Medical Marijuana 2020

FAQ

Frequently Asked Questions 

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Why Medical marijuana is needed in Mississippi

1. Why do people in Mississippi need access to medical marijuana?
Medical marijuana is a safe and effective treatment option for a broad range of serious medical conditions and their symptoms, such as chronic pain.  More than 2.8 million Americans are using medical marijuana in 33 states, and there is no reason to deny that same option for relief to Mississippians who are in chronic pain or suffer from other symptoms from debilitating medical conditions.  These laws are working well and helping patients in other states.  Mississippians with these types of medical conditions and diseases have little choice but to suffer with little or no relief, or to turn to opioids and heavy pharmaceutical drugs, which can cause dependence.

2. Is medical marijuana something that could actually be beneficial to me or my family?
In states with medical marijuana programs, medical marijuana helps many patients who suffer from chronic pain or other symptoms associated with a variety of debilitating conditions.  Mississippi’s medical marijuana initiative lists the conditions for which patients will be able to qualify, and that list relies on the experiences of other states and the available medical research.   The list includes epilepsy, Parkinson’s disease, muscular dystrophy, multiple sclerosis, post-traumatic stress disorder, HIV, Crohn’s disease, ALC, and sickle-cell anemia. To see a comprehensive list of debilitating medical conditions included in the proposal, see question 59.

3. Aren’t prescription drugs just as effective?
Patients suffering from debilitating illnesses and the treatments associated with those illnesses find that medical marijuana provides relief. Available prescription drugs, like opioids, often come with far more serious side effects than medical marijuana, which are modest compared to the risks associated with many prescription drugs.  Moreover, there have been no reported deaths from a marijuana overdose — unlike opioids and other dangerous medications that are prescribed every day.  Also, many patients who find relief from marijuana simply do not respond to prescription medications. 

 4. Are there any prescription drugs that are made from marijuana?
Yes, the FDA recently approved a drug called Epidiolex for the treatment of seizures associated with two rare and severe forms of epilepsy called Lennox-Gestault syndrome and Dravet syndrome. This is the first FDA-approved drug that contains a purified substance derived from marijuana called CBD which is a non-psychoactive component of marijuana. The FDA classifies this drug as a Schedule 5 controlled substance which is given to drugs with a proven medical use and low potential for abuse. 

The FDA has previously approved 3 drugs that are made from synthetic cannabinoids, which means they are man-made and not naturally derived from the marijuana plant. Marinol and Syndros are used to treat anorexia associated with weight loss in patients with AIDS, and nausea and vomiting associated with chemotherapy treatment of cancer.  Cesamet is used to prevent or treat chemotherapy-induced nausea and vomiting. Both Marinol and Cesamet have been legally available since 1985 and Syndros was approved in 2016. 

5. I thought Mississippi had some type of medical marijuana program?
In 2014, Governor Phil Bryant signed a bill into law that would legalize the use of CBD oil, which is an extract of the marijuana plant, for certain kinds of medical conditions.  The law was named “Harper Grace’s Law,” after a young girl who has a rare type of epilepsy that causes violent seizures. In other states, children like Harper Grace have used medical marijuana to fight seizures.  However, Harper Grace has yet to receive her first dose of CBD oil from Mississippi.  

The problem is that the Harper Grace Law required the CBD oil to be provided by the National Center for Natural Products Research at the University of Mississippi under “appropriate federal and state regulatory approval” and restricted the dispensing of CBD oil to the University of Mississippi Medical Center. Due to these restrictions and difficult-to-obtain approval from the applicable federal agencies, the hospital has yet to provide any CBD oil to qualified patients. Consequently, since the passage of the law, Harper Grace, and patients like her, have yet to receive any relief in Mississippi.

UMMC announced a small clinical trial of CBD in 2018 to determine the safety and tolerability of the medication for children with severe epilepsy whose seizures are not controlled by other medications. The trial is limited to only a dozen children and does not include Harper Grace. It is a positive step for Mississippi but does not provide readily accessible CBD medication to children or any other person suffering from a debilitating medical condition outside of the trial. 

6. What about the CBD that is available in some of the stores in Mississippi?
CBD (cannabidiol) that is for sale in stores across Mississippi may not be legal under state law or compliant with US Food and Drug Administration regulations, depending on where the CBD came from and how it is being sold. Selling CBD is currently in a legal grey area because of recent changes to federal law and a lack of direction from the FDA. 

The marijuana plant and the hemp plant are genetic cousins that both contain chemical compounds called cannabinoids which produce certain effects within the human body.  Cannabinoids can be extracted from either plant and turned into processed products. CBD is one type of cannabinoid and it can be found in both marijuana and hemp. THC is another cannabinoid and it contains psychoactive properties, yet hemp does not contain effective amounts of THC as specified by federal and state law.  Through the 2014 and 2018 federal Farm Bills, the federal government has allowed states to regulate the growing of hemp. Though Mississippi does not currently allow hemp farming or processing, many states legalized hemp leading to legally-available CBD products. 

Therefore, some producers outside of Mississippi are manufacturing CBD products from hemp and not from marijuana. These hemp-derived CBD products can be found in some stores throughout Mississippi. However, the legality of these products is unknown at this time. Though Mississippi adopted Harper Grace’s Law, that law does not allow the unregulated sale of CBD products around the state.

7. So why do we need a medical marijuana program?
A medical marijuana program will allow patients access to whole plant medicine instead of only CBD, which is just one of many helpful cannabinoids in the plant. The many different cannabinoid chemical compounds found within whole plant medical marijuana were created to work in concert with one another in order to interact with the endocannabinoid system in our bodies. Many patients, including those who suffer from seizure disorders, find their symptoms are treated most effectively when they are allowed to use the full plant to medicate instead of only the CBD component.   In addition, the use of private businesses to grow and dispense the medical marijuana will avoid the problems of using a federally regulated medical center like the University of Mississippi.

8. Has the Mississippi Legislature ever considered legalizing medical marijuana?
Over the last several years, several legislators have introduced bills to make medical marijuana legal in Mississippi.  Unfortunately, none of those bills have been given a hearing or even a vote at the State Capitol.


how the regulatory process would work in mississippi

9. Doesn’t federal law prohibit the use of medical marijuana?
Federal law does not prevent states from removing state and local criminal penalties for the medical use of marijuana, which is what our initiative would do in Mississippi.  Nothing in the U.S. Constitution or federal law prohibits states from enacting penalties that differ from federal law that would prevent states from implementing their medical marijuana laws. Moreover, since late 2014, the appropriations acts approved by Congress have included riders to prevent federal funds from being used to interfere with medical marijuana laws.  President Donald Trump has signaled his support for allowing state medical marijuana laws to function without federal interference, and a federal appellate court has ruled that the federal government cannot punish — or even investigate — physicians for discussing or recommending the medical use of marijuana with patients. 

10. Can anyone get medical marijuana under your proposal?
No. Only those persons who have a debilitating medical condition as enumerated in the ballot initiative, have been examined by a Mississippi-licensed physician, and have obtained from that physician a certification which allows the patient to use medical marijuana.  The qualified patient will then use the physician certification to apply for a Medical Marijuana ID Card through the Mississippi Department of Health. Once the patient has obtained a Medical Marijuana ID Card, they may proceed to obtain treatment from a Medical Marijuana Treatment Center in the state of Mississippi. Medical marijuana will only be dispensed to qualified patients with valid Medical Marijuana ID Cards, and Medical Marijuana Treatment Centers will confirm the following according to the rules and regulations set by the Mississippi Department of Health: the patient has a valid Medical Marijuana ID Card that is not expired, and the patient has an available allotment to purchase according to the time frame and amount allowed per the state’s regulatory requirements.

11. If I already own a gun, can I become a medical marijuana patient?
Based on the experience of what is happening in other states, the answer is a qualified yes. Currently, the policies of the Federal Bureau of Alcohol, Tobacco, Firearms and Explosives (ATF) do not allow for medical marijuana patients to possess firearms.  The ATF laid out this policy in a letter to firearms vendors in 2011: “Marijuana is listed in the Controlled Substances Act as a Schedule I controlled substance, and there are no exceptions in Federal law for marijuana purportedly used for medical purposes, even if such use is sanctioned by State law. Therefore, any person who uses or is addicted to marijuana, regardless of whether his or her State has passed legalization authorizing marijuana use for medicinal purposes, is an unlawful user of or addicted to a controlled substance and is prohibited by Federal law from possessing firearms or ammunition.”

