Understanding the Challenges Unique to the PA Medical Cannabis Community

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Getting started in the world of medical cannabis is not an easy feat. No two states treat the substance exactly the same, and in the eyes of the federal government, it's still a schedule one narcotic.

For physicians working in the Pennsylvania Commonwealth, prescribing medical cannabis requires a license, and patients must be certified as having a medical need for the drug.

In 2016, the state passed Act 16, which defines a number of regulations for how medical cannabis can be used and by whom. The law also creates a series of hoops to jump through for local businesses that want to participate in medical cannabis distribution.

Act 16 and the Certification Process

Central to Act 16 is a list of specific conditions that qualify a patient to use medical cannabis. The process is called certification, and only licensed physicians can issue a certification to patients. Doctors who want to be eligible to issue certifications must register with and receive approval from the Pennsylvania Department of Health (DOH). These conditions are:

  • Amyotrophic Lateral Sclerosis
  • Autism
  • Cancer
  • Crohn's Disease
  • Damage to the nervous tissue of the spinal cord with objective neurological indication of intractable spasticity
  • Epilepsy<
  • Glaucoma
  • HIV (Human Immunodeficiency Virus) / AIDS (Acquired Immune Deficiency Syndrome)Huntington's Disease
  • Inflammatory Bowel Disease
  • Intractable Seizures 
  • Multiple Sclerosis
  • Neuropathies
  • Parkinson's Disease
  • Post-traumatic Stress Disorder
  • Severe chronic or intractable pain of neuropathic origin or severe chronic or intractable pain in which conventional therapeutic intervention and opiate therapy is contraindicated or ineffective
  • Sickle Cell Anemia

There is also a four-hour training course that physicians must take in order to certify patients. Once approved, the DOH records the physician’s information, including physical address and medical credentials. This information is available through the DOH website in an online registry. However, physicians cannot advertise that they offer medical cannabis to just any patient, nor can they advertise the fact that they are registered providers.

Also important to know for would-be patients is that it's not legal to smoke cannabis in Pennsylvania.

Chris Goldstein, the Chapter Coordinator at the South Philly National Organization for the Reform of Marijuana Laws, had this to say:

"We have a no-smoke cannabis law, ... which means the products will only be refined oils, topical creams and vaporizable things like hash oil and cartridges...I think we’re going to find in states that push no-smoke cannabis laws like Pennsylvania. Ultimately patients won’t get access to the whole flower until full legalization comes because these programs are very, very strictly regulated.”

Risks for Physicians and Businesses

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You can quickly see how, for a physician who wants the option to provide this type of care, the state of Pennsylvania is raising the stakes to levels that will keep some doctors from participating. Having one's name and place of business added to a list on a government website – be it state or federal – definitely has an intimidation factor. 

It's not just caregivers that are struggling in the PA system, though.

For producers, it's a race to the top to get the state's approval. Only a select number of growers will be permitted by the state, and even less of them can be vertically integrated with a dispensary license. The regulations even extend insofar as to dictate the number of dispensary locations that a producer can have.

As a result, brands will have to work hard to keep up in a competitive market. It will be of crucial importance that producers, doctors, and dispensaries follow protocol and regulations to the letter. Additionally, business experts have cited having an online presence as one of the best ways to overcome the challenge of gaining visibility in this fast-paced industry.

Understanding and analyzing the market will be crucial components for businesses looking to break into the medical cannabis scene in coming years.

PA's first medical cannabis dispensaries opened in February of 2018. As the first few dispensaries open in the Commonwealth, the initial response from patients has been good. However, some speculate that the high level of regulation is causing a bottleneck and preventing people from the easy access to medicine that they would prefer.

Slow and Steady

As of February, over 17,000 potential patients have been registered for certification. Of that number, 4,000 have visited an approved physician. State politicians are positive about the level of regulation and have compared the strategy of PA to nearby states like New York and New Jersey, where the rollout of the drug has been a slow and steady process.

The focus for PA remains on providing medication for those in need, and Act 16 even outlines specific provisions for research studies that might help the medical community better understand how cannabis may help mitigate the effects of autism, epilepsy and other conditions included on the list. 
Pennsylvania will allow those in need to use cannabis, but the state is a long way from the recreational form of the drug that California and Colorado offer. It's hard to know for sure how the laws and regulations will change in coming years, but for now, getting access to medical cannabis in PA still requires you to jump through a few hoops.