Utah Experiments: The legislative debate around medical marijuana in Utah

Not too long ago, the thought of using marijuana to treat ailments seemed like a pipe dream of the hippy era, a hallmark of areas that leaned left farther than the Leaning Tower of Pisa.

But over the last few years, 23 states and Washington, D.C., have legalized the use of medicinal marijuana, though marijuana itself continues to be banned federally. Gradually, the dialogue nationwide has changed from a joking “if Colorado jumped off a bridge, would you do it, too?” to one of serious discussion about whether a plant often referred to as a “gateway drug” could also hold the key to unlocking powerful treatments for some of the most difficult conditions plaguing man today.

That discussion was certainly lively during this year’s legislative session, as lawmakers on Capitol Hill debated not one but two bills proposing legalization of some form of medicinal marijuana: SB 73, proposing a relatively broad use of medicinal marijuana; and SB 89, proposing a somewhat more narrow allowance.

Competing paths
Neither bill passed this year, an outcome perhaps caused by the division of support rather than the lack of interest, says Rep. Gage Froerer (R-Huntsville), the House co-sponsor for SB 73.

“Basically, we saw this year took two different paths,” Froerer says. “Unfortunately, they didn’t talk to each other. I think that was one of the reasons that neither one of them passed, is there wasn’t a clear direction.”

The first, SB 73, sponsored by Sen. Mark Madsen (R-Saratoga Springs), would have legalized cannabis, including marijuana, to qualified patients with conditions including HIV, Alzheimer’s disease, Crohn’s disease, cancer, multiple sclerosis, epilepsy and some cases of post-traumatic stress syndrome and chronic pain, as prescribed by a doctor. Attempts to contact Madsen for comment on the bill, dubbed the Medical Cannabis Act, were unsuccessful.

The second bill was SB 89, sponsored by Sen. Evan Vickers (R-Cedar City). SB 89 would have also granted persons with certain ailments the use of cannabis-based medicine. The bill had a more restrictive definition of what forms of cannabis would be allowed, as well as the ratio between the THC (the chemical in cannabis chiefly responsible for marijuana’s psychotropic effects) and CBD (another chemical that also stimulates the brain’s cannabinoid receptors, but has a more mellow effect). The initial version of SB 89 would have allowed therapies including up to 5 percent THC—a 10-to-one CBD to THC ratio—but the sixth draft, which had some of the language from the then-failed SB 73 inserted into it, supported a one-to-one ratio between THC and CBD.

Vickers says the string of revisions, particularly the sixth and last one, gave the bill too little time for fair discussion in the House and Senate. The time was too short to get the fiscal note down to zero, as well, he says.

“They were starting to warm up and I think we had good support on SB 89, and then when some of the aspects of 73 got merged into 89, that’s when there started to be confusion and they started to backpedal,” Vickers says. “There wasn’t enough time for a two-hour debate [on the last day of the session]. There was lots of other business that needed to be done. I don’t blame them.”

Charlie’s Law
But the bills weren’t the first to suggest using marijuana or components therein. Madsen sponsored a similar bill in 2015, which narrowly failed to leave the Senate. Two years ago, Froerer sponsored HB 105, proposing the use of hemp extract to be used to treat some epilepsy cases. The bill, which came to be known as Charlie’s Law, passed with a comfortable margin in both the House and Senate.

Before Charlie’s Law, Froerer knew little about medical marijuana. He immersed himself with research on the issue, however, after being approached by the family of a boy who suffered from epilepsy. The condition could be treated with hemp extract to greatly diminish the occurrence of seizures, allowing the boy and others like him to live more normal lives.

“For me, it was a wakeup call to see these families [and] what they were able to accomplish in the lives of their children with the major decrease in epilepsy seizures. I really became entrenched with it—if it would help with epilepsy,” Froerer says. “I saw firsthand, meeting with those families, what a difference it made in their lives.”

After Charlie’s Law passed, Froerer says he got a flood of calls from others suffering with other ailments that could be treated with medicinal forms of cannabis, prompting him to do more research. He says he believes opening access to patients for whom other treatments have not worked is important and necessary work in his role.

“If we can do one thing as policymakers, lawmakers, I believe it’s our job to help the public do what they can’t do for themselves. It’s our job to look at a policy and say what can we do for them, or get out of their way so they can do what they need to—not place more barriers in their way like we have now, forcing people to go to Colorado,” he says.

One of the chief concerns mentioned by opponents of medical marijuana is the drug’s addictive properties. Froerer, however, points to the addictive nature of several prescription pain medications currently being used to combat some of the painful conditions that could be treated with medical cannabis. According to a study from the Center for Disease Control, Utah tied for eighth for states with the highest instances of death from prescription drug overdoses.