However, since the ATF adopted this policy, and because of the large number of states that have enacted medical marijuana laws, Congress has routinely passed amendments to the appropriation bills for the Department of Justice which prohibit the expenditure of federal money to interfere with the implementation of state medical marijuana laws.  The latest protection for state medical marijuana laws was signed into law by President Trump on February 15, 2019.  Consequently, there has been no known federal enforcement of ATF’s policy or prosecution of individuals who purchased medical marijuana in compliance with state law and who also possess firearms.  

In addition, the Mississippi initiative would protect gun rights created by state law for patients who use medical marijuana. A state is not required to mirror the federal government’s policy on medical marijuana patients and guns.  In 2011, for example, the Oregon State Supreme Court ruled in Willis v. Winters that a sheriff could not deny medical marijuana patients a state conceal carry permit, even though it conflicted with federal law.

The more states that enact medical marijuana laws, the more pressure there will be on the federal government to change its policies.  In fact, there are current efforts in Congress to reform federal law as it relates to medical marijuana and gun rights. 

12. If I become a medical marijuana patient and then want to purchase a gun, will I be able to do so?
The answer to this question is more troublesome than the answer to the question about possession of firearms.  Under current law, the answer would have to be no, and it all has to do with the form that you would be required to complete when you got ready to purchase a firearm.

Currently, the policies of the Federal Bureau of Alcohol, Tobacco, Firearms and Explosives (ATF) prohibit medical marijuana patients from purchasing firearms.  The ATF laid out this policy in a letter to firearms vendors in 2011: “Marijuana is listed in the Controlled Substances Act as a Schedule I controlled substance, and there are no exceptions in Federal law for marijuana purportedly used for medical purposes, even if such use is sanctioned by State law. Therefore, any person who uses or is addicted to marijuana, regardless of whether his or her State has passed legalization authorizing marijuana use for medicinal purposes, is an unlawful user of or addicted to a controlled substance and is prohibited by Federal law from possessing firearms or ammunition.”

Until ATF's policy changes, purchasers of firearms must complete the federal firearm license form, including the question about drug use.  The form states, “The use or possession of marijuana remains unlawful under federal law regardless of whether it has been legalized or decriminalized for medical or recreational purposes in the state where you reside.”  So, if a person is a medical marijuana patient and checks the “yes” box, he or she will not be allowed to buy a gun.  On the other hand, if a person is a medical marijuana patient and checks the “no” box, he or she is subject to a perjury charge.

However, since the ATF adopted this policy, and because of the large number of states that have enacted medical marijuana laws, Congress has routinely passed amendments to the appropriation bills for the Department of Justice which prohibit the expenditure of federal money to interfere with the implementation of state medical marijuana laws.  The latest protection for state medical marijuana laws was signed into law by President Trump on February 15, 2019.  Consequently, there has been no known federal enforcement of ATF’s policy or prosecution of individuals who purchased medical marijuana in compliance with state law and who also possess firearms.  

In addition, the Mississippi initiative would protect gun rights created by state law for patients who use medical marijuana.  A state is not required to mirror the federal government’s policy on medical marijuana patients and guns.  In 2011, for example, the Oregon State Supreme Court ruled in Willis v. Winters that a sheriff could not deny medical marijuana patients a state conceal carry permit, even though it conflicted with federal law.

While the Congressional amendments have prevented enforcement of the ATF policy for possession of guns, completing the federal form in a truthful way as a medical marijuana patient represents a barrier to purchasing a gun.

The more states that enact medical marijuana laws, the more pressure there will be on the federal government to change its policies.  In fact, there are current efforts in Congress to reform federal law as it relates to medical marijuana and gun rights.  We believe that by the time the Mississippi initiative is operational in the summer of 2021, assuming it is approved by the voters in November 2020, the conflicting federal issues over gun ownership will be resolved. 

13. How do you protect someone who is using medical marijuana from getting arrested?
A medical marijuana patient’s ID card, issued to every patient by the Mississippi Department of Health, prohibits the ID card holder from arrest by any state or local law enforcement official for possession of legally obtained medical marijuana.   

14. What factors determine qualification for a certification from a physician?
A physician may only certify medical marijuana after examining a patient in person and determining he or she meets one or more of the allowable diagnoses. A physician's decision to certify medical marijuana would be based upon his or her opinion that marijuana could benefit a patient. A parent of a minor must be present at the examination and provide written consent prior to the certification being issued on behalf of the minor.

15. Are physicians required to certify medical marijuana under your proposal?
No. Physicians are not required to certify medical marijuana just as they are not required to prescribe any other treatment method. This ballot initiative will grant physicians the freedom to certify medical marijuana to patients who may benefit from it.  The initiative’s language expressly states that physicians are never required to certify medical marijuana, but that they do have the option to do so.

16. What if a physician improperly certifies a patient for medical marijuana?
The same rules would apply for medical marijuana certifications as for any other medication improperly prescribed by a physician. Only physicians in good standing and licensed to practice medicine in the State of Mississippi can certify patients to use medical marijuana. Those physicians are regulated by the Mississippi Board of Medical Licensure who has the duty to protect the public and discipline physicians who do not practice according to the appropriate standard of care.  

17. How are physicians legally protected when they certify someone to use medical marijuana?
If adopted by the voters, the ballot initiative will become part of the state constitution.  The initiative includes a provision that provides physicians with legal protection for certifications for medical marijuana for persons diagnosed with a debilitating medical condition. 

18. Where will medical marijuana be available?
Medical marijuana will only be available at Medical Marijuana Treatment Centers licensed by the Mississippi Department of Health.

19. What is a medical marijuana business?
A medical marijuana business is any business that has applied for and received a license from the Mississippi Department of Health to cultivate, process, test, or sell medical marijuana. This may include: cultivation facilities (agricultural greenhouses where the plant is grown and harvested), testing facilities where the products are scientifically tested and approved, and dispensing centers (Medical Marijuana Treatment Centers) where patients can purchase the medicine.

20. Who will oversee and regulate Medical Marijuana Treatment Centers in Mississippi?
Medical Marijuana Treatment Centers will be registered with, licensed, and regulated by the Mississippi Department of Health.

21. How will a Medical Marijuana Treatment Center work?  What will I do once I get there?
A medical marijuana patient will show his or her Medical Marijuana ID Card at the front desk. The associate will swipe the ID card into the medical marijuana patient database to verify the patient’s information and that there is an available amount of medical marijuana allowed to be dispensed. The patient will then be able to speak with a medical marijuana patient advocate to discuss treatment options and purchase their medicine. 

22. What is medical marijuana and what kind of medical marijuana product will be available in Mississippi?  How will I know what to choose or how much to take?
Medical marijuana is state-regulated marijuana that is obtained from a licensed treatment center in Mississippi and that is provided to qualified patients.  It can be offered in varying forms, some of which include beverages, topicals, patches, tinctures, sprays, juices, smoking, vaporizing, edibles, capsules, lozenges, creams, and ointments.  Offering medical marijuana in multiple forms allows patients to utilize their treatment in the way that works best for them. Certain methods get into the bloodstream more quickly, therefore providing immediate relief, while other forms may take longer to enter the bloodstream but may provide longer-lasting relief. The preferred method will depend upon patients’ preferences for ingestion, and the type of pain and symptoms they wish to alleviate. Patient advocates will be able to assist each patient at the Medical Marijuana Treatment Centers to help them find and choose what may work best for them. 

23. What training will be required for employees of Medical Marijuana Treatment Centers?
The Mississippi Department of Health will regulate requirements for employees of Medical Marijuana Treatment Centers.  

