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Md. medical marijuana panel grapples with out-of-state patients

Maryland Medical Cannabis Commission Chairman Brian P. Lopez, left, and Executive Director Patrick Jameson talk as public comment is given on potentially adding 15 processor licenses. (Bryan P. Sears)

The state does not want to run afoul of federal guidelines if it allows out-of-state users of medical marijuana, says Maryland Medical Cannabis Commission Executive Director Patrick Jameson, center, shown at an earlier meeting. (Bryan P. Sears)

ANNAPOLIS — State regulators are looking for ways to thread the needle and allow out-of-state patients to access the state’s new medical cannabis program while not running afoul of federal laws that prohibit the drug from being transported across state lines.

Maryland law removed prohibitions on out-of-state patients two years ago. The Maryland Medical Cannabis Commission, however, must determine how to implement that law while addressing concerns that the patients might transport the drug from Maryland to other states in violation of federal law.

“We know what the Cole Memorandum states and we would not want any federal involvement in the state of Maryland,” said Patrick Jameson, director of the state commission, referring to the Justice Department memo which guides federal prosecutors in the enforcement of federal drug laws.

The state has about 50 out-of-state patients who initially were granted patient cards, but questions about how the process would work while not violating federal law caused the commission to suspend actions on additional applications.

Currently, about 600 out-of-state patients are awaiting the commission’s decision on the issue, which could come by the end of October. Jameson said that any decision could affect the more than four dozen out-of-state patients who already completed the application process.

The issue of allowing out-of-state patients to participate in Maryland’s program is yet another hitch in an already complicated issue in which the state, as is a number of others, is allowing the use of a drug that is illegal by federal law.

“State law does not require residency,” said Gail Rand, chief financial officer and patient advocate for ForwardGro, the state’s first licensed grower.

Rand, who began advocating for legalized medical cannabis in Maryland because of her son’s severe seizures, said one solution could be to require patients from outside Maryland to agree that they will not take the medication across state lines.

Advocates say state regulators need to find a way to help patients and note that there is growing interest from residents of Delaware, Pennsylvania, Virginia and West Virginia.

“In this great country, we travel freely and go where we want to go to get whatever is needed,” said Greg Pappas, a co-owner of Allegany Medical Dispensary.

Pappas said the state has “a moral obligation” to help patients, even those from out of state, to access medical cannabis. He called on the commission to interpret the law “in a manner that is other than a police enforcement matter.”

Requirements that out-of-state patients consume the drug in Maryland could have consequences, he said.

“You are encouraging people to drive back to their home state impaired,” Pappas said.

The legislature in 2015 changed the state’s medical cannabis law to open the door for out-of-state patients, including members of the military and college students.

But a 2013 Department of Justice memo lays out guidelines to prevent medical marijuana from being transferred across state lines. States with medical cannabis programs are already required to use products made only from plants grown in that state and are prohibited from transferring products to other states.

In his memo, U.S. Deputy Attorney General James M. Cole wrote that law enforcement should narrowly focus enforcement efforts on eight areas, including preventing the distribution to minors; preventing diversion of marijuana from states where it is legal to states where it is not; and preventing medical or recreational marijuana laws from being used as a pretext for drug trafficking.

Anand Dugar, a physician with Green Health Docs, said there are other potential solutions, including dispensing smaller amounts to out-of-state patients who would then have to make more frequent trips to Maryland to obtain their medicine. Or the state could allow the creation of clinics that operate in-patient centers akin to a hotel or resort which would allow patients to see a physician, receive their medication and use it in the same facility.

“There are many ways for an out-of-state patient to come across state lines, get care and not violate federal law,” Dugar said. “The ultimate goal is to help patients.”



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