ARKANSAS, USA — With 5 years in and over 100,000 Arkansans participating, we're learning about the impacts medical marijuana has on Arkansas in a first-of-its-kind study.
The Arkansas Center for Health Improvements (ACHI) presented its research to the Joint Committee on Public Health Welfare and Labor. The National Institutes of Health funded the study. President and CEO Dr. Joseph Thompson said the study is "probably the first population-based report to a public health committee anywhere in the nation."
Of the many issues addressed, Thompson expressed concerns to legislators over the amount of medical marijuana being bought in the state. By state law, medical marijuana cardholders can purchase 2.5 ounces of marijuana every two weeks.
"We have individuals that are purchasing 900 milligrams of medical marijuana a day for plant, 752 for edibles, 900 for vape," Thompson said. "If you think about a 10-milligram dose, these are 90 doses a day that individuals are purchasing which we clearly think represent, probably not personal consumption, but a diversion to other sources."
Representative Zack Gramlich shared the concern saying he's seen the issue while teaching at Fort Smith Public Schools.
"That's a real concern for me," Gramlich said. "I've had kids who have dropped THC vapes in the halls at schools. They've hidden them in deodorant containers. I mean, that's a real thing. Kids are getting access to it."
ACHI also found in their research that seven physicians are certifying over a third of individuals with limited evidence of patient-physician relationship. Focused on all Arkansas physicians, legislators discussed how doctors are only certifying and not prescribing like other traditional medical treatments.
"Up to date, there's been very limited clinical research because there's no federal money flowing for clinical research, so we don't really know much about marijuana, other than anecdotal reports, small studies," Thompson said.
Sen. Missy Irvin of Mountain View agreed that there is a lack of guidance.
"There's no clinical data. There's no study. There are no recommendations of dosage and how that equates to solving the ailment or whatever like you have with other prescription drugs," Irvin said. "They are regulated federally by the DEA. This is an illegal substance federally, and so that creates a jeopardy for your physicians."
Thompson said the issue could change as federal agencies consider rescheduling marijuana and federal funding becomes available for clinical studies. Thompson adds that while physicians can't give guidelines, dispensaries are required to have a pharmacist available for recommendations.
"When we look at the pharmacists that are signed up, we see a few pharmacists signed up for a lot of the dispensaries," he said. "They're almost all remote, available for a phone call, so there's no in-person kind of consultation going on with a licensed clinical individual frequently."
Thompson pitched policy considerations to legislators, including adding requirements to the certification process and using THC limits instead of the current flower weight limit. He said ACHI is seeking another federal grant to continue researching medical marijuana usage.
Arkansas Cannabis Industry Association's response
Following the presentation, Arkansas Cannabis Industry Association President Robert DeBin added "context" to Thompson's claims.
In response to Thompson's claim that legal medical marijuana is being diverted to other sources such as the black market, DeBin said Thompson did not present any evidence besides identifying patients purchasing high volumes of the product.
DeBin said there could be several explanations as to why people legally buy higher volumes of marijuana.
"Arkansas is a rural state. In many areas, patients must drive long distances to purchase medicine from a dispensary. In these instances, it is more efficient and cost-effective for them to buy their maximum allotment, so they do not have to travel as often to refill.
Also, Arkansas law allows a patient to gift medical marijuana to another card-carrying patient. Anecdotally, we know that a family member often purchases medicines and then gifts them to a card-carrying sibling, parent or relative. This is especially likely for those patients living in rural parts of the state who live long distances from a dispensary.
Cancer patients often use Rick Simpson Oil (RSO) to treat pain. To produce RSO, it takes high volumes of marijuana flower. Patients with chronic illnesses who consume medical cannabis often require larger doses and can develop a tolerance to THC."
DeBin also said Thompson's data does not accurately reflect widespread diversion by medical marijuana patients.
"In his presentation, he claims the average annual mean spend by certified patients is $3,343, which averages to $139.29 per patient every two weeks. Purchasing the number of gummies Dr. Thompson referenced would cost patients thousands of dollars. The much greater concern is the widespread availability of hemp-derived THC gummies from gas stations and other outlets that are unregulated, untracked and unrestricted — in purchase age and quantity purchased."
If some product is diverted, DeBin said at least it is a safe product that is "rigorously tested by state-licensed and regulated laboratories for THC levels, contaminants, heavy metals, and pesticides."
In reference to Thompson's claim that seven physicians are writing 34% of patient certifications, DeBin said these doctors specialize in medical marijuana.
"The seven doctors referenced by Dr. Thompson have created a specialty practice and developed medical marijuana expertise. Those doctors advertise that specialty and expert knowledge and are rewarded with patient consultations. Notably, his statement ignores the 66 percent of Arkansas patients — the overwhelming majority — who are certified by a primary care physician or a doctor with whom they have an established relationship. Importantly, in many cases, these doctors are replacing narcotics with safe, natural and laboratory-tested cannabis."
DeBin said the state's medical cannabis industry has reached out to Thompson to discuss the findings. He said he hopes they can collaborate on ongoing and future research.
You can view Dr. Thompson's presentation in the joint committee's archived meeting recording. The study handout presented to legislators can also be found within the meeting's archived documents.
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