24. Will there be limits to the amount and frequency that patients can obtain medical marijuana treatment?
Yes. Just as other states that allow the use of medical marijuana have limits regarding the amount and frequency by which patients can obtain treatment, Mississippi will as well. Other states impose limits that range from 1 ounce to 8 ounces.  The Mississippi initiative will limit each patient to obtaining or possessing no more than 2.5 ounces of medical marijuana every fourteen days. 

25. Does this initiative allow for home grow? Will there be people growing medical marijuana in my neighborhood?
No. Qualified patients may only obtain medical marijuana from licensed Medical Marijuana Treatment Centers.  Although some states with medical marijuana programs allow patients to grow medical marijuana on their own property, Mississippi’s proposal will require medical marijuana patients to purchase medication from licensed and regulated Medical Marijuana Treatment Centers.

This medical marijuana initiative was drafted to allow the Mississippi Department of Health to most effectively and efficiently regulate the program while providing a free market approach for businesses to engage in the growing, processing, and selling of medical marijuana. Adding a home grow component to the initiative would have complicated the regulatory process and added to the cost of that regulation. Given the free market approach to the business side of the initiative, we believe medical marijuana will be readily available to any patient who qualifies for the program.

26. Will the number of medical marijuana businesses in the state be limited?
No. It will be a free market and there will not be a limit imposed per this initiative. Each medical marijuana business will have to apply to, and be approved and licensed by, the Mississippi Department of Health. 

27. Will people be allowed to smoke medical marijuana in public?
No. The initiative makes it illegal to smoke medical marijuana in a public place.  In addition, the initiative does not override any public laws or private rules related to smoking in or on public or private places.

28. Can I use medical marijuana in a hospital, nursing home, or assisted living facility?
Using medical marijuana in a hospital, nursing home, or assisted living facility will depend upon the policies and rules of each facility.  Nothing in Mississippi’s initiative requires public or private businesses to make accommodations for the use of medical marijuana.  A facility may make restrictions on the legal use of medical marijuana on their premises, so it is important to be familiar with the rules and policies of those facilities. The initiative does make it illegal to smoke medical marijuana in a public place.

There is currently no consensus among health care facilities in other states where medical marijuana is legal regarding consumption by patients and residents on the premises. It is common protocol for health care facilities to ask patients and residents about current drug regimens when the patient or resident enters the facility.  With medical marijuana, some hospitals have taken the "don't ask, don't tell" position as they do not want to assume any risk for knowingly allowing the consumption of a federally-illegal substance on their property.  Other facilities have developed procedures for allowing the consumption of medical marijuana on the premises with certain protocols, such as securing the medical marijuana in special lock boxes or by only allowing non-smokable delivery methods.

29. What is the purpose of Medical Marijuana ID Cards?
Medical Marijuana ID Cards serve as identification for qualified patients, caregivers, and employees of Medical Marijuana Treatment Centers. Medical Marijuana ID Cards are required for patients to purchase their medicine, and enables the amounts purchased to be tracked within the medical marijuana database, which each Medical Marijuana Treatment Center uses to dispense medication to patients. 

30. Will there be an expiration date for the Medical Marijuana ID Cards? What will the process for renewal be? 
Most states’ programs require a renewal annually, while some states allow for two- or three-year renewals. Mississippi will require an annual renewal unless the physician opts for a shorter time period.  To renew a Medical Marijuana ID Card, patients will need to complete an examination with a physician to determine if a qualifying medical condition is still present. The patient will then apply for their renewal card by submitting the physician certification to the Mississippi Department of Health. 

31. Will insurance cover the costs of medical marijuana treatment?
Insurance companies are not required to cover the costs of medical marijuana treatment.  Unless an insurance carrier or other third-party payer chooses to cover medical marijuana, the cost will be paid for out of pocket by the patient.

32. Will people under the age of 21 be able to use medical marijuana?
Individuals under the age of twenty-one will be able to use medical marijuana as a treatment, provided they receive a physician certification in an office visit attended by their parent or guardian who must provide written consent. Debilitating medical conditions affect children and teenagers just like they do adults.  Offering medical marijuana as a treatment option provides an alternative to the heavy pharmaceutical drugs that many children and teenagers use currently.  Families in other states have advocated for medical marijuana programs specifically for their children to have a safer and more effective option instead of only heavy drugs and medicines. 

33. Why should children be eligible for medical marijuana?
Children suffer from debilitating medical conditions, including seizure-related illnesses, for which medical marijuana has provided significant relief and reduced the symptoms of for many patients.  Medical marijuana is a helpful and effective treatment for children who either have not responded well to pharmaceutical drugs, or whose only other option is a strong cocktail of heavy pharmaceutical drugs. 

By making medical marijuana available for children, physicians will be able to provide alternative treatments, including those derived from the marijuana plant that contain low levels of THC, such as CBD oil, which provides relief to children suffering from seizures.

34. Will Mississippi allow caregivers to help children and elderly patients purchase and take their medical marijuana?
Yes. All states with medical marijuana programs authorize the use of caregivers to assist qualified patients who need help with their medicine. Mississippi’s initiative would allow this as well.  A caregiver is someone at least twenty-one years of age who has been granted caregiver status by the Mississippi Department of Health. Caregivers will be issued a Medical Marijuana ID Card specifically for caregivers that will include the patient’s name whom they are authorized to assist. The Caregiver Medical Marijuana ID Card will authorize caregivers to purchase medical marijuana on behalf of the patient and assist the patient with taking their medication. 

35. How will the regulations for this new program be paid for?
This will be a self-funding program. The program will pay for itself and will not require the use of any general fund tax dollars.  The initiative creates three sources of revenue for the Mississippi Department of Health to use in regulating and enforcing the medical marijuana program in the state.  Those sources are the cost of an ID card, licensing fees for treatment centers, and a charge at the point of retail purchase of medical marijuana that cannot exceed the state’s sales tax rate.  All of this revenue will go into a special fund for the Mississippi Department of Health to use exclusively for this program.  In order to get the program up and running, before funds are received, the initiative authorizes the Mississippi Department of Health to receive a loan from the special source funds maintained by the state treasury.  The proposal requires the repayment of any borrowed funds. 

36. How much will it cost to apply for a Medical Marijuana ID Card? 
The proposal allows the Mississippi Department of Health to charge up to $50 to obtain a Medical Marijuana ID Card and to renew the card. 

37. If the initiative is adopted by the voters, how long will it take before medical marijuana is available in Mississippi? 
Implementing a medical marijuana regulatory framework is something that 33 other states have done, and their experiences can be utilized in Mississippi.  The proposal requires the Mississippi Department of Health to have the program up and running no later than August 15, 2021, if the voters approve the initiative in the November 2020 general election. 


What does medical research say?

38. Does the U.S. Food & Drug Administration (FDA) support the use of medical marijuana?
Though the FDA does not explicitly support the use of medical marijuana, the FDA has approved four medications made from marijuana or synthetic marijuana extract. Such approval is indicative of the FDA’s confirmation that marijuana has medicinal benefits as evidenced by rigorous clinical trials. Those drugs include:

  • Epidiolex: an oral solution approved for the treatment of seizures associated with two rare and severe forms of epilepsy, Lennox-Gestaut syndrome and Dravet syndrome.

  • Marinol and Syndros: capsules and oral solution approved for the treatment of nausea and vomiting associated with cancer chemotherapy.

  • Cesamet: capsules approved for the treatment of nausea and vomiting associated with chemotherapy.

39. Why is a medical marijuana program necessary if we have four FDA-approved medications from real or synthetic marijuana extract?
The FDA-approved medications do not take the place of a medical marijuana program. Of the four FDA-approved medications, three are synthetic and the fourth, although made from real marijuana extract, only uses one of the more than 100 cannabinoids found in the plant. The three synthetic medications are only approved for nausea and vomiting associated with cancer chemotherapy and is available in oral solutions, which may be difficult for cancer patients who are struggling with nausea and vomiting. The fourth medication, Epidiolex, which is made from real plant marijuana extract is only approved for two rare and severe forms of epilepsy. 

Mississippi’s medical marijuana program will serve 22 debilitating medical conditions, will allow qualified patients under the care of a physician to have safe and legal access to whole plant marijuana, and will provide varying delivery methods so that each patient can utilize their treatment in the way that works best for them.