“The number of opioid deaths we have in the state [and] people addicted with prescription drugs prove the point that medical cannabis is far less addictive,” Froerer says. “Everything that’s been pointed to me is there’s never been any deaths linked to medical marijuana, but there’s been a substantial number of deaths [from prescription drug abuse].”

Looking forward
Despite Utah’s conservative reputation, there’s no shortage of support for cannabis-derived drugs on the ground level—according to a poll conducted by Dan Jones and Associates in February, 64 percent of Utahns said they would support legalization of medical marijuana that was prescribed by a doctor.

As much support as Charlie’s Law had, and as much good as it has done since it passed, Froerer says he doesn’t think it would have passed if there had been a similar bill introduced in the same session.

“The minute you have competing bills on any subject, the tendency is that both bills go away, no matter what the subject is,” he says. “You don’t have an opportunity to present a clear picture especially on something as complicated as this. I think it’s important on this issue to come across with whatever that policy is, agree on what direction we’re headed and then really take that and try to educate legislators on what it is. That’s what I was able to accomplish with HB 105. I’m sure if there was a competing bill with that, either to lessen or take it farther, it wouldn’t have passed.”

Froerer says he has high hopes for next year, as well, and wants to form a taskforce of regulators, families of patients, doctors, and other professionals, with different opinions about what forms and what levels of chemicals should be allowed. With the input from multiple viewpoints, he says, the next bill to go before the legislature should be well crafted and agreeable to most people concerned about the issue.

Vickers, too, says he regrets the political stalemate and what it means for patients for whom both bills were intended, but is hopeful for next year’s discussion of the issue.

“There are a lot of people who could have benefitted from this who won’t this year,” Vickers says. “I guess the positive thing is going forward another year—the framework is already there, we don’t have to recreate it. We’ll have another year of science behind us. Hopefully we can come up with something then.”

Answering the questions
Lawmakers also considered a third marijuana-centered movement, with Senate Concurrent Resolution 11, the Concurrent Resolution Urging the Rescheduling of Marijuana—a measure that passed easily in both the Senate and House. Marijuana is currently a Schedule I drug under the federal Controlled Substances Act, along with such other substances as LSD and heroin—substances that have a high potential for abuse and have no acceptable medical use or safe use under medical supervision. Drugs classified as Schedule I are also illegal to do research with without a tightly controlled permit from the Drug Enforcement Agency.

Sen. Brian Shiozawa (R-Salt Lake City), the sponsor of the resolution, says he hopes the measure leads to marijuana reclassified as a Schedule II drug like morphine or oxycodone—drugs that still carry with them a high risk for dependency and abuse, but that also have an acknowledgement of legitimate medical uses. Shiozawa says he hopes having the weight of the Utah Legislature, and Gov. Gary Herbert, should he sign the resolution, will help bring about a change in schedule. His goal is less to pave the way for legalized medical marijuana and more to make it easier for researchers nationwide to determine whether it has enough merits medically to outweigh the potential risks.

“Because of federal regulations, which can only be changed by executive order by the president or Congress, we can’t do research in this country and it’s illegal to use, but almost half the states in the country allow medicinal marijuana,” he says. “What this resolution does is it calls upon Congress to take this down to a Schedule II … to allow us to do research on it and get the research to say it’s effective, or it isn’t, and it’s safe, or not.”

Shiozawa, who is also a physician, notes that THC is itself a Schedule III drug and used in the treatment of cancer patients. The heated nationwide debate about whether medical marijuana is effective or safe could have been avoided by rescheduling marijuana years ago and allowing researchers to find the data to conclusively answer questions about its uses, he says.

“If you think about it, if we had done this two years ago, we’d already have the answers. We’d be able to say it works on PTSD or anxiety, or it doesn’t,” he says.

As it is, he says, doctors, researchers and lawmakers are forced to weigh the issue based on anecdotal evidence and research from other countries, he says. Shiozawa acknowledges that marijuana has highly addictive properties, but notes that many other prescription medications can also be very addictive, and some drugs (like chemotherapy) used with ailments that could have cannabis-based treatments are fairly toxic, as well.

Some research on medical cannabis uses will go forward in Utah this year, however, he says, through the acquisition of five Schedule I endorsements from the DEA. Those tests could begin as early as this summer and will help answer some of the questions plaguing policymakers across the country, Shiozawa says, though more answers could be obtained quicker by allowing more institutions nationwide to do their own research.

“We’re literally talking hopefully within the next year or so, we’ll have some good answers if we can get this going,” he says. “Their biggest hangup is it’s a Schedule I [drug]—it’s difficult for researchers to go head to head with the feds. We have patients asking for it. We’re kind of relying on out-of-the-country research,” he says. “This country leads the world in research. We’re the best. Why we haven’t addressed this is amazing. This should have been addressed years ago, and then there wouldn’t be questions about it.”