just submitted an ordinance that would launch a medicinal program on tribal lands.

Sneed said he is hoping that the Cherokee might eventually see some of the economic benefits that states which have legalized marijuana have seen.

Medical marijuana is legal in 36 states and Washington, D.C., and recreational marijuana is legal in 18, according to Insider, putting North Carolina in the minority of states where weed is not legal in any capacity, even as its northern neighbor, Virginia made plans to legalize up to an ounce of recreational marijuana in three years.

“States need revenue,” Sneed said, “and they see the states around them that have legalized and they see that the sky didn’t fall and that the murder rate didn’t go up and that high school dropout rate didn’t skyrocket.

“But one thing that did skyrocket was the revenue that that state was earning off the taxation and regulation of cannabis.”

Laws that the Cherokee make on their sovereign land do not extend to greater North Carolina, but legalization on tribal lands could be a draw for North Carolinians and people from other states who want access to legal, regulated marijuana.

A poll conducted by Elon University in partnership with The Charlotte Observer, The Durham Herald-Sun and The Raleigh News & Observer found that 73% of North Carolina voters supported legalizing medical marijuana and a little more than half of voters supported recreational marijuana legalization.

Of those polled, 64% of voters said legalizing marijuana would help the economy.

Sneed doesn’t foresee his efforts to legalize medical marijuana failing due to considerable grassroots support within the tribe, but “as far as the economic opportunity, that window is shrinking pretty quickly.”

Legal Weed In NC?

North Carolina Senate Bill 711, the NC Compassionate Care Act, could be landmark legislation for the state, which has long shirked legalizing medical marijuana.

The bill has bipartisan support, including that of powerful Republicans such as Sen. Bill Rabon (R-Southport) and Senate Majority Leader Kathy Harrington (R-Gastonia), two of the primary sponsors of the bill.

The bill would allow a narrowly crafted group of people diagnosed by a doctor with a “debilitating medical condition” including cancer, epilepsy, positive HIV or AIDS status, or post traumatic stress disorder to have access to a medical marijuana card.

Should it pass, North Carolina would be “the most conservative state of all those states with just a very, very narrowly tailored focus just on folks with chronic conditions, end of life care,” Sen. Wiley Nickel (D-Cary), said at a Judiciary Committee hearing on the bill on July 1.

Nickel, the secondary sponsor of the bill, has a personal connection to the NC Compassionate Care Act. His father, who has since died, had cancer and had a difficult time with chemotherapy and radiation, he said. To cope with the pain, his father used marijuana illegally, Nickel explained in an interview with NC Health News.

“He used it,” he said. “There’s no reason why we should ever deny anybody that compassionate care if they need it at the end of their life. This bill is narrowly tailored, and specifically targets legitimate needs for medical marijuana.”

Harrington said she probably wouldn’t have supported the bill six months ago, at the Judiciary Committee hearing.

“But life comes at you fast,” Harrington said.

“My husband was diagnosed with multiple myeloma and has been going through some cancer treatments,” Harrington said. “And I believe we’ve already had some moments in our life where this type of medication would have assisted in some of the responses to the treatment.”

Legislators in favor of keeping the bill’s requirements narrowly tailored argue that they do not want to see recreational marijuana in the state because of potential risks to children.

“A lot of folks have expressed to me the dangers of marijuana to teenagers,” said Sen. Michael Lee (R-Wilmington) at the Judiciary Committee hearing. “I agree with them. Recreational marijuana is not what we want in our state.”

Some argue, however, that the criteria for those who qualify for the use of medical marijuana under SB 711 should be expanded to allow for patients with substance abuse disorders and other chronic pain conditions.

Advocates Push To Lessen Restrictions

James Taylor, anesthesiologist and physician at Integrated Pain Solutions, an organization focused on reducing pain in patients who suffer from substance abuse disorder and other conditions, said he wants the bill to expand to his patients because they need it most.

He also said he understands the hesitation from lawmakers.

“You want those people who need it to have a diagnosis that is very objective,” Taylor said. “When you get into pain, anxiety, depression, these things become a little bit more subjective. So now, are people taking it for abuse or are they taking it for need? I think that’s where politicians get a little concerned.”

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Southern Pines anesthesiologist James Taylor has been treating pain with complementary techniques for six years. He believes that using cannabinoids will become a more accepted part of pain treatment.