40. Are there any research studies that demonstrate the effectiveness of medical marijuana?
Yes! There are many studies that show that medical marijuana is effective to treat a number of debilitating medical conditions. Some of those studies have been published in peer-reviewed medical journals including the following:

a. The National Academies of Sciences reported that “there is conclusive or substantial evidence that cannabis or cannabinoids are effective (1) for the treatment of chronic pain in adults, (2) as antiemetics in the treatment of chemotherapy-induced nausea and vomiting, and (3) for improving patient-reported multiple sclerosis spasticity symptoms.” (The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research, The National Academies of Sciences, p. 128)

b. The Journal of the American Medical Association published research that the “use of marijuana for chronic pain, neuropathic pain, and spasticity due to multiple sclerosis is supported by high-quality evidence.” (Medical Marijuana for Treatment of Chronic Pain and Other Medical and Psychiatric Problems, Journal of the American Medical Association, 2015)

c. The Canadian Medical Association published research that shows that “smoked cannabis was superior to placebo in symptom and pain reduction in participants with treatment-resistant spasticity.” (Smoked Cannabis for Spasticity in Multiple Sclerosis: A Randomized, Placebo-controlled Trial, Canadian Medical Association Journal, 2012)

d. The Lancet published medical research shows that adding cannabidiol to a medication regiment is “efficacious for the treatment of patients with drop seizures associated with Lennox-Gestaut syndrome and is generally well tolerated.” (Cannabidiol in Patients With Seizures Associated With Lennox-Gastaut Syndrome (GWPCARE4): a Randomized, Double-blind, Placebo-controlled Phase 3 Trial, The Lancet, Volume 391, Issue 10125, March 2018)

e. The European Journal of Medicine published research that “cannabis as a palliative treatment for cancer patients seems to be well tolerated, effective and safe option to help patients cope with the malignancy related symptoms.” (Prospective Analysis Of Safety And Efficacy Of Medical Cannabis In Large Unselected Population Of Patients With Cancer, European Journal of Internal Medicine, March 2018)

f. The International Journal of Neuroscience reported that “THC:CBD spray was effective and well tolerated as add-on therapy or as monotherapy in a relevant proportion of patients with resistant MS spasticity.” (Clinical Experience With THC:CBD Oromucosal Spray In Patients With Multiple Sclerosis-Related Spasticity, International Journal of Neuroscience, September 2013)

g. The medical journal Clinical Gastroenterology and Hepatology published research that shows that “a short course (8 weeks) of THC-rich cannabis produced significant clinical, steroid-free benefits to 10 of 11 patients with active Crohn's disease, compared with placebo, without side effects.” (Cannabis Induces A Clinical Response In Patients With Crohn's Disease: A Prospective Placebo-Controlled Study, Clinical Gastroenterology and Hepatology, October 2013)

h. The medical journal Clinical Rehabilitation published that “pain relief associated with both THC and CBD was significantly superior to placebo. Impaired bladder control, muscle spasms and spasticity were improved by cannabis medicinal extracts in some patients with these symptoms. Cannabis medicinal extracts can improve neurogenic symptoms unresponsive to standard treatments. Unwanted effects are predictable and generally well tolerated.” (A Preliminary Controlled Study To Determine Whether Whole-Plant Cannabis Extracts Can Improve Intractable Neurogenic Symptoms, Clinical Rehabilitation, February 2003)

i. The Journal of Neurology reported that “THC/CBD spray was beneficial for the majority of patients with peripheral neuropathic pain associated with diabetes or allodynia.”  (A Multicentre, Open-Label, Follow-On Study To Assess The Long-Term Maintenance Of Effect, Tolerance And Safety Of THC/CBD Oromucosal Spray In The Management Of Neuropathic Pain., Journal of Neurology, 2015)

j. The Clinical Journal of Pain reported that “the treatment of chronic pain with medicinal cannabis in this open-label, prospective cohort resulted in improved pain and functional outcomes, and a significant reduction in opioid use. (The Effect of Medicinal Cannabis on Pain and Quality-of-Life Outcomes in Chronic Pain: A Prospective Open-label Study, Clinical Journal of Pain, 2016)

k. The Journal of Pain and Symptom Management reported that THC/CBD extract is a useful treatment for relief of pain in patients with advanced cancer who experience inadequate pain relief from chronic opioid therapy. (Multicenter, Double-Blind, Randomized, Placebo-Controlled, Parallel-Group Study of the Efficacy, Safety, and Tolerability of THC:CBD Extract and THC Extract in Patients with Intractable Cancer-Related Pain, Journal of Pain and Symptom Management; Johnson, Jeremy, et al.)

l. The Journal of Oncology Practice reported that patients enrolled in Minnesota’s medical marijuana program showed significant improvements in symptoms related to cancer and cancer treatment including reductions of anxiety, lack of appetite, depression, disturbed sleep, fatigue, nausea, pain and vomiting. (Impact of Medical Cannabis on Patient-reported Symptoms for Patients with Cancer Enrolled in Minnesota’s Medical Cannabis Program, Journal of Oncology Practice, March 2019)

41. Is there anything that is preventing more research of medical marijuana?
Unfortunately, yes. Marijuana is one of the tightest-controlled substances under federal law. The U.S. government considers it a Schedule I drug, meaning the Drug Enforcement Administration considers it to have no medical value. To do research on marijuana, scientists need approval from several federal departments, which is rare because the government classifies it as Schedule I. 

Conducting clinical research in the United States on medical marijuana involves receiving approval from several federal agencies. This includes a registration from the Drug Enforcement Administration (DEA); obtaining the marijuana for research from the National Institute on Drug Abuse (NIDA), within the National Institutes of Health; and review by the FDA of an investigational new drug (IND) application and research protocol. Additionally, because marijuana is currently listed as a Schedule I controlled substance under the Controlled Substances Act, the DEA has additional Schedule I-level security requirements at the site marijuana will be studied. 

These bureaucratic hurdles have hindered many research facilities from researching the effects of marijuana on various medical conditions. However, there is considerable medical research being conducted in other parts of the world.

42. What has been the experience in the 33 states that currently allow for the use of medical marijuana?
Some states regularly provide statistics on their medical marijuana programs and others have conducted patient surveys since legalizing medical marijuana. For example, the Minnesota Department of Health (MDH) studied more than 1,000 patients enrolled in Minnesota’s medical marijuana program who were undergoing cancer treatment. The published evidence showed that these patients experienced “significant improvement in symptoms, including reduced anxiety, lack of appetite, depression, disturbed sleep, fatigue, nausea, pain and vomiting, within four months of starting the medication.” (News Release: Medical cannabis reduces severity of symptoms for some patients with cancer, according to new study, MN Department of Health, 4/8/2019.)

The Minnesota Department of Health further reported that its medical marijuana program “is providing many people with substantial benefits, minimal side effects and no serious adverse events.” MDH conducted a patient survey after its program had been operating for one year. The results of that survey found the following:

“Patients responded to a survey question asking how much benefit they believe they received from using medical cannabis on a scale from 1 (no benefit) to 7 (great deal of benefit). Across all patients, 64 percent indicated a benefit rating of 6 or 7. In the area of symptom reduction, patients achieved at least a 30 percent reduction in symptoms (an amount considered clinically meaningful) for conditions including seizures, Tourette syndrome, Crohn’s disease and muscle spasms.

For most symptoms, between half and two-thirds of patients who achieved clinically meaningful improvement also retained that degree of improvement over four months. A small but important proportion of patients, 9 percent, indicated little or no benefit with a rating of 1, 2 or 3.  Patients also reported that affordability continues to be a problem as medical cannabis is not covered by health insurance.” (News Release: Majority of medical cannabis patients saw benefit during the program’s first year, MN Department of Health, 05/16/2019)

New Jersey released program priorities to improve its medical marijuana program by expanding the initial list of debilitating medical conditions that qualify a patient to access medical marijuana, increasing product supply and reducing patient costs. “The Medicinal Marijuana Program has always prioritized patient needs above all else. Whether they are individuals with debilitating chronic pain, folks with end-stage cancer, or veterans with post-traumatic stress disorder, patients simply cannot wait any longer for therapy that is both more affordable and easier to access,” New Jersey Health Commissioner Dr. Shereef Elnahal said. “The need for this program is greater than ever.”

