Modifications to law would eliminate blister pack requirement, decriminalize previous medical users, sponsor says

A new bill expected to roll out during this legislative session would again modify Utah’s medical marijuana law, changing a controversial form of packaging and decriminalizing previous medical users.

Bill sponsor Senate Majority Leader Evan Vickers said the changes maintain a balance between patients’ needs and the compromise reached when legislators passed a replacement to the voter-approved medical marijuana initiative.

“We’re really trying to be very careful. We’re doing a couple of things, one is that we want to preserve the integrity of the compromise we’ve put together, but the ultimate goal is trying to streamline allowing patients to get medication,” explained Vickers, R-Cedar City.

While a bill file has yet to be opened, he said it has been discussed for months between members of the Legislature, pro-marijuana group Libertas Institute, the Utah Department of Agriculture and Food, the Utah Department of Health and the Utah Medical Association.Major changes to the law, including removing public health workers from being involved in dispensing the medication, were passed during a fall special session. But other, less urgent tweaks were held until this session, Vickers said.

Flower packaging

Utah voters approved ballot initiative Proposition 2 in November 2018 legalizing doctor-approved cannabis treatment for certain health conditions. State lawmakers the next month replaced the measure with a law they said puts tighter controls on the production, distribution and use of the drug.

Among the larger changes to be proposed in the new bill will be a removal of the controversial requirement that raw marijuana flower be packaged and sold in blister packs.

“No other state requires this, and it was part of what came out of the negotiations over Prop. 2 to preserve flower in the law,” said Connor Boyack, Libertas Institute president.

The bill will propose using glass jars or another type of container for the storage of raw cannabis flower. The buds will still need to be measured in a consistent amount, and the jars will show the purchase and expiration dates, after which using the marijuana becomes illegal.

Vickers emphasized that though the bill would remove the blister pack requirement, the flower will still need to be sold in sealed, secure containers “whether it be a glass jar or another type of container.”

Boyack called the change “significant.”

“Because the use of blister packs threatened to substantially increase the price without any real strong benefit for public safety or regulation, and so we’re easing up on that, and have built up some consensus from the stakeholders to move in that direction,” Boyack said.

Advocates were also concerned the process of packaging the marijuana in blister packs would reduce the potency of the medicine, as it is “very sticky” and the medicine components are on the exterior of the plant, according to Boyack.

According to Adam Laikin, chief of marketing for medical marijuana cultivator Tryke Companies Utah, the company — which has also applied for a processor’s license — supports the change.

“We’ve found through our experience in other states that glass jars are, certainly for the freshness and quality of the product, the optimal solution that we’ve come across. And I think, just from a logistical standpoint, we had concerns that a blister pack, how that was going to be executed, and potentially to be pushing that product out of the blister pack, you could degrade that product, you could cause it to crush,” Laikin said.

He said Tryke has harvested its first crop in Tooele and has found the process of getting started in Utah smooth. The grower allowed media to tour its facility Thursday.

Vickers, a pharmacist by trade, called that potential degrading of the plant the biggest concern leading to the proposed change.

Utah Medical Association, an early opponent of the medical marijuana initiative, confirmed it is working with Vickers and co-sponsor Rep. Brad Daw, R-Orem, on the bill.

“We have no further comment at this time,” an organization spokesman said in a statement.

The Church of Jesus Christ of Latter-day Saints, another early opponent of the medical marijuana initiative, did not have a comment about the new bill.

Decriminalization of medical marijuana users

The new bill will call for expungement of criminal charges for past users who had a qualifying medical need for marijuana — and used forms now approved under the law — before the law passed in Utah.

Approved conditions in the law as written now include HIV, Alzheimer’s disease, amyotrophic lateral sclerosis, cancer and cachexia (wasting of the body due to chronic illness). Other qualifying conditions include persistent nausea unrelated to conditions like pregnancy, Crohn’s disease, epilepsy, multiple sclerosis, and post-traumatic stress disorder.

“The bottom line is, we don’t want to punish someone that is a legitimate patient using a legitimate medication. Now, if they‘re using the medication illegitimately, or they’re using some kind of a recreational product ... that’s a different deal. But we do not want to punish legitimate patients that are using legitimate medication,” Vickers explained.

Another aspect of the bill will address the issue of people facing prosecution when they’re no longer impaired but the marijuana metabolite remains in their system.

Any Utahn can go to Colorado or wherever recreational marijuana is legal and use it there. But the marijuana metabolite remains in one’s system for up to a month, Boyack said. Under current law, if someone in Utah has that metabolite in their system while driving, they are breaking the law, he said.

Proposition 2 contained an “affirmative defense” for medical cannabis users so that if the metabolite was discovered in their system by law enforcement, they could defend themselves in court, according to Boyack. A similar defense was not included in the replacement bill.

“Unfortunately, right now, there’s some cases where someone is being penalized for having an inactive metabolite in their system where it really isn’t affecting their cognitive functions or anything, but yet it’s still evidence that there’s some cannabis there,” Vickers said.

Some within the past several months in Utah have also faced legal ramifications for having CBD in their system — which is legal under national law and sold over the counter. Legally, CBD can contain less than .3% content of THC, the psychoactive component of marijuana. But when people consume enough CBD over time, trace THC can accumulate in their body, causing them to fail a drug test, Boyack said.

The bill would ensure that someone can only be prosecuted under the metabolite law if the metabolite is “pharmacologically active,” meaning it can still create impairment.

Dosing requirements, doctor shortages

Another part of the proposed law would change dosing “parameters” to dosing “guidelines,” Boyack said, meaning instead of prescribing a fixed amount, doctors would be allowed to prescribe under a broader set of guidelines with flexibility for patients to “vary and adjust based on their own observations of how it’s affecting them.”

“Different patients respond differently to the same cannabis, even for the same conditions. So there’s a lot of variability, and patients tend to adjust the amount that they’re taking based on the response that they get,” he said.

Vickers said patients will still need to receive instructions about how much to use, how to take it, the frequency and dosing application.

“The challenge is, it doesn’t really matter whether it comes from the physician directly to the pharmacist, or the pharmacist working in conjunction with the physician, at the end of the day, that product still has to go to the patient with their clear understanding how to use the product, just like any other prescription medication,” Vickers explained.

The bill also will try to address the issue of a potential shortage of doctors willing to prescribe marijuana by decreasing or eliminating a cap on how many prescriptions a doctor can issue. Boyack said advocates so far have struggled to help patients find doctors willing to prescribe.

Vickers said that aspect of the bill is still being discussed.

“We don’t want to get in a situation where a handful of doctors are doing all the recommendations for the prescriptions, but we still want to have an avenue for a physician working in that arena, that they can take care of a decent patient population,” Vickers said.

He expressed optimism that the changes will pass.

Though Vickers said the changes aren’t as urgent as those passed during the special session, he’d like to get the changes in place as soon as possible.

Boyack also believes the bill “absolutely” will have a chance of passing.

“We’ve been talking with stakeholders about this. This isn’t a sneak attack, this isn’t an aggressive push forward. This is something that we’ve been talking to the various interested parties about. So we continue to drive this through consensus,” Boyack said.

Though advocates might call for bigger steps in the future, including adding more medical conditions eligible for treatment, Boyack said they are waiting to see how the law plays out once it goes into effect in March.

“We’ve excited to continue improving it, and we think patients are going to be very pleased with what’s in this bill,” Boyack said.