Broadening the criteria of the bill could give physicians like Taylor more flexibility to make a judgment call for what cannabinoid would help a patient’s medical problems.

“There may be times when I think a higher THC content (would be more helpful),” Taylor said. “For me, it’s not one size fits all. It’s all variables of gray and I need that freedom to kind of pick between the two.”

Sean Parekh, founder and CEO of Cannabliss, a store that carries hemp and CBD products based in Chapel Hill, said that while some of the products he sells, such as Delta-8 THC, can help people, they don’t have the same benefits as the marijuana flower, which contains additional substances, such as terpenoids and flavonoids that occur naturally in the plants.

In the current bill the state would be able to give out 10 distribution licenses, with each of those licensees having the ability to open four locations across the state. For a large state like North Carolina, some advocates and lawmakers alike said they would like to see more done to make medical marijuana accessible.

“The latest version I had was 10 licenses throughout the state, but it’s a work in progress on that portion of the bill,” Nickel said. “We need to make sure that people don’t have to drive great distances to get access to medical marijuana.”

Accessibility Of Distribution Sites

Though advocates such as Taylor worry about accessibility, he is also concerned about how distribution sites will be used.

“Forty is not many for a large state like ours,” Taylor said.

He also said it’s important to consider the nature of those locations.

“Where do patients go typically to get medicine? They go to their pharmacist, or their doctor gives them medicines or shots or vaccinations at their office” Taylor said. “For me, those distribution sites are important. It’s important that we hold on to them, and we keep them in the practice of medicine rather than just retail locations with bud tenders.”

In contrast, business owner Parekh said he thinks the criteria need to be expanded for economic reasons.

In order to obtain a license to grow and sell marijuana in North Carolina under the current bill, licensees must pay a nonrefundable license fee of $50,000 plus an additional $5,000 for each production facility or cannabis center they operate under that license. This is in addition to a fee of 10% of gross revenue from cannabis sales that suppliers must pay to the North Carolina Department of Health and Human Services each month.

“If they stick with the bill the way it’s been, it’ll fail economically,” Parekh said. “It wouldn’t sustain having that many limited conditions. There’s not enough of a market for everyone investing that much in their business, investing the license, investing infrastructure — the states aren’t going to make enough taxes on that to make it worth their time.

As the state continues to battle with the opioid epidemic, some advocates argue that medical marijuana could be used to curb addictions.

“My patients are at highest risk, and I think there’s a good case for [expanding criteria] since patients with pain who are requiring opioids are at a very high risk of dying, especially during what we have been observing as an opioid crisis,” Taylor said.

The Cherokee have spent money, time and resources to combat the opioid epidemic. Sneed was a high school teacher on tribal lands during the height of the opioid epidemic there in the 2000s, when he can remember at least one person dying per week due to overdose.

But to Sneed, marijuana is different, partly because the plant has deep roots with indigenous people in the United States. Ironically, many of those people are also people who oppose alcohol sales.

“Their position is that it is a traditional medicine, and that’s why they support it and they’re firm believers in it and they want us to legalize it,” Sneed said. ”That was one of the drivers behind the decriminalization as well.”

‘An Important First Step’

Cannabis advocates and some lawmakers generally agree that the bill isn’t perfect.

“It’s an important first step,” Nickel said. “Is it going to go as far as other states? No, but it’s a start. There are a lot of people that will be helped by this bill, when an effort passes, but it’s still an uphill battle.”

Paul Armentano, deputy director of the National Organization for the Reform of Marijuana Laws (NORML), said North Carolinians, like other Americans, “have a demand for cannabis.”

“I can tell you from experience,” Armentano said, “In virtually every state that has either medical access or adult-use access, every consecutive year, lawmakers go back and they tweak and they revise and they amend those laws in the cases of medical marijuana … They make them less restrictive, not more restrictive.”

No matter what happens at the state level, Sneed said, the Cherokee will proceed with their plans for legalization.

“It’s really one of those things that if we were going to be a player in it, five years ago would have been the time to go to jump,” Sneed said. “But we’ll see.”

North Carolina Health News is an independent, non-partisan, not-for-profit, statewide news organization dedicated to covering all things health care in North Carolina. Visit NCHN at northcarolinahealthnews.org.

This article first appeared on North Carolina Health News and is republished here under a Creative Commons license.