Importantly, no state that has legalized medical marijuana has reversed that decision since making it legal. More than 2.8 million Americans have safe and legal access to medical marijuana in states with medical marijuana programs.

43. There are a number of national groups, like the Epilepsy Foundation and National Multiple Sclerosis Society, that raise money to help fight diseases.  Do any of them support the use of medical marijuana?
Yes. The Epilepsy Foundation’s position is: The Foundation is committed to supporting provider-directed care and to exploring and advocating for all potential treatment options, including medical cannabis and CBD. We support lifting federal barriers to research on cannabis and CBD and support access to these potential therapies, through state-regulated programs, for individuals when other treatment options have failed them. If an individual and their health care team feel that the potential benefits of medical cannabis for uncontrolled epilepsy outweigh the risks, then the individual should have safe, legal access to medical cannabis.

The National Multiple Sclerosis Society’s position is: The Society supports the rights of people with MS to work with their health care provider to access cannabis for medical purposes in accordance with legal regulations in those states where such use has been approved. In addition, the Society supports the need for more research to better understand the benefits and potential risks of cannabis and its derivatives as a treatment for MS and its symptoms.

44. Has there been any research into the impact medical marijuana has had on America's opioid crisis?
Yes. A study by JAMA (Journal of the American Medical Association) documented that opioid overdoses are as much as 25% lower in states where medical marijuana has been made available as an alternative to opioids compared with states without medical marijuana laws. (Medical Cannabis Laws And Opioid Analgesic Overdose Mortality In The United States, 1999-2010, Journal of the American Medical Association, October 2014). JAMA also reported that opioid prescribing has been significantly reduced in the Medicare Part D population in states with medical marijuana programs. (Association Between US State Medical Cannabis Laws And Opioid Prescribing In The Medicare Part D Population, Journal of the American Medical Association, May 2018)

To combat the opioid epidemic, the New York State Department of Health recently began urging doctors to consider medical marijuana as an alternative to prescribing opioids for patients with severe pain. New York joins New Jersey and Pennsylvania as states that are using medical marijuana to treat opioid withdrawal. The JAMA researchers concluded that if medical marijuana legalization can continue to be linked to reductions in opioid overdose deaths, then the legalization of medical marijuana can be advocated as part of a comprehensive attack to reduce the risk of opioids.

45. Has there been any research into the allegation that marijuana is a gateway to other illegal drugs?
Yes. The National Academies of Sciences, Engineering, and Medicine published evidence by unequivocally stating that “There is no conclusive evidence that the drug effects of marijuana are causally linked to the subsequent abuse of other illicit drugs.” Additionally, the research concluded that “There is no evidence that marijuana serves as a stepping stone on the basis of its particular physiological effect.” 

There is also a broad social concern that sanctioning the medical use of marijuana might increase its use among the general population. However, The National Academies of Sciences concluded that “at this point there are no convincing data to support this concern. The existing data are consistent with the idea that this would not be a problem if the medical use of marijuana were as closely regulated as other medications with abuse potential.” (Marijuana and Medicine: Assessing the Science Base, The National Academies of Sciences, Engineering, and Medicine, p.129)

46. Have any research studies found that medical marijuana causes any harmful side effects? 
Scientific research and patient testimonials show that medical marijuana provides relief for the symptoms associated with certain debilitating medical conditions (see #2 above). Despite these proven benefits, some patients have reported temporary side effects after consuming medical marijuana, such as feelings of dizziness, dry mouth, loss of balance and disorientation. However, the side effects of medical marijuana are within the acceptable risks associated with pharmaceutical drugs. This means that using medical marijuana is no riskier than using prescription medications. (Marijuana and Medicine: Assessing the Science Base, The National Academies of Sciences, Engineering, and Medicine, p.127, 1999).

Additionally, research published in the journal Neurotherapeutics showed that regularly smoking marijuana can increase the risk of chronic bronchitis, emphysema, chronic respiratory inflammation and impaired respiratory function. (Safety and Toxicology of Cannabinoids, Neurotherapeutics, Aug. 2015). Fortunately, patients can consume medical marijuana in many ways that don’t require smoking, such as edibles, patches, creams, oils, vaporizers, aerosols and tinctures.

Lastly, unlike prescription opioids which caused more than 17,000 overdose deaths in the United States in 2017, “no deaths from overdose of marijuana have been reported” according to the DEA. (A DEA Resource Guide: 2017 Edition, United States Drug Enforcement Administration, p.75; CDC Morbidity and Mortality Weekly Report, Centers for Disease Control and Prevention, Jan. 4, 2019). Some states are urging doctors to consider medical marijuana as an alternative treatment option for certain patients as opposed to opioids.

As with any prescription medication, physicians and patients should discuss the risks and benefits associated with using medical marijuana. Medical marijuana is not a wonder drug, just as no prescription medication is a cure-all. However, medical marijuana has been proven by research and the experiences in 33 other states to be a valid option for patients with certain debilitating medical conditions.


What are other states doing?

47. What other states have implemented medical marijuana programs? 
A total of 33 states and Washington, D.C. have made medical marijuana available (17 through ballot initiatives, and 16 through legislative action), allowing more than 2.8 million Americans with a proper diagnosis to use medical marijuana. These include Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Florida, Hawaii, Illinois, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Montana, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, Utah, Vermont, Washington, Washington D.C., West Virginia.  

48. On average, how many people in each state become medical marijuana patients? 
For the states with medical marijuana programs, the numbers range from between 0.01% to 3.15% of each states’ respective total population. For example, Arizona’s total population is approximately seven million people and there are approximately 153,000 patients enrolled in its medical marijuana program, which is 2.2% of the total population. 

49. What has been the experience of other states that have made medical marijuana available? 
No state that has made medical marijuana available has repealed it. Medical marijuana patients report reduced pain and symptoms of their debilitating medical conditions, and increased quality of life.  

50. How are medical marijuana programs regulated in other states? 
Every state’s programs are implemented and regulated by each state’s and Washington D.C.’s respective Department of Health; require Medical Marijuana ID Cards to identify patients who are approved to purchase medical marijuana; authorize the use of caregivers to assist patients who need help purchasing and using medical marijuana (i.e. a caregiver for an elderly person or a child); require a physician examination and certification before a patient is authorized to obtain a Medical Marijuana ID Card and then purchase medical marijuana; requires a renewal of the physician certification and the Medical Marijuana ID Card to keep the patient status current (most programs require a renewal annually; Mississippi will require an annual renewal unless the physician chooses a shorter time period); regulate and provide licenses to the businesses that produce and dispense medical marijuana to qualifying patients; and regulate the amount of medical marijuana that can be sold to patients within the allowable time period.

51. How do the medical marijuana programs work in the nearby states of Louisiana, Florida, Arkansas, and Oklahoma?

LOUISIANA
Louisiana’s medical marijuana law was originally enacted by the state legislature in 2015, then amended in 2016, and expanded in 2018 to include more debilitating medical conditions like PTSD, severe autism, and chronic pain. Louisiana’s program requires patients to obtain a doctor’s recommendation to purchase certain medical marijuana products such as tinctures, oils, salves, patches, edibles, capsules, and other concentrated forms of the medicine. The program is regulated by the Louisiana Department of Agriculture and Forestry, the Louisiana Board of Pharmacy, and the Louisiana State Board of Medical Examiners.

Louisiana’s medical marijuana program originally included regulations that restricted patient access to medical marijuana, such as a cap established in 2016 limiting physicians to only 100 medical marijuana patients as well as a requirement that patients see their doctor after 90 days in order to continue treatment. The Louisiana Board of Medical Examiners has since removed both restrictions in order to allow patients greater access to medical marijuana. 

