How exactly are qualifying conditions for medical cannabis programs determined? 

How exactly are qualifying conditions for medical cannabis programs determined? 

Medical cannabis programs across the United States vary on a range of legislative points. Without any federal allowances in place, states are left to choose their own regulations, leaving patients in varying circumstances depending on where they reside in the country.

The current situation affects medical patients from the moment they register for the program to their everyday dealings as eventual license holders. One of the earliest and most apparent, examples a prospective patient may encounter occurs when attempting to qualify for the program itself. While some states allow for a wide range of conditions under their medical program, others remain restrictive, permitting just a few conditions to access medicinal cannabis.

With no set criteria, states are left to choose their qualifying conditions through a variety of processes and viewpoints-creating a range of programs across the nation.

How a State Chooses Its Medical Cannabis Qualifying Conditions

Exactly how a state chooses its list of qualifying conditions is rather uncertain at this time, according to sources who spoke to High Times for this article. What is known is that the current process can leave a person with one condition qualifying for medical cannabis while a person a few miles away in another state may not.

April Hatch, an RN, and founder of the Cannabis Care Team didn't have a clear answer when asked the question. Instead, Hatch delved into the efforts and limitations advocates like herself face when advocating for certain qualifying conditions. "I think medical cannabis advocates do their best to have a thorough list of qualifying conditions but have limitations based on what they can get legislators and constituents to vote for."

Hatch, a member of several cannabis and holistic nursing associations, touched on various viewpoints in the space. "Some people only feel like cannabis should be allowed for patients dying from cancer and some believe it could help every condition in some way."

Teddy Scott, CEO of multi-state operator Ethos Cannabis, didn't have much certainty other than that the process is primarily a political one.

"Hopefully, the politicians included input from physicians, but it isn't clear exactly how specific conditions were included or excluded from the qualifying list in any particular state," elaborated Scott.

A 2019 analysis of qualifying conditions across the U.S. helped shine some light on the issue while raising pain points already established in the space. The University of Michigan and Deloitte Consulting report concluded that chronic pain was the most commonly cited condition among patients in 2016, totaling 67.5% of patients. Additionally, the report found that 85.5% of patient-reported conditions had what was described as substantial or conclusive evidence of cannabis' medical benefits.

"Creating a nationwide patient registry will facilitate a better understanding of user trends and potential effectiveness," noted the report. The analysis concluded its report with a reiteration of the latter fact, then adding support for the removal of cannabis from its current Schedule 1 status.

"It is also important for state and federal policymakers to seriously consider how to integrate cannabis research and products in an evidence-based way into the healthcare system," concluded the researchers.

The Public Health Effect

Medical cannabis patients and applicants alike face an uneven landscape in the current medical marketplace.

The current system leaves medical cannabis patients across America left in a challenging and cumbersome situation, according to Ethos' Scott. "Without clear direction from the medical community and federal regulations, each state has taken a very independent approach to defining their acceptable conditions lists," stated the CEO.

Scott went on to discuss the importance of federal rules, "If there is some sort of legalization and regulation at a national level, more patients and doctors are provided the option to make their own choices about their own conditions and overall health."

Some level of uniformity developed out-of-state reciprocity programs, which allow patients to obtain cannabis while living or visiting another state. The model, too, has its drawbacks, with not only a select few states participating, with several having various laws and agreements that exclude certain state markets.

Cannabis Care Team's Hatch said patients have told her that they will not travel to states that prohibit them access to their medicine. Even those that permit patients to do so often present their own hurdles, Hatch stated. "Most of my patients are elderly, not tech-savvy, on a budget, and are unable to complete the online application or even afford the fee that could be $100."

Hatch added, "Cannabis patients want to travel and visit family and friends like anyone else, and they should be able to without fear of prosecution."

Various Possible Solutions

A lack of clarity exists, creating a significant room for improvement that sources believe could come in various forms.

Above all else, federal legalization of cannabis provides the most concise form of action, with standard rules and a federal list of approved conditions. That said, states and patients alike do not have to wait on the federal government to create change, according to sources.

"There are also certain initiatives introduced in specific states that could be useful to implement on a national scale," noted Ethos Cannabis' Scott. The CEO highlighted Pennsylvania, where the implementation of a clinical research program that pairs cannabis companies with medical schools in the state. Scott explained that the partnership between the two groups allows for "Real research to inform the medical community, the government, and the general public on how cannabis can affect health care outcomes."

Cannabis Care Team's Hatch focused on state program reform, as well as revising the rights of the patients and medical professionals. "The medical care a patient has access to shouldn't be decided by the state," said Hatch, who supports abolishing qualified conditions lists entirely.

Offering up an alternative to the status quo, the company founder suggested, "If there are the concern patients will be at risk for any adverse effects of cannabis then let's ensure they have access to knowledgeable medical professionals and quality education."