Unlike the Mississippi proposal, which creates a free market for regulated businesses to provide medical marijuana, the Louisiana proposal stipulates that medical marijuana can only be grown and provided to pharmacies by the agricultural centers at Louisiana State University and Southern University, which are both partnering with national corporations to grow the state’s medical marijuana; and, the Louisiana’s program only allows up to ten pharmacies where medical marijuana can be sold throughout the state. The pharmacies will be regulated by the Louisiana Board of Pharmacy. It is projected that patients will be able to begin purchasing medical marijuana in 2019; no patients have yet been served by Louisiana’s medical marijuana program. 

Due to regulatory hurdles, Louisiana’s program has experienced delay and patients have not received access to medical marijuana. Louisiana’s regulators have taken years to determine the program’s regulations related to choosing and licensing a limited number of pharmacies and limiting medical marijuana to only be grown at two places, which are both state universities. 

Mississippi’s proposal does not limit the number of Medical Marijuana Treatment Centers (where medication can be cultivated, processed, and dispensed) and requires the Mississippi Department of Health to have the program up and running no later than August 15, 2021, just nine months after the vote will take place on the November 2020 ballot. 

FLORIDA
Florida’s medical marijuana program was overwhelmingly passed in November 2016 by voters in favor of medical marijuana by more than 71% after a successful state-wide ballot initiative campaign. Although Florida’s program became official in January of 2017, the state government has been slow to enact the necessary regulations for patients to get access, and the process has been mired in legal red tape. Florida’s program allows qualified patients to obtain a medical marijuana ID card and purchase their medicine after being examined by and receiving a recommendation for medical marijuana from their doctor. The program is regulated by the Florida Department of Health.

Unlike the Mississippi proposal, which creates a free market for regulated businesses to provide medical marijuana, Florida’s program only allows a limited number of licenses to Medical Marijuana Treatment Centers (medical marijuana businesses authorized to cultivate, process and dispense medical marijuana), with preference given for up to two licenses to applicants that own one or more facilities that are or were used for processing citrus fruit or citrus molasses in some way and will convert the facility or facilities for the processing of medical marijuana. These regulatory stipulations, among others, have led to lawsuits and caused delay to Florida’s program implementation.

Although Florida’s program is still being implemented to a fuller extent, the program is functioning and patients are being served. Florida’s program stipulated that once the medical marijuana statewide database reached a 100,000-patient threshold, four additional licenses would be issued within six months; the database reached the 100,000 threshold in May 2018. As of September 2018, Florida’s database accounts for more than 166,000 total patients. 

Mississippi’s proposal does not limit the number of Medical Marijuana Treatment Centers (where medication can be cultivated, processed, and dispensed) and requires the Mississippi Department of Health to have the program up and running no later than August 15, 2021, just nine months after the vote will take place on the November 2020 ballot. 

ARKANSAS
Arkansas passed Amendment 98 to their State Constitution by more than 53% after a successful state-wide ballot initiative campaign in 2016. Regulations were established in May of 2017, but the implementation of the medical marijuana program has been delayed due to legal challenges and licensing delays. Arkansas’ program requires patients to be certified by a licensed physician, and to provide the certification to the Arkansas Department of Health to obtain a medical marijuana ID card. The program is regulated by Arkansas Department of Health.

 Unlike the Mississippi proposal, which creates a free market for regulated businesses to provide medical marijuana, Arkansas’ program only allows a limited number of licenses to Medical Marijuana Treatment Centers (medical marijuana businesses authorized to cultivate, process and dispense medical marijuana), which has caused delay to the program’s implementation due to lawsuits over the available licenses. 

The Arkansas program allows five growers and 40 dispensaries statewide. No patients have yet been served by Arkansas’ medical marijuana program. Medical marijuana business cultivators hope to begin growing in spring of 2019, with medical marijuana products becoming available to patients in summer of 2019.

Mississippi’s proposal does not limit the number of Medical Marijuana Treatment Centers (where medication can be cultivated, processed, and dispensed) and requires the Mississippi Department of Health to have the program up and running no later than August 15, 2021, just nine months after the vote will take place on the November 2020 ballot. 

OKLAHOMA
Oklahoma voters approved medical marijuana in June of 2018 by passing Question 788 with 56% approval following a successful ballot initiative. Oklahoma’s program requires patients to be certified by a licensed physician, and to provide the certification to the Oklahoma Medical Marijuana Authority to obtain a medical marijuana ID card. The program is regulated by the Oklahoma Medical Marijuana Authority, which operates under the Oklahoma Department of Health.

The Oklahoma Medical Marijuana Authority began issuing licenses to medical marijuana businesses in September 2018. As of November of 2018, Oklahoma’s program has more than 13,000 patients and more than 600 licensed businesses to grow and dispense medical marijuana. Oklahoma is experiencing lawsuits against the state on behalf of Oklahoma dispensary owners and growers who are currently looking to reduce the number and size of fees faced by medical marijuana businesses. Even so, patients already have access to medical marijuana in Oklahoma. 

Oklahoma’s program allows individuals to grow up to six medical marijuana plants in their own homes. Mississippi’s medical marijuana program will not allow home grow and requires the Mississippi Department of Health to have the program up and running no later than August 15, 2021, just nine months after the vote will take place on the November 2020 ballot.

GEORGIA
Georgia became the 34th state to legalize some form of medical marijuana when Republican Governor Brian Kemp signed Georgia’s “Hope Act” (House Bill 324) into law in April of 2018.  The Georgia Legislature approved the “Hope Act” so that Georgia residents with specific debilitating medical conditions could obtain low-THC medical marijuana oil, tinctures, patches, lotions, and capsules.  The law created a commission, Georgia Access to Medical Cannabis Commission, to regulate and license medical marijuana producers, and allows patients registered with the Georgia Department of Health to obtain a medical marijuana ID card to purchase up to 20 fluid ounces of low-THC medical marijuana products.  

Since 2015, Georgia has allowed patients suffering from severe seizures and other illnesses to use CBD oil, but the state did not allow in-state cultivation and sales of any medical marijuana products. This expanded legislation through the “Hope Act” for medical marijuana allows legal cultivation and sale of low-THC medical marijuana oil, tinctures, patches, lotions, and capsules in Georgia. The bill stipulates that medical marijuana can only be cultivated by six private growers and two designated universities, and Georgia patients will be allowed to purchase low-THC medical marijuana products from licensed treatment centers or specially licensed pharmacies. Some of Georgia’s debilitating medical conditions include cancer, ALS, seizure disorders, multiple sclerosis, Crohn’s disease, sickle cell disease, Alzheimer's disease, and Parkinson’s disease – most of which require that the patients’ diagnosis be “severe or end stage.”

While Mississippi’s initiative is broader and more comprehensive, the Georgia Legislature and the Georgia Governor recognized the medicinal value of medical marijuana and took a substantial first step in helping Georgia citizens with debilitating medical conditions.

52. Do medical marijuana businesses operating in states with legal medical marijuana programs face any business roadblocks?
Unfortunately, yes. Banks and other financial institutions face significant hurdles in serving the financial needs of businesses operating under legal state medical marijuana programs. The American Bankers Association (ABA) provides a summary of the issues that banks and other financial institutions are facing in dealing with medical marijuana companies:  

  • “Currently, thirty-three states, the District of Columbia, Guam and Puerto Rico have all legalized the use of marijuana to some degree. Yet the possession, distribution or sale of marijuana remains illegal under federal law, which means any contact with money that can be traced back to state marijuana operations could be considered money laundering and expose a bank to significant legal, operational and regulatory risk.

  • In addition to growers and retailers, there are vendors and suppliers, landlords and employees that are indirectly tied to the cannabis industry, thus posing legal risk for banks serving such entities and individuals, as indirect connections to marijuana revenues are hard, if not impossible, for banks to identify and avoid.  The rift between federal and state law has left banks trapped between their mission to serve the financial needs of their local communities and the threat of federal enforcement action.

  • ABA believes the time has come for Congress and the regulatory agencies to provide greater legal clarity to banks operating in states where marijuana has been legalized for medical or adult use. Those banks, including institutions that have no interest in directly banking marijuana-related businesses, face rising legal and regulatory risks as the marijuana industry grows. Current proposals in both the Senate and the House that seek to provide greater clarity and bridge the gap between state and federal law provide a solid starting point for discussion.”

The issues that the ABA illustrated will be a challenge for medical marijuana businesses intending to operate in Mississippi under a legal state program until the federal government amends laws and regulations related to the banking industry that permit banks to conduct business with such companies.  Fortunately, these issues are being addressed in Congress, which will provide clarity prior to Mississippi’s medical marijuana program.


THE CAMPAIGN TO MAKE MEDICAL MARIJUANA AVAILABLE IN MISSISSIPPI

53. What is a ballot initiative in Mississippi?
Mississippi’s ballot initiative law allows citizens to directly amend the Mississippi Constitution, and the ballot initiative process itself is set forth in the Mississippi Constitution. For an initiative to be placed on the ballot, a minimum of 86,185 certified signatures must be gathered with at least 17,237 certified signatures from each of the five congressional districts as they existed in the year 2000. The signatures must be certified by county circuit clerks.

54. Do you really think Mississippi could get a medical marijuana program? Will you be able to get enough signatures to put it on the November 2020 ballot?
Absolutely! We have been overwhelmed at the positive response we have received since we began gathering signatures. Thousands of Mississippians agree that we need medical marijuana here in our state. Countless personal testimonies have been shared, and we are growing a community of patients and advocates here in our home state. We need more than 86,000 verified voter signatures on our petitions to put medical marijuana on the ballot. That’s a lot of signatures, but we are well on our way. Every signature counts. 

55. How does signing a petition for the Medical Marijuana 2020 ballot initiative work? Is my signature on file as public record? 
The signed petitions will be turned in to the circuit clerk’s office in each county, which is where each signer’s voter registration is on public record, in order to verify each person’s signature. While signing a petition is a public record and an official affidavit, it’s no more public than being registered to vote. 

56. What is the Medical Marijuana 2020 ballot initiative?
The Medical Marijuana 2020 ballot initiative is a campaign to make medical marijuana available to Mississippians who have debilitating medical conditions in a legal and safe manner. If approved by the voters in November 2020, patients who are suffering will be able to obtain medical marijuana after they are examined by Mississippi licensed physicians and certified to use medical marijuana. 

To get the initiative on the November 2020 ballot requires more than 86,000 signatures on petitions. Once the signatures are verified by local officials and the Secretary of State, the proposed amendment will appear on the November 2020 ballot. That amendment, if approved by Mississippi voters, would allow physicians to certify medical marijuana for qualified patients and then allow those patients to obtain medical marijuana in a legal and safe manner from treatment centers licensed and regulated by the Mississippi Department of Health.

A total of 33 other states, including Arkansas, Louisiana, Florida, and Oklahoma have approved the use of medical marijuana. Throughout the country, more than 2.8 million Americans are using medical marijuana to relieve pain and treat other symptoms of debilitating medical conditions.

The Mississippi Department of Health would regulate and enforce the provisions of this initiative in order to ensure safe access and use of medical marijuana for qualified patients.

57. What do physicians in Mississippi think about this initiative, and who else is backing this initiative?
While we cannot speak for all physicians in Mississippi, we can say that this initiative is supported by medical and health care professionals who are part of the steering committee, and that physicians were included in the drafting of the initiative language at MSMA (Mississippi State Medical Association). The steering committee also includes law enforcement representatives, leaders in the faith community, and veterans. Please click here to see the full list of steering committee members. 

As a physician, this would be a wonderful tool to have in my toolbelt to be able to certify for patients who meet the qualifications. There is a great deal of research that shows medical marijuana to be beneficial to patients dealing with diseases like cancer, epilepsy, and the other diseases on the approved list.  – Dr. Philip Levin, M.D., President of the Mississippi Chapter of the American College of Emergency Physicians

58. Why is this ballot initiative important?

  • The goal of this campaign is to provide qualifying patients in Mississippi who are suffering from debilitating medical conditions access to medical marijuana. It would simply serve as an additional tool for doctors to help people who are in pain or who have chronic diseases, for whom medical marijuana would help make it through the day.

  • Governor Phil Bryant signed a bill into law called “Harper Grace’s Law,” named after a little girl who suffers from a rare type of epilepsy that causes violent seizures, that would legalize the use of CBD oil for certain kinds of medical conditions in 2014.  In other states, children like Harper Grace have used medical marijuana to fight the seizures. This ballot initiative will give Harper Grace, and other patients who qualify, access to medical marijuana to provide relief from pain and other symptoms of debilitating medical conditions. 

  • Veterans now account for 20% of all suicides in the United States; 18-22 veterans commit suicide every day, many of them suffering from post-traumatic stress disorder. Medical marijuana is a safe and effective treatment to assist veterans in managing the debilitating symptoms and effects of PTSD.

  • Medical marijuana is a much safer alternative to opioids for pain management. It can be used in place of opioids, or in conjunction with opioids (i.e. in some cases, medical marijuana can be used to manage ongoing pain, and if needed an opioid for severe breakthrough pain). Additionally, opioid overdoses are as much as 25% lower in states where medical marijuana is available as an alternative to opioids.

59. Who will be helped by allowing medical marijuana in Mississippi? What debilitating medical conditions will be covered? 
Mississippians who have the following debilitating medical conditions would qualify for medical marijuana: cancer, epilepsy or other seizures, Parkinson’s disease, Huntington’s disease, muscular dystrophy, multiple sclerosis, cachexia, post-traumatic stress disorder, positive status for human immunodeficiency virus, acquired immune deficiency syndrome, chronic or debilitating pain, amyotrophic lateral sclerosis, glaucoma, agitation of dementias, Crohn’s disease, ulcerative colitis, sickle-cell anemia, autism with aggressive or self-injurious behaviors, pain refractory to appropriate opioid management, spinal cord disease or severe injury, intractable nausea, severe muscle spasticity, and similar diseases.


What the Opponents Say

60. Marijuana is a “gateway drug.”  Using it will lead to more and more illegal drug use.
The Institute of Medicine of the National Academy of Sciences says no. 

“There is no evidence that marijuana serves as a stepping stone on the basis of its particular physiological effect,” and “there is no conclusive evidence that the drug effects of marijuana are causally linked to the subsequent abuse of other illicit drugs.” Those were the findings of their report, Marijuana and Medicine: Assessing the Science Base

The report went on to find that marijuana “does not appear to be a gateway drug to the extent that it is the cause or even that it is the most significant predictor of serious drug abuse; that is, care must be taken not to attribute cause to association.”  While there may be a correlation between marijuana use and the use of illicit drugs, because people who use other drugs typically also use marijuana, the study does not show that the drug effects of marijuana cause users to try other drugs.  

The study elaborates: “Because it is the most widely used illicit drug, marijuana is predictably the first illicit drug most people encounter. Not surprisingly, most users of other illicit drugs have used marijuana first. In fact, most drug users begin with alcohol and nicotine before marijuana—usually before they are of legal age.” 

There is also a broad social concern that sanctioning the medical use of marijuana might increase its use among the general population. The Institute of Medicine concluded that “at this point there are no convincing data to support this concern. The existing data are consistent with the idea that this would not be a problem if the medical use of marijuana were as closely regulated as other medications with abuse potential.”

The people who use the “gateway” argument never differentiate between marijuana and medical marijuana.  The evidence accumulated from a number of research studies refutes the proposition that marijuana will serve to lure everyone who uses it to harder and harder illegal drugs.  As for medical marijuana, the only people who can obtain it must have a specific debilitating medical condition and will be under the care of a physician.  A well-regulated medical marijuana program does not increase non-medical use, but will provide relief to patients who have not found relief in pharmaceutical drugs.   Such a program will not serve as a gateway to illicit drug use.

61. Medical marijuana is just the first step.  If it is approved, full legalization for recreational use is right around the corner.
33 states have adopted medical marijuana programs; only 10 states have legalized recreational use.  One does not cause the other.  Of the 10 states that now have recreational use of marijuana, all but one state have done so through a ballot initiative requiring approval of the voters.  The same would be true in Mississippi.  There will be no recreational use of marijuana legalized in Mississippi without approval of the voters.  And there is nothing in Mississippi’s medical marijuana initiative that sanctions the use of recreational marijuana or that would inevitably lead to the use of recreational marijuana.  There are groups in Mississippi who have tried to gather the required number of signatures to put legalization on the ballot, and they have all failed.  In fact, they have not even come close to obtaining the necessary number of signatures to even qualify it for the ballot.  Legalizing marijuana for recreational use has zero to do with this campaign’s efforts; our concern is to provide patients in Mississippi with the same medical option that more than 2.8 million patients in 33 states are benefiting from to help ease their suffering under the care of physicians. 

62. Saying “yes” to medical marijuana sends the wrong message to our children about the use of illegal drugs.
We believe that medical marijuana gives physicians an effective option for their patients who are in pain and who suffer from certain diseases and debilitating medical conditions.  Like any other medicine that has harmful side effects or that can be addictive, care must be taken with children to help them understand the good that can come from properly using medical marijuana and the harm that can come from misusing medical marijuana.  

This proposal provides checks and balances throughout, and anything outside of qualified patients who are under the care of a physician and certified to obtain medical marijuana within the legal and strict regulatory framework provided by the Mississippi Department of Health would still be deemed illegal and punishable by law.

As for the role the legal use of medical marijuana could play in encouraging young people to try illicit drugs, that has not been the experience in the 33 states that currently allow the use of medical marijuana.  A recent American Journal of Public Health article, using data covering 9 years in 4 states with medical marijuana programs concluded: "Our results suggest that, in the states assessed here, medical marijuana laws have not measurably affected adolescent marijuana use in the first few years after their enactment.”   In fact, a 2019 study published in the American Journal of Drug and Alcohol Abuse found that “legalizing medicinal marijuana has actually led to a drop in cannabis use among teenagers.”  These studies have suggested that once medical marijuana becomes legal, parents have taken a greater responsibility in talking with their children about the drug’s pros and cons.

While medical marijuana is not a cure-all, it does help people in tremendous ways as is shown in studies and testimonials of cancer patients, people with quadriplegia from spinal cord injury, and people with epilepsy, Parkinson’s disease, Crohn’s disease, Multiple Sclerosis, and ALS, and others.  We believe parents and other religious and community leaders can help children understand the difference between using a drug to help people and using a drug for other illicit purposes.

63. The use by children of medical marijuana will do permanent damage to their development.
There is no research study that provides evidence that medical marijuana used under the care of a physician is detrimental to the normal development of children. 

What is in fact detrimental to the normal development of a child is a disease that is not adequately treated, such as epilepsy or other kinds of seizures, or debilitating pain that is not overcome.   There is ample evidence that demonstrates that medical marijuana can help a young patient, while under the care of a physician.

See question 33 to read more about how medical marijuana is a helpful and effective treatment for children who either have not responded well to pharmaceutical drugs, or whose only other option is a strong cocktail of heavy pharmaceutical drugs.

64. Because medical marijuana will be available in edible forms, children will accidentally ingest medical marijuana.
There is no question that medical marijuana should be treated in the same manner as any other prescription medication.  Many prescription drugs, if accidently taken by children, can be harmful.  All drugs, including medical marijuana, should be stored in a safe place that is out of the reach of children. 

There are many delivery methods available, including edibles, because patients suffer from a variety of debilitating medical conditions, some of which respond best to certain delivery methods instead of others. For more information about the different forms by which medical marijuana can be consumed, see question 22

The Mississippi Department of Health will provide and enforce the regulatory framework for Mississippi’s medical marijuana program, which means they will have the authority to set dosage units, set potency allowance, and oversee packaging and labeling of products, etc. 

65. There is no medical research that supports the use of medical marijuana.
There is a significant amount of scientific evidence that shows medical marijuana is a safe and effective medicine for people suffering from symptoms of a variety of debilitating medical conditions. For additional scientific research that shows medical marijuana is a safe and effective medicine for people from symptoms from debilitating medical conditions, click here.

66. This is not something doctors want to do.
There is no requirement that any physician in Mississippi will be required to certify the use of medical marijuana for any patient.  The only thing this initiative does is make medical marijuana available to doctors who want to use it.

On the other hand, hundreds of physicians in the 33 states where medical marijuana is now legal, are treating more than 2.8 million Americans, having recognized that medical marijuana as an alternative treatment option for patients, many of whom have been helped by medical marijuana but whose symptoms did not respond to traditional pharmaceutical medications. 

The Medical Marijuana 2020 Steering Committee includes medical doctors and other health care professionals, as well as medical organizations, all of whom support medical marijuana as a viable treatment option for symptoms of debilitating medical conditions

67. Medical marijuana increases the risk of mental illness.
Marijuana “does not in itself cause a psychosis disorder.”  That was the conclusion reached by researchers in Current Psychiatry Reports in a 2016 study that found just the reverse, that individuals with a vulnerability to psychosis were more likely to use marijuana, but marijuana did not cause psychosis.  In other words, the use of marijuana came after the mental illness. 

On the other hand, research published in the American Journal of Psychiatry showed that marijuana derivatives had “beneficial effects in patients with schizophrenia” which “may represent a new class of treatment for the disorder.” 

These findings support the need for a tightly-regulated medical marijuana program that allows Mississippi physicians to consider medical marijuana for their patients, even those with mental illnesses.

For more scientific research that shows medical marijuana is a safe and effective medicine for people from symptoms from debilitating medical conditions, click here and here.

68. The market for medical marijuana will be controlled by just a few businesses which will drive up the price and limit availability.
It is true that some states limit the number of businesses that sell medical marijuana products by restricting the number of licenses that businesses must obtain.  That will not be the case in Mississippi if voters approve the initiative.  The Mississippi proposal would create a free market for regulated businesses to provide medical marijuana.  So long as a business meets the safety and quality control requirements imposed the Mississippi Department of Health, a business will be welcome to offer product anywhere in the state.

69. Letting the Mississippi Department of Health regulate medical marijuana means my tax dollars will go toward something I have a moral objection to.
That is not what will happen in Mississippi.  Under the Medical Marijuana 2020 proposal, the regulation and enforcement of the program will be funded by fees paid by medical marijuana businesses and by fees paid by the patients who use medical marijuana.  No general fund money of the state will be used to cover the costs associated with this program.

The initiative creates three sources of revenue for the Mississippi Department of Health to use in regulating and enforcing the medical marijuana program in the state.  Those sources are the cost of an ID card, licensing fees for treatment centers, and a charge at the point of retail purchase of medical marijuana that cannot exceed the state’s sales tax rate.  All of this revenue will go into a special fund for the Mississippi Department of Health to use exclusively for this program. For more information, see question 35

70. Alex Berenson has been in the news about his book Tell Your Children: The Truth About Marijuana, Mental Illness, and Violence.  Do any of his claims have merit?
The claims made by Berenson in his book can indeed sound alarming and serve as a cause for concern.  The good news is that Berenson’s assertions are not accurate.  He ignores much of the latest research and fails to cite the criticisms that have been published about the reports he does use.  

Many of his claims are so exaggerated that a group of 100 scholars and clinicians released a public letter that refutes Berenson, pointed out his many inaccuracies, gave examples of the way he cherry-picked evidence, and explained how he incorrectly attributes cause to mere associations. A few examples include the following:

  • Berenson wrote that “Medical science has yet to identify any verified and confirmed health benefit to using [marijuana].”   As we showed in the FAQ section titled “What Medical Research Says,” this is just not true.

  • Berenson wrote that “Marijuana is, in fact, a gateway drug, which leads to experimentation with other drugs.”   We refuted that claim in question 60.

  • Berenson wrote “But most disturbing of all is a clearly demonstrated link between cannabis use and mental illness. Rather than serving as a cure for psychiatric problems, it’s actually a cause. Marijuana can cause or worsen severe forms of mental illness, particularly psychosis, which in layman’s terms means a total break with reality.”  Again, as we showed in question 67, Berenson is wrong.

There is plenty of evidence that medical marijuana is effective in treating the symptoms and effects of a number of specific diseases.  Moreover, 2.8 million Americans are using medical marijuana in 33 states, with positive reports from those experiences. For scientific research that shows medical marijuana is a safe and effective medicine for people from symptoms from debilitating medical conditions, click here and here.